Chapter 70 – Judgment Day (4)

『…』 – talking in English/other languages

When he entered the video room, Dowook could immediately see why Chief Won called him urgently. The new symptoms in the patient were neuro-related.

“Hurry up and check it out. He’s suddenly complaining of a severe headache.”

Dowook approached the stretcher and met Professor Yeon Jung-woong of the VIP Internal Medicine Department. He was the doctor in charge who criticized him about Gabi’s disease.

“Dr. Park.”

“Professor Yeon.”

Professor Yeon, who greeted Dowook with an unhappy gaze, took a step back.

“Sir.”

Dowook checked the patient’s level of consciousness as a habit after taking out his penlight and immediately spoke in English when he realized that the patient was an American.

『Sir. Can you see this light?』

A patient wearing a respirator nodded in response to the light.

Spasms in the left eye. Edema on the eyelids. Cold sweat on the forehead and face. When he organized the information about the symptoms in his head, the Santa fairy’s sense immediately found the guidelines.

‘It’s really convenient.’

Seeing the light glistening and disappearing around the patient’s eyes, he found that there was a slight conjunctival hemorrhage.

Dowook, who turned his head away from the patient, said.

“It looks like cluster headache syndrome. I think we need to relieve symptoms first by administering ergotamine or sumatriptan.”

“What?”

Professor Yeon was the first to respond to the diagnosis Dowook gave.

“Hey, Dr. Park. I guess you’re saying that because you don’t know what symptoms this patient was brought here for. Do you think it’s a correct diagnosis if you only see a part of the symptoms and name any disease?”

“I’m talking with that in mind. Cluster headaches themselves have a wide range of triggers, such as alcohol and stress.”

“Ha. In front of an internal medicine specialist, the surgeon discusses triggers.”

“Anyway, if you don’t solve that headache quickly, the patient’s consciousness will decrease. It’s going to be harder to treat.”

Chief Won also called in neurosurgery because he was in a hurry, but he looked at Dowook with little trust.

Ryu Chul, who followed and was watching this process, suddenly asked the nurse next to him.

“I… I’m sorry. Tom Brand, is it a more dangerous disease than pericarditis?”

Professor Yeon’s ears pricked up at Ryu Chul’s question.

“Who are you?”

“Ah. I’m a volunteer who came with Dr. Park Dowook. I’m actor Ryu Chul.”

Professor Yeon asked with a face that seemed not interested in the fact that a famous actor was in one room.

“Where did you hear of pericarditis?”

“Dr. Park Dowook told me earlier”.

Professor Yeon was speechless at Ryu Chul’s unexpected answer. Chief Won, who was standing nearby, was surprised and asked.

“Did you hear the diagnosis we just came up with in there from Dr. Park?”

“Yes. What was it? If it’s bacterial, it can be dealt with antibiotics, but he was also worried that cancer would be a real disaster.”

When it was revealed that Dowook actually presented another diagnosis name with pericarditis in mind, both Chief Won and Professor Yeon were speechless.

Silence unintentionally descended on the room.

Chief of the International Medical department Lee Joseph told the nurse.

“Please bring ergotamine. We’ll continue with the CT scans.”

Dowook, who finished his job, completely withdrew from the patient.

“This is all my diagnosis. Then, keep up the good work.”

Lee Joseph raised his hand to Dowook who wanted to leave after saying his greeting.

“Dr. Park Dowook. The patient also showed neurological symptoms, so could you participate in the consultation until that is confirmed?”

“Me?”

“Yes, I understand that you’ve been in charge of VIP patients before.”

“Well, that’s…”

When the person in charge said this, neither Chief Won nor Professor Yeon could complain. In the meantime, the nurse came in with a tray of drugs and aerosol injectors.

Cheek and ergotamine were sprayed to the tip of the nose, and Tom Brand lay under the CT machine with a much better expression.

Standing on one side of the video room, Ryu Chul crept up to Dowook and smiled meaningfully. Dowook asked quietly.

“Did you mention it on purpose?”

“The timing was amazing, right? This is an experienced actor. I’m a huge fan of the White Tower.”

A CT image of Tom Brand’s chest appeared on the screen. All the medical staff’s eyes gathered on the monitor.

And

All the doctors who realized the meaning of the video let out a groan at the same time.

