Chapter 40: What else could it be? (2)

Delirium usually occurred at night. However, this wasn’t Cinderella with a fixed time for its arrival. It was particularly strange when it happened at an ambiguous hour like 2 am as it did now.

Suhyuk looked down at the patient who had completely passed out while he was deep in thought, conversing with Baruda as usual.

‘2 am…’

[Bio-rhythms that you just considered will not be taken into account.]

‘Didn’t I think it was absurd and avoid mentioning it?’

[I find it strange though. Delirium occurring at the same time. Could there be any periodic events?]

‘Hmm.’

Suhyuk briefly closed his eyes to recall the schedule of the intensive care unit.

‘Firstly, visitation hours should be at fixed times.’

[A patient with delusions about his wife sees her during designated visiting hours… Is there any connection? It seems quite forced.]

‘Yes, it is quite forced.’

Why were these delusions considered as such?

They lacked any realistic plausibility, so they were deemed delusions. One shouldn’t assume that because a husband had delusions of his wife cheating, he must have always suspected her fidelity.

‘Visitation?’

[Indeed, visitation.]

In reality, a survey conducted among patients who experienced delirium while admitted to intensive care units revealed some shocking responses. Many perceived nurses and other medical staff moving nearby as demonic entities intent on tormenting them.

From this perspective, it made sense that rounds could be considered the starting point for delirium.

‘However, the probability is low. What else could it be?’

[I cannot grasp any clues.]

‘Hmmm…’

Suhyuk looked down at the patient with confusion. No matter how hard he stared, there was no answer. It just frustrated him further.

Hours later, after completing his rounds amidst these frustrations, evening arrived.

[Firstly, I recommend going up to study and sleep. Thinking more will not change anything.]

‘Right. I need to research more about delirium.’

[A splendid idea.]

Anyone who has taken a test once would understand this fact: dwelling on an unknown question serves no purpose. It only wastes time, especially when one has ample opportunity to study, as Suhyuk did now.

It was simply a waste of time, especially when he had ample opportunity to study like now. Thus, Suhyuk and Baruda headed towards the on-call room.

The on-call room was empty.

‘Strange. I heard it wasn’t usually this quiet.’

Oddly enough, Suhyuk continually found himself alone in the room. Whenever he entered the bustling on-call room, others gradually moved to different rooms.

[Better for you, isn’t it? Good for studying as well as sleeping.]

‘Indeed, it is.’

Sleeping in a crowded on-call room presented numerous issues. Firstly, every call to another doctor would wake him up. Additionally, their constant snoring could be unbearable, making it impossible for sensitive individuals to sleep at all.

One might suggest using earplugs, but then he wouldn’t be able to hear any calls. It was almost like hell.

‘Somewhere…envy arises…’

[Please watch something other than what you’ve seen before.]

‘I have already watched textbooks.’

[Then, you can view academic papers.]

‘Wow…already academic papers…’

[Others usually start reading academic papers during their fourth year of university.]

‘Indeed.’

Suhyuk tried to ignore Baruda’s words and began searching for academic papers. In the past, finding these papers would have been challenging, but his recent experience made him quite adept at it. Thanks to this, he quickly managed to bring up dozens of articles on his screen.

‘Hmm…’

[Hm…]

‘Uhmmm…’

[Huhm…]

However, none provided particularly valuable insights.

Delirium occurring at exactly 2 PM every day - there was no paper dealing with this phenomenon. Eventually, Suhyuk had to sleep without resolving his curiosity.

‘If I consider it as fluctuating vital signs, it is terrifying.’

In that case, the patient might already be dead.

[Therefore, we need to accumulate more data on a regular basis. We still have much to learn.]

‘Well…that’s true.’

Despite being only one year into his residency, he was doing well, but indeed, there was still a long way to go.

‘Nothing will happen overnight, right?’

[It is still possible that it could be simple delirium.]

‘Do you think so?’

[No, we must assume there is no coincidence in medicine.]

‘Indeed. Hmm… What could it be…?’

A recurring delirium at a fixed time each day.

What could it possibly mean?

With these thoughts swirling in his mind, Suhyuk finally drifted off to sleep.

The next day, after waking up and completing his routine morning rounds, Suhyuk immediately headed to the intensive care unit.

‘Today’s rounds were truly short.’

[This is the first time I’ve seen such perfunctory rounds.]

The endocrinology team consisting of Seo Hyoseok, Kim Jinyoung, and Hwang Sunwoo was essentially a chaotic party. No one bothered to carefully examine their patients.

Understanding why Kim Jinyoung acted this way made sense as he had been demoted from chief during his third year. It wasn’t originally his responsibility, so it must have annoyed him greatly.

But what about Hwang Sunwoo?

‘He didn’t even notice that all prescriptions were changed due to potential drug interactions.’

[I don’t think he conducts independent rounds either.]

‘Yes… That’s why I’m doing them. I… somehow ended up…’

Strictly speaking, Suhyuk wasn’t naturally overflowing with enthusiasm for work. However, he possessed at least a minimum level of professional responsibility.

However, there was no change with the others.

[Still, you should observe Suhyuk. Aren’t you glad that he has fewer patients to handle?]

