Chapter 125: This Fracture is Strange (Part 2)

The favor was quickly granted. Even obtaining a private room was effortless. As the son of the hospital director and a highly regarded resident, his request could not be ignored.

“Are you really okay with this? We only have special rooms available here. You can stay, but…”

“Yes, it’s fine. The important thing is getting treated.”

Of course, the patient’s wealth supported these accommodations. Patient Kim Da-hyun did not hesitate to use a luxury private room costing over 400,000 won per day.

“She must be wealthy. Imagine eating sweet and sour pork or jajangmyeon every day - how enviable.”

‘Can you say that while looking at someone with broken bones?’

“[I’m just reading Suhyuk’s thoughts, right?]

‘Hmph.’

As Baruda suggested, she appeared to be quite affluent. It was truly fortunate for the medical staff since they wouldn’t need to worry about financial constraints during her treatment.

Financial toxicity, which is a harmful side effect of healthcare, need not be considered. It meant Suhyuk could utilize all known diagnostic methods and treatments without restraint.

“Just please treat me. The pain is unbearable.” Patient Kim Dahyun clutched at Suhyuk’s forearm as she spoke with desperation.

Despite receiving painkillers, it seemed to be incredibly painful for her. On a scale from one to ten, her pain fluctuated between seven and eight consistently.

“Yes, Ms. Kim. First, I will give you more medication for your pain. Also, fortunately, we can conduct tests today. Although we may have to go late tonight… Still, we’ll get the results immediately.”

“Ah… Thank you.”

The pain wouldn’t disappear even with a diagnosis. The patient bowed her head, hoping for any relief from the pain. Although she couldn’t fully bow due to the discomfort, her intention was clearly conveyed.

‘Let’s first control the pain. After all, physical examination isn’t crucial for this diagnosis.’

Anyone who has visited the emergency room due to severe pain would understand. There were instances when doctors intentionally allowed patients to endure their agony. It might seem frustrating, but there was always a reason behind it. Pain often served as the most critical clue for accurate diagnosis. However, once a fracture had been confirmed, the situation changed significantly.

[I recommend using fentanyl. It’s a potent narcotic analgesic suitable for short-term use and has relatively low respiratory depression effects.]

‘Pentanil… Yes, I need to control her pain with that at least. This cannot continue.’

[Dosage should be carefully adjusted. She is female and not very heavy.]

‘Of course. Do you think I’m a first-year intern?’

Suhyuk chuckled as he prescribed the medication. His expression might have seemed too relaxed, but there were no mistakes made. The correctly prescribed painkiller soon alleviated the patient’s symptoms without suppressing her breathing or consciousness excessively.

Thanks to this, Patient Kim Da-hyun was able to descend from the examination room with a smile once she received the test results. Suhyuk watched her wheel away towards the elevator before turning back to his monitor.

“Doctor, have you completed all your cooperations and electives?” Hayoon asked Suhyuk.

It seemed like she had been busy with tasks related to the new patient as she was bustling around the hospital room earlier. Now, things appeared to be settled enough for her to approach the station.

“Oh, yes. Earlier today.”

“Woah…there were more than twenty cases. When did you finish them?”

“Huh? How do you know this as an intern?”

“Dr. An Dae-hoon has been sighing over that list for several days now. Since I often come here for prescriptions, I saw it then.”

“Aha.”

Suhyuk looked at Hayoon with admiration as she casually answered him. Suhyuk had been through this process two years ago when he was an intern. One would never know about these matters unless they were interested.

“You have been reviewing patient Kim Da-hyun’s test results. How is it looking?”

As an intern, one would want to rest whenever there was free time. However, Hayoon seemed too dedicated for her own good. Now, Suhyuk understood why upperclassmen appreciated hardworking interns.

‘She truly is impressive.’

“Is it because she has a pretty face?”

As always, Baruda delivered his blunt remark. Despite feeling slightly embarrassed, Suhyuk managed to feign indifference thanks to his exceptional acting skills.

‘No, no! I am not that superficial.’

[Hmm… Anyways, haven’t you received the results? Let’s check them together.]

Baruda didn’t push Suhyuk further. The results had come back, but they hadn’t checked it yet. Baruda was more eager to see the results than Hayoon herself.

“Oh, yes. Let’s take a look. Hmm…”

Suhyuk shared similar sentiments and quickly brought up the test result window. Various blood tests, including a routine complete blood count (CBC), appeared before his eyes.

“The white blood cell, red blood cell, and platelet counts are normal… Where were calcium and phosphorus levels?”

When fractures occur without any external trauma, it is crucial to examine the main components of bones. Among them, calcium and phosphorus levels were especially important.

“Ah, here it is. Huh? The phosphorus level is extremely low.”

“Let me see… Oh. At 1.6… It’s definitely below normal. Additionally, the ALP is elevated.”

The normal range for phosphorus was between 2.5 to 4.5 mg/dL. Even being slightly under the lower limit would be unusual, but at 1.6, it was significantly deficient. As Hayoon mentioned, this value could indeed be described as ‘extremely low’.

“It seems they’ve also done a bone scan!” Suhyuk, rubbing his chin while examining the virtual screen, felt a tap on his shoulder from Hayoon.

