Chapter 119: Weakness of the Body (3)

Brrring.

In the middle of the night, Suhyuk’s phone started ringing relentlessly.

Fortunately, no one else visited the on-call room where Suhyuk was staying, which allowed him to wake up alone.

“Ugh…shit… What time is it?”

Half-asleep, he checked his phone and saw that it was 3 AM.

Suhyuk finally realized that he had truly returned from the training program to the hospital.

‘I enjoyed being there.’

For an entire month, he slept soundly without any early morning disturbances. In contrast, waking up at this hour while working at the hospital felt natural. The current situation caught him off guard due to his recent uninterrupted sleep.

[Better answer the call. Why are you hesitating?]

However, Baruda was different. It seemed to switch to hospital mode as soon as he received a call.

Understood…

Thanks to this, Suhyuk could wake up and answer his phone promptly.

“D-Doctor!”

As soon as he answered, Hayoon’s urgent voice came through the receiver.

This was strange. An intern calling him?

If it were Hwang Sunwoo, she would have yelled at her without listening to any explanation, but Suhyuk couldn’t do that.

‘She wouldn’t be calling just to compliment me, right?’

“Y-you realize you’re talking nonsense, don’t you?”

His feelings towards Hayoon were overwhelmingly positive.

‘Is she joking with me?’

“I hope so.”

‘Anyway, what is going on? Is it about the patient from earlier?’

Moreover, Suhyuk, regardless of everything else, was still a good doctor.

She was a doctor who cared for her patients. This concern was reflected in Suhyuk’s voice as he responded urgently,

“Yes, I am at the on-call room now. What happened?”

“The patient… The blood pressure of the patient you sent to intensive care is dropping!”

“Blood pressure? Is Dahoon there with them?”

“Yes! He has been there since earlier but…”

Hayoon looked over at Dahoon standing helplessly next to the patient. Despite being senior to him, she felt more like his guardian than anything else. Honestly, she couldn’t rely on him at all.

“Oh, okay. I understand what this means. I’ll be right there. As soon as we hang up, call thoracic surgery. Mention Ecmo; they should come quickly since I already brought it up.”

“Yes, Dr. Belzer!”

Instead, she felt more confident with Suhyuk on the other side of the phone line. With renewed vigor, Hayoon hung up the call.

At the same time, Suhyuk started briskly walking using his staff for support. It was still slower than most people’s pace, but it was better than just trudging along.

‘Her dropping blood pressure…means her heart is failing.’

“It would be difficult to induce such severe stress cardiomyopathy from acute alcohol poisoning alone.”

Unless she had been drinking insanely, which wasn’t the case according to the records. The patient had consumed only two bottles of soju.

Of course, each person’s liver detoxification capacity varied, but this amount was still too low to cause such severe symptoms.

There must be another reason for this, right?

[I can’t confirm it, but there is a possibility. For example, could pneumonia due to vomiting have occurred?]

‘But on the X-ray, I only see pulmonary edema. The auscultation findings also don’t suggest pneumonia…’

[That’s true. What could it be?]

‘I haven’t gotten any intuition about it yet…’

[Let’s go check first.]

Honestly, he didn’t expect anything significant to emerge just by visiting the patient. Even if Suhyuk went now, all he would likely find is the Ecmo machine attached to the patient. However, without checking, he wouldn’t learn anything at all.

Moreover, if there was any delay with Ecmo, Suhyuk would be the only one capable of keeping him alive during that time.

Ding dong.

Thus, Suhyuk rushed to the intensive care unit as quickly as possible.

“Ah, Dr. Belzer!”

It seemed thoracic surgery hadn’t arrived yet. He could tell from Hayoon and Dahoon’s idle state.

“Uh, how is the patient?” Instead of returning their greeting, Suhyuk immediately asked about the patient’s condition.

Fortunately, since Dahoon had proclaimed himself as a member of Suhyuk’s fan club, he was relatively competent among first-year residents.

“Until an hour ago, his blood pressure was maintained at around 90/60. However, the diastolic pressure dropped below 50, and now it’s hovering around 40? Sometimes even lower than that.”

“Did you measure it via ECG?”

“Yes. In real-time…”

“It seems reliable then. Did thoracic surgery say they were coming?”

“Yes. They are on their way.”

“Then…”

Suhyuk was momentarily lost in thought. If he used a cardiotonic or vasopressor here, there might be a response, but it could also strain the heart further. Since the blood pressure hadn’t dropped drastically yet, waiting and observing might be better.

“Do we have an echocardiogram available?”

“Yes. I prepared it beforehand.”

“Good job.”

Suhyuk decided to first accurately assess the current situation.

“[It appears to be a wise decision.]”

Baruda shared the same opinion.

Knowing the heart’s condition prior to Ecmo would help predict future outcomes and determine treatment plans.

“Hmm.”

As Suhyuk reviewed the echocardiogram, his expression immediately darkened.

‘The movement is almost non-existent… Especially in the lower left ventricle… Could this be due to blockages?’

