Chapter 78: Young but (2)

Internal strength.

One might wonder why talk of internal strength would come up in a hospital.

But it was actually one of the terms used very frequently.

‘I have pretty decent internal strength, don’t I?’

[It was fine because I was there even though my internal strength was weak.]

Good internal strength meant having fewer patients.

Weak internal strength meant having more patients.

Or receiving patients in very poor condition.

In that sense, Ahn Daehoon’s internal strength could be described as legendary.

‘How can a first-year resident have so many patients pouring in…’

[Isn’t that a good thing? Most patients now can’t even match our skills.]

In response to Soohyuk’s words, Baruda muttered in a tone reminiscent of a third-rate detective’s psychic ability.

‘Are you getting a case of middle school syndrome? Not matching our skills… What crazy talk is this?’

[That’s true. Honestly, among the patients currently admitted to Soohyuk, is there anyone who didn’t immediately have a discharge plan?]

Baruda’s words made Soohyuk blink.

Upon reflection, Baruda was right.

Indeed, the patients currently admitted to him did have clear plans from the moment they were admitted.

‘That’s true.’

[Isn’t it? But look at the patients Ahn Daehoon is getting.]

‘It’s not easy at all.’

[Yes, it’s difficult. They’re all atypical cases. But it will be helpful.]

‘Helpful, you say.’

While listening to Baruda, Soohyuk thought, ‘This guy is definitely an AI.’

Even if a patient might die, saying it would be helpful.

A human would never say such a thing.

‘Well… Anyway, let’s wait.’

Of course, Soohyuk didn’t bother to tell Baruda that his thinking was wrong.

What’s the point of teaching something to a non-human?

As long as Baruda continued to help with patient care as he had been, everything was fine.

[Yes, Soohyuk.]

Baruda, seemingly sharing a similar opinion, allowed them to wait for Professor Shin Hyuntae while standing.

“Soohyuk, how is it?”

Professor Shin Hyuntae arrived at the emergency room almost immediately, as if he had been right outside the hospital.

He was panting, looking quite rushed.

His appearance was a stark contrast to Soohyuk, who seemed relatively calm.

“Ah, yes. The patient still doesn’t show clear signs of disseminated intravascular coagulation… However, since we can’t determine the cause, I’ve already contacted the blood bank for component transfusions.”

“Well done. Hmm… There really is petechial bleeding.”

“Yes. The platelet count is 80,000. Considering she’s a young female patient….”

“It’s too low. No underlying disease?”

“According to the records from the hospital where she had her appendectomy, there isn’t.”

“Hmm.”

Appendicitis.

What we commonly know as appendicitis, which might seem like a minor surgery.

But it’s a surgery that requires general anesthesia.

Meaning preoperative tests must be conducted.

“So, there’s no basic underlying disease.”

“Yes. I also brought the viral marker results from the tests conducted at that hospital, and they are negative.”

Viral markers refer to tests to check for viral infections.

Of course, not all infectious diseases are tested, but it’s common to test for hepatitis B, hepatitis C, HIV, etc.

In other words, according to Soohyuk, the patient does not have any of these viral diseases.

“Hmm… What do you suspect then?”

After briefly checking on the patient, Professor Shin Hyuntae asked Soohyuk for his opinion again.

Indeed, the professor’s experience was not to be underestimated, and his skill at reassuring was impressive.

Moreover, Professor Shin Hyuntae had a face that clearly belonged to a professor, and his name tag even listed his title as department head, so the patients’ families looked relieved.

“Yes. Hmm.”

Soohyuk glanced at the families for a moment before speaking.

“First, considering the patient’s age, I think lupus is the most likely cause among the diseases that can cause pancytopenia and bleeding tendencies.”

“Lupus. Yes, hmm.”

The two of them repeated “lupus” and thought about the patient who had just been moved to the ICU.

Coincidentally, that patient also had lupus.

Due to the progression of lupus, ECMO had to be initiated.

Naturally, the investigation had to focus on that direction.

“Anything else?”

“There’s also the possibility of drug-induced pancytopenia. She was actually on an antibiotic that could cause this, so we’ve switched it.”

“Well done. It’s certainly a possibility.”

“Yes. Additionally, there’s the possibility of a blood cancer that destroys blood cells.”

Soohyuk deliberately turned his head away from the families before speaking.

Hearing words like cancer would do nothing but harm.

Professor Shin Hyuntae, sharing a similar opinion, nodded naturally.

“Considering her age, it’s certainly possible… It’s even possible that the appendicitis was caused by blood cancer.”

“Yes. That’s why I’ve requested that the previous hospital send us the specimen.”

“Well done. You’re really… You’re a great resident.”

Whatever he tries to do, it turns out you’ve already done it.

This is truly the first time I’ve seen such a resident.

‘No, he’s even better than when he was a fellow under Professor Jang Deoksu.’

He might even be better now.

But Professor Shin Hyuntae stopped his thoughts there.

If he went any further, it felt like the blame might turn on him.

While he was busy defending himself, he kept repeating Soohyuk’s words.

“And I’ve also requested a peripheral blood smear test.”

“Ah, well done. Hmm. So, the current treatment plan is to change the antibiotic and start a liver protectant?”

“Yes. While there’s a lack of clinical evidence for liver protectants… I still think it’s better to use them.”

