Chapter 35: I Told You So? (2)

Click.

Suhyuk swiftly moved his hand to display Yang Jae-won’s image. Meanwhile, Professor Kim Jinsil crossed her arms and watched Suhyuk attentively.

The director and Manager Shin Hyun-tae keep praising him whenever they get a chance.

Their constant talk about Suhyuk had reached a point where Lee Hahyun, the professor of Radiology and Deputy Director, would become agitated just hearing his name mentioned.

“I know, I got it! We don’t have such talent in our department!”

Lee Hahyun was renowned within the field of abdominal radiology, as he was the first person in Korea to attempt treating liver cancer without surgery by using high-frequency ablation for primary tumors or metastases from colorectal sources. Given his prestigious status, his pride was immense.

Given this statement, it was evident how persistent Lee Hyunjong must have been.

“Here…this part, Professor.” While Kim Jinsil was briefly lost in her thoughts, Suhyuk displayed the abdominal CT image. He accurately remembered the CT scan number, ensuring no mistakes were made. Thanks to this, as soon as Jinsil turned her head, she could immediately see the clearest view of the lesion.

“Hmm.”

The images were taken shortly after Jo Youngje’s admission. This particular stage is known as the arterial phase, where well-vascularized tumors typically show enhancement, much like the one visible on the screen before them.

‘In the head of the pancreas… there’s contrast enhancement during the arterial phase. Considering its shape as well…it certainly raises suspicion for an insulinoma.’

The problem was that it was impossible to diagnose all diseases based solely on medical imaging. In particular, diagnosing soft organs like the pancreas using only a CT scan could be quite risky.

“What are the clinical symptoms?”

Thus, it was essential to consider both clinical estimation and radiological findings. Fortunately, Suhyuk had already completed his near-perfect analysis of the patient’s condition.

“The main symptoms currently present are convulsions and seizures.”

“Convulsions?”

“Yes. When hypoglycemia persists chronically, autonomic nervous system symptoms such as anxiety or tremors tend to disappear. Instead, neurological symptoms like seizures, convulsions, dizziness, and confusion remain.”

“Oh…”

Upon hearing this explanation, I recalled studying similar content before.

Although I don’t directly see patients as part of the Radiology Department…

I still had to study extensively like others.

I could immediately understand the situation.

“Moreover, when symptoms occur, the patient’s blood sugar level is not at 50. It improves with glucose administration.”

“It fits Whipple’s triad.”

“Yes. Additionally, there are specific radiological findings. That’s why I diagnosed it as insulinoma.”

“Hmm.”

Professor Kim Jinsil looked again at the images based on Suhyuk’s words and different test results. Considering the symptoms and blood tests collectively, it was challenging to think of any condition other than insulinoma.

‘This kid…is truly a genius.’

According to the records, the patient was admitted due to seizures and convulsions. The guardian believed these symptoms were caused by a lack of divine intervention.

It wasn’t surprising as no hospital had provided a clear diagnosis until now. A first-year resident from Internal Medicine, who consulted on hypoglycemia, finally diagnosed the issue. Both secondary hospitals and psychiatrists missed this diagnosis.

‘What would happen if I tell Professor Lee Hahyun about Suhyuk?’

There would likely be chaos. She always felt that nurturing Kim Jinsil alone was insufficient.

“Ah, but… Why is this patient still in the emergency room? It doesn’t seem like they’ve been discharged yet?” As she pondered, Jinsil noticed the patient’s chart floating near the emergency room entrance.

It was strange. Despite having been diagnosed, she was still in the emergency room. Kim Jinsil wondered if there were no available hospital rooms as she looked back at Suhyuk.

“That’s…”

Suhyuk, who had always shown competence until now, hesitated. With her extensive experience in university hospitals, Professor Kim immediately sensed that something was amiss.

‘Come to think of it… There’s a resident on duty, yet he specifically sought me out?’

Fortunately, she recognized his name; otherwise, she would have dismissed him outright or instructed him to first consult with the resident before approaching her.

In any case, this situation was far from ordinary.

“It’s okay, go ahead and tell me. Anyway, I don’t have anything else to do right now.” Professor Kim Jinsil deliberately glanced around the room.

On weekdays, the reading room computers would be occupied, but now they were empty. Suhyuk also turned his head and wondered if there was not much work to do.

“Uh…”

“What is it?”

“I gave a note stating that insulinoma is too rare of a disease according to a third-year doctor.”

“Rare? What does rarity have to do with neglecting a patient’s care?” Kim Jinsil’s reaction made Suhyuk think again.

‘Ah… I told her to make it seem like she didn’t receive any notification. What should I do?’

[Suhyuk, June will arrive soon.]

‘So what?’

[Kim Jinyoung will step down from his chief position in October due to preparing for the specialist examination.]

‘Ah…’

In the past when Internal Medicine residency lasted four years, residents rarely left the hospital during their final year.

The exam for Internal Medicine specialists covered all aspects of medicine. In terms of study volume, Internal Medicine was considered to be the most demanding among all medical specialties. However, since it became a three-year program, residents could not completely avoid hospital duties during their final year. Nonetheless, they were often excluded from significant responsibilities, indicating a loss of influence and power.

[Becoming chief resident is crucial. Kim Jinyoung must serve as a military doctor afterward anyway. When he returns, you will face more challenges.]

‘That… That’s true.’

It was an enticing proposal, almost diabolical.

Baruda continued while Suhyuk remained captivated:

[Moreover, tomorrow’s presentation is solely for Kim Jinyoung. If that happens…]

‘He’ll claim credit for diagnosing the insulinoma.’

