Chapter 170: Getting Heated (3)

Suhyuk observed the approaching patient from a distance instead of asking various questions.

[Height is approximately 160 cm with 55 kg weight. It seems to be within normal range.]

‘Based on her gait, she appears weak… but not necessarily.’

[Yes, I do not observe any yellowing of the skin or other abnormalities.]

He was conversing with Baruda.

To others, it might seem like Suhyuk was simply lost in thought, but for him, this time served as his secret weapon.

‘So, apart from fever, there are no other notable findings?’

[Yes, there are no bruises on the elbows either. However, we should examine the knees later.]

‘Bruises?’

His platelet count was low, but it did not seem to be at a level that would cause bruising. However, factors other than platelets could affect bruising and bleeding times. There were still untested elements that could explain his symptoms adequately. If these symptoms appeared, it might tilt towards acute leukemia.

He couldn’t avoid checking something easily accessible just because it seemed bothersome.

“Doctor, shall we discuss first? It will take us longer.”

While they continued their discussions, the assigned nurse approached him, pointing at the patient who had suddenly appeared before them. The patient sat down immediately as if standing was difficult for him.

“Ah, yes. That… Could you check his vitals?”

“Certainly.”

The nurse immediately obtained permission from the patient and measured his blood pressure, heart rate, respiratory rate, and temperature. The results were relayed to Suhyuk almost instantly.

[Blood pressure is 115/78. Heart rate is 83, respiratory rate is 17, and the temperature is… 38.3 degrees Celsius.]

Apart from the fever, the other vital signs did not indicate any severe issues. It seemed Ji-sang had a valid reason for discussing this over lunch.

‘He won’t recover quickly, just as Jisang predicted.’

“Yes, according to his statement, he’s had a fever for about a week now. Although it may not be visibly apparent yet, there’s a possibility that it could progress to sepsis.”

‘Indeed, we cannot let our guard down.’

When Fleming discovered penicillin, it was believed that humanity would be freed from infectious diseases. At that time, this seemed inevitable as numerous infections were being treated with antibiotics. However, over time, bacteria gradually developed resistance, and strains emerged that were completely unaffected by penicillin. Consequently, infection remained one of the leading causes of death in university hospitals even today.

“Patient, is your name Kim Hyunju?”

Suhyuk gathered his resolve once more before speaking.

Kim Hyunju, the patient, looked slightly bewildered. She recognized him from their earlier encounter at the outpatient clinic.

Suhyuk thought it would be easier to meet with patients after they were admitted, but it seemed more challenging than dealing with outpatients.

“Is your name Kim Hyunju?”

“Oh…yes.”

This wasn’t just any hospital; it was Taehwa Medical Center, one of the top hospitals in South Korea. Despite appearing as a young doctor, the patient nodded in response due to the hospital’s reputation.

“Your age is…around thirty, correct?”

“Yes.”

“And you’re a public servant…”

“Yes.”

“You had a fever about a week ago, right?”

“Yes, it started approximately a week ago…”

Suhyuk asked questions already written on the chart again. One might think this was unnecessary, but it was part of the interview technique. Unlike doctors, patients were not accustomed to medical inquiries or structured thinking, so repeating the same question elicited more systematic responses. Additionally, they often provided information initially overlooked.

“Have you traveled abroad recently?”

“No, I haven’t.”

“Besides fever, do you have any other symptoms?”

“Other symptoms?”

“Coughing or producing phlegm?”

“Oh, no, nothing like that.”

No respiratory symptoms observed. Both Suhyuk and Baruda raised their eyebrows at this. Despite asking several more questions, the patient only complained of fever and accompanying headaches.

It would have been easier to diagnose if there were any distinctive symptoms.

‘This will be difficult.’

[I see. The initial questioning isn’t enough. Let’s start with auscultation.]

‘Okay.’

[And please show me your knees as well.]

Suhyuk put aside his disappointment, finished the interview, and picked up his stethoscope.

“I’ll listen from your back. Please breathe deeply and exhale slowly.”

“Oh…yes. I did this earlier, but again?”

“It may continue for some time since we haven’t reached a diagnosis yet.”

“Ah…understood.”

The patient looked slightly displeased but turned around obediently.

‘Sorry to say, but my stethoscope can’t compare to those on Earth.’

With this thought firmly kept to himself, Suhyuk began using his stethoscope.

[Hmm.]

‘It seems normal. Anything unusual?’

[Woo Hahyeop, one more time. Ah, nope. It’s normal. For accuracy, we would need an X-ray, but without symptoms and with a normal auscultation, there is over a 90% chance that it isn’t a lung issue.]

I refrained from asking why he couldn’t be 100% certain, as often, lung diseases aren’t visible even on X-rays. Being able to provide this level of assurance was already reassuring.

“Should I also check your knees?”

“Pardon me?”

“Your platelet count is slightly low. You might have bruises.”

“Oh… I don’t recall any injuries.”

“If you find bruises despite not remembering any injuries, it could be significant.”

“Ah, I see. Hmm.”

At these words indicating something might be wrong, the patient sighed lightly and rolled up his pants leg.

“You have severe bad breath.”

‘It’s probably due to being underweight. He has been sick for more than a week now.’