“No, sir. The EKG findings differ significantly from those of a blockage.”

‘Ah, true. Then it must indicate a severe worsening of stress-induced cardiomyopathy.’

“Isn’t that strange? Considering alcohol has been completely eliminated as the cause.”

This situation was entirely different from the lupus-related cardiomyopathy he had encountered before.

Rufus was not easily removed. On the other hand, acute alcohol intoxication could be immediately eliminated, and it rarely led to severe forms of myocarditis like this case.

“The patient? Ah, over there! We will connect Ecmo!”

While Suhyuk was momentarily lost in thought, the thoracic surgery team arrived. They were complete veterans with Ecmo, so Suhyuk hastily stepped aside.

Modern medicine had become vast and deeply advanced, making it impossible for even the most brilliant doctor to handle everything alone.

Thus, what Suhyuk needed to do now was ponder. He had to consider what caused the patient’s condition.

‘Nevertheless, alcohol couldn’t have had no effect.’

[I agree with you. Alcohol may have contributed to worsening the patient’s symptoms in some way.]

It might not be the sole cause, but it could have acted as a trigger. Naturally, they continued discussing how alcohol could initiate or exacerbate certain symptoms.

‘If there is acute alcohol intoxication…’

However, alcohol could lead to various symptoms. It was difficult to pinpoint just one. They needed slightly more specific constraints.

‘Let’s first consider the cardiovascular system.’

[The heart rate will increase. However, due to blood vessel relaxation…the blood pressure can actually decrease.]

It could be seen as a paradoxical situation. The heart rate increases while blood pressure decreases. It was obvious why myocardial infarctions often occurred after drinking alcohol.

‘And what about the digestive system?’

[Blood flow to the surface of the skin can lead to poor digestion. Directly, it may cause excess stomach acid, nausea or vomiting.]

‘Are there any chronic diseases with these symptoms?’

[A chronic disease that originally causes a fast heartbeat, nausea and vomiting?]

‘Yes, such illnesses.’

Suhyuk continued conversing while observing the insertion of Ecmo into the patient’s body.

Baruda had to pause momentarily as Suhyuk’s question was not straightforward.

‘Could it be hyperthyroidism?’

[Ah, yes. Hmm.]

In contrast, Suhyuk continued without hesitation. Initially, he suspected this direction, but that did not guarantee his assumption was correct.

[However, during the recent echocardiogram, we examined the carotid arteries and neck veins. At that time, the thyroid appeared normal.]

‘Yes, you’re right. Hmm. It seemed normal.’

Of course, there were cases where hyperthyroid symptoms could occur despite a normal-looking thyroid gland.

However, for such severe symptoms to occur, there should have been some slight changes detectable. Thus, they ruled out thyroid disorders as the cause.

As neither could think of any other potential diseases, they fell silent for a moment.

“Sigh… It’s done now. At least… thanks to your quick response, the patient is stable.”

The silence lasted much longer than just a moment, enduring until the thoracic surgery team completed setting up Ecmo. Despite their veteran status, managing Ecmo was never straightforward.

“Primary physician?”

“Oh, yes. That’s me.” An Dae-hoon promptly responded to the call from thoracic surgery.

“The designated doctor is… Ah, it’s Professor Seo Hyoseok.” Without even looking at An Dae-hoon, the thoracic surgeon inspected the chart and shook his head upon seeing Seo Hyoseok’s name. He also clicked his tongue disapprovingly.

“You’re passing this patient to us entirely? It might be better that way.”

Then came an incredibly generous proposal: taking on such a difficult and complex case. This act of self-sacrifice truly resonated with Dahoon. However, considering the nature of their specialty, it was somewhat expected. Choosing thoracic surgery meant embarking on a path few would take due to its demanding responsibilities, reflecting their immense dedication to patients’ well-being.

“Uh…”

As soon as he heard the proposal, An Dae-hoon glanced at Lee Suhyuk. Normally, he would have called Seo Hyoseok, who was assigned to the patient. However, frankly speaking, there was no need for that. That man would be thrilled if it meant not having to see another patient. It was embarrassing that they were both from Internal Medicine, but what could Dahoon do?

The reality was as such.

“What should we do, Dr. Belzer?”

Thus, Dahoon’s focus shifted to Suhyuk’s opinion. Even someone from thoracic surgery seemed to agree with this assessment. After all, Lee Suhyuk wasn’t just any ordinary resident. Based on his performance thus far, even many professors struggled to match his expertise.

‘Hmm. What should I do? If it’s not thyroid-related… In fact, there might be no reason for her to see Endocrinology.’

“Actually, thoracic surgery would be better suited than Seo Hyoseok. However…”

‘However?’

“I didn’t think much about it before hearing the thyroid issue mentioned, but now, it seems like some endocrine disorder.”

‘Really? What could cause these symptoms?’

Despite Baru’s words, Lee Suhyuk couldn’t immediately come up with any other possibilities beyond thyroid issues. This time, however, Baruda sounded quite certain.

“Considering tumors affecting endocrine organs, doesn’t anything come to mind?”