Ryu Chul asked Dowook.

“What’s wrong?”

“This is…”

Dowook pointed to the crumpled area near the liver.

“That’s a damage factor, which is mainly found in smokers.”

“Smoking is bad for you. I know it well, but what’s wrong with that?”

“It’s acute. Cigarettes generally don’t cause this much acute damage. Here, you can suspect the action of other drugs similar to cigarettes.”

Ryu Chul also understood and groaned. It was similar to cigarettes but illegal in Korea.

“Maríjuana…”

Dowook saw that the Santa fairy’s guidelines on the patient sparkled and disappeared in all directions arbitrarily due to new evidence.

This was probably because all preceding diagnoses were denied.

Joseph said to everyone in the room.

“The medical history of VIP patients is confidential. Please refrain from contacting the outside world at all until the confirmation is completed.”

To Tom Brand, who was moved back to the negative pressure bed. Joseph began to explain slowly.

『The most suspicious cause of Mr. Brand’s illness is the side effects of marijuana. The THC component that causes nervous system disturbance can explain all the symptoms Mr. Brand is currently experiencing.』

『So. You’re saying that I’m in this state because I took drugs, right?』

『We estimate so.』

Tom Brand frowned.

『What if I’ve never smoked?』

『That’s…』

『If you’re going to say something like, “Let’s take a drug test,” I’ll have to move to another hospital. It’s unpleasant.』

Yeon Jung-woong quickly approached next to Lee Joseph, who was embarrassed.

『We just checked the symptoms and informed you the results. If Mr. Brand’s words are true, aseptic meningitis would be closer than drug addiction.』

『Aseptic meningitis?』

『It is an infectious disease in the central nervous system, and most of them recover naturally, but if they were traveling to and from various countries on a tight schedule like Mr. Brand, their immunity would have decreased. That’s why it developed.』

Dowook, who’d been quietly listening at the back, nodded because it was a reasonable diagnosis. Ryu Chul poked Dowook’s side and asked quietly.

“What are they talking about? I think he’s a little angry. There are so many medical terms that I can’t keep up with. Do you understand everything?”

“Just roughly. What we read every day are overseas papers.”

Dowook explained that the diagnosis shifted from marijuana side effects to aseptic meningitis.

“That’s right, that’s right. Tom’s a good person in real life. No matter how common marijuana is in the United States, I’ve never seen it scattered when filming. He’s exactly like Jet America.”

“I guess we shouldn’t have suspected it.”

“Wait. Was it because he was sick during the shoot? He was a bit forgetful. He often forgot his lines.”

“What?”

Forgetfulness was not a symptom of aseptic meningitis. However, when combined with other symptoms, a completely different diagnosis came up.

Chest musculoskeletal pain. Pericarditis. Liver inflammation. Cognitive dysfunction.

As the puzzle was put together, Santa Fairy’s guidelines clearly sparkled.

Tom Brand’s head. It shone accurately in the white matter of the right frontal lobe. However, since the diagnosis had been changed several times so far, he wasn’t so confident about bringing it up.

It was certainly not easy to communicate and to examine patients with completely different cultures. Just looking at Ryu Chul, Santa Fairy’s guidelines clearly emphasized “hemorrhoids” “hemorrhoids” “hemorrhoids.”

Tom Brand’s agent asked Lee Joseph.

『If you’re sure of that, please do something quickly. Can’t you see from Tom’s face that’s about to die from the pain?』

Joseph nodded.

“Professor Yeon?”

『Antiviral drugs could be injected immediately after a cerebrospinal fluid test confirmed the virus. Until then, we will perform symptomatic therapy with steroids and pain relievers.』

Flinch.

The old man’s sense suddenly gave off a strong impulse when he heard Professor Yeon’s response.

Spinal tap performed to confirm aseptic meningitis. This could pose a completely contradictory threat to the diagnosis directed by the guidelines.

Dowook spoke to Professor Yeon, who was preparing a long needle for tapping.

“Hold on, professor.”

Since the inside of the room was quiet, everyone’s eyes turned to Dowook at his words.

“If you have tumor symptoms in your skull, the intracranial pressure will increase with that puncture. Then the patient’s headache will be dozens of times worse than it is now.”

Professor Yeon snorted.