[According to my analysis, he is more than capable of handling it.]

What if I can’t handle it?

[However, what will happen if other professors find out about your insulinoma diagnosis?]

I guess they’ll keep pressuring me… In fact, they already treat me specially.

Suhyuk nodded as if making a decision. Thinking about it, there was no reason for him to yield to that bastard Kim Jinyoung. If Suhyuk were just an ordinary first-year resident, he might have complied. However, his current abilities far surpassed those expected of him. There was no need to hold back due to Baruda’s influence.

“He didn’t trust the judgment of a first-year resident.”

“Ah, so he’s on his way now?”

“That… No, he said we should meet tomorrow morning.”

“Morning? Did you leave the patient in the emergency room?”

“Yes.”

“I don’t understand. Who is it?”

Suhyuk debated whether he should reveal the name again but…

[Baruda]

Influenced by Baruda’s impulse, Suhyuk disclosed:

“It’s Mr. Kim Jinyoung.”

“Kim Jinyoung? Sounds familiar.” Professor Kim Jinsil pondered before making eye contact with her resident and slamming her desk. “Ah, that…that’s right.”

As she recalled, during her internship, the most troublesome intern was indeed Kim Jinyoung. Interestingly, even current third-year residents would strive to provide accurate readings for patients named Kim Jinyoung. Realizing there must be some truth behind these rumors, she turned back to Suhyuk.

“In any case, since the patient is still in the emergency room…why did they request my reading specifically?”

“Th…Dr. Kim Jinyoung requested for a formal review by a professor instead of relying on the resident’s oral interpretation.”

“By tomorrow?”

“Yes.”

“Hmm.” Kim Jinsil immediately understood what was happening.

It seemed like this third-year doctor named Kim Jinyoung wanted to embarrass Lee Suhyuk.

He probably thought there wasn’t any insulinoma.

This wasn’t entirely wrong as it was indeed extremely rare.

However, Suhyuk was correct, right?

Moreover, Professor Kim Jinsil, who favored Lee Suhyuk and belonged to the Lee Hyunjong-Lee Hahyun line, became aware of this situation.

“What treatment is being given to the patient? Diazoxide?”

“Yes. The treatments available in the emergency room are limited.”

“However, considering his severe neurological symptoms… And look here; it’s quite large. Medication alone might not be enough?”

“Yes. We may need to urgently supply glucose when blood sugar levels drop.”

“The best department for this at our hospital would be Endocrinology and Metabolism, right?”

“Yes, Professor.”

Nurses didn’t have different specialties like doctors, but within a hospital, medical tasks varied greatly depending on the department. Even among nurses with similar roles, their experience and expertise differed based on where they had worked previously. In other words, for an endocrine patient, the safest place was not the emergency room but rather the Endocrinology and Metabolism ward.

“Then we should admit him there.”

“But I don’t have the authority…”

“Hold on. Department Head Shin’s number is…”

“What? The department head?”

“Yes. Since it concerns his department, he needs to be informed.”

“Oh…”

Suhyuk felt this matter was becoming bigger than anticipated.

Kim Jinsil noticed his slightly troubled expression and gently patted him on the shoulder.

“Don’t worry. It won’t cause any trouble for you.”

“Ah, okay.”

“He answered.” She then exchanged routine greetings with Department Head Shin Hyun-tae.

Having become quite friendly over time, Manager Shin spoke casually with Professor Kim.

“How’s your golf game lately?”

“I’m not sure what happened today. Dr. Choi seems to have improved significantly.”

“Golf? Did he take lessons without telling me?”

“Payo? 18 holes?”

“Yeah. Are you crazy? Have you been secretly taking lessons without me knowing? By the way, what’s going on today? I thought you were on call.”

“Ah…that Lee Suhyuk. You know him, right?”

“Suhyuk? Yes, we’re close.” Kim Jinsil shook her head at Manager Shin’s exaggerated statement before continuing.

“He hit another home run today.”

“Huh? Really? Oh, I saw it earlier. He was supposed to be on call, wasn’t he? What happened?”

“A patient with seizures and convulsions was transferred from psychiatry.”

“Oh, yes. What was the issue?”

“It turned out to be insulinoma. Dr. Lee suspected neurological symptoms due to chronic low blood sugar levels, so he ordered an abdominal CT scan.”

“Really? Wow… How did he make that connection? That guy is truly a genius.”

Department Head Shin shouted loudly as if his frustration from golf was finally dissipating.

As he did so, Lee Hyunjong, who seemed to be preparing for the final hole’s drive far away, became agitated.

“Etiquette, please show some etiquette! I’m about to hit my driver!”

“It is hospital business, Director. Hospital business.”

“Hmph… Look at him making excuses. Ahh…I should’ve caught it earlier.”

“In any case, you made the diagnosis. Why did you call me?” Shin Hyun-tae asked Professor Kim Jinsil with great satisfaction, having managed to steal her moment.

Professor Kim had been waiting for this question.

“I also confirmed it was insulinoma from watching the video. So I requested her admission and consultation with surgery.”

“But?”

“The third-year resident refused to admit her.”

“What?”

What kind of nonsense was this? Naturally, Shin Hyun-tae yelled, catching Lee Hyunjong off guard amidst his golf swing. As Lee Hyunjong’s shot went awry, Professor Kim Jinsil continued calmly:

“He claimed she couldn’t have such a rare diagnosis, so he wouldn’t admit her.”

“Did you see him personally?”

“No, he said he would come tomorrow.”

“That…that bastard! Who is he?”

“It might be Kim Jinyoung.”

“This idiot will pay for this. Hang up on him immediately.”

“Yes, Manager Shin.”