Chapter 150: I Must See the Patient (2)

“Ah, Doctor!”

As soon as Suhyuk appeared at the hospital room the next day, An Dae-hoon called out to him. It seemed like Dahoon didn’t get much sleep; there were dark circles under his eyes.

[I see you had some patients yesterday?]

‘But he didn’t contact me?’

[An Dae-hoon is now midway through his first year, so it’s natural for him to handle more patients independently.]

‘Ah, indeed. It seems it’s time for that.’

One might think six months of internal medicine training isn’t enough, but those who have experienced it firsthand would likely agree otherwise. Medical training is no easy feat.

“So, what happened y-yesterday?”

“Oh… Yes, nothing significant. But I managed to resolve it.”

“Oh. Let me see.”

“Uh… Yes, sir.” An Dae-hoon hesitated momentarily before entering the patient’s registration number.

Showing his treatment process to someone higher up was never easy for him. It felt like having homework checked by a teacher. Moreover, it was even more nerve-wracking since the reviewer was Suhyuk, whom he deeply admired. However, Suhyuk’s brilliance transcended mere genius, so having such an exceptional person review his work could also be considered an honor.

“Hmm… Ah, these symptoms brought them here. Interesting.” Suhyuk muttered as he read through the chart.

[It’s good. Thinking about this here means you have studied it somehow.]

‘Indeed. He is diligent.’

[Diligent indeed. Somehow, I feel like I’m losing more hair because of him.]

‘Don’t sound so sad; we should be proud.’

[Why not? Suhyuk has abundant potential.]

‘I feel even guiltier now. It doesn’t make sense that he is younger than me…’

Dae-hoon occasionally glanced at Suhyuk, to be precise, towards his scalp, but Suhyuk didn’t notice.

‘What am I doing wrong?’

His focus was solely on whether he was correct or incorrect.

“Is it good?”

When Suhyuk uttered “good,” Dahoon’s face lit up immensely.

“Really?”

“Yeah. The diseases you suspected from the initial response… and your treatment was excellent as well. I would have done the same.”

“Wow.”

“You seem to be the most intelligent among the first-year residents.”

“Thanks.” If someone else had praised him, it might not have been as impactful. However, hearing these words from Suhyuk deeply moved Dahoon.

“Hey, are you crying, upperclassman?”

Tears were about to roll down his cheeks.

“N-no, I’m not.” An Dae-hoon hastily wiped away any tears. At age twenty-seven, he already had a receding hairline, but Ha-yoon’s compliment brought him close to tears.

Suhyuk discreetly wiped his own eyes while observing Dahoon.

“Well, let’s check on the patient admitted yesterday.”

Suhyuk wanted to spend more time comforting Dahoon, but it was not possible at this moment as they needed to check on the patient. It had been a while since he felt uncertain about a patient during their first meeting. Suhyuk wasn’t alone; Baruda was also extremely curious.

“Ah. Yes. The tests…many results have come back.”

“Let’s see them.”

“Yes, sir.”

Dahoon quickly brought up the patient’s chart, seemingly forgetting his own hair loss issue for now. As Dahoon mentioned earlier, numerous tests had been conducted.

“Firstly… Hmm.” Suhyuk started by reviewing the blood test results swiftly due to his extensive experience and Baruda’s assistance.

[White blood cell count and platelets are normal. Hemoglobin is 11. Slightly anemic.]

‘There aren’t as many abnormalities as I thought… Hmm?’

[The CRP is elevated. A level of 8.5 is quite high.]

‘ESR is also high. Hmm.’

CRP and ESR were basic indicators used to assess inflammation levels. Elevated values suggested inflammation somewhere in the patient’s body.

‘The PT is prolonged. The aPTT too.’

These two measurements indicated a tendency towards bleeding. Given that the patient mentioned bruising easily for some time now, it wasn’t surprising to see these numbers increased.

[As for the X-ray and EKG, they appear normal. Oh, the X-ray does show weight gain, but well… That can be confirmed with just a visual inspection.]

‘If I summarize, the current issues are… Firstly, abdominal pain and blood in stool from four years ago. Tendency to bleed, skin bruising easily, and anemia?’

[The albumin concentration in her blood is also low.]

‘Do you have any ideas?’

[Honestly, no.]

‘Me neither, for now.’

Despite numerous test results, nothing stood out as definitive.

However, neither Suhyuk nor Baruda felt disappointed. After all, the diagnostic process in Internal Medicine can often seem elusive at first glance.

“Did any other tests show anything?”

“The colonoscopy this morning… Oh, she’s coming down now.”

“That was quick?”

“Since your orders expedite things lately.”

“Huh.” Suhyuk chuckled with a sigh.

He knew too well why this was happening, but ironically, it wasn’t due to his influence.

[I am glad I didn’t reveal it earlier.]

‘There is no need to reveal it now anyway. After all, the director already shouted about it at the conference.’

[Indeed, you are right. He tends to act impulsively.]

‘Anyway… not many patients, right?’

In response to Suhyuk’s question, Baruda briefly accessed data. The ‘briefly’ was actually using Suhyuk’s brain, so the noise he heard resembled tinnitus.

[Two patients admitted for respiratory issues were discharged yesterday. Apart from them…there aren’t any others.]

‘Then let’s go down and check personally. Specifically, I want to see the colonoscopy results.’

[Ah, shall we proceed?]

In reality, if they waited a bit longer, the images would have been uploaded along with the attending physician’s report. However, there was no comparison to witnessing the procedure live. Whenever possible, it was best for the primary physician to verify the findings themselves.

