Chapter 44: What Kind of Question is This? (2)

[Brrm…]

Baruda murmured as he looked at the red dot. Suhyuk had done it, and surprisingly, Hayoon did it too.

“Indeed, you’re different from others, upperclassman.”

“Huh?”

Hayoon’s random comment made Suhyuk look away from his foot for a moment towards her.

Hayoon continued while still staring at his foot.

“My dad mentioned that this problem will be on the second semester exam.”

“Oh…”

“So even though I know all the problems, I am confused by this one.”

It seemed like she wasn’t told about the answer beforehand.

‘These professors…’

They could have informed their children, but they chose to keep it secret. There was a reason why there were phrases such as ‘celebrity disease’ or ‘academic disease’.

“He told me to pay attention here.” Hayoon continued without realizing Suhyuk’s thoughts. Hearing this, Suhyuk was convinced that his hunch was correct.

‘See! Did you hear that? This is crucial.’

“I am not sure about this. It truly is non-specific. These pulses…”

Non-specific. It was one of the phrases medical professionals hated most.

‘Ah, the patient’s symptoms are non-specific.’

It was often used like this. While it sounded professional, it essentially meant ‘I don’t know what’s wrong with the patient’.

‘This idiot.’

“No… They really are non-specific. There are no distinguishing features.”

‘Nope. No way.’

As Baruda repeated the word ‘non-specific’, Suhyuk suddenly shook his head vigorously.

As Suhyuk moved his head abruptly, Hayoon narrowly avoided hitting her forehead against him as she was leaning quite close to him.

“Oh.” Taken aback, Hayoon retreated backward and stared at Suhyuk, who appeared frozen in place. It seemed he wasn’t even aware that he almost hit her.

I’ve heard sometimes he’s odd.

Professor Woo Changyun had asked her to meet with Suhyuk initially but hadn’t mentioned him since then. Given Professor Woo Changyun worked at another hospital and had a busy schedule, it couldn’t be helped. Instead, Taejin Jo, being both a colleague from their hometown and schoolmate, would occasionally bring up Suhyuk when they talked during idle moments.

“He can be somewhat strange at times, but he truly is a genius, right?”

And every conversation about Suhyuk invariably started with “He can be somewhat strange at times.”

‘Indeed, he is slightly odd.’

Hayoon observed Suhyuk with fascination as he remained motionless for several minutes. Of course, his mind was not idle during this time.

He mentioned it wasn’t specific. Keep going.

[Yes. It isn’t specific because…]

‘But can’t we consider that lack of specificity itself a characteristic?’

[Pardon me? The absence of specificity…is its characteristic…?]

‘Exactly. As you said, the patient’s pneumonia is severe. However, severity isn’t the cause here. Ultimately, our main focus should be on the rash.’

[That…that’s true.]

In internal medicine, what mattered most was not ‘how’ the patient ended up in their condition but rather ‘why’. To determine this, one needed to trace back to the earliest symptoms.

To do this, they needed to look back at the earliest symptoms.

‘Where does non-specific rash primarily appear?’

Suhyuk redirected Baruda’s attention with this question. They had worked together on numerous diagnoses until now, but this was their first time encountering such a situation. As a result, Baruda momentarily showed signs of confusion. Of course, these emotions were only occurring within Suhyuk’s mind.

‘Don’t get distracted.’

[N-No. I am not. Sorry, Suhyuk.]

‘I asked where non-specific rashes usually appear.’

[Rashes can occur due to contact with substances that cause irritation, even if it isn’t an allergic reaction.]

That was true, but it wasn’t the answer Suhyuk sought.

‘I mean besides that.’

[They can also appear during high fevers.]

‘Nope. It isn’t all over his body. Primarily, it is appearing at the joints.’

If Baruda were human, it would have been annoyed by now. However, Baruda was an artificial intelligence designed for diagnosis purposes.

[Umm… Non-specific rashes can also occur due to drug allergy reactions.]

‘Yes. That explains the rash on his entire body.’

[However, based on Suhyuk’s description, we need a reasonable explanation for why there was no initial itching associated with the rash.]

‘The patient is elderly.’

[Rashes in elderly individuals can often present non-specifically. Hmm.] Baruda momentarily fell silent. Despite having access to vast amounts of data, its understanding of medicine was still far from comprehensive. Unlike machines, human bodies varied greatly among individuals.

Several minutes passed before Baruda spoke again.

[Considering Drug Rash with Eosinophilia and Systemic Symptoms (DRESS),… many symptoms can be explained.]

Drug reactions were not limited to skin rashes. Depending on the situation, it could cause various problems such as fever, enlarged lymph nodes, hepatitis, nephritis, eosinophilia, etc., leading to multi-organ failure experienced by the patient now.

[However, the treatment for DRESS is steroids. If the diagnosis is incorrect, i.e., if the patient has an infectious disease, it could lead to irreversible consequences.]

‘That’s correct.’

Steroids had the effect of suppressing all inflammatory responses.

Thus, if this drug was used for allergies, it would be considered one of the best medications in the world. However, using it during an infection could be worse than administering poison. It would allow viruses or bacteria to consume a person alive.

‘What should I do then? Yet, it feels wasteful not trying at all.’

