Chapter 41: What else could it be? (3)

Medication. If it was medication, there could be side effects. Suhyuk reached this conclusion immediately, put down the chart, and rushed towards the monitor.

Tap.

Tap.

His speed wasn’t very fast despite running. Nonetheless, thanks to his actions, several nurses and surgical residents guarding nearby were able to safely escape by fleeing far away from him.

“Royals…right?”

“Yes, that’s right.”

“I’ve heard something about them too.”

While the nurses whispered amongst themselves, one of the surgical residents joined their conversation. The resident had an expression as if they knew something significant. In a hospital where there is little entertainment, gossip is always welcome. Consequently, not only the nurses but also fellows from other departments, standing at a distance, perked up their ears attentively.

“I’m from the same year as Kim Insoo in Internal Medicine. You know, the chief.”

“Oh, Doctor Kim Insoo.”

Kim Insoo was intimidating but always got things done. While opinions might differ elsewhere, he was universally appreciated within university hospitals. Many residents buckled under the immense workload, so nurses often trusted those who could handle it.

The resident hesitated momentarily, enjoying their attention before continuing.

“He mentioned something about cardiology next month?”

“Oh, get to the point! The main point!” One of the older nurses urged him along.

As she was among the most senior staff members, even the resident couldn’t help but be mindful of her presence.

It was natural as they had learned from her about patient care.

“Originally, Dr. Lee Hyunjong should have been his primary physician.”

“Huh?”

“No way?”

“They gave it to Doctor Lee Suhyuk.”

“Woah… He truly is the son.”

The rumors about Professor Lee Hyunjong were not limited to Internal Medicine alone. Various versions of legends circulated within Surgery as well. From a young age, he gained fame due to his exceptional talent and unique personality. In particular, his reputation among thoracic surgeons bordered on infamy because of their disagreements over whether open-heart or catheter-based procedures should be used for certain cases. It made sense that people referred to Suhyuk as ‘the son’ when considering he would serve as the first-year resident under such a figure.

“What are they whispering about…?”

On the other hand, Lee Suhyuk scratched his ear before finally sitting down on a chair. He looked at the surgical staff watching him but didn’t recognize any faces.

‘Do they like me?’

[The possibility of them liking you approaches zero, Suhyuk.]

‘But why are they whispering whenever I come here? They are hiding and talking.’

[Your hearing doesn’t reach that far, making it difficult for me to analyze.]

‘Useless.’

[U-Useless indeed!]

‘Anyway, check the medication properly. What is he taking?’

Ignoring Baruda’s ranting, Suhyuk moved the mouse to bring up patient Park Taesu’s chart.

[Antibiotics… Levofloxacin, Metronidazole, Ceftriaxone. There are three.]

‘What are the side effects of each?’

[Gastrointestinal disorders, kidney problems, liver damage, etc., may occur.]

‘Dementia?’

[There is no record.]

‘How do these drugs interact with each other?’

Drug side effects were often difficult to address individually, especially when multiple medications were administered simultaneously like this patient. Unexpected side effects could suddenly arise that weren’t observed with single drug usage.

[Based on my recorded data, there are no observed interactions.]

‘Can you give more specific clues instead of vague responses?’

[It’s due to insufficient data. Please make more effort.]

‘Eh, whatever. Let’s move on.’

Generally, severe side effects often stemmed from antibiotics, but it didn’t seem to be the case here.

It didn’t seem to be the case now. Thus, Suhyuk scrolled down further.

‘Laxix… Is it used as a diuretic?’

[The total amount of fluids administered during surgery exceeded 3 liters, but only 1 liter was excreted through urine. The chest scan also shows slight fluid buildup in the lungs.]

‘He is trying to balance the fluids. However, if that’s the purpose, he should have prescribed more. What’s with half an ampule?’

[Ah ah. Do not change prescriptions arbitrarily. He isn’t your patient.]

‘Oh, right.’

If the prescription significantly impacted the overall treatment plan, it might warrant intervention, but for minor adjustments, it was best to leave them as they were. Nevertheless, Suhyuk couldn’t simply ignore this situation. Therefore, he left a small note in the progress record:

[Overstepping…]

‘Shut up. Laxix is not the cause?’

[Based on the data review, there is no record of Laxix causing dementia.]

‘Then it’s not this one either.’

As each medication was ruled out, Suhyuk began to suspect that none of them were the cause. However, Baruda, being a machine, seemed unaffected by these thoughts and maintained its initial stance.

[I see you have prescribed anti-inflammatory painkillers for pain relief. Three times a day. The frequency is correct, but there are also no records of hallucinations as a side effect.]

‘Is it really not any of these?’

[There are still many medications left. Please continue reviewing them.]

‘Understood.’

Suhyuk nodded and examined steroids and other immunosuppressants.

However, as expected, nothing was confirmed.

At this point, another thought emerged.

‘Do I need to study more?’

Based on the circumstances, it seemed clear that there was a drug side effect. However, no matter how Suhyuk looked, he couldn’t find any mention of dementia in the data. Could Baruda be making an error? It didn’t seem likely at all.