Additionally, there would be comments from doctors who performed the actual colonoscopy. However, nothing could compare to witnessing it live. If possible, it was best for the primary physician to check directly.

“Dahoon, have you finished with your patients?”

“Ah…not yet.”

“Is it urgent?”

“No, I don’t have any schedule this morning… Anyway, I planned to stay in the hospital room. Why do you ask?”

“Let’s go together to the endoscopy room and see that patient.”

“Oh, yes!” An Dae-hoon immediately nodded.

He was always ready to accompany Suhyuk anywhere, not just the endoscopy room.

As Dahoon prepared to follow, Ha-yoon also joined them.

“Can I come along too?”

Her tightly tied hair seemed to emphasize her dedication as an Internal Medicine intern, even though she appeared exhausted.

In Internal Medicine, there were many tests that needed to be conducted early in the morning due to its characteristics. Suhyuk recalled waking up at around 4:30 AM during his internship days to handle prescriptions.

“Are you sure you don’t need rest? More prescriptions will likely come in this afternoon.”

“The endocrinology team has been handling most of them…so it’s not too overwhelming.”

“Oh, I see.”

Suhyuk remembered sorting through those prescriptions. Although everyone was working diligently, there were still too many unnecessary tasks. While interns might not discern which tests were necessary, someone like Suhyuk could potentially reduce the workload by half with careful attention.

“Yes, let’s go then.”

“Thank you, sir.”

Thus, Suhyuk ended up leading two colleagues downstairs.

The endoscopy room was located on the second floor. As expected of Taehwa Medical Center, the endoscopy room was massive due to its reputation and because it wasn’t separated from the health check-up center.

“Wow… There are so many people at this time.” Dahoon looked around as if he had never been here before during these hours.

“Yes. Recently, our hospital has been focusing heavily on health screenings. We have been losing ground against Ashian and Chilseong Hospitals.”

On the other hand, Suhyuk had heard numerous things by associating with high-ranking individuals. In particular, he knew more about the hospital’s revenue than most professors.

“Where should we go? This way?”

Suhyuk entered the endoscopy room and briefly closed his eyes. Baruda then provided him with the stored map.

It felt like having access to a mini-map in a game.

“Ah, this way.”

“Yes, sir.”

Dahoon and Ha-yoon followed Suhyuk without question. To them, Suhyuk was their truth and life. Moreover, most of the time, Suhyuk’s intuition proved correct, including this instance.

Suhyuk easily reached the colonoscopy room and grabbed a nearby nurse passing by.

“Hello, I’m Lee Suhyuk from Internal Medicine, second-year resident.”

“Oh, yes. Dr. Lee Suhyuk. How can I help you?”

The rumor that “the resident doctors with a staff are VIPs” had long spread throughout this large hospital. Consequently, the nurse treated him with utmost courtesy, noticeably different from the typical experience at university hospitals.

“Do you happen to know where patient Hong Yeonsu is located? She came from the outpatient ward and is an endocrinology patient.”

“Hong Yeonsu… Just a moment.” The nurse briefly searched through some charts before pointing towards a curtained area. “Over there.”

“Thank you.”

“You’re welcome.”

The nurse then left with medical equipment, likely heading to assist another room.

Instead of barging straight into the indicated space, Suhyuk knocked on the wall first.

A voice responded immediately, “Who is it? I’m busy.”

It was a young male voice, apparently in the middle of performing a colonoscopy. Most resident doctors would apologize profusely and wait their turn, but Suhyuk chose not to follow that norm.

“There’s no need for apologies,” he replied, echoing Baruda’s words.

“Oh, Dr. Lee Suhyuk? Please come in.”

As soon as Suhyuk mentioned his affiliation and name, the tone of the voice inside noticeably changed.

Thanks to this, Suhyuk could enter the endoscopy room with Dahoon and Ha-yoon.

The gastroenterologist continued while observing them, “Take a good look. What do you think?”

He pointed at the screen displaying the endoscopy image. For someone seeing it for the first time, they might question if it was indeed the large intestine due to its peculiar appearance. It showed numerous ulcers, irregularly shaped rather than uniform, and not connected seamlessly.

“What does it look like to you?” asked the gastroenterologist.

Of course, experienced doctors would recognize it as a typical finding. An Dae-hoon also identified it immediately, albeit with slight hesitation before responding:

“Crohn’s…?”

“Oh, yes. Crohn’s.”

“You’re correct. This is a very typical presentation of Crohn’s disease. Although, ulcerative colitis or even tuberculosis cannot be ruled out completely, but there are differences here compared to those conditions.”

In response to Dahoon’s words, both Soohyuk and the gastroenterologist nodded their heads. However, there was a slight difference between Suhyuk’s nod and that of the gastroenterologist. The gastroenterologist appeared more confident, while Suhyuk seemed filled with doubts.

[Isn’t it strange?]

‘Yes, it is Crohn’s Disease. But…’

[The CDAI (Crohn’s Disease Activity Index) score is less than 150. Considering factors such as bowel movement frequency, abdominal pain, presence of masses, levels of anemia, and overall well-being…]

‘To be precise, it’s around 131 points… That classifies it as inactive, right? Yet, notably, only blood in the stool is significantly elevated. Could there be another underlying cause?’

[Might it have something to do with the skin condition?]

‘So you still haven’t figured out what exactly it is?’

[Unfortunately, no.]