Chapter 78: Young Yet... (2)

Internal strength.

One might question why ‘internal strength’ is mentioned in a hospital setting, but it was actually a frequently used term among doctors.

‘Don’t I have quite decent internal strength?’

[It’s okay even if your internal strength is weak because you have me.]

Having good internal strength meant having fewer patients, while poor internal strength indicated many patients or receiving patients with severe conditions.

In this regard, An Dae-hoon could be described as legendary for his internal strength.

‘That bastard, ever since he started working here, the number of patients has plummeted…’

[Isn’t that great? Most patients can’t match our skills now.]

Baruda muttered in a tone reminiscent of a third-rate psychic detective when Suhyuk spoke.

‘Did he suddenly develop chuunibyou? “Can’t match our skills”… What nonsense is this?’

[Yes, honestly, is there any patient currently admitted to Suhyuk for whom you haven’t planned their discharge date immediately upon seeing them?]

Suhyuk blinked at Baruda’s words. Surprisingly, Baruda was correct. He indeed had plans ready for all his current patients as soon as he saw them.

He does have a point.

[Right? Now take a look at the patient An Dae-hoon mentioned.]

It sounds incredibly challenging.

[Indeed, it’s difficult. It’s an atypical case, but I believe it will be helpful.]

‘Helpful’, huh?

Listening to Baruda, Suhyuk couldn’t help but think how quintessentially artificial intelligence this sounded. To claim something could be ‘helpful’ even when a patient might potentially die - no human would ever phrase it like that.

Well… In any case, let’s wait and see.

Of course, Suhyuk didn’t bother correcting Baruda’s misconception. Why teach something to someone who isn’t human? As long as Baruda continued helping with patient care, everything was fine.

“Yes, Suhyuk.”

Baruda seemed to share a similar viewpoint, and they both stood waiting for Professor Shin Hyun-tae.

“Suhyuk, how is it going?”

Professor Shin Hyun-tae arrived at the emergency room shortly after, appearing genuinely rushed and slightly out of breath. In contrast, Suhyuk remained calm and composed.

“Oh, yes. There are no clear signs of disseminated intravascular coagulation yet… However, since we don’t know the cause, I’ve contacted the blood bank for component transfusion preparations.”

“Good job. Hmm… It appears there is genuine petechial bleeding.”

“Yes. Her platelet count is 80,000. Considering she is a young female patient…”

“It’s too low. Does she have any underlying diseases?”

“According to her hospital records from the appendicitis surgery, there are none.”

“Hmm.”

Appendicitis… It was commonly known as inflammation of the appendix. While it might seem like a minor surgery, anesthesia had to be used regardless. This meant pre-surgery tests were conducted.

“So, there aren’t any basic illnesses present.”

“No. I brought the viral marker results from that hospital, and they are negative.”

Viral markers referred to tests confirming infection by viruses. Naturally, not all infectious diseases were tested, but common ones included hepatitis B, hepatitis C, and HIV.

In other words, according to Suhyuk’s statement, this patient did not have any viral diseases.

“Hmm… Then what do you suspect?” Shin Hyun-tae returned from checking on the patient and once again asked for Suhyuk’s opinion.

Indeed, as expected of someone with professorial experience, his ability to reassure others was exceptional. Moreover, Professor Shin Hyun-tae had the demeanor of a seasoned academic, further bolstered by his title as Department Manager displayed on his name tag, which visibly comforted the patients’ guardians.

“Yes. Hmm.” Suhyuk briefly glanced at the relieved expressions of the guardians before responding, “Considering the patient’s age and symptoms such as pancytopenia and bleeding tendencies, I believe lupus is a strong possibility.”

“Lupus. Yes, hmm.”

As they repeated ‘lupus,’ both recalled the patient who had just been transferred to the intensive care unit. Coincidentally, this patient also did not have lupus. Due to the progression of lupus, Ecmo was required, inevitably leading to complications.

“Again?”

“It’s difficult to rule out drug-induced pancytopenia. In fact, we used antibiotics that could cause it, so I switched them initially.”

“Good job. It is certainly possible.”

“Yes. Additionally, there is a possibility of blood cancer causing the destruction of blood cells.”

Suhyuk intentionally turned away from the guardians before speaking. There was no benefit in mentioning words like “cancer.”

Shin Hyun-tae, who shared similar thoughts, instinctively braced himself and nodded.

“Considering her age, it’s quite possible… Initially, appendicitis could have been caused by blood cancer.”

“Yes. That’s why I requested sending samples to another hospital for testing.”

“Good job. You really… Yes, you’re truly exceptional.”

Suhyuk always seemed one step ahead of everyone else. Shin Hyun-tae had never encountered such a resident before.

‘In fact, he might be better than when Professor Jang Deoksu was a fellow.’

Suhyuk could potentially surpass even current expectations. However, Shin Hyun-tae chose not to dwell on this thought further, fearing that his praise might inadvertently reflect poorly on him. As he mentally defended Suhyuk, he continued processing the information provided.

“I have also requested a peripheral blood smear and examination from Dr. Jin.”

“Ah, good job. Hmm. Then for now, should we change the antibiotics and start liver protectants?”

“Yes. Although there is limited clinical evidence supporting liver protectants… I still believe it would be beneficial to use them.”

“When there’s nothing else you can do, at least try something. Okay, admit her, and let’s closely monitor her condition. We shouldn’t resort to Ecmo again if possible.”

“Understood, Professor.”

“Alright, please take care of her. As for me… hmm… I won’t be able to go home today. I’ll be in my research lab, so contact me if anything happens. I need to study more about this related illness.”

