Chapter 57: The Conference (2)

‘Previous surgery?’

Suhyuk’s trust in Baruda had significantly increased compared to before. Instead of questioning the diagnosis itself, he asked how it was made.

“Yes, Suhyuk. The patient has undergone a splenectomy.”

Baruda, too, was much more cooperative with Suhyuk than previously. Thanks to this, they were able to have a productive conversation quickly, even as Taejin Jo reached for his phone during their desperate moment.

‘A splenectomy is performed when the spleen becomes too large.’

“Correct. Why do you think the spleen became enlarged?”

‘Well, obviously due to extramedullary hematopoiesis… Wait, hold on. Extramedullary hematopoiesis?’

As Suhyuk muttered to himself, his face lit up as if he had just experienced an epiphany.

Baruda’s expression confirmed Suhyuk’s theory, and he spoke with great admiration:

[Suhyuk, you have truly grown significantly. I am impressed by your progress.]

‘Yes, that makes sense. Tuberculosis seems unlikely.’

[Indeed. Although tuberculosis is prevalent in our country, there isn’t enough evidence to suspect it here.]

The only relevant treatment history was three months of steroid therapy from years ago. There were no signs of previous tuberculosis lesions on imaging, nor did the patient report any similar past illnesses. It made more logical sense to analyze the current symptoms based on the known conditions.

With newfound confidence, Suhyuk opened his mouth to explain further just as Taejin Jo was about to reach for his phone button.

“U-um, Professor.”

“Yes, Suhyuk?”

Fortunately, Taejin Jo and Suhyuk had an incredibly strong bond, almost to the point where it seemed one-sidedly affectionate on Taejin’s part. Nonetheless, this relationship proved immensely helpful in such situations.

Despite daring to interrupt his professor, Suhyuk continued speaking warmly to Taejin Jo:

“That video earlier… Is it really tuberculosis?”

“Huh?” Taejin looked puzzled, wondering why Suhyuk would raise such a question out of nowhere.

The shape seen in the video was quite distinctive, so for someone to doubt its identification as tuberculosis seemed odd. If anyone else had raised this concern, Taejin might have felt irritated. However, strangely enough, he wasn’t angry at all with Suhyuk.

‘Why is my heart racing like this?’

Taejin was startled by how fast his heart was beating. It felt as if Lee Suhyuk would present a convincing argument, even if it wasn’t entirely correct. At least, it seemed plausible to Taejin at that moment.

Regardless, he didn’t mind.

“Why do you think so?”

He put away his phone and opened his laptop again.

The other residents had similar thoughts upon witnessing this exchange:

Damn. Is Lee Suhyuk going to hog all the glory?

Of course, Professor Taejin Jo wasn’t truly devilish. However, neither was he known for being overly lenient, especially not during moments like these.

As a professor of Hematology-Oncology, he stood on the front lines battling diseases within Internal Medicine. Would someone with such responsibilities walk around grinning foolishly?

This made it even stranger.

‘If I were him… No, he wouldn’t have sat next to me.’

There were plenty of empty seats, so why sit beside someone else? The professor would get annoyed if they chatted casually during the lecture.

Fortunately, this was Lee Suhyuk, Taejin Jo’s favorite student.

“Here, look at this. Doesn’t it resemble tuberculosis?” Laughing heartily, Taejin paused the image.

It highlighted multiple narrowed segments along the chairman’s spine, immediately catching their attention. Due to its distinctive appearance, even Baruda agreed with Suhyuk that it looked like tuberculosis. However, having already considered another diagnosis, both doctors noticed something slightly off about the case.

“The shape is clearly tuberculosis. However, if we consider the blood test results sent by Doctor Kim Insoo, there is something unusual.”

“Test? This one? Well… There are no inflammation markers present.”

Taejin Jo had already analyzed the blood test results earlier. As a professor of Internal Medicine at Taehwa Medical Center, reputed to be the best in Korea, he was well-equipped for such tasks.

“But considering steroid usage and the patient’s chronic myelofibrosis, it would be harder to obtain accurate numbers.”

He then provided a plausible explanation to support his claim.

The reasoning sounded so convincing that Suhyuk internally called upon Baruda for reassurance.

‘Hey, we’re right, aren’t we?’

[Correct. Professor Taejin Jo will agree with just one word from you.]

‘Okay.’

However, Suhyuk trusted Baruda’s words more. With newfound courage, he began to recite what he had prepared earlier.

“Yes, that is true. However, looking at the narrowed area of the patient, it is localized specifically here. This observation differs from typical tuberculosis.”

“That… Hmm. You are correct. But tuberculosis can indeed involve segmented infiltration.” Taejin Jo was pleased by Suhyuk’s solid reasoning.

He had encountered numerous residents who would dismissively say, ‘I don’t think so,’ without any valid argument. Compared to them, having a resident capable of engaging in such discussions felt like a refreshing relief during a drought.

In comparison, having residents who could engage in such discussions was akin to rain during a drought.

“Yes, you’re correct. However, if you closely examine this narrowed segment, don’t you find something peculiar about it?”

“The disease? The disease itself doesn’t seem unusual.”

“Not the disease, but rather, where it has invaded, what do you notice?”

“The location…?” Taejin Jo tilted his head at Suhyuk’s question.

He wants me to focus on the location instead of the disease?

