Chapter 22: This is Confusing (2)

“Radiology… It is from the May 2014 issue.” Suhyuk muttered to himself as he turned on the computer at the hospital station. However, he couldn’t immediately start searching. Patient Park Sangah entered the hospital room. As Professor Taejin Jo had mentioned, she was a woman in her 40s, but she didn’t look as emaciated as I thought.

‘Rather, she looks healthy… Her gait seems strong.’

She wore a hat, perhaps due to hair loss. Apart from that, there were no obvious signs of illness. While subjective impressions could be misleading, they often held significant importance when dealing with chronic patients. A doctor’s role extends beyond treating cancer; they must care for the patient regardless of their condition.

[Based on my observations, there doesn’t seem to be any weight loss. Rather, I think she has gained more weight compared to when she was admitted three months ago.]

Baruda agreed with Suhyuk’s opinion.

“Ms. Park Sangah, right? I will guide you to your hospital room.”

While Suhyuk and Baruda were discussing information based on their visual assessment of the patient, the nurse led her to a hospital room. As usual, Taehwa Medical Center was crowded, so she was taken to a shared two-person room.

‘Is it really not metastasis?’

“If metastasis occurred, we should see symptoms related to it. Currently, the patient appears to have no such symptoms. Of course, this isn’t definitive, but it is worth considering the possibility that it might not be metastasis.”

‘What does her outpatient record show?’

[Professor Taejin Jo didn’t leave any records.]

It seemed he decided to admit her immediately after seeing the image. In fact, it was natural. The most important and frightening aspect of cancer treatment was metastasis. Regardless of what others said, this issue had to be confirmed before proceeding further. It could also be considered the most frustrating moment for most hematologist-oncologists.

‘Let’s search some papers until she arrives.’

[Please do that. If I had hands, I would’ve done it right away. How unfortunate.]

‘Don’t sound so sarcastic.’

Suhyuk shook his head and accessed a medical paper site using the station computer in the hospital ward. Despite hearing him constantly muttering, the nurses didn’t say much about it. They just thought their peculiar first-year resident had started another strange habit.

They simply thought that our peculiar first-year resident had started another strange habit.

Meanwhile, Suhyuk logged into his desired academic journal website - Radiology.

As expected from the largest radiology journal among standalone journals, there were numerous papers published on their site. Among them, Suhyuk needed to search for the May 2014 issue.

‘Oh man, why is there so much… When will I finish all this…?’

After easily navigating to it, he found that several dozen papers were published just for that month.

[I told you, you shouldn’t have fallen asleep during your first attempt.]

‘I should’ve set an alarm.’

[Wa… Didn’t you say earlier that you would forget about alarms? How did you end up needing one now?]

‘If this knowledge is essential, it should’ve sounded.’

[Wow, this sh… Understood. I will make sure to adhere strictly to your instructions based on your recent statement.]

‘T-That isn’t necessary…’

While conversing, Suhyuk scanned through numerous titles displayed on the screen. Fortunately, as Taehwa Medical Center was the top hospital domestically, they had access rights to all these papers. There was no need to separately request and call for them elsewhere.

“Mr. Lee Suhyuk. The patient is ready.”

Before he could even open the first paper, his assigned nurse called out to him. Looking up, he spotted Park Sangah standing behind her. Even from a distance, she didn’t appear visibly ill.

Looking closely, it became even more apparent.

‘Is this not really metastasis?’

[It is too early to conclude. Think well about the characteristics of cancer.]

‘Indeed.’

In many cases, cancer was scarier because symptoms weren’t immediately visible. In other words, phrases like “I’m not in pain” or “there’s nothing else wrong” had little relevance when dealing with cancer.

“Yes, hello. Patient Park Sangah, I am Lee Suhyuk, your primary physician.”

“A…hello.”

“Professor Taejin Jo will be here for the rounds tomorrow morning. Shall we sit down?”

“Ah…yes. Okay.”

The patient seemed uneasy having a young doctor instead of her assigned professor and kept glancing around before reluctantly taking a seat.

Suhyuk hastily picked up his cane, which he had left near the patient, and moved it to the opposite side. Apparently, such incidents were frequent due to his unfamiliarity with using a cane regularly.

This often happened as he wasn’t yet accustomed to using a cane.

“You must have heard from Professor Taejin about tomorrow’s examination. Is that correct?”

“Um… Yes. Roughly? But why is it being done?”

“Hmm.”

Suhyuk briefly recalled what Taejin Jo had said:

‘Don’t mention this.’

It meant not to unnecessarily upset the patient when there was no confirmed diagnosis yet. Of course, they were already anxious after deciding to be hospitalized.

“I just heard we need to confirm something. The professor will likely explain it directly when he arrives tomorrow.”

[“You’re quite slippery, aren’t you?”]

Fortunately, during his one-month training as an Internal Medicine resident, Suhyuk learned more than just medical knowledge. He also picked up various skills from observing other residents and professors interact with patients.

