Chapter 79: Young (3)

‘Is it still far?’

Suhyeok had been working at the university hospital for another year, and his perceptiveness had improved even more than before.

He was well aware that Andae-hoon was looking at him with high expectations.

He was worried that if he said something wrong, it might disappoint those expectations.

Of course, even if he said something ridiculous, Andae-hoon would probably still respect him.

[Analysis is complete. There are very few cases similar to the patient's, and the relevant medical literature is also sparse, which took some time.]

Fortunately, Baruda spoke again just a little over ten minutes after Suhyeok had closed his mouth.

Coincidentally, it was around the time Professor Shin Hyuntae was getting off the elevator from a distance.

‘It’s okay. Go ahead and speak.’

[Why are you letting it go this time? Without blaming me.]

‘If I do, you’ll just say it’s because I used my brain instead of the CPU, right?’

[You’ve grown, Suhyeok. Yes, it’s because I used your brain.]

‘Damn it. Just tell me the analysis. I can’t make sense of it.’

[Understood.]

Baruda started to speak only after riling Suhyeok up a bit.

It seemed he needed to do this to feel satisfied, even though he could have just started.

It was almost as if the AI had emotions.

[The patient currently shows no reaction to antibodies of autoimmune diseases such as lupus. This means the possibility of an autoimmune disease is low.]

‘That’s right.’

[Additionally, all the viral markers, including those prescribed yesterday, show negative results.]

‘Right.’

The other viral markers referred to viruses like CMV, EBV, and herpes, which had at least some possibility.

The fact that all of them came back negative meant that the patient was almost certainly not infected with any of the listed viruses.

[Considering these two facts, I analyzed the patient's problem list.]

‘Fever, anemia, pancytopenia, increased LDH, and ferritin, right? But the peripheral blood smear showed normal morphology.’

[Yes. The patient’s pancytopenia is not due to a problem in production but rather due to the destruction of blood cells. This suggests a high possibility of hemophagocytic syndrome.]

‘Hemophagocytic syndrome?’

[Yes.]

‘But... why suddenly...’

Hemophagocytic syndrome refers to a condition where phagocytic cells suddenly increase in the bone marrow and consume normal cells.

It is a very serious disease, and the risk of death is extremely high if left untreated.

Of course, it doesn’t just appear out of nowhere.

[To identify the cause and confirm whether it is hemophagocytic syndrome, I recommend a bone marrow examination.]

“Bone marrow examination...”

Suhyeok, surprised, inadvertently said the words out loud.

Shin Hyuntae, who had just approached, looked at Andae-hoon with a puzzled expression, wondering what was going on.

Andae-hoon, of course, had no idea.

“I, I don’t know. He was closing his eyes and suddenly said this.”

“Oh... It’s that state again.”

Upon hearing Andae-hoon’s words, Shin Hyuntae made a knowing expression and pulled a chair to sit down.

He didn’t touch Suhyeok.

He knew that disturbing Suhyeok when he was deep in thought was pointless.

He also knew that Suhyeok almost always came up with brilliant answers when he was done thinking.

So, the two of them just watched Suhyeok.

[Yes, a bone marrow examination is necessary. I recommend performing it as soon as possible.]

‘How likely is it to be hemophagocytic syndrome?’

[The probability of a normal adult female developing this condition is less than 0.01%. Therefore, the likelihood of it being hemophagocytic syndrome is over 90%.]

“Damn it.”

Suhyeok thought about Baruda’s improving diagnostic skills.

If Baruda said 90%, it was almost safe to assume 99%.

Moreover, hemophagocytic syndrome is a disease where the mortality rate skyrockets if not treated promptly.

So, without realizing it, Suhyeok muttered a curse and walked into the ward station.

Shin Hyuntae and Andae-hoon, who were behind him, were quite taken aback.

He suddenly cursed and went into the storage room inside the station.

“What is it?”

“I, I don’t know.”

“Don’t just say that; follow him.”

“Professor, what about you?”

“I...”

Shin Hyuntae was about to say, “Of course, I’ll follow,” but he closed his mouth.

Suhyeok had come out of the storage room with a cane and a surgical set, including a very large syringe that was rarely used in the infectious disease department.

‘Hyung...’

Shin Hyuntae, recalling the “Suhyeok is a weirdo” theory that he had been repeating ever since he first met Suhyeok, stepped back.

Andae-hoon wanted to join, but Shin Hyuntae stopped him.

“You should follow.”

“Just me?”

“Yes. See what the senior resident is doing... you should.”

“...Ah, I understand.”

Fortunately, Andae-hoon was unaware of the “Suhyeok is a weirdo” theory that had once been popular in the hospital.

Moreover, he had a deep respect for Suhyeok.

This meant that even if Suhyeok showed some strange behavior, it wouldn’t shake his respect.

Thud.

Thud.

So, Andae-hoon ran after Suhyeok.

Suhyeok was in a hurry, but he was using a cane, so Andae-hoon quickly caught up.

“Teacher.”

“Ah, right. You’re here. Good timing. Follow me.”

“Where to?”

“We need to perform a bone marrow examination.”

“A bone marrow examination?”

Andae-hoon couldn’t quite grasp who Suhyeok was planning to examine.

After all, a bone marrow examination out of the blue?

“Yeah.”

It wasn’t until Suhyeok entered the room where the patient he admitted yesterday was staying that Andae-hoon realized who he was planning to examine.

“Teacher, the patient’s platelets...”

“I know. I’ve already prescribed a transfusion.”

