Chapter 39: What Else Could It Be? (1)

“Patient! You just had surgery!”

Rather than attending to Suhyuk’s discomfort, everyone rushed towards the patient first. Especially Professor Ryu Jinsu of the transplant surgery department practically slid across the floor to reach the patient.

This was understandable as this particular patient had undergone lung transplantation surgery. Due to immunosuppressive drugs used during the procedure, the patient developed pneumonia and required partial lung resection before being admitted to the intensive care unit.

“No! My wife is cheating on me!” However, the patient boasted a remarkably robust physique. Moreover, he was still in his vigorous thirties. As someone who had only ever wielded scalpels throughout his life, Ryu Jinsu found himself helplessly pushed aside by the patient’s strength.

“Oh no.”

“Hey! No! You shouldn’t get up!”

Fortunately, there were several nurses besides Ryu Jinsu in the intensive care unit. With Lee Chuljin, the youngest and only male nurse, leading them, they barely managed to lay down the patient just as he was about to remove his chest tube.

“Huff.”

What would have happened if the patient had pulled out the tube? Professor Ryu Jinsu would have needed to rearrange the operating room for emergency surgery once again. The patient’s immune system clearly wasn’t functioning normally.

He breathed a sigh of relief as he approached the patient.

“My wife! Affair!” The patient continued repeating these words.

Such delusions were not uncommon in the intensive care unit.

“Dementia, it’s dementia.”

Ryu Jinsu approached the patient while muttering ‘dementia’.

By then, Suhyuk had already reached the patient’s bedside.

[Dementia. Currently, it is the most likely diagnosis.]

‘Then there’s no need to worry about it?’

[However, this case isn’t typical.]

‘Not typical?’

Ryu Jinsu stood beside the patient without paying any attention to Suhyuk, who seemed lost in his own world. The situation was too urgent for him to be concerned with someone from another department wearing a badge clearly marked “Internal Medicine” on their left chest pocket.

“For now… request psychiatric cooperation. Right now…” Ryu Jinsu looked slightly troubled as he gazed down at the patient.

“Wind!”

The patient continued obsessing over the delusion of his wife having an affair. In this state, conducting interviews or treatments seemed impossible.

“First, let’s put him to sleep.”

Although he didn’t like it, he decided to administer a sedative.

‘How much longer will his hospital stay be extended due to this…?’

One of the drugs known to induce dementia was a sedative. The principle was to minimize its use as much as possible; however, there is no universal rule that applies to all situations, especially in medicine when treating patients.

“Yes, Professor.”

“Let’s request psychiatric evaluation for medication review first. If he starts causing trouble again…it could become really problematic.” After administering the sedative, Ryu Jinsu approached the relaxed patient and muttered while examining his wounds.

The residents and nurses nearby nodded their agreement.

Only Suhyuk was lost in his thoughts or rather, absorbed in his conversation with Baruda.

‘What do you mean it’s not typical? The sudden delusions and aggression are clearly dementia?’

Suhyuk recalled seeing some patients with dementia during his time as an intern in the intensive care unit. It was inevitable for anyone working there. Moreover, the symptoms of this patient closely resembled those he had observed before.

[Firstly, please consider the patient’s age.]

However, Baruda did not rely solely on direct experience. As an artificial intelligence, he treated both direct and indirect experiences equally, and he was quite advanced in that regard.

‘Age… Hmm. 34 years old. That is young.’

Usually dementia occurred in elderly individuals. It might sound a bit insensitive, but there weren’t many positive aspects of aging from a medical perspective.

[That’s correct. His age is not typical for this condition.]

‘Is that all? He underwent lung transplantation surgery. How weak must he be?’

[I find it surprising you consider him weak after witnessing him push aside Professor Ryu Jinsu with one hand.]

‘No… That’s not what I meant. Having good muscle strength doesn’t necessarily mean overall health.’

While strong muscle strength often correlated positively with various health conditions, it did not guarantee immunity to chronic diseases. Baruda refrained from disputing Suhyuk’s point further.

[Correct. However, what is unusual about this patient goes beyond their age.]

‘What then?’

[Please answer me. What time is it now, Suhyuk?]

‘Huh? Why do you suddenly ask for the time?’

[Just respond.]

Suhyuk looked around, unsure of why he was being asked. The patient had already fallen asleep deeply after receiving sedatives. One nurse closely monitored the oxygen saturation monitor to check for any irregular breathing patterns.

‘It’s 2 PM.’

As Suhyuk noted the time, he realized how bright it still was during the day. This thought quickly led him to find something slightly odd.

‘2 PM?’

[Yes, it is broad daylight.]

‘Dementia typically…’]

[It mainly occurs at night.]

‘Hmm… But we can’t definitively rule out dementia based on these two observations alone.’

[Suhyuk’s opinion is valid. I request further observation.]

‘What…?’

Suhyuk briefly checked his watch. It was indeed 2 PM. This would be a busy time if there were urgent patients in the hospital ward, but that wasn’t the case for Suhyuk today.

‘Baruda does provide some help.’

With Baruda’s assistance, he could quickly prescribe medications to most hospitalized patients. Especially for those already diagnosed upon admission, prescriptions flowed almost immediately after their arrival.