“When there’s nothing else to do, you have to do something. So, admit her and take good care of her. We shouldn’t need to initiate ECMO again.”

“Yes, Professor.”

“Right, I’m counting on you. I… Hmm… I can’t go home today. I’ll be in the lab, so let me know if anything happens. I need to study related diseases.”

“Yes.”

After entrusting the patient’s care to Soohyuk, Professor Shin Hyuntae hurriedly left.

Not towards the outside of the hospital, but towards his lab.

[You’re really dedicated. Soohyuk, you should try harder. The professor is working this hard.]

‘I’m already working hard, you know?’

[It means to work even harder.]

‘Then I’ll die…’

[If you really feel like you’re going to die, I can intervene. What’s there to worry about? I’m in charge of Soohyuk’s health check-ups.]

‘Ha.’

Indeed, since Baruda arrived, Soohyuk hadn’t even caught a cold.

Whenever his condition started to decline, Baruda would manage it ruthlessly.

This meant that his management was indeed very strict.

After the patient was moved to the ward, Soohyuk returned to the on-call room.

It had been a very tiring day.

He wanted to collapse on the bed.

But Baruda wouldn’t let him.

‘You have to read all of this before sleeping, right?’

[Yes, related papers.]

‘Sigh.’

[Why the sigh? Don’t you want to save the patient?]

Baruda, as always, launched a mental attack.

And Soohyuk, as always, fell for it.

For a doctor to talk about a patient’s life like that.

How could he not fall for it?

‘No, no. I’ll read it…’

[Good decision.]

‘Well… It will actually be helpful in saving the patient.’

Soohyuk fiddled with his phone and put it in his pocket.

If something happened, Ahn Daehoon would call him right away.

He was ready to rush over when that happened.

[Whyyyyyy!]

‘Ugh.’

Fortunately, there was no contact throughout the night.

He only woke up due to Baruda’s annoying alarm.

[You’re not as dedicated as before.]

Baruda said it with a slightly disappointed tone.

For Soohyuk, it was a ridiculous situation.

‘It’s because you keep setting it. I’ve gotten used to it. Indeed, humans are… creatures of adaptation…’

[If you’re up, go see the patients. The test results should be out.]

‘Ah, right. Indeed.’

While surgery is a field of cutting with a scalpel, internal medicine is a field of inferring the inside from the outside.

Naturally, this process is incredibly time-consuming and difficult.

Various tests are essential.

The phrase “I was admitted to a university hospital, and all they did was tests!” comes from this context.

‘Let’s check on my patients first.’

[Yes, but there shouldn’t be any issues.]

‘That’s true.’

As Baruda said, Soohyuk’s patients were indeed fine.

He had promptly found the right antibiotics and administered them upon admission, so it was natural.

The problem was with Ahn Daehoon.

Or rather, with the patients admitted to him.

‘We’ll have to maintain the ECMO for now.’

The patient who was moved to the ICU showed no significant changes.

This meant there were no changes in the echocardiogram performed by the cardiology department, specifically by Lee Hyunjong.

[There won’t be any changes for a week. It would be good if there were, but there are no such precedents.]

Baruda interpreted the results based on his analysis.

Soohyuk, who agreed entirely, didn’t offer any other opinions.

Instead, he started checking on the female patient admitted yesterday.

He had ordered a large number of tests for her.

“Ah, Doctor. Did you cough?”

Just as he was about to check the test results, someone approached and greeted him in a somewhat awkward manner.

It was Ahn Daehoon, without a doubt.

“Cough? … Are we in the Joseon Dynasty? Just say hello.”

“I, I wouldn’t dare…”

“Are you filming a historical drama? Just be casual.”

“Ah, no. Senior. To show my respect for you, I should kneel right now…”

“Stop it and just look at this with me.”

“Ah, yes, Senior.”

The guy kept acting silly until Soohyuk started using rough language, at which point he finally pulled a chair over and sat down.

Meanwhile, Soohyuk quickly brought up the test results from yesterday.

Since he had ordered so many tests, there were a lot of results.

‘The peripheral blood smear is normal… except for the anemia.’

[It means the cells are being produced well.]

A peripheral blood smear is a test where blood is spread out to examine the shape of the blood cells.

If the shape is normal, it means the production of blood cells is normal.

In other words, the likelihood of a cancer diagnosis, which was the biggest concern yesterday, had significantly decreased.

“The liver function is still high… and LDH is also high. Hmm.”

Soohyuk deliberately spoke aloud so Ahn Daehoon could hear.

Of course, Ahn Daehoon didn’t react to this.

To him, Soohyuk was almost a god.

Instead, Baruda, as usual, responded.

[The serum ferritin concentration… has skyrocketed. It’s 12,944.5 ng/mL.]

‘The normal range is 10 to 290, so it’s almost 50 times higher.’

[That’s strange. The presence of iron means…]

‘It means red blood cells are breaking down. The anemia is due to that.’

[Yes. We need to determine the cause.]

‘The current issues are… fever, liver dysfunction, high LDH, and ferritin.’

[I’ll start the analysis.]

‘Okay.’

Baruda made a whirring sound as he began the analysis.

Soohyuk waited, tapping the mouse with his index finger.

Ahn Daehoon waited reverently for Soohyuk to speak.

He never imagined that Soohyuk was waiting for Baruda’s opinion.

‘How can… even his deep-in-thought expression be so cool…’

He was just marveling to himself.