Chapter 80: Young (4)

"What's taking so long...?"

Professor Shin Hyuntae, who was outside, couldn't hide his anxiousness.

At least there were no screams or anything from inside, which was a relief.

Still, it was worrying that he hadn't come out for so long.

'Why did he go in with the microscope just now?'

Upon further thought, that itself was strange.

"Huh."

When he came to his senses, he was already standing in front of the ward.

It seemed he had walked there out of anxiety.

He thought about turning back, but the curiosity to peek inside was stronger.

'Hmm...?'

The moment he peeked inside, Shin Hyuntae could see the side of Seohyuk.

Seohyuk was looking through the microscope, so focused that Shin Hyuntae felt a bit guilty for not going in with him.

Thinking about it, the 'Seohyuk is a weirdo' theory ultimately stemmed from Director Lee Hyunjong's exaggeration.

Seohyuk had never done anything harmful to others.

He did act a bit strangely, though.

Just like a moment ago.

'But what... is he looking at?'

As soon as he felt safe, his curiosity flared up.

Fortunately, the microscope was an educational one, with an additional lens on the right side besides the main lens.

An Daehoon didn't dare to get close to Seohyuk, who was doing something.

The intern just wanted to finish the task and return the microscope to rest, so the lens was left empty.

'So...'

Thanks to this, Shin Hyuntae approached and looked through the lens, almost hypnotized.

Seohyuk was so focused on his own lens and talking to Baruda that he didn't notice Shin Hyuntae.

Of course, Shin Hyuntae's quiet approach also helped.

'What is this... Is this bone marrow?'

The moment he put his eye to the lens, he thought, 'Is this kid crazy?'

Suddenly barging into the ward in the middle of the night to perform a bone marrow test.

And then examining the bone marrow right there.

He was quite bold even in his first year, but now in his second year, he was completely reckless.

What amazed Shin Hyuntae even more was that not only was the bone marrow test perfect, but the microscope angle was also perfect.

'Crazy... Did he already extract the bone marrow? It looks like he did it in one go... Is there really that much? Is this kid really a monster?'

Shin Hyuntae had always believed that he wouldn't be amazed since he constantly faced the genius Lee Hyunjong.

But since meeting Seohyuk, it seemed like he was only surprised.

Meanwhile, Seohyuk was muttering something.

He was so focused that he didn't even realize he was speaking out loud.

[The cell ratio is 30%. As expected, it's normal. It's not cancer.]

"Can't say it's a relief just because the bone marrow is normal..."

[That's right. A significant number of phagocytic cells are observed.]

"The reason is... as expected..."

[Large pre-erythroblasts are observed.]

"Large pre-erythroblasts are not observed in parvovirus infection."

Parvovirus.

Also known as 'Parvovirus B19,' this virus can rarely cause acute hepatitis and histiocytosis.

"Such madness..."

Professor Shin Hyuntae, who was listening, finally let out a curse.

It wasn't out of anger, but sheer surprise.

For a man known for his integrity, this was truly unusual.

"Oh, Professor. When did you come?"

Only then did Seohyuk notice Shin Hyuntae's presence and looked at him, taking his eyes off the main lens.

Shin Hyuntae, unsure of what to say, decided to bluff.

"I just got here. I thought you might be here since no one else was around."

An Daehoon momentarily showed a puzzled expression but immediately bowed under Shin Hyuntae's silent pressure.

"Oh, I see."

Seohyuk, who had no particular thoughts, simply accepted it.

But Shin Hyuntae found it hard to do so.

The words he had just heard from Seohyuk were still swirling in his mind.

"Ah, what did you say just now? While looking at the microscope."

"Oh... right. I'll inform you."

"Sure, go ahead."

Shin Hyuntae still didn't understand why Seohyuk had performed a bone marrow test.

To resolve his curiosity, he had to hear it from Seohyuk himself.

So, he nodded vigorously and leaned against the wall.

It was a somewhat awkward moment for a patient's guardian to hear a young doctor's explanation.

"First, the patient's current issues include fever, abnormal liver function, pancytopenia, increased LDH, and ferritin. Among these, pancytopenia is the most serious."

"Of course. I thought it might be blood cancer, suppression by antibiotics, or an autoimmune disease, so I ordered the tests."

"None of the three results satisfied. It means we need to consider other causes."

This was different from yesterday.

This made Shin Hyuntae listen even more intently, and he found himself leaning forward, almost falling over.

"Right, so what did you suspect?"

"Ferritin is an indicator that rises when red blood cells are destroyed, right?"

"Right."

