Chapter 85: I have to go to America (2)

“Ah… So that’s why you came to the emergency room?”

“Yes. Although it is chest pain, the patient was too young so the intern notified me.”

Lee Hyunjong continued asking questions about the patient as if he didn’t want to waste any time. Suhyuk also enjoyed discussing medicine with Lee Hyunjong, and he eagerly participated in their conversation.

[Listen carefully. Lee Hyunjong is truly an excellent doctor.]

Even Baruda took an active stance, emphasizing his agreement. As Baruda stated, Lee Hyunjong was indeed an outstanding physician. His expertise extended beyond mere knowledge; his experience and insights were equally impressive. In short, there was much to learn from him, and fortunately, he willingly shared his wisdom without holding back.

“Hmm. How do you perform triage? If it is chest pain, then treat it as chest pain. Would young people come to the emergency room just because of minor discomfort? We shouldn’t ignore their symptoms if they came here.”

“Ah… That… You’re right.”

It was true even now. Initially, Suhyuk and Baruda focused on the patient’s age being only 18 years old, which led them to underestimate the severity of his condition. Lee Hyunjong immediately pointed out this issue.

As he mentioned, for a young person to visit such a large hospital, the problem must be significant. It takes both time and money, indicating that the discomfort must have been considerable.

“It’s not just about his age. What about dizziness? By prevalence rates alone, benign paroxysmal positional vertigo (BPPV) would be the most common cause, overwhelmingly so. However, does our Taehwa Medical Center’s emergency room data support this?”

“Um… I am not sure.”

Suhyuk and Baruda were knowledgeable about publicly released statistics, but they were less informed about internal statistics. Initially, Suhyuk believed there wasn’t much need to delve into them since universally accepted data was more important than individual experiences in clinical settings. Baruda also held the belief that relying too heavily on one hospital’s statistics could lead to distorted information. Suhyuk shared this viewpoint.

However, with Lee Hyunjong citing these statistics, it became difficult for Suhyuk to ignore them, and he inadvertently started paying close attention.

“Yes, according to Taehwa Medical Center’s emergency room statistics, benign paroxysmal positional vertigo is indeed more common. However, the difference is minimal. Cases of dizziness due to neurological causes versus those caused by benign paroxysmal positional vertigo are almost equally frequent.”

“Th…that can’t be possible?”

Based on common sense, it sounded absurd. The prevalence of Benign Paroxysmal Positional Vertigo (BPPV) was ten times higher than vascular diseases, making the difference laughable.

“You have also been immersed in that damned evidence-based medicine.” Lee Hyunjong clicked his tongue as he observed Suhyuk’s shocked expression.

Of course, Hyunjong wasn’t trying to denounce evidence-based medicine. In fact, he himself adhered to its principles. However, through numerous experiences, Lee Hyunjong had developed a perspective that allowed him to step back and view things more objectively.

“Suhyuk, if you develop a fever, would you immediately go to the emergency room?”

“No, I’d first try taking medication or visit a local clinic.”

“Yes, but what if your temperature reaches 42 degrees Celsius? What would you do then?”

“Then immediately to the emergency room… huh?”

Lee Hyunjong didn’t blindly get angry or try to teach Suhyuk. Instead, he asked a question. Smart individuals usually learned something from this type of query. Naturally, Suhyuk realized what was being implied.

“The degree of symptoms…would be different. Especially at Taehwa Medical Center.”

“Yes. People don’t come here unless it is serious. If someone arrives here feeling dizzy, it means their condition is significantly different from ordinary cases. During your internship, did you see patients with benign paroxysmal positional vertigo (BPPV)?”

“Yes.”

Dizziness was quite common among women over middle age, and BPPV was the most frequent cause. If one had completed a proper internship, they would have encountered such patients naturally.

“Weren’t those patients vomiting uncontrollably?”

“Yes. Oh… That… Yes.”

It wasn’t surprising that she vomited due to dizziness. Of course, treating patients amidst the mess was challenging for medical professionals. Consequently, BPPV wasn’t a pleasant experience for interns.

“However, not all cases of BPPV are severe. Most often, patients just feel faint.”

“Oh… Really?”

“Yes. Such patients should be referred to local ENT clinics. We only need to see the filtered cases here.”

“Ah…”

“It’s the same with chest pain. Typically, benign chest pain can be treated at neighborhood hospitals. If a patient comes here, we must consider their condition serious; otherwise, we might miss something crucial.”

“I see. Wow… I always learn so much talking with you.” Suhyuk genuinely bowed his head.

Recently, while working as a team with Baruda and correcting various diagnoses, Suhyuk had started to become somewhat arrogant. However, listening to Lee Hyunjong now, he realized how far he still had to go.

“Don’t be too modest. There’s plenty I’ve learned from you.”

Lee Hyunjong chuckled and pointed ahead of them. It seemed they finally arrived at the intensive care unit for thoracic surgery on the third floor of the main building. Turning his head, Suhyuk spotted the entrance to the ICU.

Bip.

Suhyuk swiped his badge to open the door and walked inside.

Lee Hyunjong was quite famous, but the director of the hospital followed him closely behind. Naturally, several nurses from the intensive care unit rushed over to them. Initially, Lee Hyunjong couldn’t recall admitting any patients recently.

“Director, what brings you here?”

The first person to approach and speak was the chief nurse of the thoracic surgery intensive care unit. Typically, she would be managing nursing staff inside rather than being stationed outside. However, since surgical departments like thoracic surgery often conduct rounds before surgeries, the chief nurse had already come out ahead of time to wait for them.

