Chapter 90: Outpatient Clinic (1)

‘What?’

Dr. Steve, who appeared to be assigned as Suhyuk’s guide at Iowa State University Hospital, muttered something audible only to himself. Despite having Baruda installed, Suhyuk couldn’t hear his words since it was too soft. It was natural that he wouldn’t catch what was said.

[Bummer, you have to teach this guy from a backward country.]

However, Suhyuk could see Dr. Steve’s lips moving, and with Baruda, he could read them. Although Suhyuk had been taught how to do this, it wasn’t an easy task for him. For artificial intelligence like Baruda, it seemed effortless.

‘A backward country?’

[Are you crazy? How dare you call Korea, which created me, Baruda-nim, a backward country? Should I kill him?]

‘Huh? Kill… What is this nonsense?’

[He has insulted my great homeland, so it is fitting for him to die.]

‘Homeland…’

Baruda’s reaction was unexpected, but upon reflection, it made sense. After all, South Korea had created him. It was strange for an artificial intelligence to have such nationalistic sentiments though.

[Steve… that bastard…]

‘Don’t suddenly take control of my body or anything?’

Suhyuk expressed concern at Baruda’s intense reaction. He was worried that Baruda might use his body to harm or kill Steve. When he thought about it objectively, Suhyuk with one bad leg had no chance against Steve, who appeared over six feet tall and weighed more than 220 pounds. Nonetheless, it wasn’t entirely impossible considering Baruda had previously controlled Suhyuk’s mouth, albeit briefly and for a simple utterance.

[What nonsense is this? I am not some parasitic entity. Such control is impossible.]

‘Yes, right?’

[Still, revenge must be taken.]

‘R-revenge?’

[What kind of revenge can a doctor do? I will crush his pride. I wonder what expression he will make when beaten by a doctor from a developing country.]

‘That…well, yes.’

The motivation might be impure but it was satisfactory. It was similar to Baru stating that he would do his best. Perhaps there were few doctors who could compete with him even in the United States. In fact, Taehwa Medical Center had world-class standards and Steve still stood out among them.

[Let’s find out about Steve first… Ah, there is a file on Steve in the emails exchanged between Lee Hyunjong and this hospital.]

‘Huh?’

[It is an unusual background. Both his parents worked at Iowa State University, and he lived here all his life. In the United States, high schools, universities, and hospitals are usually located in different regions. Anyway, he seems like a typical country boy.]

‘Is this place considered rural?’

[Didn’t you see the cornfields stretching out on both sides while traveling from the airport to our accommodation?]

‘Ah, indeed.’

The university buildings were grand enough not to give off a shabby impression, but it couldn’t be described as a vibrant area. Compared to Seoul, it felt significantly less developed, making Suhyuk feel somewhat apologetic for his initial judgment.

With these thoughts, Suhyuk’s attitude softened slightly, now considering Steve merely a naive young man from the countryside spouting nonsense.

In contrast, Baru interpreted the situation entirely differently.

“Did you dare to ignore me, the heir of Taehwa Group, Korea’s top company, just because you’re from some backwater town?”

In truth, Steve had ignored Suhyuk rather than Baruda. However, the enraged Baruda was incapable of rational thought at that moment.

As more time passed, Steve sighed and stared blankly at Suhyuk.

“Let’s get down to business first. Do you speak English?”

It was a provocative statement, enough to offend Suhyuk.

Look at this bastard! Asking if I can speak English?

In reality, before meeting Baru, Suhyuk’s English proficiency wasn’t particularly strong. Nonetheless, feeling offended is never pleasant, and on this point, Suhyuk agreed with Baruda. They both understood it would be foolish to provoke unnecessary conflict when facing such formidable enemies ahead.

“Yes, I am proficient.”

In response to this answer, Steve gave an even more remarkable reply:

“Wow, you’re the first Asian person who has told me directly that they are proficient. Are you really good?”

It felt like he was speaking faster on purpose. However, it posed no problem for Baruda as his computational speed far exceeded Steve’s.

“Yes. By the way, where are we going?”

“Oh. First…I want to greet the professor. Do you know Dr. Allison by any chance?”

Steve seemed to expect Suhyuk not to recognize the name. Unfortunately for him, Suhyuk knew Allison very well.