[Hm.] Baruda closed its mouth again. It seemed to be analyzing something. Finally, Suhyuk could look away from Baruda’s face.

He noticed Woo Hayoon staring at him with surprise written on her face.

“Ah. Sorry about that. When I concentrate…”

“It’s okay. Professor Taejin Jo told me.”

“Oh… You saw Professor Jo?”

“He occasionally visits our home.”

“I see…”

In moments like these, Suhyuk felt Woo Hayoon’s privileged background as a Royal. Having professors casually visit their house was beyond his imagination. As envy started creeping up within him, Baruda interrupted his thoughts.

As someone who grew up as an orphan, Suhyuk couldn’t even imagine such a scenario. Just as envy started creeping into his mind, Baruda interrupted him.

[Let’s perform a tissue examination.]

‘Tissue…examination?’

[Yes, for your rash.]

‘Ah! If eosinophils appear there, it would confirm my diagnosis.’

[Correct. Until we have those results, it is best to continue antibiotic treatment. The lung issue might be due to medication, but it is too severe to stop now without confirmation.]

‘Indeed.’

Suhyuk nodded in agreement. As Baruda suggested, the chest x-ray looked too ominous to abruptly halt the antibiotics. It was so severe that he wondered how they could save him if it worsened further.

In any case, the final examination and results were decided.

“Firstly, it is better to perform blood culture, sputum culture, PCR, and tissue tests on the rash.”

Suhyuk didn’t silently press ‘OK’. Instead, he spoke towards Hayoon. Naturally, her eyes shone with curiosity about the last test.

“The rash?”

“Yes.”

“If you do a tissue test… What can you find out?”

From her question, she seemed to have never suspected this before. It was understandable. Lee Hyunjong had dug a pitfall at the forefront of their current situation, making them believe that the rash wasn’t due to side effects from the drug.

“If there is an increase in eosinophils, we could suspect drug-related side effects.”

“But…”

“Let’s try it first. How many lives do you have?”

“Yes. Five.”

“Huh? You have lives? We didn’t have any.”

“Back then…someone manually pressed all of them, and as a result…they appeared.”

“This is crazy.” Suhyuk forgot about Hayoon’s presence and cursed out loud.

However, Hayoon wasn’t bothered by it. When she was alone, she had also uttered curses several times.

“What kind of lives are these for a PBL? How many do you have left?”

“One…left.”

“One. Huh.”

It meant this would be his last chance if Suhyuk failed again.

[Think of it as actual combat. In any case, you won’t make better decisions than the one you just made.]

As he felt despondent, he heard Baruda’s words. As always, they were designed to encourage him with regards to patient care.

‘Yes… Let’s try it. I can’t think of any more logical answer.’

Through his discussion with Baruda, Suhyuk completely agreed with this diagnosis and treatment plan. He looked back at Hayoon with confidence.

“This is correct.”

“Mm.”

Hayoon observed Suhyuk for a moment before nodding her head.

“Yes, upperclassman. If I did this alone, I would have made mistakes, and the patient might have died.”

“Good. Then let’s choose these options. We will perform this test. For treatment, we will initially add Teicoplanin and do dialysis until the results come out from the tests.”

“Yes.”

Once they completed their selection, a sand timer appeared on screen. Next to the sand timer, there was a doll representing the patient along with vital signs.

“If… this choice is wrong, she will suddenly worsen and die.”

“Evil never comes alone…”

“Yes. It really feels creepy.”

“Do you think it’ll happen immediately?”

“No. Maybe three days?”

“In three days… We won’t have results from the culture test by then.”

As Suhyuk said this, one day had passed. As expected, only one result appeared - the tissue examination for the rash. The culture test would take several more days to complete. Before the results were available, the patient would undoubtedly die.

“Let’s see…” Suhyuk quickly clicked on the tissue examination result. Hayoon leaned forward towards his tablet screen.

As they focused on their work, Suhyuk and Hayuni leaned closer together until they were sharing each other’s breaths without realizing it.

[Baruda observed moderate infiltration of lymphocytes and eosinophils around the blood vessels.]

Suhyuk was completely absorbed in his conversation with Baruda.

‘I was right.’

[Yes. It is due to the reaction from medication.]

‘I nailed it.’

[You seem quite pleased.]

‘Why aren’t you arguing with me?’

[I couldn’t analyze that aspect before.]

‘Damn. Anyway, let’s add steroids to the medication. Do not stop the antibiotics.’

[Agreed. That would be best.]

Having made this decision internally, Suhyuk opened his mouth.

“It seems like an allergic reaction to medication, correct?”

“Ah… This eosinophil count… Is this how it works?”

Hayoon didn’t have the same rigid manner as other professors since she was still a student. Suhyuk chuckled, reminiscing about his own innocent past.

“Yes. That’s why we should use steroids.”

“Oh… Yes. Right. Since I would’ve died anyway.”

“Well then, let’s proceed with the treatment.”

Suhyuk made the decision for Hayuni, who hadn’t fully grasped the situation yet. As he did so, the hourglass appeared again, and the next day arrived.

“You’re feeling much better now, right?”

“Wah… My lungs feel improved too!”

“Exactly. Now that we’re certain, let’s stop the antibiotics and switch to steroids.”

“Yes, upperclassman! Thank you so much, truly!”