The Returning Doctor Wanted to Live Quietly - Chapter 327



Only Noblemtl

Episode 327. Giving orders (9)

What qualities make a good doctor?

Memory? Sense of humor? Hand skills?

There are many qualities, but if I had to pick just one, it would be curiosity.

Because to be a good doctor, you need to have endless intellectual curiosity.

So, Han Dong-soo was definitely a great doctor.

Because my eyes were sparkling with curiosity right away.

but.

“well.”

“Well, what is it? What is it?”

“Professor, right now it’s a bit… … .”

“Why? If you don’t know, you should say you don’t know. That’s how you can make progress. There’s nothing stranger than pretending to know when you don’t. So what are you asking?”

“… … It only makes sense if the kids get it right.”

Han Dong-soo didn’t ask for more.

As expected from a surgeon, he had a hasty personality, but it was clear that he was holding back.

Well, how could someone not even know about Han Dong-soo, but it is one of the rare diseases.

That could be confusing too.

Because I even set a trap.

‘Because you said it happens when you do extreme exercise. Well.’

Jinhyuk immediately turned his head.

“The original clinical practice was complicated and dirty. There was a lot of meaningless information. That’s why reasoning skills are needed. Internal medicine is a place where you have to be a detective.”

“I’ve heard that a lot. But I’m curious how you know so much about internal medicine!”

“Did you see that before? I studied. I learned. I experienced various cases.”

“Why? You’re a surgeon, sir.”

“To be exact, I’m a prospective thoracic surgeon.”

Han Dong-soo interrupted, but Jin-hyeok took a moment to catch his breath and answered.

“There were a lot of attackers.”

“ah…….”

“There were a lot of people who bullied me. So I studied endlessly. Did you see that before?”

“yes?”

“Bringing in a polycle who knows nothing and asking questions. Internal medicine is a bit like that. It’s not on good terms with surgery either.”

“… … .”

“Okay, enough rambling. Does anyone know what the answer is?”

“Could it be EIA (exercise-induced asthma)? You said it occurs when you exercise too hard. The symptoms are similar.”

“also?”

“yes?”

“Is that the only reason you thought it was EIA? You said it reacts even when you don’t exercise?”

“that…….”

“You can talk comfortably. The advantage of surgery is that there is no upper or lower limit. Right, Professor?”

“Well, well. That’s our strong point.”

Smart self-PR.

It was truly a sad and funny situation.

Because the busy thoracic surgery associate professor and Jinhyeok were even skipping meals to sow the seeds.

One of the trainees shouted:

“I wonder what it means that there is no up or down!”

“The military discipline is not as strict as you think. No. There is no military discipline at all.”

“Why is that?”

“that…….”

Jinhyuk was silent for a short while.

I couldn’t say that such a culture could not exist in the first place because I thought that if you pester them when there are no people, they would run away.

He changed the subject.

“You’ll know it as you experience it. So what’s the answer?”

“Let me tell you. I learned that EIA (exercise-induced asthma) is caused by airway sensitivity.”

“so?”

“This patient was confirmed by EIA. Could it be that he was exposed to cold air?”

“The symptoms appeared even in the summer.”

“Then, isn’t it possible that the bad air is stimulating the prayer? There are many factors that can cause a prayer response.”

“Symptoms started to appear after I turned 25?”

“ah…….”

The trainee who boldly challenged the correct answer let out a deep sigh.

I don’t think Jinhyuk would have given an easy question.

And it was a wrong answer that was buried in the word ‘excessive exercise’.

* * *

Polycles (trainees) work in independent departments as well as in groups to rotate through sub-departments.

As short as one week.

It is a practical training program that lasts for up to two weeks.

Sometimes I observe.

Sometimes, a polycle stands behind a professor who is seeing an outpatient clinic and watches him like a totem pole.

I also had to submit an impression (expected diagnosis).

Everyone was racking their brains because they had to report and receive evaluations along with the treatment plan.

‘I heard that the hospital director is a supporter of Professor Lee Jin-hyeok.’

‘Hey, hey. Do your best. If you get it right here, you’ll get full marks in the surgical department. I told you the hospital director is behind you.’

‘Oh, it’s difficult. It’s difficult.’

After a while of exchanging glances without answering.

Park Hyuk-soo, who had asked a question after receiving Yoo Yeon-jae’s fortune, raised his hand.

“I think I have OAS (Oral Allergy Syndrome)!”

“You don’t have a pollen allergy?”

“I learned that even if there is no cross-reactivity with pollen antigens, food allergies are also considered OAS.”

“That’s true. But.”

“yes.”

“OAS literally stands for oral allergy syndrome. The symptoms are limited to the mouth or pharynx. But it has reached the level of anaphylaxis.”

“ah…….”

Park Hyuk-soo let out a deep sigh at the thought that he had missed the correct answer.

But this is also a trap.

Jinhyuk smiled brightly.

“In rare cases, it can also cause systemic reactions such as anaphylaxis.”

“Then I will give you the correct answer… … .”

“No, I didn’t even get halfway there.”

“This time, I’ll tell you. It’s not a double-column speech. Can I tell you in a double-column speech?”

“uh.”

After Jinhyuk gave a short answer, he turned his head towards the large, distracted trainee.

“Assuming the medical history is already done, I think we’ll do a skin test first.”

“It’s good to talk about the plan first. But the skin test. I can’t trust that.”

“You mentioned earlier that the accuracy is low. I also read it in the book.”

“Let’s go into more detail. You’re saying that you put in an allergen extract and see how your skin reacts?”

“yes.”

“It’s not universal. If it’s not in the extract, it won’t react. Especially in this case.”