“What did you say? Tumor? What brain tumors in the world cause simultaneous diseases that make you suspect hepatic inflammation and pericarditis?”

“It wasn’t at the same time. Liver, heart, chest, brain. It’s blood vessels that pass through all of these, and there are lymphocytes in them. The symptoms spread.”

“So what do you want to say?”

Dowook remained silent for a while. And he said the name of the disease that the Santa fairy’s sense claimed more clearly than ever.

“That patient. I think it’s a primary central nervous system lymphoma.”

Professor Yeon laughed in vain when Dowook mentioned a rare tumor that occurred in 0.5 out of 100,000 people. Chief Won tumbled and clicked his tongue and pointed at Dowook.

“You’re talking like a movie star to diagnose a movie star. Dr. Park Dowook. Can you take responsibility for that? Can you tell Tom Brand that he’s going to die because of a malignant tumor?”

“If you do a contrast MRI and biopsy of the tumor, you can confirm it. And then it’s the doctor’s duty to tell you the results.”

“Biopsy? Oh, my ears are itchy. Why do you keep talking nonsense? Professor Yeon. Hurry up and finish the spinal cord examination.”

Dowook’s diagnosis was ignored, and Professor Yeon’s needle dug into the back of Tom Brand’s waist and spine.

Flinch. Flinch.

The impulse was stronger than before, so Dowook clenched his fists and suppressed it as much as possible. Participating in the collaboration did not mean the right to decide on treatment.

Professor Yeon neatly pulled out the spinal fluid and put it in a syringe. Professor Yeon, who put the syringe on a sterile tray held by the nurse, looked at Dowook.

“Dr. Park. What did you just say? The patient’s headache will be dozens of times worse? Does it look like that right now? It doesn’t even make sense…….”

Professor Yeon stopped talking because Tom Brand suddenly began to shake.

“Convulsions?”

“It’s epilepsy!”

At the same time as Dowook shouted, he ran toward the patient, took out all the anticonvulsants filled on one side of the wall, and put them on the cart.

Topiramate, Ramotrijin, Bibabatrin…….

Among the dozens of anticonvulsants, Santa Fairy’s guidelines, which considered the patient’s age, accompanying disease, and interaction with other drugs, selected two pills.

He pointed it out right away and stuck it out to the patient.

『Take it. The convulsions will stop.』

“Park Dowook! What are you doing?”

Chief Won, who was screaming, also had to close his mouth because the patient stopped convulsing.

When Professor Yeon’s diagnosis failed perfectly, Tom Brand began to get mad at the agent.

『I heard that Korea has excellent medical standards! What are they doing? What have you been doing to me for an hour?』

『Calm down, Brand. All of these people understand English.』

『I’m going crazy because I’m sick. What do you mean calm down?』

Chief Lee Joseph turned to Dowook while listening to the conversation with an awkward look.

“Dr. Park Dowook. Are you sure about the diagnosis?”

“If it weren’t, I wouldn’t have intervened rudely.”

“Okay.”

Lee Joseph approached Tom Brand.

『Mr. Brand. Our neurosurgeon strongly claims that your disease is a primary central nervous system lymphoma.』

『How can I trust a simple claim? You made me a drug addict earlier.』

『That part is my mistake as the person in charge of diagnosis, but one thing is certain. If lymphoma is correct, that doctor’s clinical reasoning ability to find it in just an hour is among the world’s top. It is rare and difficult to find this disease so quickly. In ordinary hospitals, it may take weeks to be confirmed.』

Tom Brand’s eyes moved toward Dowook who relieved his pain by taking action immediately after the convulsions occurred. Come to think of it, that doctor had prescribed him something when he suffered from a headache in the previous room.

『What should I do to trust that argument?』

『There are a few tests we have to do.』

Tom Brand nodded and showed consent. Lee Joseph turned to Dowook and said.

“From now on, please lead the examination. Brain tumor patients are under the charge of neurosurgery. And….”

Lee Joseph’s gaze headed toward Won Dong-Gil and Yeon Jung-woong.

“Chief Won and Professor Yeon, please refrain from getting angry. We’re here to collaborate. We’re not here to fight.”

Ryu Chul, who was interested in watching the whole process, saw the two’s poop-chewing expressions, covered his mouth, and laughed.