The Returning Doctor Wanted to Live Quietly - Chapter 354



Only Noblemtl

Episode 354. Overseas Dispatch (6)

The next morning.

Kian turned his head towards Christie.

“Today I will show you a real example.”

“Isn’t that too immersive?”

“yes?”

“They’re saying they’re retaliating by calling me on my off day. Isn’t that too much?”

“No. This is a battle of pride.”

“It seems like they don’t even care?”

He himself is strange.

Gian frowned.

“Didn’t Christie even use her vacation days?”

“He’s clearly a fraud. His dexterity is extraordinary. Why, you said yesterday wasn’t a big deal. You even got his autograph?”

“that…….”

“You didn’t even get a draft, did you?”

“… … .”

“What? Did you really get it?”

“Why would I get your autograph!”

Gian, who had nothing to say, suddenly lost his temper.

The act of receiving an autograph.

It was no different from a beggar’s mentality being displayed.

The habit of waiting in line with someone else for fear of losing out.

The behavior that occurred during the rationing system has simply been reproduced in the same way.

“Dr. Lee just sat there. He didn’t do anything.”

“Really? So you’re more curious?”

“… … .”

“Why is that? You’re under suspicion. You’re saying you didn’t come forward? Isn’t that strange?”

“Huh. He must have left because he was scared. He only knows how to train, but he can’t do anything else.”

“But you’re a little strange.”

“yes?”

“I’m going to change jobs anyway. Why are you so upset?”

Sharp point.

Kian tried to say something in response.

But when he saw the faces of the Korean doctors, including Lee Jin-hyeok, from afar, he smiled silently.

Today is the day to visit the internal medicine department.

It was a day to take down those arrogant guys.

* * *

Missed work due to hospital tour.

At this point, I would have been grateful, but Gian was persistent.

so.

“Okay, let’s go.”

As soon as Jinhyuk arrived, he started walking briskly.

I arrived at the general internal medicine department in an instant.

When the black-haired foreign doctor we had only heard of through rumors appeared, everyone’s eyes lit up.

But that was only for a moment.

Continue what you were doing.

Even when I greeted him, he just gave me a so-so reaction.

At this point, it was close to indifference.

Jang Hyuk-jun, whose pride was hurt as much as it could be, let out a loud voice.

“You don’t even pretend to know.”

“Well, this is normal. This is a country with strong individualism.”

“But it still hurts a little. They say that no comments are scarier than malicious comments.”

“In that sense… … . It’s not wrong.”

Jinhyuk answered with a sly smile.

I’ll be working at the Platenbau Hospital for a while anyway.

I had to show those who unknowingly looked down on me because I was Asian that I was not easy.

That way, we can request smooth cooperation and our hospital life will also become more stable.

As the conversation grew longer, Gian stepped forward.

“Oh, right. I told you not to speak Korean.”

“… …Where are you going now?”

“This time I’m going for the hematoma.”

“Is it a hematoma?”

“I’m going to attend the conference. Why? Are you nervous?”

“Well, let’s go.”

When Jinhyeok shrugged his shoulders, Gian raised the corners of his mouth.

hematoma.

By no means was it an easy task.

* * *

Department of Hematology and Oncology.

The so-called hematoma.

Cancer diagnosis.

Weapon definition.

Choosing an anticancer drug.

Up to capacity adjustment.

You could say that it covers everything about blood diseases and cancer patients.

So, it was by no means an easy place in terms of difficulty.

If the only goal is a cure, then that may not be the case, but this is a place where you need to improve your quality of life.

There were more than one or two things to consider.

“Okay, everyone knows that a Korean doctor is here. Don’t worry about it and let’s get started.”

Instructions from the head of the hematology/oncology department.

There was a lot of discussion.

It seemed like there was more free discussion than in Korea, but I would say it was somewhat stiff.

Without even smiling.

Even the jokes are cold.

It was a really stiff conference.

hereto.

“Ugh. Let’s do something.”

Jang Hyuk-jun whispered.

A sack of barley that has been borrowed.

He was treated like an invisible man. But Jinhyuk didn’t move right away.

The opponent is an expert among experts.

It was only right that I take the opportunity to sneak out.

When 30 minutes had passed so quickly.

Another patient was mentioned.

