Chapter 11
Chapter 11
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Translator: crow
Chapter Title: Weird Guy (4)
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Once upon a time, these people might have been called the hands of God in their respective fields, but now, after they died, they were hyped up over some trivial diagnosis from a first-year resident.
Was it that they were starving for real patients and clinical practice?
These crazy workaholic ghosts.
At that moment, the image of me stitching up that kid's forehead earlier flashed in my mind.
The crooked, messy sutures.
What other seniors could have finished in five minutes took me twenty, grunting and struggling just to wrap it up.
In the end, Senior Choi Soo-min couldn't stand it and came over to finish it off, saying, "You're doing fine for now, but you need more practice with suturing."
I could borrow brains, but not hands.
On impulse, I started typing a post in the gallery.
Title: But seriously guys
Author: HellKoreaSlave1
How do you improve hand skills? Took forever even stitching a forehead on a guy who fell. Tips pls.
Post.
Regret hit me the second it went up.
Ah, fuck.
Shouldn't have posted that.
What if they mock me like 'Handicapped? Quit being a doctor'?
***
I slammed the gallery window shut.
I was the idiot for expecting anything.
Anon (14.52): You'll get it with practice.
Back-in-my-day-is-just-talk: Buy some pork rind and practice suturing it at home every day. That's what we all did back then.
Sitting-in-the-OR-Corner-Tard: YouTube's full of suturing tutorials these days. Look those up instead of sitting there like a moron.
God's Scalpel: Hands are pure talent territory. If you can't, you can't. Stick to using your brain.
...Fuck this shit.
I let out a hollow laugh and leaned my head against the wall. This damn gallery wouldn't download hand skills for me.
Ha, maybe I'd never need to use possession.
Wonder if the day would ever come when I scraped together 5,000 LP to make God's Scalpel descend into my body for thirty minutes.
I was wallowing in self-loathing when—
The automatic doors at the ER entrance slid open smoothly, revealing someone I never expected to see.
Professor Choi Young-jun from Rheumatology, the one I'd run into a few days ago over the VEXAS syndrome patient.
My heart dropped.
Why at this hour?
Why the ER of all places?
Don't tell me he came to chew me out because it wasn't VEXAS after all?
Professor Choi walked straight toward me without even glancing around.
"Han Hyun-jae."
"Yes, Professor! What brings you here?"
I shot up reflexively and bowed at the waist.
Professor Choi acknowledged my greeting with a light nod, then shoved his tablet PC right in my face.
"I was passing by while checking the patient's progress, and today's bone marrow biopsy results caught my eye—they're intriguing. Thought I'd drop in."
The screen was crammed with English abbreviations and numbers on the lab report.
Bone marrow biopsy result: Hypercellular marrow with prominent erythroid and myeloid dysplasia… prominent ring sideroblasts (18%)…. UBA1 somatic mutation confirmed. (*Bone marrow biopsy result: Hypercellular marrow shows distinct erythroid and myeloid dysplasia. Prominent ring sideroblasts (18%) confirmed. UBA1 somatic mutation confirmed.)
"Han, anything ring a bell with these results? You said you were interested in rheumatic diseases, right?"
It's the VEXAS patient's results, so obviously VEXAS-related.
But what these numbers and terms specifically meant? Fuck if I knew.
Shit. Emergency.
My mind went blank. UBA1 mutation confirmed means definite VEXAS diagnosis.
But the clinical implications of the other findings? No way a first-year like me would know that. Plus, I'm an ER doc, not Internal Medicine.
Anyway, to avoid wrecking my image, I had to buy time desperately.
I plastered on my most intellectual expression and pretended to study the tablet screen.
At the same time, the gallery window was flying open at light speed.
Title: Guys what is this??? VEXAS pt bone marrow biopsy URGENT
Content: (scanned photo) Hypercellular marrow, dysplasia, ring sideroblasts 18% What does it mean?
The instant I posted, I opened my mouth and started bullshitting to stall.
"Uh, Professor. Give me a second. From what I can see, considering the bone marrow findings and genetic markers together, it's hard to dismiss this as just autoimmune inflammation..."
I mashed words together and spewed nonsense into the air.
Professor Choi stood there, arms crossed, watching me with keen interest.
Please, just one comment!
My inner scream must've worked—the corner of my vision lit up with a notification.
Hematology-is-Hell: Besides UBA1 mutation, clear MDS (*Myelodysplastic Syndrome) findings. Ring sideroblasts over 15% puts it in high-risk group. Means VEXAS progressing to MDS. Prognosis sucks—needs Hematology-Oncology consult now for chemo and maybe hematopoietic stem cell transplant plans. Otherwise, leukemia in a few years.
The fog in my head cleared instantly.
"Professor, let me cut to the chase."
Professor Choi's eyes widened slightly.
"This patient has very likely progressed to myelodysplastic syndrome—pre-leukemia, basically blood cancer precursor."
I pointed to the 'ring sideroblasts 18%' on the tablet.
"Especially with ring sideroblasts over 15%, it's high-risk. If left as is, acute myeloid leukemia transformation is highly probable within years. We need to contact Hematology-Oncology immediately for chemo and long-term allogeneic hematopoietic stem cell transplant planning."
A heavy silence fell over the ER station as I finished.
Professor Choi stared at me in disbelief, mouth slightly agape.
At first, it seemed like intellectual curiosity.
Like, 'Oh, not bad?'
But as my explanation went on, his gaze turned to outright shock.
He gawked at me blankly for a long stretch. I nearly suffocated in that time.
Did I overstep? Too know-it-all for a first-year? Crossing into Hematology-Oncology territory arrogant?
"Han."
"Yes, Professor."
"You prepping for Internal Medicine double board or something?"
...?
"...Pardon?"
The words tumbled dumbly out of my mouth.
Double board.
One doctor getting certification in two specialties.
And he's asking me that?
Seeing my blank face, Professor Choi chuckled, shook his head like his own question was ridiculous.
"Nah, forget it. I got ahead of myself. Our hospital's ER just got a real gem."
Professor Choi patted my shoulder with genuine admiration.
"Learned a ton today, thanks to you. I'll pass it along to the Director."
With that, he turned and left the ER with a light step.
Wait, what?
Director? Pass what along to the Director?
Hey, fuck?
I could feel the stares around me shifting.
Standing there dazed in the awkward silence, a massive shadow loomed over me from behind.
I turned around very, very slowly.
Senior Lee Min-jae, the ER chief resident, had been standing there god-knows-how-long, mouth agape.
He must've heard every word of my convo with Professor Choi. That look said it all.
The chief alternated between staring at me and the direction the professor vanished, like he'd seen a ghost.
"You crazy bastard!"
Whoosh!
Senior Lee grabbed both my shoulders.
Not this again. What now? Why torment me?
"You... you little shit! Prepping double board behind my back?! No wonder! You seemed off from the start!"
I couldn't think straight amid the chief's roar.
"Hey! That's why you knew all those Internal Medicine cases cold? Huh? Spouting rare diseases we don't know—all prep to switch to IM? ER just a pit stop?! Betraying us! Your ER comrades! To bail to Internal Medicine, you traitor!"
The chief's wail had crossed the river of misunderstanding into the ocean of delusion.
All I could do was stand there getting shaken. My head was starting to spin, but I kept my mouth shut.
Explain?
What could I even say?
This guy's not listening anyway.
Fuck, Senior, first-years don't prep double boards.
I'm just a temp surviving day by day without getting reamed or killing patients.
Double board my ass. Right now, I'd kill for a double cheeseburger and some sleep, fuck.