Chapter 121: Tumors Can Be Found Anywhere (2)

Not long after Suhyuk’s request, Professor Kim Jinsil arrived. It was rare for such a distinguished professor to respond to a resident’s request.

Dr. Kim even brought her portable ultrasound device that she frequently used.

Suhyuk naturally bowed his head and expressed gratitude.

“Thank you, Professor.”

“Huh? No problem. Where is the patient?”

“Yes, over there.”

“Ah.”

After briefly examining the patient, Professor Kim sighed. The patient appeared to be in quite a poor state, which was understandable given he had been on the brink of death.

“Oh right. You mentioned they’re connected to Ecmo.”

“Yes. If the cause is not resolved… there’s a possibility that he may never wake up.”

“And you believe this brown tumor to be the cause?”

“Yes, I think so.”

“Hmm. Then I need to examine it closely.” A sense of urgency filled Professor Kim’s eyes.

A brown tumor refers to a benign lesion typically found on adrenal glands located above the kidneys. Normally, one would diagnose such tumors using CT or MRI scans rather than abdominal ultrasounds due to their challenging visibility with ultrasound technology.

However… It depends on the skill of the operator.

Kim Jinsil thought about her mentor and renowned expert in abdominal medical imaging, Lee Hahyun.

He was a monster who could effortlessly perform pancreatic tissue tests that others found challenging. Consequently, Professor Kim Jinsil, having trained under him, also took pride in her skills.

Swish.

With confidence, she placed the ultrasound device on the patient’s abdomen and briefly turned to Suhyuk.

“Just in case…”

“Yes, Professor?”

“You won’t find what isn’t there. Only existing issues can be detected, understand?”

“I do, Professor.”

“Remember, even if I don’t find anything, make sure to proceed with other tests just to be thorough.”

“Understood, Professor.”

After giving these important reminders, Professor Kim returned her attention to the monitor.

Fortunately, since the patient wasn’t obese, it was relatively easy to perform the examination. However, finding the organ I needed, the adrenal gland, wouldn’t be straightforward.

“First…let’s look at the right kidney.”

“Yes.”

“If you see this upper part… Hmm.” Nonetheless, Professor Kim Jinsil lived up to her reputation by quickly locating the right kidney and examining its upper region. There seemed to be nothing unusual there, just normal tissue.

“It appears to be a regular adrenal gland. Well…although if you squint, it might seem slightly enlarged, but not enough to indicate any abnormality.”

“Could you please check the left side as well?”

“You’re quite certain about something, aren’t you?”

“Yes, Professor.”

While others were clueless, Suhyuk had already consulted with Baruda, the world’s leading diagnostic AI, confirming his suspicions.

Suhyuk had just finished discussing with Baruda, which is considered the world’s best diagnostic artificial intelligence for medical purposes. They continued their conversation afterward, leading Suhyuk to firmly believe that the patient has a pheochromocytoma.

[Do not waver. There cannot be any other reason except for a pheochromocytoma.]

I know. This is 100%.

Thus, even though Professor Kim couldn’t find anything on the right side, Suhyuk remained steadfast. Naturally, his unwavering stance deeply impressed Dahoon and Hayoon.

Even if he were wrong, I would follow him forever.

Yes… An internal medicine doctor should have this level of confidence in their diagnosis. He truly embodies what it means to be an internist.

As a result, everyone present started observing the ultrasound monitor more intently than before.

‘Ah, I feel nervous.’

Professor Kim shook her head as she felt everyone’s gaze on her. This was the first time so many doctors from different specialties had gathered for one test result.

‘They truly are amusing guys.’

Kim Jinsil knew there was a fan club of Suhyuk within Internal Medicine due to Lee Hyunjong, Shin Hyun-tae, and Taejin Jo acting like his cheerleaders, advertising him relentlessly.

Swish.

In any case, amidst this palpable anticipation, Professor Kim Jinsil moved the ultrasound device again. Soon, the left kidney appeared on the screen along with its adrenal gland above it.

“Oh.”

There was something present, and it wasn’t small at all. In fact, ‘massive’ would be an apt description.

“Almost… It’s about 6 cm.”

“Do you think it is a pheochromocytoma?”

“Huh? Yes. It is very clear? The size is quite large… Why haven’t there been any symptoms until now?”

A pheochromocytoma of this size should have caused symptoms such as palpitations or nausea on a daily basis. However, Professor Kim Jinsil’s question remained unanswered because the patient was unconscious and lying still.

“I’m not sure. In fact, when they arrived at the hospital, they were already semi-conscious.”

“Are there no family members? I doubt this condition could go unnoticed by those around them.”

“They do exist… but they live abroad. They haven’t visited since the patient was admitted.”

“Oh dear.” Professor Kim nodded as if she already knew this wasn’t uncommon.

From a healthcare perspective, it was concerning that more people were living alone these days. Family or close friends could be of immense help, especially during illness, both emotionally and practically.

“I assume regarding any preexisting conditions…you don’t know yet?”

“Fortunately, I visited the hospital where the patient had been regularly receiving treatment earlier today and managed to access their records. However, even those files didn’t indicate any other symptoms or issues.”

“Hmm.” Professor Kim Jinsil turned once again towards the photographs she had taken.