“Well then… … . Hmm… … .”

The large, distracted trainee rolled his eyes.

An allergy that cannot be diagnosed through skin testing.

It was just a hint.

“If there is no reaction to the skin test, you can immediately run an ImmunoCAP (fluorescent enzyme-linked immunosorbent assay, allergy test).”

“It could take a week?”

“I don’t think it’s that urgent because the problem is only with certain food groups.”

“A lot of people came.”

“Thank you, sir.”

“Okay, now I’ll tell you the IgE results. Cor a 9 is 0.67kU/L, Phl p 5 is 0.38kU/L, Cor a 8 is 0.67kU/L, Pru p 3 is 1.83kU/L… … .”

As Jinhyuk started calling out the results of the allergy test.

Everyone had a shocked look on their face.

A look that asks how you memorize all this.

Of course, I wasn’t memorizing it.

He is just roughly giving numbers that fit the cases he remembers.

But right now.

“You, you punk, are you the devil? Huh?”

Even Han Dong-soo shook his head.

This is because the trainee was not aware of terms such as Pru p 3, an allergen found in peaches.

* * *

Just one person.

Even just one person would have been fine.

The future he experienced was one where even nurses would die in a general hospital because of the absence of that one person.

So Jinhyeok, who had to appeal that internal medicine was difficult, smiled awkwardly.

“You have to memorize it. It’s similar to memorizing the seniors’ cadet roster in the military.”

“You’re still underage.”

“What about the professor?”

“Me? I’m an Air Force officer. A reserve captain.”

“Did you go to the military hospital and come back?”

“Then. It’s on a different level from public relations.”

“Well, no matter how comfortable it is, the military is the military.”

“Yeah. Being stuck in a remote corner of the countryside? That’s nothing special.”

Han Dong-soo suddenly shows signs of military aggression.

It was clearly intended to buy time for the trainees.

Just in case you remember.

Although it was advantageous for him not to be able to guess correctly, he was fundamentally a person who loved his juniors.

While we were chatting like that for a while.

One of the trainees immediately raised his hand.

“I…….”

“uh.”

“We haven’t memorized the allergen components yet. Could you please explain the source?”

“Okay. You can think of Cor a 9 as hazelnut, and the others… … .”

The explanation went on for a long time.

Jinhyuk gave another hint.

“First of all, it’s not OAS (Oral Allergy Syndrome).”

“I learned that reacting to certain foods is also called OAS. You mentioned that earlier.”

“Let’s do it right.”

“yes.”

“The specific foods you’re talking about. I’m talking about when they contain proteins similar to pollen.”

“So the cross-reaction is… … .”

“uh.”

Now we’re back to square one.

This time, Jeong So-yeon stepped forward.

“I know I’m allergic to peaches, but apples and plums don’t seem to be related. I really don’t know.”

“There is a connection. All three are in the Rosaceae family.”

“Then peanuts, walnuts, and almonds too… … .”

“It’s the Juglandaceae family.”

“Do I have to memorize even this?”

“If you want to be a great internist, you have to memorize it.”

“Then what about the raw fish? Why did you have an anaphylactic reaction after eating the mixed raw fish? The numbers you gave me earlier were low. And they were negative. I really don’t know.”

Even Jeong So-yeon, who had seemed confident, started to cry.

Eating mixed raw fish led to anaphylaxis, which was different from the number given.

It was clear that he was completely caught in the trap.

“Have you given up on getting the answer right?”

“Yes, to be honest, I don’t know. At first I thought it was OAS. But then you said it wasn’t. Then it seems like it’s an allergy to a certain food group. And that too… … .”

Jinhyuk scanned the expressions of the other trainees.

Even though Jeong So-yeon declared a quick surrender, no one objected to them.

It seemed like everyone had given up.

“The group meeting was a trap.”

“yes?”

“Have you been to Garak Market? If you order assorted sashimi, they give you a lot of different things. Lettuce, peppers, tomatoes, peanut powder. They say they give you so much that your legs will break.”

“then…….”

“I don’t know exactly what the patient ate. I can only guess. I think he ate the food that caused his symptoms.”

“Then what about excessive exercise?”

“I told you earlier. I ate something like peanuts before working out.”

“ah…….”

“The correct answer is LTP Syndrome.”

A disease I’m hearing about for the first time.

Everyone was silent in a heavy manner.

* * *

There are less than 10 minutes left now.

I had to slowly organize things and go up.

“Peaches, apples, plums, peanuts, walnuts, almonds. They are all foods that contain LTP.”

“I’m sorry, I don’t know what LTP is.”

“Lipid transfer protein. It is a food group that contains lipid transfer protein.”

“Do I need to know that?”

“Then, that’s how you become an internist. LTP syndrome. It’s mainly reported in Southern Europe.”

“Then it’s okay if I don’t know… … .”

“No. There are rare cases that occur in Korea, so you have to know them all. Diseases that you don’t have to know about? There’s no such thing. Thousands, tens of thousands of cases. You have to memorize them all.”

“You mean you see as much as you know?”

“uh.”

“and…….”

Everyone’s eyes widened and they started to gasp.

A situation where I already knew through my internship how difficult the job of an internist is.

Outwardly visible symptoms.

And I just realized once again how difficult it is to diagnose a patient’s illness based on a questionnaire and various test results.

When everyone was blinking like that.

Han Dong-soo, who had been linking arms with me, intervened.

“You, you punk. Seriously. Are you the devil? Huh?”

“yes?”

“No, how do you get this right? Is this what you call a problem? Huh?”

I was appealing to how difficult it is to live as an internist.

The same side was committing a team kill.