“You did?”

“Yes.”

Andae-hoon, who had tried to stop him, realized that Suhyeok had already prescribed a platelet transfusion.

Suhyeok wasn’t just an excellent resident; he had Baruda, the AI, to assist him.

At least, he didn’t make mistakes that he knew about.

“Patient, did you sleep well?”

“Ugh... No... I have a fever...”

As soon as Suhyeok entered, he asked the patient about her condition.

“Did you have trouble sleeping?”

“Yes... There was a man by the curtain. He said my father wasn’t there...”

“Hmm.”

Suhyeok then visually examined the patient from head to toe.

His gaze lingered on her chest to check her respiratory rate.

He also wanted to ensure proper chest expansion.

‘The respiratory rate has increased.’

[28 breaths per minute. Oxygen saturation is normal, but...]

‘Is there fluid in the lungs?’

[It’s possible. The condition is progressing rapidly. The statement about the man by the curtain could be delirium. We need to diagnose and treat as soon as possible. Otherwise...]

‘Understood. I’ll perform the bone marrow examination right away.’

While exchanging opinions with Baruda about the observations, the patient’s guardian, who had been complaining since yesterday, spoke up.

“Doctor.”

“Yes, sir.”

“Is the professor who saw us yesterday not coming? Our child looks very serious.”

“He will be here soon, but we need to perform an examination before he arrives.”

“Examination? No, you keep doing tests and never treat. Is this treatment?”

“Hmm.”

Suhyeok paused and turned to look at the father.

[He’s more anxious than angry. The emotional analysis is still inaccurate, so take it as a reference.]

‘I understand.’

Baruda immediately analyzed the guardian and reported back.

It wasn’t hard to understand.

When they came to the big hospital, they must have thought their child would be saved.

But the patient’s condition was not improving; it was getting worse.

“Is this treatment?”

Meanwhile, the guardian approached Suhyeok.

He was quite tall, which was intimidating to Suhyeok, who was using a cane.

“We can’t treat without knowing the disease, sir.”

But Suhyeok was no longer a naive first-year resident.

He had learned not to compromise on medical content.

“What do you mean you don’t know? She has a fever.”

“That’s correct. However, I have a suspicion about a disease and need to confirm it with a test.”

“This... after so many tests yesterday...”

The guardian’s face was hard to read—whether he was angry or just anxious.

His voice was loud, but he didn’t seem particularly threatening.

[He is definitely anxious. I recommend calming him down. If that doesn’t work, you can try intimidation.]

Moreover, Suhyeok could hear Baruda’s advice, which helped him lead the conversation more effectively.

“Sir, this is the most important test. We determined it was necessary based on the tests we did yesterday. Please step aside. Once we diagnose, we can start treatment immediately.”

“Eh... But...”

“Please step aside. If the diagnosis is delayed, so will the treatment.”

“I understand...”

Suhyeok, following Baruda’s advice, combined reassurance and a bit of intimidation to get the guardian to step aside.

“Patient, this test might hurt a little.”

“Ah... But... If it helps with treatment...”

“Yes. I’ll do my best to make it as painless as possible.”

Convincing the patient was easier.

Due to the high fever and poor mental state, she found it difficult to think of anything else.

“Dae-hoon, ask the intern to bring a microscope. I’ll prepare this while you’re gone.”

“A microscope?”

“Yes. We’ll examine it right here and make a diagnosis.”

“Ah... Yes! Yes! Teacher!”

Dae-hoon, initially wondering if it was possible, nodded upon realizing he was dealing with Suhyeok.

‘Of course, he’s a genius!’

While thinking this, Suhyeok had the patient lie on her side and slightly pulled down her pants.

Although the curtain was closed, the guardian was clearly unhappy with this.

“It’s for the test. It’s the most important test.”

“Who... who said...”

But the guardian couldn’t voice his complaint after Suhyeok added a word.

Suhyeok, having quieted the guardian, wiped the area near the pelvic bone with betadine.

The area was quite large to prevent any potential infection, which could be very serious.

“Now, I’ll administer the anesthesia.”

“Yes...”

“It will sting a bit.”

Following Baruda’s advice, Suhyeok injected the anesthetic in various spots.

The patient, experiencing less pain than Suhyeok had described, looked more reassured.

‘Phew.’

In contrast, Suhyeok’s face was dark as he held the syringe.

[It’s not difficult. You’ve done it before.]

‘It’s not difficult. It’s just tiring.’

[You should exercise more.]

‘You’re supposed to manage my health, right?’

[That’s just to keep you from dying.]

‘Damn it.’

It was a test that required piercing the pelvic bone to extract bone marrow.

It was not only difficult but also physically demanding.

He had to put his full weight into it.

The only fortunate part was that he could hear Baruda’s advice, which was very helpful.

[No, tilt it 3 degrees. Yes, like that.]

Especially when he had already reviewed the pelvic bone structure from the CT scan, it was even more helpful.

“Good. It’s coming out. Perfect.”

Thanks to Baruda’s advice, Suhyeok was able to complete the bone marrow examination as if it were a routine blood test.

It was so quick that the intern had just entered with the microscope.

“Okay, send the rest to the lab. Just push this much out for now.”

After giving instructions to Dae-hoon and the intern, Suhyeok immediately looked into the microscope.

To an outsider, the image would be incomprehensible.

But to Suhyeok and Baruda, who had seen thousands of bone marrow images, it was a piece of cake.

‘It’s hemophagocytic syndrome.’

[I also know what caused it.]