Bad breath could provide various clues, sometimes even decisive ones if it had a foul smell of pus, but unfortunately, that wasn’t the case here. It only suggested the patient was unwell and slightly dehydrated.

Moreover, there were no abnormalities with the knee either. This situation was disappointing as he hadn’t gained anything significant from this examination.

“Please remember Dr. Lee Hyunjong’s advice. Finding nothing can also be a clue.”

‘Ah… Yes, indeed, true.’

However, thanks to Baruda, they could alleviate some of it.

“Is it done?” The patient lowered his pants with a bored expression.

Suhyuk nodded at the patient’s question. “Yes. I need to perform several tests.”

“Tests…”

“Well, basic blood tests and X-rays.”

“Oh, okay.”

“Please talk to the assigned nurse. I will prescribe something for you.”

“Yes…” The voice of the patient sounded weak due to lack of energy.

After bidding farewell to the patient, Suhyuk faced the monitor.

‘Firstly, let’s do a blood culture.’

[Let’s include the standard tests along with a CBC. If there is any change, this information will be useful.]

‘Hmm, okay. Add a chest X-ray as well.’

“Yes. This is currently the best course of action. There is no need to do anything else.”

It was unclear whether this infection was bacterial or viral. Moreover, her vital signs were stable, so there was no need for preemptive treatment. In medicine, every treatment and test had to be weighed against potential side effects.

Click.

As soon as Suhyuk finished writing the prescription, Ji-sang entered with Soohyuk’s ordered coffee.

“Hey, you saw the patient?”

Ji-sang looked delighted after glancing at the prescription window opened by Suhyuk. The first day prescriptions were always cumbersome, but Suhyuk had already taken care of it. As colleagues with similar years of experience, there was no issue with handling each other’s patients. Within Taehwa Medical Center’s Internal Medicine department, including Jisang, everyone regarded Suhyuk as more than just a prodigy.

“Yeah…well…nothing special came up during the interview or examination. The basic tests were already done.”

“Ah…yes, that’s right.”

“I also have one patient here. I will check on them daily since I am already coming to this floor.”

“Oh…that would be greatly appreciated.”

“But you really don’t want me to notify anyone? Manager Shin Hyun-tae should know about the fever of unknown origin.”

“That is true…but let’s wait until we confirm if it is cancer or not.”

“Hmm…yes, okay. Gotcha. Enjoy your coffee.”

Suhyuk patted Ji-sang’s shoulder as if telling him to handle it himself and sipped his coffee.

After approximately twenty minutes, calls started pouring in for Suhyuk and Ji-sang. Despite their meticulous care for patients, minor issues still arose that couldn’t be resolved solely by morning orders.

Naturally, Ji-sang received more calls than Suhyuk. Consequently, they naturally split up to attend to their patients.

The Internal Medicine department was already understaffed due to fewer people taking annual leave, and with the third-year residents away for studies, it made scheduling even more challenging.

Finally, Soohyuk returned to Kim Hyunju’s hospital room the next morning.

“Did anything…happen?” he asked the visibly exhausted night shift nurses.

One nurse looked back at him, revealing dark circles under her eyes. Although Suhyuk didn’t know her name, he recognized her face, indicating she was likely a veteran nurse. Why did she seem so drained?

‘Did something happen with that patient last night?’

[“I assume you’ve been notified by now.”]

‘Strictly speaking, she wasn’t my patient. Jisang must have taken over.’

[Ah… Could it have happened again?]

Thinking along those lines, Suhyuk hurriedly asked, “Did something happen last night?”

“Yes, something occurred after quite some time… Oh boy, it was chaos. It wasn’t even a patient with a Do Not Resuscitate order…” The nurse shook her head and pointed towards the treatment room as she spoke.

Suhyuk finally noticed a significant number of people, including guardians, gathered around the treatment area.

“It’s not about yesterday’s patient, right?”

“Ah… That patient? No, not them. They were a surgical patient. After being discharged post-operation, they ended up back in the emergency room, but there were no available rooms, so they were placed here. Wow, I’m not sure if it’s related to their surgery or something else… Suddenly, their blood pressure.”

“Ah… it’s surgery.”

The nurses of Internal Medicine wards become experts at internal diseases just like doctors. However, they tend to forget how to handle surgical patients.

Finally, Suhyuk understood why the nurses seemed particularly stressed today. They were dealing with critical patients in their general ward, which was unusual for them.

“How is he now?”

“He expired… without even being able to touch his hand…”

“Oh…”

Given the unfortunate outcome, it was no wonder the mood in the hospital room was somber.

However, Suhyuk couldn’t be lost in his thoughts as he had patients under his care.

“Is the patient who was admitted yesterday doing okay?”

“Oh… Yes. However, their blood pressure has slightly decreased. I notified Doctor Yoo Jisang, but we haven’t assessed them yet.”

“Their blood pressure?”

“Yes.”

“Did the test results come back from yesterday?”

“I believe so… Yes, they should have.”

“Understood.”

A decrease in blood pressure indicated that the disease was progressing somehow. Having just heard about someone’s death, Suhyuk furrowed his brow deeply.

‘Let’s check the results first.’

[Yes.]