“[Dr. Allison is from Cardiology.]”

His name often appeared in cardiovascular research papers.

“[If mentioning his most famous paper, then it must be…]”

Suhyuk even knew Allison’s published research papers by heart.

“Yes. I was deeply impressed with your paper titled ‘Factors predicting cardiovascular disease over the next five years’ published last December in the American Heart Association Journal.”

“Oh… Oh. Th-thank you.” Baruda smiled as he observed Steve nodding slightly, appearing somewhat flustered.

[Looks like this guy didn’t know about it, huh?]

‘Seems so. He pretends to be smart but doesn’t actually bother studying.’

Before meeting Baru, Suhyuk himself would have spent more time pondering how to enjoy his off-hours or strategizing ways to become a specialist and earn big money rather than focusing on studies. However, he had undergone a significant transformation since then, valuing education more highly than most university professors.

He had already transformed into someone who valued studying more than most university professors.

“Firstly, let’s go inside.”

“Yes. Let us do that.”

In any case, Professor Allison’s research lab was not far away. The entire floor of the Internal Medicine department served as professorial labs. It seemed they could afford to be less conservative with space compared to Seoul’s cramped cityscape.

“Professor, this is Lee Suhyuk from Korea. He will be here for training for one month starting today.” Steve knocked and entered the room, bowing towards Professor Allison before introducing Suhyuk.

“Oh.” With a brief gasp, Professor Allison looked at Suhyuk with an intriguing expression on his face.

It seemed Allison had heard of him before.

This is…the friend Professor Lee Hyunjong has been boasting about?

Under normal circumstances, it was unthinkable for someone like Allison to recognize a trainee, especially one staying only for a month. The Iowa State University Hospital not only had an excellent reputation but also was renowned for its educational programs. This month alone, several short-term trainees similar to Suhyuk were scheduled to visit. Of course, the primary reason behind this influx was the financial contribution from the trainees’ fees.

Regardless, it was highly unusual for the head of a department to be familiar with a short-term trainee.

I remember hearing that they moved up the schedule because they wanted to showcase him quickly… Hmm.

Lee Hyunjong was not only famous in Korea but also internationally, earning him the nickname “World Star Lee Hyunjong.” At one point, he had even been considered for president of the International Heart Association, although his candidacy fell through due to political reasons and the jealousy of other Korean cardiologists at that time.

Regardless, Allison acknowledged Lee Hyunjong as an esteemed doctor.

He doesn’t seem particularly special.

The cane did leave an impression, though strictly speaking, it was more of a weakness than a unique trait.

Thus, Allison nodded with uncertainty.

“You’re from Taehwa Medical Center, right? Let’s make this next month productive. The healthcare system here is quite different from Korea, so there will be much to learn.”

Unlike Steve’s arrogant tone, Allison’s words came from genuine pride. Only someone extremely confident could claim they had more to learn. However, considering his expression and manner of speaking, it didn’t come across as offensive but rather friendly.

“I certainly have, Professor Allison. I’ve learned so much from your research papers over the years, so it is truly an honor to meet you in person. In particular, I was very impressed by your article titled ‘Factors Predicting Cardiovascular Disease within Five Years’ published last December in the Journal of the American Heart Association.”

“Oh, really? You’ve read that?”

People were such peculiar creatures, and there were so many different types out there, but they all had one thing in common: They appreciated those who read their research papers. Allison was no exception to this rule.

“Yes, studies with sample sizes of over a hundred thousand aren’t unheard of, but your research considered numerous variables… It truly left a lasting impression on me. And it was quite useful as well.”

“Ha-ha! Writing that paper was quite challenging.” Allison laughed heartily, genuinely pleased by Suhyuk’s words.

Of course he was delighted; not only did Suhyuk take the time to read his work, but he also acknowledged the effort and thought Allison had poured into it.

The doctor suddenly pointed outside the window toward the beautiful garden filled with leafy trees.

However, Allison pointed to a massive building beyond the garden.

“Ah, my research institute is over there. If you have time… Would it be okay for me to show you around?”

“Yes, of course. It would be an honor.” Suhyuk nodded sincerely.