A massive tumor of approximately 6 cm was located near the kidney.

It was both surprising and unfortunate that this wasn’t previously detected, but worrying about it wasn’t the doctor’s responsibility.

“It seems like surgery is necessary. However, isn’t it difficult given the current condition?”

The doctor needed to think ahead for future actions.

“Yes, attempting surgery now would be extremely challenging. With the patient already on Ecmo, removing the pheochromocytoma without prior treatment…”

Suhyuk shared these concerns, or rather, he had been contemplating the patient’s future for some time.

“Oh, do you have a plan?”

“Yes, I do.”

“Would you like to share your thoughts?”

“Yes, Professor.”

Kim Jinsil could partially understand Suhyuk’s perspective from his words. As a professor of abdominal radiology, she had been involved in diagnosing and treating numerous cases of brown cell tumors. Since they were on similar paths, she was curious about Suhyuk’s thoughts.

I’m already aware of how exceptional he is.

It wasn’t just based on hearsay from Lee Hyunjong and two other renowned doctors; she had witnessed it firsthand. However, it remained difficult for her to completely forget that Suhyuk was still a resident. Despite this lingering doubt, there was a faint hope within her - perhaps once again, Suhyuk might prove her wrong?

“Firstly, we need to maintain Ecmo while monitoring blood tests. Based on the test results taken after starting Ecmo, the patient currently has hyperkalemia and metabolic acidosis with increased cardiac enzymes. We should wait for these levels to decrease before removing Ecmo.”

“Hmm.”

Anyone would agree that this was the correct approach. It was clear enough even for Dr. Kim Jinsil, who specialized in Internal Medicine, not Radiology.

However, Suhyuk continued without giving her time to be amazed.

“However, to achieve this, it is necessary to first suppress the symptoms caused by the recently discovered pheochromocytoma. This will help eliminate the root cause.”

“Yes, then what will you do?”

“We need to prescribe alpha-blockers as expected. Of course, since it cannot be 100 percent diagnosed with ultrasound alone, depending on the patient’s recovery, I would like to perform an MIBG scan once.”

“Okay. And after that?”

“In this pre-treated state, my understanding is that surgery should not be too difficult. I will request a laparoscopic left adrenalectomy.”

“Yes. Hmm. Yes.” Professor Kim Jinsil was once again reminded of Suhyuk’s excellence. Not only was his diagnostic process remarkable, but also his post-diagnosis plan was perfect.

‘I envy Lee Hyunjong, Shin Hyun-tae, and Taejin Jo.’

In truth, she often found their boasting annoying, but witnessing them in action showed her how restrained they were - well, except for Lee Hyunjong.

‘There’s no need to linger here any longer.’

Thinking about teaching relatively less skilled residents back at the hospital made her feel somewhat inadequate. However, Professor Kim Jinsil understood that everyone had room for improvement. Although she herself was frequently praised as a prodigy, none could match Suhyuk’s exceptional talent.

‘Let’s go and nurture our own talents.’

With this thought, Professor Kim Jinsil slowly rose from her seat.

“Excellent. I’ll provide my opinion, so please attach it when requesting surgery from the urology department.”

“Yes, thank you.”

She then started to leave the intensive care unit with her ultrasound equipment. However, she was unable to proceed as someone blocked her path.

“Hey, who is blocking the way? Huh, Professor Kim?”

It was Shin Hyun-tae, and unlike his usual demeanor, he appeared quite agitated. As soon as Suhyuk saw his face, he recalled a forgotten promise.

‘Oh right.’

[Is it already morning?]

‘Damn… I completely forgot about my agreement with Manager An.’

Shin Hyun-tae profusely apologized to Professor Kim Jinsil before striding towards Suhyuk. Although he seemed visibly displeased, he wasn’t raging mad either.

“Were y-you examining patients?”

While waiting alone in the research lab, he had been slightly angry when Suhyuk didn’t answer his phone calls. However, after learning from a nearby nurse that Suhyuk was in the intensive care unit, his emotions settled down somewhat.

“Ah, Manager Shin. I’m sorry. I’ve been looking after this patient…”

“No, no. With Ecmo attached and everything… Yes, it must have been tough.”

Shin Hyun-tae quickly inspected the patient due to concerns about missing something crucial. It felt strange, but he desperately hoped that Suhyuk hadn’t abandoned their meeting for such a trivial reason.

‘Ah, there is Ecmo connected? Then it can be forgotten. Perhaps I would have done the same even if Lee Hyunjong hadn’t asked me to keep quiet? Yes, that’s right.’

Fortunately, the Ecmo was clearly visible nearby. Thanks to this, Shin Hyun-tae felt quite relieved.

“Still, you should’ve called. My apologies.”

Moreover, Suhyuk’s attitude showed his sincerity to some extent. Therefore, Shin Hyun-tae laughed heartily instead.

“No, no. It’s okay. Everything turned out fine, right?”

“Yes, indeed. The patient has been stabilized. And since opinions were already shared earlier… Dr. An Dae-hoon will be able to document it now.”

“Right. Let’s talk about something else then. Thinking ahead, we need to start preparing now for next year’s conference.”

“Understood, Professor.”