He was also learning how various residents and professors approached patient care.

“I understand…”

Fortunately, it seemed like the patient reluctantly accepted Suhyuk’s explanation. Perhaps they were uncomfortable discussing their condition with a young doctor like Suhyuk.

In any case, having successfully navigated through the difficult question, Suhyuk continued:

“May I ask you a few more questions?”

“Yes, go ahead.”

“Have you experienced any abdominal pain within the last month?”

“Well… Not really anything specific. Oh, sometimes I felt slightly nauseous.”

“Did you need medication for it?”

“No, not to that extent.”

As repeatedly emphasized, pain is a crucial indicator. Although many cancers don’t show symptoms until reaching a certain size, it’s still essential to inquire about pain. What might seem like minor discomfort could potentially signal a larger issue.

Nevertheless, it was essential to verify any pain reported by patients. Sometimes, what they perceive as minor discomfort can indicate more serious issues than expected.

“Are there any specific pains?”

However, this patient had no notable pain.

“Have you experienced nausea at any point?”

“Hmm… Just once or twice?”

“Did it lead to actual vomiting?”

“No.”

No abnormalities were found through further questioning either.

“Have you felt unusually fatigued or slept for more than half the day?”

“Not really. In fact, I feel better now compared to a month ago.”

If liver metastasis caused tissue damage, it could trigger symptoms such as nausea, vomiting, abdominal pain, and fatigue. Additionally, weight loss and yellowing of the skin might be accompanying signs. However, these latter symptoms were already evident without needing to ask specifically about them.

“Yes, thank you. Today, there will only be one blood test, so please rest.”

“Understood. Thank you.”

Afterwards, Suhyuk asked several more questions but gained no additional insights.

[It isn’t that there were no gains; it is because I obtained the opinion that there are no symptoms.]

‘Well, I know that?’

[Then why do you look so disappointed?]

‘It’s about Director Nam.’

[Can we really say ‘Nam’? I am sensing Suhyuk’s expression.]

‘Get lost, damn it. You’re giving me goosebumps.’

As soon as the patient left, Suhyuk started muttering to himself before turning towards the monitor he had been observing earlier. Nobody had touched his computer while he was away, leaving the list of research papers still displayed on the screen.

‘I guess I should look at abdominal images?’

[I believe so. It had a title similar to hepatitis.]

‘Are you an artificial intelligence with a poor memory?’

Baruda responded without backing down from Suhyuk’s provocation.

[Finally, can you understand my plight of using your brain as storage space?]

‘My grades…were quite good…I graduated fourth.’

[Then there are already three people you know with superior brains. Can I truly make Suhyuk the world’s best internal medicine doctor? I am becoming fearful.]

‘It was because my family was struggling financially… Ah, fuck it. Forget about it. Find the paper.’

Suhyuk stopped explaining various reasons and shook his head. He felt it was too pitiful. Moreover, if he couldn’t find evidence that there was no metastasis before Professor Taejin Jo’s rounds tomorrow, all this effort would be futile. Therefore, rushing was now his top priority.

‘Abdomen, abdomen…’

[Third, the abdomen.]

With Baruda’s help, Suhyuk began reading each paper one by one. Despite having artificial intelligence assistance, his English proficiency didn’t improve dramatically, so his speed wasn’t insanely fast. However, he could read more quickly than others because he stored information rather than relying on memory recall.

‘This is useless…’

[It seems to be another failure.]

Thanks to this, two hours had passed by the time Suhyuk skimmed through about ten papers. He muttered with evident exhaustion on his face:

‘Are you sure about this? May 2014?’

[I am certain. Baruda boasts the world’s best artificial intelligence performance.]

‘Don’t you feel embarrassed making such claims?’

[If you are referring to emotional changes similar to when you used to proclaim ‘I wish I could become a high-earning doctor’, then no, I do not feel any embarrassment.]

‘Bastard.’

Suhyuk cursed under his breath, seemingly fed up with Baruda’s unyielding responses.

‘Oh.’

At that moment, one particular paper caught his eye.

‘Detection of hepatic lesions due to chemotherapy for gastrointestinal cancer. Is this it?’

[Based on your incomplete memory, there is approximately a 99% chance that you are correct.]

‘Great. Let’s read it.’

[Yes.]

Suhyuk briefly glanced at the paper. As he continued reading, he became more certain - this was indeed the article Baruda had mentioned.

[Now do you understand? When Baruda says something, believe him!]

Thanks to this discovery, Baruda started shouting triumphantly inside Suhyuk’s head with immense pride. Despite the annoyance, Suhyuk managed to finish reading the entire paper.

The content was interesting, but more importantly, it matched too well with the current patient’s situation.

‘Our professor will be really surprised tomorrow?’

Until recently, Suhyuk wished time would slow down. Now, he wanted tomorrow morning to arrive quickly.