In terms of clinical care, there wasn’t much difference between Taehwa Medical Center and Iowa State University Hospital. It wasn’t that Iowa State’s hospital was inadequate; rather, Taehwa Medical Center was exceptionally outstanding.

However, when comparing their research capabilities, the difference was laughably vast. This disparity stemmed from the significantly higher funding allocated to Taehwa Medical Center.

“That’s great. I’m sure I’ll learn a lot.”

‘Yes, there might be something valuable to gain.’

I thought I might gain some expertise by visiting such research institutes. While Suhyuk was lost in his thoughts, Allison slowly stood up.

“Ah, today is Jungyeong-sul. I should get going now. What’s on your schedule for today, Professor Lee Suhyuk?” She asked Steve this question.

Steve fumbled with his notebook from his pocket before answering, “Yes, today…we will observe the patient rounds of Professor Hank from the Hematology-Oncology Department.”

“Ah…is Dr. Steve currently the primary physician for Hank?”

“Yes.”

Allison nodded at Steve’s response and turned towards Suhyuk.

“Yes, then see you later…and we’ll meet tomorrow morning at the conference.”

“Understood, Professor.”

With that, Allison left the room. Steve’s demeanor abruptly shifted from being docile to confrontational as he stared at Suhyuk.

“You read my research paper on your way here, right? Good thing you did. Professor Allison is quite strict, but with him observing, I won’t get reprimanded as much.”

It seemed Steve assumed others shared his own aggressive nature. Suhyuk was about to respond sharply, but unexpectedly, Baruda intervened.

“Let’s address this outside the clinic. As an internal medicine doctor, use knowledge.”

“Hmm?”

“Professor Hank, today’s observer…uh…ah, Dr. Lee Suhyuk from Korea.”

“Oh…yes, indeed. Please take good care of him.”

“Yes, Professor.”

Hank exchanged brief greetings with Steve and then turned towards Suhyuk.

“Yes, nice to meet you.”

As they shook hands, Hank’s hand was truly as large as a pot lid. Seeing this massive hand piqued Suhyuk’s curiosity as a doctor.

‘What glove size does he wear?’

[Size 9? Or maybe 8 and a half? I’m not sure. You’re a size 7, right, Suhyuk?]

‘Yes, it is indeed huge…’]

Even without holding it, Hank’s hand appeared large, but gripping it made it feel even more colossal. Additionally, his hairy forearms gave him more of a detective or bandit vibe rather than that of a physician.

[He’s completely bald.]

Moreover, Hank had no hair on his head. If there were some strands remaining, it might have been amusing, but the complete absence of hair lent him a slightly intimidating appearance.

His complete lack of hair gave him a somewhat intimidating appearance. Of course, Suhyuk was no longer naive enough to reveal his inner thoughts, so he didn’t show any discomfort.

“Yes, Professor, I’m Lee Suhyuk. Please take care of me.”

“Sure, sure. It’s just an observation, right? First patient…who is it?”

Hank nodded slightly with a hint of annoyance on his face. While this might seem rude, it wasn’t entirely unexpected given the circumstances.

‘Remember, you’re here mainly to kill time and have fun.’

‘Iowa isn’t far from Chicago, so make sure to enjoy weekends there.’

These were most of the advice Suhyuk had received from his upperclassmen before coming here.

In other words, both the sender and recipient often approached these exchanges with half-hearted enthusiasm. Considering this had been ongoing for several years, it was unrealistic to expect professors like Hank to be enthusiastic about them.

“The number of people wanting to impress me keeps increasing.”

However, Suhyuk and Baruda had different perspectives on this matter.

“Your first patient is waiting for you in Room 1.”

“Oh, really? I’ll go ahead and examine them. Is it Mr. Thomas?”

“Yes.”

“Okay. While you’re gone, I’ll review their chart.”

“Understood. Then I will…go with the trainee.”

“Sure. Well…even though they seem well-behaved, still keep an eye on them.”

“Will do.”

Although Hank said this, both Steve and Suhyuk knew it was unlikely to happen. Doctors from Eastern countries, especially those from Korea, were incredibly well-behaved. Despite their proficiency in English, many acted timidly as if they had lost their voices.

