Chapter 15
Chapter 15
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Translator: crow
Chapter Title: Special Tutoring (3)
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Latte's Like: What's so exciting? Sit down.
Cardiology Ghost: Morning? Cut the crap and open your book. We're starting with a review of that Wells syndrome you got wrong yesterday.
Nephrology Geezer: We let you sleep through yesterday, and now you're climbing the walls? Not today. Get ready.
Rheumatology Granny: Come on in, my little quack. Today we're memorizing the serologic diagnostic criteria for lupus perfectly. If you don't, I'll make your brain swell up like lupus cerebritis.
Fuck. Don't these bastards ever sleep?
No, they're dead, so of course they don't sleep.
Goddamn it.
Korean Intern Hell #1: ?
Korean Intern Hell #1: I'm off today.
Yeah, today was a godsend holiday. A day off.
But apparently, the gallery ghosts didn't give a shit about my day off.
Latte's Like: Off? On call? Who cares?
Pulmonology Ghost: Since when do doctors get days off? Patients don't stop hurting just because you're slacking. Let's study.
God's Scalpel: Idle hands get stiff. Idle brains rot. Shut up and start.
I was floored.
These workaholic ghosts had no concept of rest.
"Fine. Let's do it. Yeah. You fucking assholes."
And just like that, my sacred day off turned into a forced study session with otherworldly master physicians.
***
How much time had passed?
Dozens of ECG waveforms flashed through my mind. The Cardiology Ghost hurled bizarre, atypical EKGs at me, pushing me to the brink.
Cardiology Ghost: What's this one! Brugada syndrome! See how the ST segment lifts in that curved type! What about this? WPW! You see the delta wave? Are your eyes just for show!
ㄴ Korean Intern Hell #1: Got it!!
"Yeah, yeah! I see it! I see it!"
No sooner had my scream ended than the Nephrology Geezer took the baton.
Nephrology Geezer: Think electrolyte imbalances are a joke? Here, DKA patient. Gave insulin, and now phosphate levels are crashing. Why? Treatment? Can't answer, and I'll strip every last phosphate from your bones.
"Insulin drags glucose and phosphate into the cells together, causing hypophosphatemia! Treatment is oral or IV phosphate supplementation!"
I howled out the answer, nearly in tears as I typed.
By the time I came to, the Rheumatology Granny was barking at me to list the antibodies for rare autoimmune diseases, and without a moment to catch my breath, the Pulmonology Ghost dumped dozens of arterial blood gas results, demanding interpretations.
Every now and then, God's Scalpel ordered me to fetch pork rind.
God's Scalpel: Not good enough yet. Subcutaneous suturing practice this time. No scarring—stitch under the skin. Video it and report every five minutes. Fuck it up, and I'll do the same to your face.
I staggered to the table, grabbed the needle again.
My hands were just a tiny bit better than yesterday.
How much longer?
Right before my soul detached from my body.
Latte's Like: ...That's enough!
Cardiology Ghost: Hm, better than yesterday. Looks like your brain sprouted a couple wrinkles.
Nephrology Geezer: Remember this. Patients don't come straight out of textbooks. Always assume the worst.
God's Scalpel: That's it for today. Get lost!
God's Scalpel said it like he was doing me a favor.
Korean Intern Hell #1: Thanks everyone. Good work.
I barely managed to reply.
Whew... Finally, some rest.
It's over.
Liberation.
I hauled my tattered body upright. Outside the window, darkness had already settled thick.
I picked up my phone in a daze.
What time is it?
The number on the screen hit me like a brick, freezing my brain.
[7:13 PM]
PM?
Seven?
I roared with enough fury to shake the officetel.
"You fucking ghost bastard pieces of shit!!!!!!!!!!!!!!!"
.
.
.
***
A blaring alarm jolted me awake.
Ding ding ding.
Good morning.
Bap bap bap bap bap bap bap bap.
"Fuck...."
A raspy voice burst out.
Yesterday's "day off" hadn't been a day off. It was torture, abuse, a hellish study group.
