Chapter 56: The Conference (I)

Lee Hyunjong wanted to head straight to the conference venue immediately if possible. However, it was a tradition for the fall conference to be held during the weekend before Chuseok, so even Lee Hyunjong had no choice but to wait patiently despite his eagerness.

“Finally, finally!”

Thanks to this anticipation, Lee Hyunjong arrived at the hospital lobby early in the morning with a gleeful expression as he boarded the bus. He looked like an excited third or fourth grader going on a field trip.

“Director, please maintain some dignity.” Unable to stand watching any longer, Shin Hyun-tae grabbed Lee Hyunjong’s arm and made him sit down.

“What? You wouldn’t understand how much effort I’ve put into this conference.”

“I know everything, boss. Suhyuk really suffered a lot because of you…” Shin Hyun-tae glanced back at the bus behind them as he spoke.

In smaller departments, they might rent one bus for academic conferences, but Taehwa Medical Center’s Internal Medicine department required three large buses due to its size. Even with some members staying on duty and others traveling separately, it was still quite a sizable group.

‘Poor guy… To be stuck with Lee Hyunjong, of all people…’

Suhyuk’s face popped up in his mind whenever he closed his eyes. It wasn’t surprising considering how often Suhyuk had been summoned to the director’s office to rehearse his presentation. The astonishing part was that despite Lee Hyunjong constantly changing the script, Suhyuk managed to memorize the updates flawlessly each time.

‘A genius is truly a genius.’

And at Suhyuk’s request, this genius was not on Lee Hyunjong’s bus but rather the last one.

‘Ah, damn…’

Suhyuk thought there would be no more landmines once he arrived here.

“I didn’t expect Taejin Jo to show up.”

‘Seems like he’ll keep talking throughout the trip… I barely slept due to being on-call duty yesterday.’

Unfortunately, Taejin Jo, who arrived late, spotted Suhyuk boarding the third bus. Since Professor Taejin Jo openly pursued Suhyuk now, without hesitation, he followed Suhyuk onto the same bus despite the manager’s notice for all professors to board the first bus.

“Hey, Suhyuk. Eat this. It’s half-boiled and tastes amazing.”

“Oh, thank you, Professor.”

Moreover, Suhyuk had become somewhat of an outcast among the residents recently. This was natural since either Director Noh Sang, Manager Kim or Taejin Jo constantly surrounded him. Although he wasn’t ostracized outright, no one wanted to sit next to him. Consequently, the seat beside Suhyuk remained empty, which Taejin Jo naturally claimed as his own.

“Woah. You peel eggs well too. Is there anything you can’t do?”

“Ah… No, it is just…”

Taejin Jo continued praising Suhyuk with absurd reasons before suddenly starting to search through his pockets.

His phone rang with a number from the hospital.

“Damn it. They know I’m attending the conference.”

Despite his grumbling, he hurriedly answered the call. As a professor at a university hospital, especially within the Hematology-Oncology Department dealing with numerous critical patients, this was inevitable. It was both his destiny and burden.

“Taejin Jo of Blood Type here.”

“Professor, it’s Kim Insoo, third-year resident.”

“Oh, Insoo? What’s wrong? We’re supposed to be at the conference. Why are you at the hospital?”

Kim Insoo should currently be serving as a third-year chief resident. Taejin Jo favored him due to his intelligence and diligence compared to other residents of the same year. Perhaps because of this fondness, Taejin’s tone softened noticeably.

“I’m on call tonight and will head down tomorrow morning since I don’t have any presentations this time around.”

“Oh… So you’re taking it easy for once as a third-year chief resident.”

“Yes, my apologies.”

“No worries. But why…?”

“There’s a patient who came to the emergency room for follow-up with you, Professor. Kim Sungwon, male, age forty-two, diagnosed with myelofibrosis. He presented with abdominal pain, so I thought you should be aware. Also, he mentioned that you know him personally, is that correct?”

“Oh…”

Taejin couldn’t forget a patient named Kim Sungwon. The man had visited the outpatient clinic just a few days ago. Moreover, he wasn’t just any patient but Taejin’s high school classmate. Although they hadn’t been particularly close during their school years,

Since their initial meeting as patient and doctor, they occasionally had lunch together. It was quite unique for them to reconnect after over twenty years of no contact due to this doctor-patient relationship. Additionally, myelofibrosis is not an easy disease to manage.

“Yes, he’s an acquaintance. But did he come in with abdominal pain?”

“That’s right.”

“Hmm…”

Myelofibrosis encompasses various conditions depending on its extent, and Kim Sungwon’s case was idiopathic myelofibrosis. The prognosis tends to be poor, and for Sungwon, his life expectancy was estimated at approximately five more years.

Has something else gone wrong?

Taejin Jo expressed his concern for their friend to Kim Insoo.

“What tests have you done so far?”

“We’ve run blood tests first and plan to do a CT scan of the abdomen next.”

“Oh, okay. Good thinking. Once you get those images, please send them over to Radiology immediately for interpretation.”

“But I heard there’s a three-day abdominal imaging conference starting today, and none of the professors will be around.”

“The AIC?”

“Yes.”

“Ah, man.”

Autumn posed this kind of problem as all the conferences that took summer breaks resumed simultaneously, often leading to overlapping schedules.