Consequently, without much concern, Steve accompanied Suhyuk towards Room 1. In his relaxed state, he failed to notice Suhyuk’s expression.

‘Hmm. The outpatient clinic has almost as many rooms as an operating theater.’

“[Indeed. It’s quite unique.]”

Rooms numbered one through four lined the hallway, but it didn’t seem like any other professors besides Hank used them.

It seemed Hank was using them all by himself. Suhyuk realized that everything here was on a different scale compared to South Korea.

“Mr. Thomas, hello.”

“Oh, yes. Hello.”

“It’s nice to meet you.”

“Yes, likewise.”

“I’ll just take a quick look at your chart.”

While Suhyuk observed his surroundings, Steve greeted the patient. Initially, Suhyuk thought the patient might be a returning visitor due to Hank’s friendly demeanor, but upon checking the chart nearby, he noticed it was a new case.

[Melanoma. Hmm, skin cancer, right?]

‘It’s quite rare.’

[Not particularly uncommon among Caucasians.]

‘Ah, true. There can be racial differences when it comes to skin cancer.’

[I’ve never seen this type before, and its location is unusual too.]

‘That’s what I thought. Melanoma in the nasal cavity?’

Suhyuk’s interest grew even more as he examined the patient closely.

At least, he had never encountered such a patient in South Korea, and it was unlikely that he would come across one in the future. This case could be easily observed in more diverse countries like the United States or Europe. If Suhyuk didn’t thoroughly examine this patient now, there was a chance he might make mistakes when encountering similar cases later on.

“Well, first, I need to inspect inside your nasal cavity. Let’s start with local anesthesia.”

Despite appearing quite perplexed by the chart, Steve managed a friendly smile as he approached the patient. His demeanor was markedly different from how he treated Suhyuk earlier. Considering his previous brash behavior, this transformation was quite surprising.

“It may feel slightly uncomfortable.”

Suhyuk observed Steve cautiously spraying local anesthesia inside the patient’s nose. He had never seen this done in Korea before. In his experience, anesthesia was not used for observing the nasal cavity unless it involved the nasopharynx at the back of the throat.

“You’re making efforts to minimize discomfort for the patient.”

‘I have something to learn from this.’

‘Despite being such a jerk…there is indeed something I can learn from him.’

‘Perhaps, this is just how their system operates here.’

“I believe so.”

It couldn’t be solely Steve’s approach; this must be the standard practice within the hospital’s system. While Taehwa Medical Center also had efficient protocols, its primary focus was on saving lives effectively, often overlooking patient comfort during routine procedures.

On the other hand, this hospital seemed to prioritize patient comfort. This was evident from the fact that Steve washed his hands and put on gloves even for a simple procedure like nasal endoscopy.

“Have you had any nosebleeds?”

“How about pain?”

“Are your ears okay?”

While waiting for the anesthesia to take effect, Steve asked various questions. Some of them appeared unrelated to Suhyuk’s current condition. Although it might seem like a waste of time, at least he wouldn’t miss anything by asking comprehensively.

“All right. Now I will examine inside.”

“Yes.”

“It may cause slight discomfort.”

“I understand.”

After allowing sufficient time for the anesthesia, Steve gently inserted the nasal endoscope into Suhyuk’s nostril. He only went in very shallowly.

If he had just inserted it without warning, it wouldn’t have been that uncomfortable.

In any case, melanoma was revealed through the monitor. It was located on the outer wall of the left nasal cavity, and unlike normal mucous membranes, it appeared jet black. There were bloodstains around it, indicating either inflammation or necrosis.

‘Ah, this color. Do you remember?’

[Of course. I will add it to the database.]

Baruda immediately entered the shape and color of the melanoma into his data. Although he had already studied this information, seeing it directly felt different.

“Hmm.”

While Suhyuk and Baruda were excitedly discussing their first-ever encounter with such a case, Steve sighed heavily with a grim expression.

He bowed to the patient before leaving the room. Suhyuk followed Steve out of the room since he couldn’t do anything alone as a trainee and not yet a doctor.

“Hmm.”

Steve had planned to return immediately to Hank, but instead, he was pacing in the hallway. His expression looked troubled, and Baruda seemed to understand the reason behind it.

