Chapter 179: No Cause?, Part 4

“Yes… Right. It seems there is no immediate need for intervention? Anti-coagulants should work. Yes, Suhyuk.” Professor Kim Jinsil ended the call with a smile, but she couldn’t maintain it afterward. Her thoughts were jumbled due to Suhyuk’s subtle hint.

‘Can a resident independently decide to perform a Liver Dynamic CT scan?’

Well…

It might be possible after consulting with the Radiology Department. While other departments may vary, the Abdominal Imaging Division, led by Manager Lee Hahyun and comprising over ten exceptional professors, had active communication with clinical divisions.

However, for an Internal Medicine resident to evaluate and interpret it alone? It was absurd.

“Sigh…”

Professor Kim Jinsil sighed as she recalled how incredibly accurate his interpretation was. The only thing that made Suhyuk seem human was his inability to perfectly establish a treatment plan yet.

‘Someone is exceptional even outside their specialized field, while someone else…’

Her anger increased with each thought. Why were they so different when both residents trained at the same hospital? Nowadays, wasn’t Radiology attracting only the top-ranked residents?

‘I was number one.’

“Dr. Lee Hye-young…” Professor Kim muttered a name while turning around.

It was like seeing a fierce beast growling. At this sight, Lee Hye-young, the third-year resident of the Radiology Department, inadvertently swallowed her saliva and took a step back.

‘Wow, she is scary.’

I heard that if she wasn’t angry, she was a really good teacher. Now I knew why such words were spoken about her. When she was angry, she became a bad teacher.

“What do you want?”

“Huh? No, yes. Sorry.”

“Do you know why you came here?”

“That…” Lee Hye-young quickly started thinking. She had come promptly when called, but the other person just got angry before hanging up. It was as if there was some personality switch, for her voice over the phone was incredibly smooth. She even praised me with phrases like ‘you are great’ or ‘let’s grab coffee’.

Did I do something wrong by coming here?

Hye-young racked her brain during their conversation but couldn’t think of anything she might have done to upset the professor. Even staring at Jinsil’s furious face didn’t jog her memory.

As Lee Hye-young quietly stood there with her lips pressed together, Professor Kim Jinsil started typing aggressively on her keyboard. It was hard to tell if she was tapping or pounding the keys.

“Take a look at this.” After a moment, Professor Kim pointed at the monitor screen.

“Oh…”

Lee Hye-young’s jaw dropped slightly. The ultrasound image displayed there was one she had taken earlier today.

What did I say about it again?

Yes, she’d marked it as normal. She couldn’t recall any unusual findings from that day.

“So what do you think about this scan?”

But why would the professor call her at this hour to ask about a normal ultrasound result? Something wasn’t right.

Damn it, did I miss something?

She scrutinized the image but couldn’t find anything unusual. It was embarrassing to admit, but despite being in her third year as a resident, Lee Hye-young’s ultrasound skills were lacking, especially when it came to abdominal scans. The abdomen contained numerous organs, and depending on how one positioned the probe, the resulting images could vary greatly.

“Well? Tell me quickly. You’re the one who read this, aren’t you? And you’ll be starting your fourth year soon, correct?”

“I…I diagnosed it as normal.”

“Normal? Do these look normal to you?”

When Lee Hye-young declared it normal, Professor Kim’s frustration boiled over.

I’m just a resident… You need to teach me these things.

Lee Hye-young pursed her lips, realizing she might have gone too far with that remark. If she hadn’t been taught properly and genuinely didn’t know, even Professor Kim wouldn’t have reacted this angrily. There was another reason for his outburst.

“This patient is admitted, right?”

“Oh, yes.”

“Do you know why they were hospitalized?”

“Well…”

There was a common misconception that doctors in the Radiology Department did not interact directly with patients. It was true that radiologists typically didn’t have their own patients, but that didn’t mean they should never see or understand their cases. Failing to do so would inevitably lead to mistakes, as demonstrated by Lee Hye-young’s current predicament.

It was bound to happen sooner or later, just like Lee Hye-young’s current predicament.

“You don’t know? Did you order this ultrasound without even looking at the patient’s chart first?”

“I…”

“When I told others that some residents were lazy, they didn’t believe me. A radiologist being lazy doesn’t make sense, right? If we’re negligent, patients die. How could such a resident end up in Radiology?”

Professor Kim glared at Lee Hye-young as she hung her head, seemingly speechless.

“This patient is admitted for follow-up due to a gallbladder polyp. You can tell from the previous CT scan alone. Didn’t you bother checking it?”

“I’m sorry.”

“Sigh… Lee Hye-young. If you find it bothersome, at least perform the ultrasound properly. Is this what you call an adequate window? If you don’t know how to do it correctly, you should ask for help. How can clinicians trust us if we dismiss cases just because they’re inconvenient? In fact, even though the attending professor couldn’t pinpoint the issue, he contacted me due to his concerns.”

Professor Kim shook his head in disappointment and brought up another image on the screen. At first glance, the difference in quality was evident. This new scan showcased a textbook-perfect view through the optimal window.

“Without that professor’s intervention, we would have missed this patient’s condition. The polyp has grown significantly! We’ve already scheduled surgery for tomorrow. Understand? You nearly caused the death of this patient!”

“Oh…”

Only then did Lee Hye-young realize her mistake. The patient had been admitted to monitor any changes in size of their gallbladder polyp. Had she known this, she would have examined them more thoroughly. Regret and self-blame washed over her.