As a result, Suhyuk now managed all of Professor Seo Hyoseok’s admitted patients by himself. If there were more patients, it would have been overwhelming for him. As Baruda mentioned earlier, the number didn’t exceed ten. This was because Seo Hyoseok constantly bounced patients between different departments, and other departments stopped sending patients directly to him. Even the emergency room staff understood this, ensuring they usually admitted patients under other endocrinology professors instead of Seo Hyoseok, minimizing notifications for him.

‘Well… indeed. Can you believe such people exist?’

[Compared to them, Suhyuk is truly an exceptional doctor. I acknowledge that.]

‘Comparatively? Why did he give such a clue?’

[I believe you know the reason better than anyone else.]

Suhyuk entered the elevator along with Baruda’s sarcastic remark.

There was a hidden elevator at each hospital ward corner. During meal times, trays filled with food were transported using this elevator. Naturally, patients and their guardians had no idea about its existence. Moreover, professors rarely used it since they had dedicated elevators leading to their research areas. This meant that there was a way for private transportation within the hospital.

Ding.

However, the professor who boarded on the fifth floor was well-known to Suhyuk.

“Oh. Our Suhyuk. Where are you heading?”

It was Professor Shin Hyun-tae immediately.

‘Ah… The director’s office is on the fifth floor…’

It seemed he had been chatting with Professor Lee Hyunjong again. Perhaps, he was heading to the outpatient clinic on the first floor.

“Hello, Manager An. I am going to the intensive care unit.”

“The intensive care unit? Don’t they usually assign it to someone who has completed one year? It isn’t Professor Seo?”

“No, not at all. The patient with insulinoma was transferred to surgery, so I just check up on them daily.”

“Ah… That makes sense as you were their primary physician. Suhyuk, your attitude is commendable.”

“Not at all, Manager An.”

“Yes. Then take good care of them. If there are any difficulties, let me know.”

“Yes, professor.”

Suhyuk descended towards the third floor.

No, he tried to descend.

If Shin Hyun-tae hadn’t pressed the open button…

“Ahh. Wait a moment.”

“Yes, Professor?”

“You’re going to cardiology next month, right?”

Cardiology…

It could be considered as one of the most dreaded schedules among residents. Not only were they dealing with the dynamic organ known as the heart, but also the temperamental professors who had spent their entire lives studying this dynamic organ. They were regarded as the wildest individuals within Internal Medicine.

“Yes, Professor.”

“Do you know that usually second or third-year residents serve as Dr. Choi’s primary physician?”

“Yes.”

Among them, Lee Hyunjong stood alone at the top. His remarkable achievements were so significant that no one dared to question him. After all, he was the man who revolutionized cardiology textbooks worldwide. Losing such a person would undoubtedly be detrimental to any hospital.

“If I become his primary physician, it’ll truly be hell on earth…”

There was even a term called ‘Cardiovascular Diet.’ Working under Lee Hyunjong caused doctors to lose weight rapidly each day.

‘I’m feeling uneasy…’

Suhyuk looked at Shin Hyun-tae with disbelief on his face.

On the other hand, Shin Hyun-tae appeared incredibly excited.

“The director mentioned that Suhyuk would be the primary physician this time.”

“Ah… Yes, Professor.” Suhyuk hesitated momentarily before vigorously nodding when prompted by Baruda’s shout. The decision had already been made by the director, and it wouldn’t be wise to question it further.

“He usually performs stenting procedures with Jo Youngsool, right?”

“Yes, I’ll prepare myself beforehand.”

“Yes. What is this about? Recently, he has become interested in arrhythmias.”

I didn’t expect someone over sixty years old to develop new interests. Suhyuk’s mouth dropped open in surprise.

“You should study it beforehand as well. Expectations for you are really high? Even mine too. Study hard so that you don’t disappoint him.”

“Ah, yes. Professor, I will keep it in mind.”

“Good. Keep up the good work.”

“Yes sir.”

With these not-so-good news left behind, Shin Hyun-tae descended downstairs. Suhyuk couldn’t leave even after the elevator door closed.

‘Lee Hyunjong’s primary physician…’

He was a legendary attending physician who even second-year residents feared due to his meticulousness and strict nature.

To think that he would be responsible for this during his first year and on his initial rotation.

[Isn’t it good news? Based on my analysis, Lee Hyunjong likes Suhyuk.]

‘That… That could change this time. Observing someone else’s patient is different from treating your own.’

[Just study diligently. It is fortunate.]

‘All you say is study, study…’

As Suhyuk conversed with Baruda, there was commotion inside the intensive care unit. The door was closed, making it difficult to hear exactly what was happening, but he managed to catch a few words like ‘wife’ or ‘affair’.

‘Again?’

[I will go immediately!]

Suhyuk quickly moved while leaning on his cane.

However, walking was much slower than running, so by the time he entered the intensive care room, the situation had already ended. The patient had collapsed after receiving a sedative.

“[9 o’clock. It is similar to yesterday morning.]”

‘During both morning and evening times?’

[No. There was also an event at 2 p.m. yesterday. It seems certain that there will be one today at 2 p.m. In other words, events occurring at regular intervals during breakfast, lunch, and dinner seem strongly related to the patient’s delirium. What could it be?]

‘Hmm…’

[Food?]

Food was eaten three times a day at fixed hours. But would this cause delirium? It didn’t make sense.

‘Nope. That can’t be it. Besides food, something else happens at set times… Ah.’

[Medicine?]

‘Yes. Medicine. It might be due to side effects of the medicine!’