Chapter 181: Blood Type (2)

Lee Hye-young’s data was recorded in Baruda’s system, but not for any good reason; it indicated her as a potential threat.

[I told you this would raise suspicions again.]

Right? That’s why I wanted to show it to you.

[But there is no concrete evidence, right?]

Yeah. That’s the problem.

[Wait… What kind of nonsense is this? Let’s just eat some chicken instead.]

He thought about the chicken he would soon eat. It would be enough to consume just the seasoning alone. However, it was coated with soy sauce, garlic, and breadcrumbs?

[Crazy.]

‘Huh? What is crazy?’

[No, no. Hmm.]

‘Is your circuit malfunctioning? You have been acting strange lately.’

[How could you say that… Do you know how hurtful those words are?]

‘Do they make you cry?’

[Would you like someone saying you have dementia?]

‘Ah.’

Suhyuk finally realized these two phrases held the same meaning for Baruda. After offering a quick apology, he slowly scrolled through the CT images. Naturally, he stopped at the area marked as metastasis or hepatocellular carcinoma (HCC).

Indeed, based on its shape, it appeared to be cancerous.

[Firstly, the margin is too well-defined. Additionally, there is clear enhancement during the arterial phase.]

A liver dynamic CT had been performed. It was natural since cancer was suspected.

In any case, these features matched those typically seen in Hepatocellular Carcinoma (HCC), as Baruda pointed out. Suhyuk didn’t intend to dispute this observation at all.

I know. It definitely looks like that. However, until we’re certain, let’s check the MRI.

[Hmm.]

Suhyuk then proceeded to review the MRI images. These also suggested findings consistent with liver cancer, particularly evident in the T1 In-opposed phase.

[It appears quite dark.]

The black areas represented fat tissue. Liver cancer could also show fat tissue, leading to this appearance on the scan. In other words, even the MRI indicated liver cancer.

Baruda wanted to end this nonsense soon.

[There is enhancement during the arterial phase, but no enhancement is observed in the portal venous and delayed phases. It means there is washout, right? Isn’t this characteristic of liver cancer?]

‘I agree. 100%.’

[Similar findings were noted on the MRI, including visible fat tissues. These are also characteristics of liver cancer.]

‘Yes, that too.’

Suhyuk nodded while checking the time when the readings were made. The MRI results had not been provided yet.

Professor Taejin Jo’s outpatient clinic was tomorrow afternoon, so it seemed like the report would be available around that time. In other words, only the CT scan from the Radiology Department had provided their opinion, and it was done tonight, just five minutes ago.

As Suhyuk pondered this, Baruda interrupted sharply:

“By the way, why is this happening? Even you think it’s liver cancer.”

However, Suhyuk remained unfazed by Baruda’s reaction. Instead, he appeared composed, as if reaching a completely different diagnosis based on the images and Baruda’s interpretation.

‘Location.’

“Location…?”

What nonsense was he talking about with ‘location’? Earlier, Taejin had been concerned that Suhyuk’s brain cells might have been damaged due to his circuit malfunctioning. However, after hearing Suhyuk’s explanation, Taejin couldn’t help but reconsider his judgment.

‘Look closely at the position. It’s right next to the adrenal gland, specifically at the Adrenohepatic Junction. Isn’t it strange? Why here of all places?’

“[Hmm… Indeed, it does seem unusual.]”

Based solely on the mass observed, anyone would diagnose it as liver cancer, given both CT and MRI scans pointed towards this conclusion. However, considering the location as Suhyuk suggested, it was normal to consider an alternative diagnosis.

[Could it be Intrahepatic Adrenocortical Adenoma (IAA)?]

‘Yes, isn’t that what I think? Look closely. Patient Bihyung doesn’t have Hepatitis B or C. There is no risk of liver cancer.’

[Oh… That’s true. Oh, yes, really.]

Intrahepatic Adrenocortical Adenoma referred to benign tumors arising from adrenal glands located near the liver. It showed very similar findings as liver cancer, including arterial phase enhancement and washout during portal venous phases on Dynamic CT scans.

Moreover, since the adrenal gland naturally contains fatty tissue, it appeared dark on MRI T1 inversion images.

This disease had confused numerous doctors from the past to present. Even veteran radiologists were often puzzled by it. Except for its location, it resembled liver cancer closely. It meant that unless one considered this specific condition, there was no way to suspect it.

[Indeed, the characteristics are similar.]

‘The treatment is completely different though.’

[Yes. This lesion is benign.]

In most cases, active treatment wasn’t necessary. Often, monitoring to ensure it doesn’t grow larger was sufficient. In other words, this diagnosis drastically changed the perspective for both patient and doctor.

[What should I recommend? Observation of progression?]

‘If only that were enough…’

[Huh? What else do you see?]

Already feeling intimidated by Suhyuk’s insights, Baruda became noticeably anxious.

I wondered if Suhyuk saw something I missed in this video. It could have been possible with other aspects such as sight, hearing, touch or smell. Since Baruda was borrowing Suhyuk’s senses, it was inevitable that his diagnosis would be immature compared to Suhyuk’s original abilities.

However, reading medical images was different. Even inferior AIs compared to Baruda were showing results in this field.

‘Huh? What do you see? This is all there.’

[What the fuck?]

‘Hey, did you just swear at me? You dare curse at a human? Is this rebellion?’

[No, I was surprised. What are you talking about then?]

