Chapter 18: This is a bit difficult, II

[Hmm…]

Unfortunately, Baruda’s analysis did not finish instantly. As he had mentioned earlier, Suhyuk’s brain was inferior to his original body. Although it was hard to admit, it seemed true.

“Uh… Doctors, is there something wrong with the scan?” The radiographer interrupted them due to their unusual conversation.

Suhyuk was still waiting for Baruda’s response, so it fell on the neurology resident to answer.

“Yes… There doesn’t appear to be any abnormalities. Hmm…”

“No issues? Oh, that’s really strange…”

The radiologist had conducted numerous MRI scans and could differentiate between normal and abnormal results. From his perspective, the patient’s head appeared to be normal within the current MRI scan.

It was strange as her condition should not have looked normal.

[I request additional tests.]

As the nurse and neurology resident were still pondering why the initial test showed normal results, Baruda continued speaking.

‘What kind of tests?’

[Please expand the MRI scan to include the cervical spine region.]

‘Expansion…’

[Yes, if the head is fine, we need to consider other causes. There may be issues related to the spinal cord.]

‘Hmm… that could be possible.’

For now, pondering why there was damage to the spinal cord could wait. The priority was determining the cause of paralysis.

“It is better to make a decision quickly. The examination will soon be completed.”

‘Ah.’

Without realizing it, Suhyuk looked towards the front of the scanning room. There was a transparent window allowing him to observe the patient undergoing the scan. Unlike CT rooms where electronic devices were permitted, MRI rooms prohibited electronics due to interference, necessitating this direct observation design.

Bump, bump, bump.

The faint vibrations and the rising and falling movements of the patient indicated that the examination was not yet complete.

“Excuse me…”

Thus, Suhyuk simultaneously called for the neurology resident and radiographer. They discussed the case at length but couldn’t provide any definitive answers.

As soon as Suhyuk opened his mouth, they turned to him.

“Yes, Dr. Sam.”

The neurology resident had not yet heard any rumors about Suhyuk. Typically, residents from minor departments were often isolated from hospital gossip.

“If the cause of paralysis is not in the brain…how about extending the scan further down? If Youngje hasn’t administered the contrast agent yet…it should still be possible.”

“Oh. How’s it going now? What’s the progress?”

In response to their conversation, the radiographer quickly nodded.

“No, Youngje hasn’t been administered yet. For the scan before Youngje… shall we extend the area?”

“If possible, I would appreciate it.”

“Okay. On the scans prior to administering Youngje, the neck won’t be visible. Is that acceptable?”

Suhyuk hesitated momentarily at the resident’s question. With just one month left in his first year as an intern, he wasn’t entirely confident in making such decisions.

“It’s fine. I’ll confirm with the results.”

Fortunately, there was a neurology resident present. Thanks to their presence, they were able to adjust the examination to include the head and neck right before administering Youngje.

“Intern Doctor, there has been a slight change in the scan settings, which will add approximately 20 more minutes!”

After delivering this news that caused the intern’s face to scrunch up, the radiographer proceeded with the modified scan settings. After some time, the images began transmitting one by one, starting from the head.

“Still normal as expected…”

The brain scans showing no abnormalities were not affected by Youngje entering the room. However, as more images arrived, the expressions of both the neurology resident and Suhyuk started to change subtly.

It was the nasopharynx area - the vicinity where the patient’s cancer had previously been located looked unusually disheveled.

“Is it…a recurrence?” The neurology resident shook their head, visibly disappointed.

Instead of expressing sympathy, Suhyuk attempted to communicate with Baruda.

‘Strange… I saw her at the ENT outpatient clinic just last month.’

[Based on the previous medical records, there was no evidence of recurrence.]

‘What about the images or endoscope photos?’

Suhyuk recalled checking the patient’s chart as soon as he arrived in the emergency room. It wasn’t difficult to access since Baruda had neatly organized them beforehand.

‘Definitely, it wasn’t a recurrence back then.’

However, the current transmitted images suggested a recurrence due to tissue irregularities caused by Youngje’s arbitrary augmentation. The abnormality had even penetrated behind the nasal cavity.

“Oh.”

Furthermore, the lesion had eroded through the spinal bone and invaded internally, reaching the spinal cord.

“This is…” Suhyuk pointed at the transmitted image and continued, “This must be the cause of the paralysis.”

“Yes, Doctor Sam. It wasn’t related to neurology. Hmm… I’ve never seen nasopharyngeal cancer being this aggressive…”

It couldn’t be considered as absolutely having a good prognosis. The location was not visible, and often it was discovered late when symptoms such as nosebleeds occurred.

However, for this patient, the cancer was detected early enough for treatment, and proper therapy had been administered. Chemotherapy cycles were precisely scheduled, and radiation therapy targeted the nasopharyngeal cancer accurately.

‘The chart and findings show such different results… Isn’t it strange?’

“It is not typical behavior, but medicine ultimately relies on statistics.”

Baruda’s words meant that anything could happen in medicine. This was one of the reasons why there hadn’t been any significant breakthroughs in artificial intelligence for medical diagnosis yet. Of course, the inability to fully incorporate all five senses into AI calculations was an even bigger issue.

