Chapter 65: Cause (1)

‘What am I missing?’

Suhyuk couldn’t fully focus on Baruda as he was having a conversation with Shin Hyun-tae. However, thanks to his previous experiences, Suhyuk could continue this dialogue roughly.

[Yes, Suhyuk. What type of patient is this?]

Instead of immediately sharing his thoughts, Baruda posed a question. Initially, it annoyed Suhyuk, but he realized that this approach allowed both Baruda and himself to learn and improve together. Therefore, instead of getting frustrated, Suhyuk decided to answer thoughtfully.

‘A patient taking immunosuppressive drugs.’

In fact, the patient was taking two different medications. This was because it had been only about a month since their transplant surgery.

It had been only about a month since his transplant surgery.

[Correct. It is easy to predict that immunity is suppressed compared to ordinary people.]

‘Yes. That’s why we suspect infection by super bacteria.’

While answering Baruda, Suhyuk observed Shin Hyun-tae.

“I think so too.”

He roughly responded based on what he understood from their conversation. Both Suhyuk and Shin Hyun-tae were convinced that the patient’s immune suppression somehow influenced the potential super bacterial infection. This was a reasonable inference.

Firstly, the patient likely had multiple opportunities for exposure to the super bacteria.

The patient had been hospitalized for quite some time in the intensive care unit. Even if there was a small amount of super bacteria present, it could still lead to infection due to the weakened immune system.

‘Currently, this is the most likely possibility.’

[I do not completely rule out the possibility of a super bacterial infection.]

‘Hmm? Then, do you suspect something else? The pus clearly indicated a bacterial infection, not viral.’

[I am not suspecting a viral disease either.]

‘Huh.’

Suhyuk realized that Baruda’s suspicion lay beyond his current understanding and momentarily closed his mouth. He fell silent, partly because he didn’t know what to say next, but also as he awaited Baruda’s follow-up question.

As Suhyuk anticipated, Baruda soon asked another question:

[Why is this patient taking immunosuppressants to inhibit their immune system?]

The query seemed somewhat naive. However, despite Baruda’s increasing human-like behavior, Suhyuk was well aware that its core essence remained artificial intelligence. This meant Baruda never performed actions without purpose. While it could engage in trivial tasks, there was always a reason behind them.

Immune suppression is necessary because they had a kidney transplant a month ago.

Suhyuk promptly responded:

[Yes, the patient received a kidney transplant.]

Baruda emphasized his response as if it held significant importance and sought confirmation again.

‘What?’

Suhyuk couldn’t understand it and just blinked his eyes.

Meanwhile, Shin Hyun-tae was contemplating which antibiotic to use after imipenem. He even contacted the transplant surgery team to inquire about maintaining immunosuppressive drugs. Naturally, he sought advice from nephrologists regarding the patient’s current condition as well.

However, none of them provided a satisfactory answer. They could only estimate that the patient had roughly one week left to live. Typically, sudden infections following organ transplantation rapidly lead to multiple organ failure.

‘Why does it matter what organ this patient received?’

Thanks to Shin Hyun-tae being preoccupied with calls from other department professors, Suhyuk could fully immerse himself in his conversation with Baruda.

Baruda responded with more enthusiasm, as if waiting for this moment:

“This patient underwent kidney transplantation. Based on the examination, interview, and CT scan conducted today, there is strong suspicion that the transplanted kidney is the source of infection.”

‘Yes, the kidney is currently suspected as the source of infection.’

While it didn’t entirely convince him, he vaguely concluded that the infection might have occurred either during surgery or in the intensive care unit.

‘Ah.’

Suhyuk suddenly realized that he had overlooked the most crucial potential cause of infection.

Baruda chuckled as if proud of Suhyuk’s realization and continued:

“In that case, our first step should not be to investigate the operating room but rather the source of infection from the brain-dead donor who provided the kidney.”

The organ donor… Ah… That makes sense. Yes!

Taehwa Medical Center boasted world-class medical standards. An infection occurring during surgery? The chances were extremely slim. It would be an irresponsible gamble to risk a patient’s life on such unlikely odds. Of course, infections could still occur in intensive care units, but it was peculiar for it specifically to lead to a urinary tract infection rather than some other type.

“Thus, I request information on the organ donor.”

While Suhyuk exclaimed ‘Eureka,’ Baruda completed his statement. Naturally, there was no reason for Suhyuk to refuse this request. He tapped Shin Hyun-tae’s arm, who had been aimlessly holding onto his phone.

In any other resident-professor relationship, such behavior might have seemed careless. However, it was widely acknowledged that Suhyuk could get away with anything.

“Huh? What is it, Suhyuk?” Despite being on a call with another department’s professor, Shin Hyun-tae immediately turned to him.

Given the gravity of the situation, Suhyuk decided not to wait and interrupted, signaling he needed to speak urgently.

“Professor, the source of the patient’s infection is their kidney.”