"But the peripheral blood test showed no abnormalities. This means the cause of the patient's red blood cell destruction is something else."

"So... you suspected histiocytosis. You did the bone marrow test to confirm it."

"Yes. As you saw earlier, the findings of histiocytosis are clear."

"Ah, right."

In fact, all Shin Hyuntae could understand from the microscope was that it was bone marrow.

It was difficult to tell if the findings were normal or not.

He wasn't a specialist in that field.

But how could he admit he didn't know when his student was talking as if it was common knowledge?

So, he nodded, and the conversation became even more complex.

"Normal bone marrow findings with phagocytic findings. Given the observation of large pre-erythroblasts, it is clear that the histiocytosis is caused by parvovirus. The hepatitis findings further confirm this, as parvovirus can cause acute hepatitis."

"Ah... right."

Shin Hyuntae nodded, thinking he would have to look up what large pre-erythroblasts were later.

Seohyuk, of course, assumed he understood everything.

If Baruda had been analyzing Shin Hyuntae's expressions, it might have been different.

Unfortunately, Baruda was now intensely focused on treatment after completing the diagnosis.

"Therefore, I suggest immediate treatment according to the HLH 2004 protocol."

Seohyuk recited the opinion Baruda had given.

"HLH 2004 protocol..."

To Shin Hyuntae, this was shocking.

'Frankly, I don't really know...'

Histiocytosis, even if caused by an infection, was no longer within the scope of infectious diseases.

The treatment involved immunosuppressants and steroids, and in some cases, bone marrow transplantation.

This was a hematological disease.

The fact that Shin Hyuntae had even heard of the HLH 2004 protocol was impressive.

"Since proper treatment might be difficult in the infectious disease ward, it would be better to transfer the patient to Professor Jo Taejin in the hematology-oncology department."

Fortunately, Seohyuk didn't intend to keep a patient outside his specialty.

The skill level of the nurses was as important as the doctors in affecting treatment.

Infectious diseases were better treated in the infectious disease ward, and hematological diseases in the hematology-oncology ward.

Shin Hyuntae nodded and smiled when he heard about the transfer.

It was natural, given that he was relieved from the responsibility of a treatment he didn't understand.

"Sure, I'll call."

"Yes, Professor."

"Um... what about the attending physician?"

"I don't have many patients, so I can continue to see this one."

"Ah, that's good. I'm sure Taejin will be happy too."

For Shin Hyuntae, this was a win-win situation.

The patient he didn't understand would be transferred to another professor.

He didn't feel guilty about it.

He hadn't done anything wrong.

After all, the diagnosis was correct.

If the patient received proper treatment, the prognosis would be good.

'Probably... such a quick diagnosis of histiocytosis is almost unheard of...'

Thinking about it while making the call, it was truly absurd.

The patient had been admitted for just two days.

It hadn't even been 24 hours.

Yet, Seohyuk had identified the sudden onset of histiocytosis in a 21-year-old patient and pinpointed the cause.

'This patient... if they don't need a bone marrow transplant, it's all thanks to Seohyuk.'

What would have happened if the patient had gone to another hospital?

It would have been delayed by at least a week.

It would have taken time to decide on a bone marrow test.

Even if the test was done on time, it would have taken a day or two to interpret the results.

'No... even in our hospital, it would have been the same without Seohyuk.'

What could Taehua Medical Center have done differently?

Without Seohyuk, nothing would have changed.

"Yes, Director. This is Jo Taejin."

Just as Shin Hyuntae's thoughts reached that point, Jo Taejin answered the call.

"Ah, not really. I have a patient diagnosed with histiocytosis. It seems to be caused by parvovirus."

"Really? Such a patient? Did you consult with me?"

"No."

"Then how did you diagnose it? It's not an easy disease to suspect."

Jo Taejin's surprise was understandable.

Shin Hyuntae hadn't suspected histiocytosis until Seohyuk mentioned it.

It was a very rare disease.

While there were risk factors like surgery or acute condition deterioration, the incidence was very low.

To suspect this, one needed an extensive thought process.

"Ah... I suspected histiocytosis."

Of course, he didn't reveal everything to his junior, Jo Taejin.

"Did you really diagnose it yourself, Director?"

Jo Taejin didn't let it go easily.

"Of course, man! Seohyuk did it!"

Shin Hyuntae finally lost his temper.

"Sure."

"Sure of what? I'm the professor, not him."

"You're an infectious disease professor."

"Then Seohyuk? How does he know about this?"

"He's a genius. The best in Taehua Medical Center's history."

"That... that's true. Really... I was surprised this time."