However, that wasn’t enough for Professor Kim Jinsil, who faced her now.

If we let her graduate like this, it’ll bring shame upon our hospital…

Worse still, the patient could die as a result. Such an outcome must be avoided at all costs. It was imperative to ensure aspiring specialists acquired certain knowledge before graduation, even if they disliked the subject matter. After four years of training, there were some things every doctor simply needed to know.

“Dr. Lee Hye-young.”

“Yes, ma’am.”

“From tomorrow onwards, attend all abdominal ultrasound sessions.”

“Huh…?”

“You’re assigned to the abdomen part this month, right?”

Lee Hye-young’s face immediately stiffened at Professor Kim’s words. Not only did she dislike ultrasounds, but it also conflicted with her planned curriculum.

“Oh…yes. But, regarding Professor Lee Hahyun’s interpretation…”

“Why bring up Professor Lee Hahyun? I’ll discuss it separately with Manager An.”

Hye-young soon realized how inappropriate her comment was.

‘Ah…right, Professor Kim is…the direct disciple of Professor Lee Hahyun.’

It was said that Professor Kim had shown exceptional talent even during his residency days. Recognizing his potential early on, Professor Lee Hahyun took him under his wing as a graduate student, co-authored research papers with him, and strategically placed him at Taehwa Medical Center for fellowship training to fill a specific gap within the hospital. Upon completion, he promptly appointed Kim as an attending physician upon his return.

Currently, she might not have much influence, but soon she would become a powerful figure.

“Also, you will handle all the cooperative ultrasounds. If unsure, ask your senior fellow. If it doesn’t work out, then call me.”

“Ah…”

“What?”

“No, I understand. I’ll do as instructed.”

“Yes. Remember, this isn’t just about one incident. It’s not only within our department; there is talk in other clinical departments too. They say you don’t cooperate well.”

“That…”

“You don’t need to make excuses. Just show me that you’re not like that, okay?”

“Yes, yes. I’m sorry.”

While Lee Hye-young was enthusiastically scolding Suhyuk, he leaned on his staff and rose from his chair, observing the patient who had arrived via the elevator.

His face did not look possessed due to the longer duration compared to a typical CT scan.

‘What was I possessed by?’

Instead of gradually building rapport and then requesting the scan, he had hastily pushed for it like striking while the iron is hot. However, regardless of how it happened, it didn’t matter now. He still needed to investigate what caused Bird-Kiari Syndrome.

In any case, Suhyuk had identified the immediate problem at hand.

“How do you feel, patient?”

Perhaps his confidence reassured her, or maybe she noticed the cane she hadn’t seen earlier. The patient hesitated before expressing her discontent.

“It’s just…not as bad as I thought.”

She merely shrugged her shoulders.

Dahoon, eager to pass Suhyuk and leave, abruptly turned towards the bed.

He didn’t expect that Suhyuk had already reviewed his recent CT scan results.

“Ah, wait a moment.” Suhyuk placed his staff before Dahoon.

“Huh? Yes, Doctor. What…?”

“I need to explain your CT scan.”

“Oh… You’ve seen it already?”

“Yes. Listen carefully while watching this with me.”

“Ah, yes, Doctor.”

Suhyuk skillfully turned one of the station’s monitors towards the patient. It was quite useful, installed by Taehwa Electronics. In fact, some patients claimed their lives were saved after seeing these monitors being used here.

[“Don’t waste time thinking about unnecessary things. When will you eat those four flavors of chicken?”]

‘Okay, okay.’

Unable to withstand Baruda’s nagging, Suhyuk hurriedly began explaining the CT findings. He provided detailed explanations since both the patient and Dahoon were listening.

Despite his impatience, Suhyuk used clear and simple words so that the patient could understand. Now, the patient finally realized why and how their liver was damaged.

“When veins become blocked, congestion occurs throughout the liver, causing swelling. This led to an enlarged liver… The increased pressure caused blood vessels entering the liver to swell as well. In particular, the portal vein swelled more than the arteries, resulting in ascites. During your hospitalization, you likely experienced temporary improvement due to diuretics administered both orally and intravenously. Diuretics are one of the treatments for this condition, although not the primary treatment.”

Suhyuk continued explaining, noticing both Dahoon and the patient nodding attentively.

“As you may already know from previous admissions, your liver is somewhat hardened now. Especially around this area, there are dead sections… However, it’s not entirely damaged overall. If treated properly, there’s a possibility for your liver function to recover. It appears that these issues haven’t been present for too long.”

“Ah… So, it can improve?”

“Yes, but…”

“But what?” The patient was now fully engrossed in Suhyuk’s explanation. This level of clarity had never been provided during his previous hospital stays, so hearing the “but” naturally heightened his anxiety.

“We still don’t know the exact cause of your blood clotting issues. There could be various underlying diseases causing this…”

“Ah…what happens if we don’t know?”

“At present, we can manage it with anticoagulants, but more clots could form. Additionally, some of the underlying causes are dangerous. Well…we have been able to rule out several possibilities.”

“Do you not know now?”

“Now is…”

The patient’s words caused Baruda to erupt.

“If he knew, he would be a fortune teller, not a doctor. Let’s quickly eat chicken. Anyway, aren’t they going to administer warfarin as an anticoagulant?”

‘Just let me sleep. I’ll ask one question. Just one.’

Suhyuk tried to appease Baruda and opened his mouth.

“Hmm…it isn’t very likely, but by any chance, have you recently started taking oral contraceptives?”

“Eh?”