“Huh? Yes, that’s right. Many circumstances indicate this. That is why you suspect an infection in the surgical site and want to treat it with super bacteria.”

“I was wondering if the infection might have come from the organ donor?”

“Eh? Eh…” Just like Suhyuk earlier, Shin Hyun-tae momentarily lost his words. It was because he hadn’t considered this perspective at all. The cause of the infection wasn’t within this patient but rather, someone else who donated the organ. It wasn’t something easily thought of.

“Wait. Ah… Professor Yoo. Sorry, I need to end this call now.”

However, once the idea struck him, he wondered why he hadn’t considered it before.

“Uh, yes. Suhyuk-ah. This… In other words, the donor could be the source of infection?”

“Yes. If it is a super bacteria resistant to imipenem, we have virtually no chance.”

“That… That’s right.” Shin Hyun-tae looked at the patient who had worsened significantly just one day after being admitted to the intensive care unit. With pneumonia spreading rapidly, staying idle would likely lead to death in no time.

“In that case, exploring alternative causes and attempting treatments accordingly might be meaningful. Of course, if it truly is a super bacterium… there’s not much we can do. However, I find it hard to believe that the surgery itself caused the infection.”

“Yes, that’s right. Our hospital’s transplant surgery team wouldn’t make such mistakes. Then umm… Yes, as you said, it is more likely due to infection from the donor.”

“Then I will look into it.”

“But since the donation occurred one month ago… Additional tests may not be possible?”

“It might be possible to determine the cause of death by examining the reason for their passing.”

“Hmm.” Shin Hyun-tae pondered briefly before nodding.

It seemed most probable based on Suhyuk’s explanation. Moreover, following Suhyuk’s advice had never led him astray until now.

He had a strong feeling that Suhyuk’s theory was correct again. Without delay, he immediately called the transplant surgery department.

“Ah. Professor Yoo. Sorry, sorry about this. Suddenly, something came to mind.”

The professor from the transplant surgery department was Ryu Jinsu. He was the same professor who helped with the patient experiencing side effects from boriconazole not too long ago.

“Oh, yes. No problem at all.”

As a newly appointed assistant professor, Ryu Jinsu showed utmost respect towards Shin Hyun-tae, a renowned figure in their field.

“Yes, I needed to look into something related to it. Regarding Patient Son Geumsuk… Can you provide any information on the organ donor?”

“Huh? Um… That is…”

Originally, information about organ donors was kept confidential. Therefore, Ryu Jinsu hesitated and couldn’t say anything outright.

“No, this information is essential for treating the patient. Without it, the patient might die.”

However, when a patient’s life was at stake, what importance did confidentiality hold? It might have been different if she were just any stranger, but she had received surgery from him, albeit indirectly through his hands.

After briefly contemplating, Professor Ryu Jinsu nodded.

“I’ll send you the patient’s records via your email, professor.”

“Yes, thank you. While you’re at it, please forward them to Dr. Lee Suhyuk of our department as well.”

“Lee Suhyuk? Ah, he’s currently the primary physician under you, isn’t he?”

“Uh, yes.”

“Yes, understood.”

If it were another professor, they might have wondered why there was a need to send the information to the resident as well. However, Ryu Jinsu had received crucial assistance from Lee Suhyuk before. As soon as he hung up, Jinsu promptly forwarded the materials to Suhyuk.

Both Shin Hyun-tae and Suhyuk, seated at their respective workstations, simultaneously checked the email. The attached files contained mixed documents such as charts and medical opinions since the organ donor had passed away not at Taehwa Medical Center but at a different hospital. This indicated that analyzing the data would take considerable time.

[Open multiple windows simultaneously.]

Of course, it wasn’t a big problem for Suhyuk with Baruda installed. He could open eight windows simultaneously and analyze up to eight pages at once.

[The patient is quite young. Only 24 years old.]

‘No pre-existing conditions… Found in Han River. Hmm.’

Upon further investigation, the donor had been drinking with colleagues near Sungsoo Bridge when he went to use the restroom but accidentally fell into the Han River and drowned. Emergency services rushed him to a nearby hospital’s emergency room in cardiac arrest and respiratory failure. However, on the sixth day of his hospitalization, he was declared brain-dead, and following the guardian’s consent, organ donation proceeded.

[During his hospital stay, there were three instances of fever.]

‘There were no findings from blood, urine, and sputum culture tests.’

“It would have been easier if there was something. How unfortunate.” Baruda clicked his tongue as if they had returned to square one. This gesture was typically used when expressing extreme disappointment, but Suhyuk found it utterly amusing every time he saw it.

However, instead of mocking Baruda, Suhyuk’s mouth dropped open. Under Baruda’s guidance and on his own initiative, Suhyuk had read numerous case reports, and now memories of those readings came flooding back.

‘No, no. There is no need for disappointment.’

“What?”

‘I… I think I know the cause.’