“Oh… I came to see the patient admitted yesterday.”

Lee Hyunjong was on a first-name basis with the chief nurse, so he spoke casually to her. As someone acquainted with Lee Hyunjong, she knew well his eccentricities and refrained from making unnecessary comments like “We don’t have any patients here.”

“So…which patient?”

“Well…Royce-Diaz syndrome.”

“What?”

“Oh, do you know it better as dissecting aortic aneurysm?”

“Oh…yes, yes. You mean the female patient, right? This way, please. The surgery finished at dawn, and we’re still tidying up.”

In general, surgeons often remembered patients by their procedure rather than their diagnosis.

The tradition was strong within thoracic surgery, considered one of the toughest surgical specialties, and even shared among the nurses.

“Here she is.”

“Oh.”

Suhyuk unintentionally followed Lee Hyunjong to see the patient and gasped upon witnessing her condition. It was far worse than he had imagined. Patients in Internal Medicine’s intensive care unit were undoubtedly severe cases, but their wounds weren’t as extensive as hers. Moreover, the numerous tubes connecting both inside and outside her body added to the eerie sight.

“Weren’t you exposed to this during your internship?”

‘But those patients weren’t mine.’

“You mean it feels different now?”

‘Yes.’

“I find that hard to understand.”

‘You…you will be like this.’

Suhyuk was quite disturbed as he overlapped yesterday’s image with what he saw now. In contrast, Lee Hyunjong actively assessed the patient’s condition. He started by reviewing the surgical records and then observed the vital signs along with the overall appearance of the patient.

“Hasn’t the genetic test result come back yet?”

“No, there were no instructions for it.”

“Then go ahead and order the test.”

“Uh…without consulting the primary physician?”

“Yes, go ahead. I’ll take responsibility. Anyway, looking at this, we need to contact Social Services… So, cost shouldn’t be an issue, right? I’ll handle it.”

“Oh…yes, understood.”

Lee Hyunjong even prescribed medications according to his own judgment, which actually benefited the patient. A diagnosis based solely on clinical estimation differed significantly from one confirmed through genetic testing.

“And why haven’t you prescribed enjotensin inhibitors yet? I saw your input on cooperation earlier.”

“The primary physician has not…”

“What is he doing that it hasn’t been done yet?”

“He was discharged at 5 pm today.” The chief nurse pointed to the clock, which had just passed seven o’clock. This meant the patient’s primary physician had only gone home about one and a half hours ago. She implied Lee Hyunjong should understand the situation.

However, Lee Hyunjong wasn’t someone who easily empathized with others’ circumstances. “Who cares? Doctors need to see patients when they are present. In any case, stop making excuses for not seeing him yet and give the medication.”

“B… Without notifying anyone?”

“He wants to sleep. Moreover, I am a professor of cardiology. I know this disease very well. If we delay further, his condition might worsen again.”

“U… Understood.” The chief nurse hesitated but eventually nodded, unable to find a suitable response.

Regardless of whether the thoracic surgery professor arrived, the outcome wouldn’t change much beyond causing more arguments. Ultimately, Lee Hyunjong was certain to win.

“The specimen has been sent to the pathology department. Was this from the operating room?”

“Pardon? Oh, yes. The specimen… It is not under the jurisdiction of the intensive care unit.”

“Good. Follow the prescribed instructions for now. Suhyuk, let’s go to the pathology department together.”

“Huh? Pathology department?” Suhyuk, who thought it was over, looked puzzled.

Of course, Lee Hyunjong had no intention of explaining further. He simply left with Suhyuk.

“I heard rumors, but…Lee Hyunjong truly is eccentric,” murmured one senior nurse as they watched Lee Hyunjong swiftly depart.

The chief nurse shook her head in response.

“He is quite mild compared to before. When Professor Wang was here, there were daily fights right here… It wasn’t as if they were professional boxers… They even exchanged punches?”

“What? Really?”

“Yes. With this change… it’s fortunate.”

“So we should wait for the primary physician or professor’s opinion regarding the prescription?” The senior nurse asked, sensing that the chief nurse had mixed feelings about Lee Hyunjong. Naturally, she also felt pride towards her department of thoracic surgery and thought Internal Medicine shouldn’t be involved with prescriptions.

However, once again, the chief nurse shook her head.

“No, follow his instructions.”

“Huh? Why?”

“Although Dr. Lee Hyunjong has made many mistakes… he hasn’t been wrong medically. He isn’t called a genius for nothing. Just proceed as directed.”

“Ah…yes.”

While matters were being resolved at the intensive care unit, Suhyuk and Lee Hyunjong had already reached the office of the pathology department. Fortunately, due to most samples coming from the operating rooms on the third floor, the pathology department was also located there.

Ding-dong.

Lee Hyunjong pressed the doorbell next to the entrance. Soon, a voice came from inside.

“Emergency specimens?”

It wasn’t yet the regular time for specimen collection.

“No. I’m here to see a patient.”

“A…patient? There are no patients here.”

The pathology department only dealt with specimens. Naturally, the person responded with confusion written all over their face.

The manager, who was about to preside over a pre-work meeting in the next room, looked with annoyance at Suhyuk’s intrusion.

“Is it the director?”

When Suhyuk asked this through the intercom, Lee Hyunjong nodded.

“Ah, Cheolyong? Open the door. I need one sample.”

“We have a meeting…”

“Do you want to hear the chime throughout the meeting?”

“No sir. Opening now.”

Watching Lee Hyunjong, Suhyuk had a question.

‘Did he become the director because he is the best fighter?’

[Based on his current attitude, it seems like a plausible hypothesis.]