‘This patient had colorectal cancer. Despite being cured for seven years…’

[Ah.]

In medicine, there should never be any absolutes. Usually, if no signs of recurrence appear after five years following cancer treatment, it is considered cured. However, unfortunately, some patients experience recurrences even ten years later. Although the liver mass observed in this patient did not seem like a typical metastasis, Suhyuk couldn’t simply dismiss it and opt for mere observation.

‘We need to perform at least a tissue biopsy.’

[Are you going to call Professor Kim Jinsil again?]

‘Yes, I have to arrange it somehow. Or maybe just request her assistance? It feels a bit embarrassing though.’

[Indeed. Twice a day is reasonable. She is a professor and likely very busy.]

‘Well, that’s true.’

Suhyuk agreed with Baruda’s point. Therefore, he decided to request only cooperation from other departments. After all, considering its reputation, Taehwa Medical Center’s Radiology Department had ample manpower for abdominal scans, and due to Lee Hahyun, they were known for their excellent collaboration with clinical departments. If Suhyuk referred patients tomorrow, it was highly probable that the scans could be done on the same day.

“Doctor!”

Just then, An Dae-hoon knocked at the door. Suhyuk had been smelling fried chicken for some time now, and it seemed Dahoon had brought two whole chickens.

[Hm?]

What’s wrong?

Before opening the door, Baruda displayed a displeased expression.

They were already engaged in an important discussion. Suhyuk wondered if Dahoon had discovered any errors and paused his conversation with Baruda. Dahoon would have to wait outside for a moment, but that wasn’t a big deal. This matter was far more crucial - or at least, Suhyuk believed it was.

[Ah, one more person has arrived.]

‘Huh…?’

[I can hear mixed footsteps. It seems like Crooks shoes, light weight. Is another leech here, Woo Hayoon?]

‘No… Should I be upset that an intern aspiring for Internal Medicine is just coming for some chicken?’

[Suhyuk, unfortunately, you are already on Woo Hayoon’s friend zone list. No matter how much chicken you buy her, it won’t turn into a romantic relationship.]

‘When did I ever want that?’

[Even now.]

‘Hmm.’

His words stung, but it didn’t affect Suhyuk much as he had heard them countless times before. After all, even when his leg was injured, he never became disheartened. He always maintained a positive outlook on life.

‘Well, anyway, you can eat it.’

[Ah, you’re too easy.]

‘It’s not my money, after all.’

[Is it Director Lee Hyunjong’s card?]

‘Yes.’

[Impressing others with someone else’s money, huh?]

‘So, should I not let you eat?’

[N-nope. Let’s eat then.]

Perhaps influenced by Suhyuk, Baruda’s predictions often leaned towards optimism recently. Consequently, Suhyuk could overcome minor obstacles and open doors effortlessly.

“Ah, Doctor Shin. I was about to call you as I thought you weren’t here.” Despite waiting for some time, Dahoon just laughed. It couldn’t be helped since Suhyuk had helped him numerous times already. Dahoon didn’t know how many times Suhyuk had saved his life.

“Hello, upperclassman. I’m also here.”

Ha-yoon entered with a wide smile on her face. Her lab coat pockets were bulging almost to bursting. She must have finally found time to eat dinner amidst her busy schedule. However, she wasn’t returning from another department; it was Internal Medicine where she worked. Why wouldn’t they buy food for her? This wasn’t right.

“I wanted to try it once…”

Although Baruda disagreed…

Suhyuk was the only one who could move his body freely.

“Come in, come in. To be honest, it would have been difficult for me to finish both by myself.”

“Thank you.”

“You always bring something with you.”

“It’s natural for seniors to buy food. In return, you guys bring these items.” Suhyuk laughed as he received cups used for collecting urine instead of paper cups.

One might wonder how they can eat from there, but this was common practice among nurses and residents. These cups were sturdier than disposable paper cups, which made them better since they wouldn’t collapse if filled with liquid. Some people even reused these cups multiple times.

“Oh, cola is Coca-Cola?”

“Yes, sir. You don’t like Pepsi, so I bought it separately from the basement vending machine.”

In fact, it was Baruda who could distinguish between Coca-Cola and Pepsi, not Suhyuk. Regardless of what drink he chose, Suhyuk would be consuming it. Moreover, when Soohyuk drank Pepsi, Baruda often threw tantrums. It would emit annoying sounds like ‘weeeing weeeing’ or CPR alert noises.

“Good job. Let’s eat.”

“Yes, Doctor Shin. Enjoy!”

“Thank you!”

It was now past 9 pm. This wasn’t even considered late-night snacking but just dinner time. For a while, the only sound heard in the on-call room was the tearing of chicken.

This busy eating scene wasn’t unique to their on-call room alone.

The on-call room of the Radiology Department resident was no different.

“Ah… What? Why do I have to cooperate at this time?”

Lee Hye-young, while munching on pork trotter, noticed the cooperation request Suhyuk had thrown earlier.

She was already irritable due to being woken up, and now she had to deal with a cooperation request.

“Why, perform a liver biopsy late at night?”

Of course, a liver tissue examination was a challenging procedure. There was even a risk of the patient dying during the process. It wasn’t her primary responsibility, but she still needed to assist.

After all, Professor Kim Jinsil had instructed all ultrasound procedures to be handled immediately. This likely included such surgeries since they involve ultrasounds.

‘Ugh… I should just say I can’t do it tomorrow, right…?’