Chapter 49: Risk of Death if Left Unchanged (2)

‘Based on what you said… indeed…’

Suhyuk cocked his head as he watched the video closely.

The neurology resident had already lost interest and was making a phone call to the hospital room. It seemed like they were planning to administer medication quickly and complete the admission process.

“The range is narrow. There is a high possibility that unconsciousness is due to another cause.”

Meanwhile, Baruda continued to assert his thoughts to Suhyuk. His opinions sounded too convincing to dismiss as nonsense. Indeed, the range of possibilities was limited.

‘Then what could be the reason?’

“It seems impossible to confirm with just an MRI scan. The information is restricted. I request prioritizing other tests.”

‘Other tests.’

[It would be better to first list other organs that could cause unconsciousness.]

‘Hmm.’

Suhyuk momentarily frowned. Anyone observing him might find it strange. In fact, visiting a patient unrelated to him was quite peculiar since university hospitals were incredibly busy places where everyone focused solely on their tasks. Yet here he was, looking displeased while reviewing images with already known results. Fortunately, no one paid attention to Suhyuk.

The radiographer was concentrating on a patient nearing the end of their examination, and the neurology resident remained engrossed in their phone call, seemingly struggling to secure a hospital room due to Taehwa Medical Center’s high demand.

‘Organs that can cause unconsciousness… Heart?’

“Yes, we cannot overlook the heart.”

However, there was no mention of pain in the patient’s chart.

“The case presented by student Suhyuk earlier also had non-specific symptoms.”

‘Well, well, that is true. Hmm.’

It seemed they needed to examine the patient’s heart further. Of course, the patient already wore a device monitoring their heart rate, but it only provided real-time data without much additional information.

“Excuse me, Dr. Hwang.” With some hesitation, Suhyuk managed to speak up.

The resident, still on the phone, turned towards him with a slightly annoyed look.

“What is it?”

“By any chance, have you performed an electrocardiogram for this patient?”

“Electrocardiogram? Most likely.”

In university hospitals, performing an ECG was routine practice in emergency rooms.

Even if it wasn’t immediately critical based on their judgment, residents typically conducted an EKG as part of standard procedure.

It seems they haven’t checked yet.

“We need to verify this ourselves. Alternatively, we can perform another test.”

Wouldn’t the intern have alerted them if there was something unusual?

Suhyuk felt slightly discouraged by the neurology resident’s dismissive attitude and turned to Baruda for advice. However, Baruda remained firm.

“Think back to your time as an intern. Were you considered a doctor then?”

I am indeed a licensed physician recognized by the country!

“Now compare that with who you are today. Would you consider yourself an intern now?”

Ahh, well…

Although Suhyuk had been a resident for only a few months, there was a stark difference between his current role and following orders as an intern.

Suhyuk’s growth wasn’t solely due to Baruda’s assistance. The skills of his fellow residents were improving rapidly as well.

‘An intern cannot… be underestimated.’

[Yes, you can consider them clueless.]

‘That sounds too harsh. You’ve been using strong words since earlier.’

[Why are you defending Suhyuk when he isn’t even an intern anymore?]

‘Well, until recently, I was still an intern.’

Psychologically, there were times when Suhyuk felt unsure if he should identify as an intern or a resident. Baruda neither understood nor cared about Suhyuk’s feelings, deciding to simply ignore them.

[In any case, we need to perform an ECG or at least check her condition further.]

‘Hmm.’

Baruda’s opinion resonated with Suhyuk to some extent.

Suhyuk looked up at the resident again. Fortunately or unfortunately, his expression seemed better than before. It appeared that things were progressing well regarding the patient’s admission to the hospital.

However, it might all fall apart.

With this thought, Suhyuk cautiously spoke.

“Sir. Have you seen the patient’s ECG?”

“Huh? No.”

As expected, the resident had not reviewed the electrocardiogram. The neurology resident came down primarily due to the patient’s unconsciousness and neurological symptoms. From the moment he decided to focus on the brain, the heart was no longer a priority for him. Hence, he wore a puzzled expression.

The diagnosis of stroke had already been made for this patient, making the ECG examination less urgent.

To put it bluntly, it could have been checked tomorrow morning.

“Then you should take it now. The examination is finished…”

However, Suhyuk had no intention of backing down. He was convinced that the cause of the patient’s unconsciousness wasn’t a stroke. If not a stroke, there must be another reason, and the likelihood of it being related to the heart was extremely high. Suhyuk believed confirming this would significantly impact the patient’s prognosis.

“The examination is done, so we need to administer medication and move the patient back to their room immediately! What do you mean by suddenly requesting an ECG? You’ve seen the images, right?”

Naturally, the neurology resident had no intention of conceding either.

Moreover, I believed that it was best for the patient to immediately start treatment for stroke rather than waste time on additional tests.

“Still, we need to confirm this. The stroke area is small! It isn’t enough to cause unconsciousness!”

Furthermore, Lee Suhyuk’s words touched upon his pride. No matter how excellent of an Internal Medicine resident Lee Suhyuk might be, he belonged to internal medicine, not neurology. Yet here he was, presumptuously lecturing someone from the field of neurology. While Dr. Hwang could’ve overlooked it if Suhyuk had less experience, as a senior doctor himself, he found it utterly unacceptable.