“A 53-year-old male was diagnosed with gastric cancer 3 years ago and underwent a distal partial gastrectomy via laparoscopy. Follow-up visits were made every 6 months. There has been no evidence of recurrence to date.”

“But why are you asking for power already? It seems like the blood test results haven’t even come out yet.”

“Both the guardians and the patients are anxious.”

“Are you in a hurry?”

“Yes, my condition has definitely gotten worse. I got angry and said that I think I relapsed… … .”

“hmm.”

“If you don’t admit me right away, I’ll go to another hospital.”

Unpopular hospital.

This was the reality of a failing hospital.

Well, it was clear that the patient was also very scared as he had been battling an illness.

“What were the weapons like back then?”

“It was pT1AN0M0.”

“It was the beginning.”

“Yes, the tumor had invaded the muscularis mucosa, but it was early. It had not spread to the lymph nodes. There was no distant metastasis either.”

“Hmm.”

“The biopsy results aren’t out yet, but if you look at the images taken at the emergency room first… … .”

The video was immediately launched.

Before and after contrast-enhanced photos filled the screen.

A mass with unclear boundaries.

Not one, but many.

At first glance, it could be said to be typical.

At this, Jang Hyuk-jun whispered.

“Is this an abdominopelvic CT?”

“Hmm… … .”

“Isn’t that malicious?”

“Let’s wait and see. AFP (alpha phytoprotein) and PIVKA II (pivka two) levels have not been confirmed either.”

This means that there is no liver cancer marker test that can immediately detect infection with tumor cells or viruses.

Jang Hyuk-jun lowered his voice even further as he observed the situation.

“Still. By the way, it seems there are a lot of serious patients here too.”

“Well, I was diagnosed with cancer before. I guess it’s scary.”

“If it were us, we would just be cut at the residency line… … .”

“I think it’s good because it seems like there’s enough discussion and debate.”

“Does this look good? It seems like they raised the issue to ask for a quick decision because they were worried about losing patients.”

Continued muttering.

When he saw the doctor who was briefing frowning, Jang Hyuk-jun shut his mouth.

He continued his briefing again.

“If you look here, you can see that the contrast enhancement is brighter than the liver tissue.”

“It looks like a pseudomembrane (one of the characteristics of hepatocellular carcinoma).”

“yes.”

“But it’s so messy.”

“It looks like you drink wine every day. Not to mention beer.”

“Oh, right.”

“I think I was too careless.”

He had to be observed for a full five years, but he continued to drink before a full recovery was announced.

Even before the biopsy results came out, the atmosphere began to shift to one side.

Excessive drinking.

History of cancer.

Distant metastases to the liver could occur at any time.

But then.

Christie, who had been sitting quietly, stepped forward.

“I’m also curious about the opinions of doctors from Korea. How about we listen to them?”

“Aren’t they the West?”

“But you never know.”

“Don’t you know?”

“Yes. Haven’t you heard the rumor?”

When Christie reminded Jinhyuk of his abilities, the head of the hematology oncology department turned his head toward Jinhyuk.

“What do you think?”

“well…….”

Jinhyuk’s answer was immediate.

Blur the tail of the horse.

I just kept looking at the CT scans that were displayed on the screen.

The blood test results haven’t come out yet.

Patients who also do not have tumor marker test results.

It was difficult to judge just by watching the video.

But Gian, who had been aiming for this, seemed to have seized the moment and made a fuss.

“Well, I’m a surgeon. So I don’t know. You’re not going to say that, are you?”

“Hey. No way. We didn’t get the board that easily.”

“Do you have any knowledge of internal medicine?”

“Well, when you work 100 hours a week, you learn things.”

“I heard that the system has been improved.”

“Because I was working before it got better.”

“… … .”

Jinhyeok immediately covered Gian’s mouth as he was muttering and turned his head towards the head of the blood transfusion department.

“It’s true that this is a typical video, but shouldn’t we consider other cases as well?”

“Are there other cases?”

“Yes, I don’t think we should judge based on the pseudocapsule alone.”

“Isn’t it one of the main factors of HCC (hepatocellular carcinoma)?”

“It can also occur in cirrhosis of the liver. Excessive drinking. Well, it’s common.”

“Hey, Doctor Lee. It’s more often caused by fibrosis around the liver parenchyma and tumor.”