“Yes, sir.”

After entrusting the patient’s care to the fellow, Shin Hyun-tae briskly walked away. Contrary to his earlier statement, he headed not towards home but to his research lab.

Contrary to his words about going home, he headed towards his research lab.

[He is truly diligent. Suhyuk should also work hard. The professor works just as diligently.]

‘Isn’t I working hard too?’

[I mean you should work even harder.]

‘Then I’ll die…’

[If it seems like you will really die, I can intervene. What are you worried about? After all, I am responsible for Suhyuk’s health check-ups.]

‘Hah.’

Indeed, since Baruda arrived, Suhyuk hadn’t caught a cold once. Whenever Suhyuk showed signs of illness, Baruda relentlessly managed his condition. This indicated that Suhyuk was being meticulously cared for.

After escorting the patient to their hospital room, Suhyuk returned to the on-call room. It had been quite a challenging day, but…

Thus, although Suhyuk wanted to collapse on his bed, Baruda wouldn’t allow it.

Can I read this later after getting some sleep?

[Yes. Here is the related research paper.]

Sigh.

[Why did you sigh? Do you not want to save your patient?]

Baruda launched its usual mental attack, and as always, Suhyuk fell for it. How could he resist when saving patients was a doctor’s duty?

No, no. Let me read…

[Good decision.]

I mean…it might actually help save the patient.

Suhyuk fidgeted with his phone before placing it in his pants pocket. If anything happened, An Dae-hoon would call immediately, so Suhyuk needed to be ready to rush over at any moment.

[Ahhhhh!]

‘Ah.’

Fortunately, there were no calls during the night. He woke up due to Baruda’s nagging alarm.

“You aren’t covering your head as much as before.”

Baruda sounded somewhat disappointed.

For Suhyuk, this was an absurd situation.

‘It’s because you keep waking me up every day. I’ve gotten used to it now. Humans truly…are adaptable creatures…’

[Let’s go see our patients since we’re awake. The test results should be available by now.]

‘Oh right. Thanks.’

Surgery relied on cutting with a scalpel, whereas Internal Medicine required inferring what was happening inside based on external symptoms. Naturally, this process took an incredibly long time and was quite challenging. Various tests became essential for diagnosis.

This explained why people often say, “I was admitted to a university hospital, and all they did were tests!”

‘First, let’s check on my patients.’

[Yes. There shouldn’t be any issues.]

‘That’s true.’

As Baruda mentioned, Suhyuk’s patients genuinely had no problems. It was expected since they received appropriate antibiotics immediately upon admission.

The issue lay with An Dae-hoon or rather, his hospitalized patients.

‘We need to continue maintaining Ecmo.’

There were no significant changes yet for the patient transferred to the intensive care unit. This meant that the echocardiogram performed by Lee Hyunjong himself showed no noticeable differences.

“[There won’t be any changes for one week. It would be great if there were, but there is no precedent.]”

Baruda interpreted the results based on his analysis. Suhyuk fully agreed with Baruda’s opinion, so he didn’t offer any other views. Instead, he started examining the female patient who was admitted yesterday. This was because most of the test results came from her side.

“Ah, Doctor. Did you cough?”

As Suhyuk tried to confirm the test results, someone approached him and gave a somewhat burdensome greeting. Without looking, I knew it was An Dae-hoon.

“Coughing… Are we living in the Joseon Dynasty? Just say ‘hello’.”

“H-How could I dare…”

“Are you filming a historical drama? Just relax.”

“N-no, upperclassman. To express my admiration for you, I should kneel and…”

“Stop talking nonsense, just look at this with me.”

“A-yes, upperclassman.”

The newcomer continued to chatter incessantly until Suhyuk’s harsh words prompted him to pull up a chair behind them.

Meanwhile, Suhyuk swiftly navigated through yesterday’s test results on his screen. There were numerous entries due to the extensive tests conducted.

‘The peripheral blood smear shows normal results… except for signs of anemia.’

[It means the cells themselves are being produced correctly.]

As its name suggests, a peripheral blood smear involves spreading blood on a slide to examine the shape of blood cells. The ‘normal’ result indicated that the production of blood cells was functioning properly.

Normal cell shapes indicated that blood cell production was functioning correctly. In other words, the possibility of a cancer diagnosis, which had been Suhyuk’s biggest concern yesterday, significantly decreased.

“The liver levels remain high… and LDH is elevated as well. Hmm.”

Suhyuk purposefully spoke aloud so An Dae-hoon could hear. However, there was no reaction from Dahoon since he viewed Suhyuk almost like a god.

Instead, Baruda provided a response:

“[The ferritin concentration in the blood… has increased dramatically. It is now at 12944.5 ng/mL.]”

‘Considering the normal range is between 10 to 290… it’s nearly fifty times higher.’

“[That’s peculiar. Elevated iron levels indicate…]

‘It means that red blood cells are breaking down. This is also causing the anemia.’

[That’s correct. We need to determine the cause.]

‘For now, the list of issues… fever, liver dysfunction, high LDH, and ferritin levels.’

[I will start the analysis.]

‘Okay.’

Baruda momentarily emitted a whirring sound as it began its analysis. Suhyuk tapped his finger on the mouse while waiting.

An Dae-hoon anxiously awaited for Suhyuk to speak. He never imagined that Suhyuk would rely solely on Baruda’s opinion.

‘Surprisingly… he even looks cool when deep in thought…’

Dae-hoon couldn’t help but silently admire Suhyuk.