Chapter 178: No Cause?, Part 3

“Ahh…”

Due to Baruda’s best efforts, Suhyuk was having difficulty standing upright. It appeared that his brain was being affected, which controlled motor functions. Just as he started worrying about his heart stopping abruptly, Baruda opened its mouth again.

[I do not have the ability to control involuntary muscles. Perhaps due to lack of study, your imagination has gone astray.]

‘For fuck’s sake… Do you know how terrifying it is when suddenly your body stops responding?’

If Soohyuk were just an ordinary young man in his twenties, he might not have been so frightened. However, Suhyuk was a doctor - specifically, an internal medicine physician working at a university hospital.

As someone who had to deal with severe cases when he was bored, Suhyuk couldn’t help but think of the most serious illness whenever symptoms appeared. Just now, before suspecting Baruda’s disease, he even considered Wind Disease.

“Don’t worry, Soohyuk. I perform daily self-examinations on your body anyway.”

‘That gives me goosebumps too.’

It would be more concerning if Suhyuk felt comfortable knowing that someone, whether he liked it or not, scrutinized him every day. Fortunately, Suhyuk wasn’t at that point yet and shook his head, visibly annoyed.

“Firstly, sit down and try scrolling the mouse wheel. It doesn’t matter if you don’t have any specific thoughts; just roll it.”

However, Baruda did not leave Suhyuk alone. He continued to urge Suhyuk to do something, leaving him no choice but to comply. After all, it was Suhyuk who had suggested taking a scan.

Strictly speaking, it was Baruda’s suggestion, and Suhyuk merely agreed. Nonetheless, Suhyuk himself brought it up.

Scroll, scroll.

Thus, he started rolling the mouse wheel. As Baruda mentioned earlier, his mind wasn’t completely blank. What should be visible on this liver dynamic CT? It must have been crucial enough for the patient to undergo this scan late at night.

‘Hmm…’

“[Hmm…]” Both Suhyuk and Baruda couldn’t immediately find anything significant.

Their silence was broken by Suhyuk.

‘Wait, hold on. Here…’

Suhyuk circled around the entire liver using his mouse cursor.

“What? You’re saying the enlarged liver? We could see that from previous scans.”

‘No, it’s not just the liver; the spleen is also enlarging.’

The observation known as hepatosplenomegaly had been present earlier. Baruda remained unconvinced, but Suhyuk vigorously shook his head, indicating he meant something else. Considering Baruda’s diminished cognitive functions, this was quite a forceful disagreement.

“Again, h-he’s doing it again.”

“Shh. Don’t stare too much at him. It’s scary.”

“He seems nice… I heard he started acting like this after his accident.”

“He is intelligent and the son of the director, but…”

To others, Baruda appeared to be just a mentally disturbed man, but for Baruda, it was a significant act of rebellion.

[Let us hear your thoughts then.]

‘Look, look! This is clearly the arterial phase we’re seeing now. Right? The arterial phase.’

[I know.]

‘The liver shows overall heterogeneous infiltration, doesn’t it? Doesn’t this indicate amyloidosis?’

[Mm… Amyloidosis? An interesting suggestion.]

Even to Baruda’s eyes, the uneven infiltration appeared quite distinct. Among diseases exhibiting this characteristic, amyloidosis was one of the most representative conditions. It involved abnormal protein formation leading to fibrous deposits in organs or tissues. The liver was often prominently affected by such infiltrations.

However, Baruda’s interest didn’t last long.

[But if it were amyloidosis, wouldn’t the spleen and kidneys also show signs? They appear clean.]

‘Hmm… What if it’s just…the early stages?’

[Amlodysis in its initial stage causing liver sclerosis? That’s a novel theory.]

‘Don’t mock me. If you think I’m wrong, just say so.’

[I was trying to be considerate as I didn’t want you to feel hurt. Didn’t I tell you before not to tell someone they are wrong when they are incorrect?]

‘That… No. Never mind.’

I heard this artificial intelligence was created for medical purposes. Why did it argue so well? If there was an opportunity later, I wanted to grab the development team from Taehwa Electronics and ask them about this. Ideally, I would shake them by the collar.

[Let’s get down first? The next phase is also approaching.]

‘Okay. Hmm… Damn, what is this?’

I had thought quite deeply to come up with amyloidosis. However, my opinion was immediately rejected, which was disheartening. In one corner of my heart, anxiety began spreading that maybe there really wasn’t any cause.

Moreover, Baruda constantly warned him against such thoughts:

“Here we go again with this fellow. Listen up! If you start claiming liver sclerosis without any cause, there would be no need for internal medicine doctors, right?”

‘No, it was just a fleeting thought. Just for a moment.’

“In that time, watch the video instead. Why do you keep giving up so easily? Did you experience some significant disappointment when you were young? No, right? My analysis of your data didn’t show anything like that.”

‘Dude… It’s because you only have access to my physical body. Being an orphan itself is a great hardship.’

“That’s… hmm.”

‘See how quickly you dismiss it when faced with discomfort? A bad habit for an AI…’

“No, be quiet. Please rewind to just before.”

Baruda had a very serious expression on his face. It was subtle enough that only Suhyuk could detect the change in emotion.

Anyway, he did as requested.

‘What is it?’

[R-right here, scroll back from this point.]