As he regained his composure, something shiny caught his eye on the screen as mentioned by Hayoon. It was a notification indicating new scan results were available. This feature had been implemented due to frequent delays in reviewing test results amidst the hospital’s hectic environment.

Patients were highly satisfied with this service, and it proved useful once again.

“Oh. Let’s check them quickly.”

Suhyuk temporarily paused his conversation with Baruda and clicked on the full-body scan notification. An additional video player launched alongside the existing program. Thanks to Taehwa Electronics’ sponsorship, the computers at the hospital were of high quality, ensuring minimal delay. Moreover, full-body scans typically involve only a few images.

“Hmm.”

Suhyuk rapidly scanned through the displayed videos.

Any fractures or abnormalities would appear as black areas on the scan. Unlike X-rays, this was one of its advantages where issues could be detected instantly with a single glance.

“The right side, ribs number 1, 2 and 9… On the left side, there are fractures at numbers 1, 2, and 3. The coccyx is also broken? No wonder his lower back hurts intensely.”

In addition, a clear fracture in the left pelvic bone was visible on the X-ray. It truly justified being described as multiple fractures. Multiple fractures occurring while the spirit had departed?

Suhyuk began earnestly contemplating this situation.

‘Firstly, what situations can cause the spirit to depart?’

[The reabsorption by the kidneys may not have occurred.]

‘Is there an issue with the tubules?’

[I am making assumptions here, but it is most likely due to problems with the tubules. Next, absorption could be reduced in your intestines, or hormones might be causing excessive movement of calcium into cells. Alternatively, there could be increased production of bone mesh.]

‘I need more tests for accurate diagnosis.’

[Yes, considering you have managed to control the pain, we have bought some time.]

‘Good.’

Instead of asking Baruda various questions, Suhyuk directly ordered specific tests. He requested measurements of 25(OH) Vitamin D3, commonly known as vitamin D, and parathyroid hormone levels, which are involved in bone formation and breakdown.

When Baru saw these two items, he appeared genuinely impressed.

[Good. Very good.]

‘Did it increase significantly?’

[I am not exaggerating; I’m actually a better endocrinologist than Seo Hyoseok.]

[Huh huh.]

[Despite your laughter, you would look cooler if you didn’t smile. Are you smiling because you think no one can see your face?]

‘Damn.’

Suhyuk suddenly remembered that Hayoon was standing next to him, observing his every expression. Although he quickly tried to maintain a straight face, it seemed too late as she had already noticed. Hayoon wore an awkward smile.

“Multiple fractures despite having low phosphorus levels? First, we need to check how well phosphorus is being absorbed by the kidneys. If absorption is poor, it could indicate kidney disease.”

“Ah…”

Of course, Suhyuk’s acting skills were already at a level surpassing most actors, so he could easily brush off her question. Hayoon also believed Suhyuk was amazing enough to be taken seriously without any issues.

“There is a formula that can determine this. Do you remember it?”

“Ah… I think I learned it before. Um… It involves dividing something found in the blood by something in the urine.”

“Oh! You really studied well. This isn’t typically covered in our curriculum.” Despite asking the question, Suhyuk genuinely expressed his admiration. Even among residents, very few would likely know this information; it was more expected of kidney disease fellows to be familiar with it.

“I don’t remember it exactly. Just that much…”

“Most people wouldn’t even know about this condition. Let me show you these two tests.” Suhyuk prescribed additional tests not included in routine check-ups. They were tests to measure creatine and phosphorus levels in urine samples.

“Oh. By looking at the ratio of blood phosphorus and blood creatinine levels… we can determine how much phosphorus is being reabsorbed.” Hayoon instantly remembered what she had learned previously as soon as he mentioned it.

Suhyuk, genuinely impressed, patted her on the shoulder.

“Amazing! You’re right. With these results tomorrow, we should be able to pinpoint the cause to some extent.”

“I’ll make sure to attend the rounds meeting tomorrow.”

“You will?”

“Yes. As an intern… I’m unsure if my presence would be appropriate, but I’d like to join.”

“Yes, see you tomorrow.”

“Alright, upperclassman.” Hayoon bowed her head before briskly walking away.

Baruda muttered as he watched Hayoon leave, “She is truly unique. What does Suhyuk find attractive about her?”

I’m not bad for my level.

“Have you heard of narcissistic personality disorder?”

Shut up… Let’s get some sleep first. Today was exhausting from running around all day.

“I agree. Your blood stress hormone levels have significantly increased. You should rest today.”

Suhyuk’s body condition seemed poor even to Baruda, so it observed quietly as Suhyuk went straight to the on-call room and lay down.

While Suhyuk’s night passed quietly…

Unfortunately, this wasn’t the case for everyone else.

After observing Suhyuk’s condition, Baruda unusually allowed him to rest quietly in the on-call room.

As Manager Choi Nokphil exited from the operating theater, he noticed that patient Kim Dahyun had been discharged. He immediately yelled at Dr. Dongho Kang, a first-year resident:

“You crazy bastard! Do you know who this patient is? And yet, you just let her go!”