Should I disembark here myself?

He regretted it now, but the bus had already left the hospital behind.

Moreover, Taejin Jo had to give a presentation shortly after arriving, so he couldn’t leave early.

“Firstly, you need to film it. Film and send me the footage. Understood?”

“Yes.”

“If there is a clear diagnosis, proceed accordingly.”

“Yes, Professor. I will handle it as per your instructions.”

“Oh, right. Thank you.”

Taejin Jo nodded and ended the call.

Meanwhile, Suhyuk was discussing the conversation between Taejin Jo and Kim Insoo with Baruda.

‘Myelofibrosis of unknown origin?’

“The official name is chronic idiopathic myelofibrosis.”

‘I am familiar with the patient, Kim Sungwon.’

“[He seems to have been digitized].”

Suhyuk had been rotating through various departments and returned to the Hematology-Oncology Department once again. Normally, he should have moved on to another professor, but due to rumors of Taejin Jo’s eccentric behavior at faculty meetings, including lying down on the floor, Suhyuk found himself back under his supervision.

Naturally, this included attending Taejin Jo’s outpatient clinics. With Suhyuk’s ability to store information as data rather than relying on memory, he had Kim Sungwon’s medical records readily available.

Since Sungwon is quite young, I suspected it might be something else, right?

[Yes. It is a rare condition typically appearing after age 50, so the patient’s youth raised suspicions.]

‘But it wasn’t anything else. What treatment were they pursuing?’

Originally, idiopathic myelofibrosis was considered incurable.

It wasn’t that treatment was unnecessary; rather, there was no available cure. Treatment primarily focused on managing symptoms as they arose. In other words, this disease required ongoing management until ultimately, patients had to be helplessly sent off when their time came.

“Suhyuk, do you remember patient Kim Sungwon?” Just as Suhyuk was about to respond to Baruda’s question, Taejin Jo interjected.

Naturally, Baruda closed its mouth, and Suhyuk shifted his attention to Taejin Jo.

“Yes, he visited your outpatient clinic last week.”

“Did he complain of abdominal pain then?”

“He mentioned occasional discomfort but nothing severe.”

“But today, he ended up in the emergency room. Hmm.” Taejin Jo began pondering whether he might have missed something crucial.

Simultaneously, Suhyuk and Baruda engaged in a deep discussion on a similar topic.

‘Is abdominal pain possible with myelofibrosis?’

[Yes, it is possible. As the spleen enlarges, pressure can occur.]

‘Ah, yes, the enlarged spleen.’

Myelofibrosis referred to a disease where bone marrow becomes fibrous, preventing proper blood formation. Consequently, extramedullary hematopoiesis increased significantly, and one of the organs responsible for this process was the spleen. However, rather than treating the condition, it often exacerbated symptoms. The primary issues included abdominal fullness or pain, but occasionally, it could lead to fatal complications such as splenic infarction.

‘Wait, didn’t they remove their spleen because of this?’

[According to the records, the patient had their spleen removed a year ago. So, the abdominal pain cannot be due to the spleen.]

‘Huh, then what?’

[The patient has a history of long-term steroid use for anemia symptoms.]

‘Steroids…’

Steroids could be considered similar to magical potions. In reality, they were used as a definitive treatment for various diseases. Even without steroids, myelofibrosis patients received them for treating anemia. However, side effects could always be problematic, especially with long-term use.

“Could there be an infection?”

It seemed Taejin Jo had a similar thought, mentioning one of the steroid complications, infections. Suhyuk passionately nodded, as his mind was already heading in that direction.

“Yes. It is possible.”

“When will the test results come back? I’m curious. Oh.” As Taejin Jo started grumbling, his phone rang.

He muttered that Kim Insoo was not a gentleman as he answered the phone call.

“H-How is it?”

“I have sent you the video and blood test results.”

“You’re talking about CT scans?”

“Yes.”

“What do you think?”

“There is narrowing of the ileum with observed masses on the intestinal lining. It appears to be tuberculosis. The Radiology Department also mentioned this based on the images.”

“It’s hard to understand just hearing it.”

This sentiment was shared by Suhyuk and Baruda alike. Naturally, Kim Insoo had no intention of continuing this conversation verbally either. There was no need for further discussion when they already had the images.

“Please review the videos and contact me back. We will prescribe medication for the patient’s symptoms.”

“Oh…right. Please ensure he doesn’t suffer too much pain.”

“Yes, Professor.”

After hanging up, Taejin Jo immediately took out his laptop from his backpack. This was not surprising as nowadays, no one attended presentations without their laptops.

“Let’s see.”

Taejin Jo downloaded and played the video sent by Kim Insoo on his laptop. As expected of someone with good sense, he had recorded the scrolling through the CT images using a camera.

Thanks to this, Taejin Jo, Suhyuk, and Baruda were able to scrutinize the images as if they were present at the hospital.

“Ahhh… So that is what it means.” Taejin Jo nodded while pointing to the area where the small intestine connects to the large intestine.

The intestines appeared narrowed, and there were lumps surrounding them.

“It is tuberculosis indeed.”

Any doctor would diagnose these findings as tuberculosis. Suhyuk also thought so, but just before nodding, Baruda interrupted:

“It is not tuberculosis. Please consider the patient’s medical history more carefully.”