[That bastard… It seems like this is his first time seeing such a condition?]

Although Steve examined the patient, his face showed confusion, indicating that he didn’t fully comprehend the situation. This was a familiar expression to Suhyuk, so Baruda must have analyzed it accurately.

It seems so? Although melanoma is common among Caucasians… it’s rare to find it inside the nasal cavity.

“Since ultraviolet rays are a risk factor.”

Melanoma increased with exposure to ultraviolet rays, yet it had developed within the nasal cavity where one would never encounter sunlight throughout their lifetime. Even briefly considering this, it was quite unusual. Despite his training in the United States, Steve could have been seeing such a case for the first time.

“Ah… What should I say?” Steve muttered, momentarily forgetting Suhyuk’s presence before finally noticing him again.

He wouldn’t know anything about this.

Naturally, he didn’t expect any help from Suhyuk. In Steve’s mind, South Korea was considered a developing country.

Despite Seoul being much larger than Iowa where Steve lived and even rivaling Chicago in size, it was difficult to shake his preconceived notions until he experienced it firsthand.

Still… Who knows?

If he returned to Hank now, they would likely engage in another debate disguised as educational discussion. Like other professors, Hank enjoyed asking questions, which meant Steve’s lack of knowledge would be quickly exposed. This could decrease his chances of securing one of the increasingly scarce positions at prestigious hospitals despite having completed his specialization training.

Thus, Steve continued to gaze at Suhyuk with low expectations.

“So…you’re a trainee?”

“Yes, Steve.”

“By any chance, do you know the disease…that we just saw?”

“I do.”

“I thought not… Huh? You know it?”

Suhyuk looked at Steve as if it was obvious and trivial knowledge. He made this expression based on Baruda’s advice, implying ‘Do you really not know?’ while also conveying his confidence.

Wow… How cool…

Thanks to this, Suhyuk managed to display the most impressive demeanor possible. This type of expression seemed universally understood, so Steve clearly picked up on Suhyuk’s self-assuredness.

I don’t want to ask more questions…

However, since Suhyuk claimed to know, there wasn’t much choice left for Steve.

The clueless man had to ask:

“Uh… Could you please explain it?”

“You went in without any knowledge about this case? Are you from another hospital?”

“I only knew…the patient’s name… That’s all I was given. It is my first time seeing them.”

“Do you not know melanoma?”

“No…I am aware of that… However, one occurring in the nasal cavity…it’s my first time encountering it.”

It made sense. Based on what Suhyuk just read using Baruda, it confirmed his suspicion.

[Extremely rare… They used such strong language.]

‘Is it because it’s a case report?’

[Yes.]

In the medical field, terms like ‘extremely rare’ were rarely used due to the availability of more objective measures like percentages. The fact that they employed such phrasing indicated the condition was so uncommon it hadn’t even been captured statistically.

However, using ‘extremely rare’ meant it was so uncommon that it wasn’t captured by statistics. It made no sense for a third-year internal medicine resident, albeit from the United States, to be familiar with such a condition.

“Well, indeed, it is rare.”

“H-have you seen this before?”

“I’ve encountered many cases. I’ve also read numerous research papers on it.”

“Oh, r-right…”

“The patient we saw earlier exhibited very typical symptoms…”

“That…”

Steve’s expression had noticeably changed as he observed Suhyuk. Unable to directly ask for guidance, he fidgeted like an anxious puppy. Both Suhyuk and Baruda were well aware of his intentions but had no intention of helping him; rather, they wanted to crush his ambitions.

No, instead of helping Suhyuk, Steve now wanted to crush him completely.

Grrr.

Thus, Suhyuk opened the door rather than his mouth. It was the same door where Hank had been sitting earlier.

“Wow, that was truly impressive.”

Suhyuk chuckled as he looked at Hank. In order to delay entering for as long as possible, he dragged Steve inside, who had briefly started Googling during this short interval.

“You seem quite skilled, Dr. Steve?”

“Really? Steve is indeed intelligent. So, can you share your findings from the examination?”

“Well…uh…”

“What’s wrong?” As soon as Hank finished speaking, Suhyuk interrupted.

“You promised to tell me! You said it wasn’t difficult.” His expression made anyone want to punch him due to its smugness.