Taejin had never considered that angle from the start. Perhaps that’s why he immediately felt like he might have missed something crucial.

‘What is it? What exactly did he see?’

Until now, Taejin had been speaking as a professor imparting knowledge.

Currently, he was struggling to catch up. It was inevitable since his beloved disciple had observed something that Taejin himself missed.

“Ah… This is somewhat strange?”

Fortunately, Taejin Jo became an Internal Medicine professor at Taehwa Medical Center due to his expertise. Soon, he identified the peculiar aspect.

“This area within the digestive system…is one of the few regions capable of producing blood cells…”

“Yes. The region responsible for generating blood cells has narrowed.”

“That means…”

“It appears as if this mass formed while attempting to produce blood here.”

“Ah… That’s correct. The patient’s spleen was removed.”

Myelofibrosis could lead to extramedullary hematopoiesis as a side effect after splenectomy. There were more severe complications like leukemia, but…

At that time…was it unnecessary to remove his spleen?

Taejin Jo recalled the past incident. However, even if he could go back in time, he wouldn’t have made a different decision. Kim Sungwon’s spleen was on the verge of necrosis at that point. If they hadn’t removed it, he likely wouldn’t have survived until now.

“Yes. That might explain why the patient only has abdominal pain without blood in the stool. If this narrowing was due to tuberculosis, there would definitely be blood present.”

“That makes sense. So considering this is due to extramedullary hematopoiesis…it explains the blood test results.”

Occasionally, misdiagnoses were inevitable. However, most errors occurred when doctors missed something or couldn’t explain certain symptoms. Taejin Jo felt a sense of catharsis as all the unexplained aspects now made perfect sense.

“This is why I chose Internal Medicine. Excellent job! Well done.”

“Thank you, Professor.”

“No need to thank me; it’s I who should be grateful. Ah, by the way, there was one more thing I wanted to give you instead of presenting this case myself, but Lee Hyunjong beat me to it…”

Taejin Jo chuckled once again and picked up his phone. The other residents watching him sighed enviously.

He truly is amazing… That crazy bastard. How does he diagnose such things?

Yoo Jisang, Suhyuk’s colleague, felt jealous of him. Despite working diligently and achieving considerable success, no one looked at Yoo Jisang with the same admiration as they did Suhyuk. This was understandable since there were many excellent residents like Ji-sang every year, but Suhyuk stood out among them all.

“Oh, Insoo. I’ve seen the video.” While other residents, including Yoo Jisang, experienced feelings of despair, Taejin Jo hastily called Kim Insoo. He wanted to ensure that Insoo wouldn’t prematurely conclude it was tuberculosis based on the video alone.

“Yes, Professor. I administered painkillers and am currently attending to another patient,” replied Kim Insoo promptly. As an experienced resident, he never rushed unnecessarily or allowed mistakes to occur due to haste.

“Ah, yes. Good job. Based on the images, it doesn’t seem to be tuberculosis.”

“Huh? Not tuberculosis?”

“Nope. Suhyuk was here with me when I reviewed them. He noticed a possible connection between the extracted spleen and the current diseased area.”

“Oh, okay. Suhyuk…”

Kim Insoo’s voice noticeably deflated at the mention of Suhyuk’s name. Despite being only two years apart from him, Suhyuk’s abilities were overwhelmingly superior. There were already talks among higher-ups about appointing Suhyuk as a professor immediately since he didn’t need to serve in the military. This implied that Kim Insoo’s chances of becoming a professor significantly diminished.

Of course, Taejin Jo wasn’t one to consider such subtle emotions and continued speaking without hesitation.

“It appears to be due to extramedullary hematopoiesis. That…that’s right. Extramedullary hematopoiesis.”

“Huh? Ah…yes, yes.”

“Yes. You understand immediately, don’t you?”

“Yes.”

Honestly, Kim Insoo didn’t fully comprehend what was said, but he decided to pretend otherwise. He wanted to avoid appearing incompetent compared to a first-year resident.

“Right, as I mentioned earlier. Do you know the treatment? Just do it accordingly.”

The problem was Taejin Jo didn’t suspect that Kim Insoo might not truly grasp the situation. Instead of explaining the specific treatment, he simply instructed him to handle it and hung up.

“S-Shit, what should I do?”

It was truly a big problem for Kim Insoo. Based on Taejin’s description, it seemed like there should be a clear treatment method for this symptom. However, nothing came to mind for Kim Insoo.

‘What should I do… Use steroids? No way. If something goes wrong… Ahhh…I shouldn’t have pretended to know.’

He always warned his juniors not to cause accidents by assuming they wouldn’t get caught. Making the same mistake himself left him feeling frustrated.

Vrrr.

At that moment, his phone vibrated from within his pocket. Thinking it might be Taejin Jo, he quickly checked but found it was Lee Suhyuk instead.

It wasn’t a call but a text message.

Doctor, Professor Jo asked me to arrange radiation therapy for you. >

I burst out laughing after reading the message.

‘This bastard…’

Kim Insoo had worked with Taejin Jo for three years, so he knew his personality well. This man would never contact someone via text message like this. It meant that Suhyuk sent the message on his own accord.

Fortunately, Kim Insoo was very different from Kim Jinyoung; instead of feeling resentful, he appreciated the gesture.

‘Yes, become a professor… You’re the right person for it…’