‘Like this?’

[Yes. Look closely. Here… Isn’t something strange?]

Unlike Suhyuk, Baruda couldn’t physically spin anything with his mouse-like appendages. However, instead, he possessed the ability to manipulate objects within Suhyuk’s field of view akin to Demonic Scribe. The first time Suhyuk experienced this, he thought his retina might be detaching, causing immense surprise. Now, though, he casually accepted it as simply another built-in feature, akin to using a laser pointer within his body.

‘Hmmm…’

Suhyuk looked at the areas indicated by Baruda - the middle and upper veins. Initially, during the arterial phase, it was natural for these veins not to be enhanced. However, even when reaching the delayed phase, there was no enhancement of these two veins. This lack of opacification suggested only one possibility:

‘The blood…the blood isn’t flowing through here?’

It implied that the veins were obstructed, preventing proper circulation.

“[And it’s not just about the circulatory system.]”

‘Let me take another look.’

“Yes. Please take a look.”

Suhyuk regained his composure as most of his brain functions returned to normal while scrolling through the images from start to finish. This was not a typical CT scan, so there were numerous images; however, it didn’t take long due to having already identified the major issue. They only needed to check for any circulation within the blood vessels.

And indeed, they found no evidence of blood flow.

It’s blocked. There is currently no blood circulation in this person’s liver.

“Why do you think it’s blocked?” Baruda responded with another question instead of answering Suhyuk directly. It might seem unexpected to some, but if that were the case, they wouldn’t be considered excellent internal medicine doctors.

Fortunately, Suhyuk was considered as a good internal medicine doctor by Baruda’s standards, and he immediately understood what Baruda was implying.

There is no tumor or abscess nearby. Well…it isn’t due to cancer invading the blood vessel either. We should exclude secondary causes.

[So?]

It seems to be Primary Budd-Chiari Syndrome caused by a blood clot in the hepatic veins.

[Oh…you have grown significantly, Suhyuk. Not only can you interpret liver dynamic CT scans but also diagnose Budd-Chiari Syndrome. This Baruda has endured much hardship until today… I must treat myself to four different flavors of chicken tonight.]

‘That… I will buy you chicken later. Can you please take a look at the patient first?’

[Is there anything else to see? I have already diagnosed it.]

Not all diseases were like this. There existed challenging and even incurable illnesses. However, due to advancements in modern medicine, most diagnosed conditions could be treated effectively. Fortunately, Budd-Chiari Syndrome fell into the latter category, making Baruda’s point valid.

Nevertheless, Suhyuk shook his head again.

‘No. We are not specialists in Radiology. We need confirmation.’

[Ah…]

Suhyuk meant they should consult Professor Kim Jinsil. Although his words sounded innocent enough, having worked closely with Suhyuk for many years, Baruda instantly understood his true intention.

Having spent quite some time with Suhyuk, Baruda instantly noticed his intentions.

[This fellow. Are you planning to spread rumors about this diagnosis everywhere?]

‘That… huh? No? Why would I?’

[Why wouldn’t you? Despite your innocent appearance, your intentions are as dark as night.]

‘B-but… calling my intentions dark?’

[A compliment, indeed. One must dream big like this. And considering it involves me, Baruda, I appreciate it even more. Too much innocence can be tiresome.]

‘Hmm…’

Should I feel pleased hearing such words from this guy? The question lingered briefly, but it was hard to maintain that thought for long.

I was unsure if Baruda’s continuous chatter was due to excitement over eating chicken or Suhyuk’s ambition.

[Then please contact her first. Ah, is Professor Kim Jinsil on duty today?]

‘Yes, she is on duty. I confirmed it earlier when she prescribed medication.’

[Indeed, her intentions seem impure…]

‘Shut up…’

In any case, Suhyuk picked up the phone. Initially, he considered using his personal cell phone but decided against it, feeling it might be too intrusive. Instead, he opted for the hospital room phone. Despite their friendly relationship through joint research, reaching out personally seemed inappropriate. Moreover, rumors circulated that Professor Kim Jinsil could be quite intimidating, although she had always been kind to Suhyuk. As they say, people tend to treat others well when they want something from them.

“This is Dr. Kim Jinsil from the Radiology Department.”

Her voice sounded like she was glad to hear from him. If there had been any significant issue, considering her low tone, he might have hung up immediately if not for their relationship.

“Oh… Yes, Professor. This is Lee Suhyuk from Internal Medicine. Is this a good time to talk?”

“Ah… Soohyuk. Well, yes, it’s fine. No, I meant you’re okay! Wait, stay on the line! Ah, sorry about that. Haha. There’s something going on here. It’s nothing serious.”

However, it didn’t seem like ‘nothing serious’ at all. Since he had already started the call, Suhyuk quickly proceeded with his notification.

“There is a patient suspected of having Budd-Chiari syndrome based on liver dynamic CT. The patient number is 2020052…”

“Huh? Budd-Chiari? Dynamic?”

“Yes.”

“Can you repeat it? I will check immediately.”

Both words sounded unfamiliar coming from an Internal Medicine resident’s mouth. Professor Kim thought this must have come from someone with at least three to four years’ experience in Radiology as he tapped his computer screen. Then, shaking his head, he muttered under his breath:

This is insane…