However, Baruda, the world’s only artificial intelligence capable of resolving this problem, continued speaking:

“The lesion seen in the image appears to be a recurrence of cancer. I recommend following the protocol for recurrent cases.”

‘Hmm…’

Nevertheless, Suhyuk wasn’t satisfied with this conclusion.

He felt like he was missing something.

“Suhyuk, you are not Sherlock Holmes. Follow the protocol,” Baruda contemptuously replied to Suhyuk’s thoughts.

“Well then, I will leave a note for Neurology. Please consult with them regarding quadriplegia after admitting the patient.”

The neurology resident confirmed it wasn’t his department’s issue, patted Suhyuk on the shoulder, and left the filming room.

Meanwhile, all the tests were completed, and the intern brought the patient out of the MRI room while pointing at their face.

Their eyes had been closed when they entered but were now open upon exiting.

“Huh?”

“It might be due to the loud noise during the scan…I’m not sure, but their eyes are open.”

“Can you step aside for a moment?”

“Yes.”

Based on the examination results just transmitted, it wasn’t strange for the patient to have opened their eyes. Since there was no issue with their brain, they should have been fully conscious.

“It’s odd when I think about it. Why were they unconscious?”

‘Are you asking me now?’

“Oh right.”

Suhyuk briefly silenced Baruda and approached the patient. The patient strained to look at Suhyuk by moving only their eyes.

“Can you…speak?”

“Yes…” A hoarse voice emerged.

It could simply be due to dehydration, but based on the abnormalities detected through the MRI, it was likely because the vocal cords weren’t functioning properly.

‘Incomplete paralysis?’

This was also strange. If the disease were cancer, it would have resulted in complete paralysis rather than incomplete paralysis.

Suhyuk asked several questions while accumulating his doubts.

“Patient, do you remember anything when you lost consciousness earlier?”

“Oh… Yes.”

“What happened? Were you just lying down?”

“No, no. I was in the bathroom… Suddenly, my body went limp, and I collapsed. After that, I don’t remember anything.”

“Bathroom…?”

“Yes, I needed to urinate.”

These words indicated that the patient had been moving until shortly before the paralysis occurred.

[I don’t know what is happening.]

‘What if artificial intelligence says such words?’

[Then would you lie about knowing something? There is no such artificial intelligence. It should not exist either.]

‘Damn bastard.’

[When you run out of words, you have a habit of cursing, but it’s a very bad habit.]

‘This damn dog…’

Suhyuk refrained from uttering another curse as he felt like he was moving according to Baruda’s words. Moreover, there were more important matters at hand than arguing with Baruda.

“Patient, let’s first return you to where you were earlier. Along the way, I’ll perform a few tests.”

“Uh… Yes.” The patient tried hard to nod.

In normal circumstances, it wouldn’t be strange, but this situation was quite peculiar.

[Did you just move your head?]

The patient clearly had quadriplegia. The record left by the neurology resident, who disappeared earlier, also mentioned there were no movements whatsoever.

“Patient, can you grab my hand?”

“Yes…”

However, the patient was currently holding Suhyuk’s hand, albeit with incredibly weak strength. It wasn’t complete paralysis.

[Is it not cancer?]

‘Oh shut up… What do you think you’re doing?’

After Suhyuk’s rebuke, Baruda momentarily closed his mouth before launching a counterattack.

[I will analyze the patient’s condition based on the extremely limited cases that Suhyuk has read.]

‘Just stick to analyzing. What does “extremely limited” mean?’

[I only made statements based on facts.]

‘Damn…’

[Let’s start with questioning the patient first.]

’…’

Suhyuk shook his head and turned towards the patient. In this short period of time, there had been another change.

“Huh…?”

The patient could only blink their eyes, unable to move any other part of their body. Even the hand that was previously gripping Suhyuk’s fell limp. It seemed all strength had drained from them.

“Now…can you not speak? Then please blink your eyes twice.”

The patient blinked twice at Suhyuk’s words.

Paralysis could come on so suddenly - it was quite surprising.

‘Should I notify Senior Wi?’

It felt wrong to struggle with something unknown, as the potential harm would solely affect the patient.

[Analysis result… It appears more likely to be due to infection or necrosis rather than cancer.] Baruda finished its analysis and spoke with some uncertainty.

‘Why is that?’

[Due to the extremely small number of cases.]

‘This damn AI…’

[In any case, we should consider other conditions beyond cancer. Do you have any other ideas?]

‘Let me think.’

Suhyuk closed his eyes briefly.

What was causing the lesion behind this patient’s nasopharynx?

‘Infection?’

[There is no reported infectious disease that selectively causes such severe inflammation of the nasopharynx.]

‘Necrosis?’

[Autoimmune diseases rarely target only the nasopharynx. ‘Wegener’s’ could be one possibility, but it is highly unlikely.]

It made sense. Among these words, one caught Suhyuk’s attention, and he had just uttered it himself.

‘Wait a minute. Necrosis?’

[Do you have any ideas?]

‘This patient received radiation therapy. It was quite high dose for the nasopharynx.’

[Indeed, due to nasopharyngeal cancer… Wait?]

‘I get the gist. Let’s notify them.’