Well, that wasn’t wrong.

That doesn’t necessarily mean it’s true.

Caustic film.

Pathologically, there was no membrane, but it was called a pseudomembrane because it was confirmed only by contrast enhancement.

Jinhyuk immediately pointed to the screen.

“A mass invading the right abdominal wall. The margins are unclear. The shading is unclear. It can’t necessarily be called cancer.”

“Metastatic cancer can do that. It can invade adjacent structures without a pattern.”

“It could be a liver abscess. It could be an inflammatory pseudotumor. It seems like it’s just buried in the history (cancer history). We have to keep all possibilities open.”

“That’s a pretty standard answer.”

“I learned it the right way.”

The atmosphere became tense at Jinhyuk’s answer.

The opponent is Seojeon.

He’s a surgeon too.

I wasn’t an internist, and I didn’t even specialize in hematomas.

The moment one of them was about to step forward.

Jinhyuk hit the player.

“Did you have a fever?”

“There wasn’t any.”

“I see? Then it’s not a liver abscess. I’d like to see another CT scan.”

“that…….”

“Watch other videos too.”

“Yes, sir.”

The screen changes instantly.

The CT images kept changing.

Jinhyeok, who had been observing this, opened his mouth again.

“Huh? Hey, yeah. That video.”

“… … ?”

“Isn’t it a bit strange that the mass is infiltrating between the ribs?”

“Hmm?”

“It looks like an invasive tumor due to chronic inflammation. Isn’t it?”

“Malignancy (malignant tumor) also shows the same appearance.”

“Maybe so, maybe not. I think I’ll keep it for now.”

“They put it in the emergency room?”

“Yes, we need to get the blood test results and then we can power them on.”

“… … .”

Silence fell in the conference room after Jinhyuk’s answer.

* * *

“Well, that’s not wrong.”

The head of the hematoma department nodded obediently.

You can’t know everything with just a video diagnosis.

Given the variety of diagnostic tools available, he quickly admitted that he had been too hasty.

He immediately turned his head.

“When will the lab test (blood test) results come out?”

“It will be out soon.”

“Call me.”

“ah…….”

“Right now!”

“four!”

A resident who immediately takes out his cell phone.

As Jinhyeok watched this quietly, Gian stepped forward.

“Huh. What do you know that makes you want to come out…?”

“There is a Korean proverb that says:”

“… … ?”

“Even if you cross a stone bridge, test it first.”

“The mouth is alive… … .”

Although Gian continued to harass Jinhyeok, he did not respond.

Rather, he was busy taking a close look at the doctors belonging to the hematoma department.

At first I was indifferent.

I got upset later.

Those who accepted the opinion again.

What should I say?

They were the same doctors.

Well, other than the fact that he seems anxious about the hospital going under.

How much time has passed like that?

The test results from the blood test lab were immediately displayed on the screen.

WBC (white blood cell) 8,000.

HB(Hemoglobin) 12.4

Platelet 328.

.

.

.

.

Clonorchis AB (liver fluke test) Negative.

Paragonumus AB (paragonimiasis test) Negative.

Toxocara AB (Toxocara test) Positive.

Jinhyeok’s gaze was directed to the very bottom. That is, to the positive toxocariasis test results.

A parasite found in cats and dogs.

If I hadn’t taken the deworming medication, I could have easily gotten infected.

‘Toxocariasis positive, Actinomyces mistaken for liver cancer. A case I’ve seen before… ‘

“I need to see the liver cancer marker test results, but they won’t come out right away. For now, I… … .”

“… … ?”

“Is it Actinomyces?”

“what?”

“It’s not that the stomach cancer has metastasized to the liver, but it seems to be Actinomyces.”

“… … !”

Everyone looked surprised.

Jang Hyuk-jun whispered next to me.

“Are you sure?”

“I’m almost 90% sure.”

“Is it true?”

“Yes, I need to look at the AFP (alpha phytoprotein) and PIVKA II (Pivka II) levels as well… … .”

“Oh, then that’s fine.”

Jang Hyuk-jun immediately turned his head and straightened his shoulders.

“I think I have actinomyces too.”

It was a spoon-placing feat.

Oh, shame on you.

Jinhyuk’s face turned hot.