In that case, the problem must lie with Suhyuk himself.

[Being cautious is desirable, but it isn’t suitable now. I recommend turning your gaze towards the monitor. You can’t see it otherwise.]

‘Even if I look, I won’t understand.’

[Please examine all the drugs before saying such things.]

‘Hmmm.’

Baruda, being machine-like, refused to give up. Once given an order, it appeared Baruda had to fulfill it.

Suhyuk also felt it would be a waste to leave without finding out more since he had come this far. Thus, he turned back towards the monitor and discovered another medication.

‘Using boriconazole?’

Boriconazole was an antifungal drug used to treat fungal infections. The primary reason for the patient’s surgery was due to Aspergillus, a type of mold infection, making this medication crucial.

[Three times a day. It seems to be taken after meals.]

‘The timing matches exactly.’

[I will analyze the data.]

‘Yes. Boriconazole… I distinctly remember studying about it.’

This medication might be unfamiliar to doctors treating general infections, as fungal infections are rare in patients with normal immune systems.

However, this was a university hospital. It was Taehwa Medical Center, considered one of the best hospitals domestically. There were numerous patients with cancer and rare diseases. To work here, doctors needed to be proficient in various antifungal agents. And now, Suhyuk could feel the rewards at this very moment.

[Boriconazole… there have been reports of dementia occurring in patients with decreased metabolism.]

‘Really?’

[Yes, it was written in a case report I read last week.]

‘But… decreased metabolism means…’]

[I believe it refers to patients with enzymes that metabolize boriconazole being reduced. This can be confirmed by conducting separate tests.]

‘Good. Currently, is this the most likely cause?’

“[Not just now, but there is close to a 100 percent chance that boriconazole is the culprit. Based on the circumstances and theoretically, it seems likely.]”

Hearing Baruda’s confident words, Suhyuk felt his own confidence surge.

‘Then I need to inform someone about this.’

He looked around thinking he should tell anyone nearby. At the same time, several people who were secretly observing Suhyuk quickly dispersed. However, one person was slow, unfortunately Kim Insoo’s friend.

“Sir.”

“Huh? Me?” Suhyuk blinked at being addressed with such formality unexpectedly. As far as he knew, the individual addressing him was a school upperclassman from their school. Typically, students from different schools used formal language towards each other, but within the same school, informal speech among peers was common.

It was common for school seniors and juniors to use informal language with each other.

“Upperclassman, I am Lee Suhyuk from the year below you. You can speak informally.”

“No, no… It’s different. Well, yes. What is it about?”

However, the surgical resident insisted on using formal language. Strangely, he saw similarities between Suhyuk and Lee Hyunjong. From some angles, they looked alike. No, their noses - their noses seemed identical.

‘My son… My son…’

The surgical resident appeared excessively stiff for someone talking to a first-year resident from another department.

“Uh…”

Suhyuk wondered why this person acted like this, but analyzing the psychological state of the surgical resident wasn’t his priority now. The important matter was how to handle this patient. If left untreated, chaos would likely ensue again within a few hours.

No, it would continue unless he stopped taking medication. Staying longer in the intensive care unit would only worsen his condition.

“Yes, Doctor. Regarding patient Park Taesu…”

“Huh? I don’t recall requesting assistance from Internal Medicine.”

The surgical resident desperately tried to remember if they had forgotten about cooperation with Dr. Choi’s son. However, that wasn’t the case.

“Oh… No, it wasn’t for cooperation. Every time he visits, he exhibits signs of delirium. It seemed unusual, so I decided to examine him once.”

“Ah…”

It dawned on me that this might be the reason behind informing the director.

‘Our Professor Ryu Jinsu… He hasn’t even completed two years as a full-time professor yet…’

As Suhyuk’s mind was about to drift away, he continued speaking, “It turns out there is a reason.”

“A reason?”

Did Suhyuk suspect some unprofessional behavior? Upon reflection, it seemed like they hadn’t given their best effort for patients in the intensive care unit.

Why does this person look so pale? Is it due to anemia?

[I think she might be overwhelmed.]

Overwhelmed by what?

[I’m not sure about that either.]

On the other hand, Suhyuk barely managed to hide his disbelief as he explained, “One of the side effects of boriconazole is dementia. Observing the patient’s dementia events, they occur at consistent intervals, suggesting a strong correlation with the blood concentration levels of boriconazole.”

“Huh?”

Finally, the resident realized Suhyuk was approaching this from a different angle.

‘He is diagnosing the patient’s dementia…as a drug side effect? And he is just a first-year?’

Suhyuk wasn’t like Lee Hyunjong from Cardiology or Dokgo Dae, Professor Jung Moonhyun from Infectious Diseases. The resident initially thought it sounded unreasonable.

However, after examining the intensive care unit chart and prescription history provided by Suhyuk, it seemed plausible. Moreover, when Suhyuk presented a case report he had read last week along with its printout, there was no denying his theory.

“Uh…wait a moment. I’ll notify the professor.”

“Yes.”

“Oh, can you stay here until they arrive? It might be difficult for me alone.”

“Ah, yes. I will wait right here.”