‘That’s why nurses like me.’

When handing over patients, it was mentioned how neat and organized Suhyuk’s cases were. Prescriptions not only covered the current day but also extended to the next day or even beyond. Thanks to this efficiency, Suhyuk had more free time compared to other Internal Medicine residents.

“I recommend starting with the intensive care unit charts.”

On the other hand, Baruda seemed impatient and unwilling to waste any time on sentimentality. Nonetheless, Suhyuk’s curiosity about the patients was piqued, so he decided to follow Baruda’s suggestion without delay.

He swiftly began examining the intensive care unit charts. Professor Ryu Jinsu had already left for another surgery, as had the residents from the transplant surgery department. Only nurses remained in the intensive care unit.

“Who is that person? Psychiatry?”

“No, looks like Internal Medicine.”

“Isn’t it… Lee Suhyuk?”

One of the nurses recognized him. The others, hearing his name for the first time, looked intrigued, signaling their interest in learning more.

“Lee Suhyuk?”

“You don’t know? Rumor has it, he’s the director’s hidden son.”

Only a few within the Internal Medicine department were aware that this rumor was false.

Moreover, due to Manager Shin Hyun-tae’s email, they were now suspicious that he might not actually be the director’s son. Otherwise, there would have been no need for such explicit instructions to leave him alone.

“Woah. He is completely untouchable.”

“But why did he come here? Is it related to respiratory diseases?”

“I’m not sure. There hasn’t been any request for cooperation from his department.”

“For now…for now, just let him be. Don’t get too close.”

“Y-yeah.”

Approaching a Royal without reason and falling out of favor could lead to disastrous consequences. It was best to hide unless specifically sought out. Fortunately, Suhyuk seemed more focused on reviewing the intensive care unit charts than paying attention to others around him.

[Blood pressure, body temperature, heart rate, and respiration are all stable.]

These vital signs, crucial indicators of a patient’s condition, appeared extremely stable.

It seemed there were no issues at all.

‘However, the chest X-ray is messy.’

[Based on the examination of the excised lung tissue, it appears to be Aspergillus species.]

Aspergillus - a type of fungus occasionally found in healthy adults. Normally, their immune system prevents any problems, but when the immunity is significantly weakened like this patient, it can cause massive issues.

Just as seen with this patient now.

‘A painful fungal pneumonia. Not bacterial, but fungal.’

[I suppose that’s why they performed surgery. Fortunately, it seems the operation was very clean.]

‘There is a record of thoracic surgery cooperation. The surgeon was Kang Ilgoo. He is quite famous.’

[I am aware of it as well. There is a related paper in the data.]

‘Oh, really?’

[Suhyuk read it himself but doesn’t remember.]

Since it was digitized, he could load it without any errors if he searched for it. However, since he had no memory of reading it, it was useless to him.

‘Well… that’s not important now.’

Thus, Suhyuk decided to let it go. Fortunately, Baruda was preoccupied with the patient’s condition and didn’t pursue the argument further. It seemed feeding him occasional Chinese dishes like jjajangmyeon had its benefits.

[This isn’t your first experience today, Mr. Shin.]

‘Really? Ah, you’re right.’

As Baruda mentioned, there were instances of dementia both this morning and last night.

[The episode this morning was very brief.]

‘He immediately stopped taking his sedatives.’

[And there was also an illustration last night. Based on yesterday’s situation, it is difficult to think of anything other than dementia.]

‘I see. Is it indeed just dementia?’

[The likelihood has increased significantly.]

‘Previously… Ah, he removed the tube yesterday.’

[Yes, before that, you had completely put him under anesthesia.]

In other words, Yang Jae-won did not exhibit any symptoms similar to dementia during that time. Feeling somewhat relieved, Suhyuk approached Yang Jae-won’s bedside.

Fortunately, Yang Jae-won’s surgery went exceptionally well. Throughout the procedure, his vital signs remained stable without any fluctuations. Since the tumor itself wasn’t large, with proper recovery, he should be able to return to his normal life soon.

However, Suhyuk couldn’t ignore him just because he was transferred to another department as his primary physician. After completing all his work at around 8 pm, Suhyuk headed back to the intensive care unit.

“He is still asleep.”

Patient Yang Jae-won looked exactly the same as after surgery.

“His test results are stable. It seems we can perform extubation tomorrow.”

‘Shall I go?’

‘Let’s study.’

‘Okay.’

As Suhyuk was about to leave for upstairs, Patient Park Taesu had another episode.

“She cheated on me!”

As a doctor, it was impossible to overlook a patient experiencing dementia. Coincidentally, Suhyuk was the only physician available in the intensive care unit at that moment.

Coincidentally, Suhyuk was the only doctor currently present in the intensive care unit, making his involvement even more necessary.

“Give him a sedative first! It will be serious if he pulls out his chest tube!”

“Yes, sir!”

The nurses, who were already attentive due to considering Park Taesu as a Royal, rushed towards the patient promptly. Soon after receiving the sedative, the patient collapsed sideways.

Hasn’t psychiatry been consulted yet? This issue remains unresolved.

As Suhyuk observed this scene, he was about to leave when Baruda shouted:

[Wait!]