“Mr. Lee Suhyuk. Are you a neurologist now? How dare a first-year Internal Medicine resident try to teach a third-year neurology resident?”

“I wasn’t trying to teach… Just look at it. Isn’t the range narrow?”

“Does the range matter for cerebral infarction? The location is important.”

“But…”

“It’s not your patient anyway, Dr. Lee. Neurology will handle this. Please leave now.”

The neurology resident forcefully pushed Suhyuk out of the room after these words.

In the past, Suhyuk might have tried to stop them somehow, but with his leg bothering him now, he couldn’t do anything.

Slam!

All he could do was stare at the firmly closed door.

[Tsk, what a temper!] Baruda chuckled as if disapproving of Suhyuk’s reaction.

However, Suhyuk couldn’t understand this reaction at all.

‘If someone junior to me from another department was being stubborn, I would be annoyed.’

Honestly, considering the resident’s response now, it could have been worse. Others might have addressed him informally or even kicked his shins.

“I’m not nagging. I am just stating facts. Don’t you think he knows already? His range is insufficient.”

‘In any case, this cannot continue. Hmm.’

Suhyuk lacked the courage and strength to open the door again.

‘My cane is inside though.’

[Tsk…]

‘It’s because you got injured during your explosion!’

[Who said that? It simply didn’t work out, that’s all.]

‘That wasn’t the tone of your voice?’

[Anyway. Are you going to leave it as is?]

‘No.’

Suhyuk quietly shook his head at Baruda’s words. Then he put his hand into his gown pocket and took out his phone. Seeing this, Baruda opened its mouth with a strange tone:

[Do you realize how despicable you are right now?]

‘So what? You want me to take your ECG?’

[I should be taking it.]

‘Then stay still.’

Kang Hyeok swiftly subdued Baruda before calling the director.

“Hey, Suhyuk.”

Lee Hyunjong, who had mentioned attending a meeting earlier, hastily answered the call.

He said meetings were often half-hearted…

Especially if the meeting was about money, he would almost cover his ears until it ended.

Suhyuk assumed today’s meeting was related to finances as he started speaking, “Yes, Dr. Lee. I am calling regarding the patient you mentioned earlier.”

“Oh, really? An urgent case?”

“No, it is not that… Just an ECG…”

“I understand, I understand! If there is a heart issue, I need to check!”

“Um, no…”

With a puzzled expression, Suhyuk looked down at his phone wondering if there was some confusion with the call.

Meanwhile, Lee Hyunjong used all his acting skills and hastily exited the conference room.

“W-Where are you going, Dr. Lee?” Shin Hyun-tae, the head of Internal Medicine who barely avoided deficits, tried to stop him but failed.

“A patient, a patient!”

How could anyone stop him when he was pointing at his phone and rushing out of the room? Moreover, if it were indeed Dr. Lee’s patient, they likely suffered from myocardial infarction.

“This time, is it a real emergency?”

Of course, Shin Hyun-tae remained suspicious. Lee Hyunjong had used fake patients as excuses numerous times before. However, Hyun-tae couldn’t risk checking who made the call.

“Department Head Shin, let’s not beat around the bush. What will you do about these deficits? We’re wiping out all the profits from the Gastroenterology and Hematology-Oncology Departments.”

Firstly, Hyun-tae himself needed to escape this barrage of criticism.

Amidst the chaos, Lee Hyunjong managed to safely exit.

‘What nonsense.’

“Did the stroke occur over there?”

Meanwhile, Suhyuk and Baruda continued their audacious and impudent speculations.

“Hey, Suhyuk. You’re back now. What happened?”

Naturally, Suhyuk’s imagination ended after Lee Hyunjong completed his act. In an instant, he returned to reality and thought about the patient. No, there was no need to recall it as Baruda presented the information neatly.

“It is regarding the patient you asked me to follow.”

“Oh, they are heading to the emergency room. Tell me while we walk.”

“Yes, Dr. Lee. The history of this patient is quite unclear. They were found unconscious and brought to the emergency room. However, since only three minutes have passed since confirming they are stable, the golden hour has not yet elapsed.”

“Continue.” Lee Hyunjong nodded at Suhyuk’s smooth note and started walking as usual. For someone over sixty years old, his gait appeared remarkably light. This alone demonstrated why he deserved to be appointed as a professor emeritus by the hospital.

“In the recent brain MRI, we observed cerebral infarction.”

“Oh, there is evidence of stroke?”

“Yes, but it isn’t extensive enough to cause unconsciousness.”

“So, it’s localized?”

“Yes. Not only is the affected area small, but compared to typical vascular occlusion-induced strokes, the boundaries appear quite unclear.”

“Aha. Is it diffuse?”

“Yes.”

Lee Hyunjong already had one diagnosis in mind, and it exactly matched what Suhyuk and Baruda were thinking.

“It seems to be right ventricular infarction. In this case, instead of chest pain, the main symptom would be decreased blood pressure…”

“In some case reports, there have been instances where reduced blood flow to the brain led to cerebral strokes. Wait. No, hang up and book a cardiovascular angiography suite immediately under my name. I’ll head straight to the emergency room.”

“Understood, Dr. Lee.”