I rose like a zombie, stumbling to the bathroom. The mirror showed a first-year slave even more wrecked than yesterday—if anything. I flipped the bird at those hollow eyes.
Regulations.
'You assholes... give me back my day off.'
I changed clothes and boarded the bus to the hospital, face like a rotting corpse.
I thought this was a cheat key, but I never imagined it'd be one of the things fucking up my life. These maniacs are dead serious about education.
I considered opening the shop for a fatigue recovery potion but prioritized buying the possession skill, so I closed it right away.
***
8 AM.
Emergency Medicine conference room.
I wedged myself in the most obscure corner to stay invisible.
"Alright, let's begin. Last week's case."
The presenter was Lee Min-jae, a fourth-year chief resident.
"48-year-old female patient. Presented with persistent fever over 39 degrees for a week, myalgia, and arthralgia. Initial labs showed elevated WBC and liver enzymes but nothing else remarkable. Blood cultures and imaging failed to pinpoint the infection source. Classic FUO—fever of unknown origin."
The screen was crammed with the patient's tangled labs and charts.
The chief methodically ruled out differentials, explaining the logic without a single stumble.
The presentation was clean, no fluff. The guy's an ECG pervert with a quirky personality, but his skills are top-tier among the residents.
"...So ultimately, combining sky-high ferritin over 20,000 on bloodwork with the characteristic symptoms, we diagnosed Adult-Onset Still's Disease and started high-dose steroids. Patient's showing dramatic improvement and is stable on the rheumatology ward."
When the presentation ended, Director Park Woong—who'd been sitting front row, arms crossed, listening quietly—spoke up softly.
"Good presentation. Solid case. Ferritin was the key clue for AOSD."
The director nodded, satisfied, then suddenly turned, scanning us juniors.
My heart plummeted.
I know that look. Incoming pop quiz.
Please, not me. Please.
"Ferritin spikes abnormally in AOSD, as we know. But in the ED, when you see extreme hyperferritinemia over 20,000, there are other deadly differentials you must rule out. Essential knowledge for emergency physicians."
The director's gaze drifted through the air before locking dead on my eyes.
"Dr. Han Hyun-jae."
Ah, fuck.
"Give us your take. What else?"
Every eye in the room turned to me.
My mind went blank. Ferritin? Hyperferritinemia? I've heard of it.
List multiple non-Still's diseases? Right now?
My mouth went dry. Cold sweat trickled down my back.
Pity flashed across the chief's face as he saw my panic.
...?
Huh?
Wait a sec.
Ferritin... hyperferritinemia...
Didn't one of those ghost bastards grill me on this yesterday?
Hematology-Oncology Ghost? Shoved cancer cases at me, stressing ferritin levels.
'Dumbass! When ferritin hits five digits, what's the first thing you think? Your patient's cytokine storm is raging, and they're dying right in front of you!'
Yesterday's memories flickered back.
I stammered, opening my mouth.
"Uh... first off, systemic inflammatory response with sepsis."
The director's eyebrow twitched up at my answer.
"And... uh... MAS—Macrophage Activation Syndrome—can cause extreme ferritin spikes too. Especially in rheumatic disease patients..."
Memory fragments clicked into place.
The knowledge those ghosts crammed into my skull was saving me in conference.
"Also, lymphomas or leukemias—hematologic malignancies—can release massive ferritin from tumor cells. And in fulminant hepatic failure, severe hepatocyte damage floods the blood with stored ferritin."
Silence blanketed the room as I finished.
I held my breath, waiting for the director's reaction.
Please, be right? Spare me.
He stared at me for a beat, then nodded with a satisfied smile.
"Correct. Excellent. Mentioning MAS deserves special praise."
Whew.
All tension drained from my body.
The chief gaped at me, and the seniors and peers stared in shock.
Yesterday's hellish day felt rewarded.
Of course, the downside was they'd peg me as "that psycho prepping for internal medicine double boards." Fuck.