Matters Outside of Medicine
The screen of the EMR tablet displayed neatly organized data. Kim Young-tae. Sixty-two years old. Fourth day after partial colectomy. All vital signs, including blood pressure, pulse, and temperature, traced stable trajectories. Bowel sounds that had halted immediately after surgery had returned to normal, and the transition from liquid diet onward was progressing without complications.
As Baek Ijun walked the ward corridor for morning rounds, he quietly finished his calculations while checking the final item on the chart. At the current recovery rate, full discharge will be possible in two days.
Yet the instant he slid open the door to room 11, the atmosphere inside the room carried a temperature entirely different from the stable figures on the chart.
Patient Kim Young-tae sat propped against the bed, gaze fixed out the window. His eyes were unfocused and vacant. On the guardian’s fold-out bed, a man in his early forties wearing a wrinkled shirt sat with arms crossed. The moment the door opened, the man’s sharp eyes drove straight into Ijun—like a gaze pulled taut, waiting for someone to arrive.
“Are you the doctor?” the man asked, rising from his chair.
Ijun approached and introduced himself in his characteristically soft, composed voice. “Yes. I’m Baek Ijun, the resident in charge of Mr. Kim Young-tae.”
“I’m his son. When can my father be discharged?”
The question came without preamble. Ijun glanced once at the patient still staring out the window, then met the son’s eyes again.
“The surgical site is progressing very favorably. We plan to monitor him for two more days and arrange a safe discharge.”
“Two days?” The son uncrossed his arms roughly and stepped closer. “Can’t he leave today?”
“Today would be premature.”
“But I asked earlier and they said his blood pressure and temperature are all normal. Why not?”
“The vital signs are indeed stable,” Ijun continued calmly. “However, after colectomy, we must verify that bowel function has fully normalized. In addition, dietary progression is not yet complete, so we need to observe a little longer.”
“Can’t he just go home and slowly adjust to porridge or whatever?”
“If a complication such as bowel obstruction occurs immediately after discharge, he would require immediate readmission. That could extend the recovery period far beyond what it is now.”
“If he just lies still, complications won’t happen! Lying at home or lying still here is the same thing. If something goes wrong, he can just come back then! So discharge him today.”
The air inside the room froze sharply. If something goes wrong, he can come back then. The statement was far too contradictory to come from a guardian whose foremost duty was the safety of a living person.
Inside Baek Ijun’s mind, the analytical circuits processing the situation spun at high speed. The guardian was prioritizing another factor above medical stability.
Ijun lowered his voice slightly and spoke with firm clarity. “Complications after discharge can drastically alter the patient’s prognosis depending on when they occur and how quickly they are treated. Two days is the medically necessary minimum period for the patient’s safety.”
“That damn—! Look, do you even know how much extra the hospitalization fees will be if he stays two more days?” The son’s voice cracked roughly, unable to contain his pent-up emotion. “My father has been hospitalized for a whole month. I work at a small company. Managing work while caregiving is only sustainable for so long. My bank account has reached its limit!”
A heavy silence descended on the room. Ijun looked at the patient again. Even as his son shouted with veins bulging, Kim Young-tae continued staring out the window. No change in expression, no movement. His pale profile made it impossible to tell whether he was listening to his son’s desperate plea or deliberately turning away.
Ijun spoke to the son once more, voice calm. “Two days. Explaining the medically required period is my role. Any discharge schedule after that will be decided entirely by the patient’s own wishes.”
“The patient’s wishes?” The son gave a hollow laugh. “What does my father know about medicine? He just follows whatever the doctors tell him.”
It was then. Kim Young-tae’s gaze, which had drifted only through the empty space beyond the window, trembled for the first time and turned inward. Ijun did not miss the faint quiver at the tip of the patient’s emaciated fingers.
Ijun spoke gently to Kim Young-tae. “Sir, I’ll return later to discuss the discharge schedule with you directly. Please rest for now.”
Avoiding further unproductive argument, Ijun left the room. In the corridor he went straight to third-year resident Oh Jae-hyeong. He approached the senior, who stood at the station desk reviewing an EMR monitor, and delivered a concise report on room 11: the patient’s medical status, the guardian’s stubborn demand for immediate discharge, and the economic pressure beneath it all.
Oh Jae-hyeong listened in silence until the end, eyes never leaving the chart, then issued instructions in a detached tone. “Connect them to the social work team.”
“The social work team?”
“Yeah.” Oh Jae-hyeong clicked the mouse and continued dryly. “If the issue is inability to cover hospitalization costs, the hospital has channels for financial assistance. Route them there for consultation. It’ll persuade the guardian far more quickly.”
Ijun turned the words over in his mind. Not forcing medical justification head-on in defense, but creating a practical detour that can be taken.
“Understood. I’ll handle it immediately.”
Oh Jae-hyeong closed the EMR window, turned, and looked at him. “Repeating medical explanations like a parrot to the guardian achieves nothing.”
“Yes, I’ll remember that.”
“You must first identify exactly where the guardian is hitting a wall. Only then can our next intervention land. Your job as a first-year resident isn’t limited to monitoring patient signs alone.”
As a first-year resident and primary physician, the core duty was to observe, judge, and determine treatment direction while staying closest to both patient and guardian. Beyond pathological signs, one also had to read and understand the surrounding circumstances.
Having said his piece, Oh Jae-hyeong strode briskly toward another room. Ijun quietly watched his direct senior’s retreating back. A third-year resident steeped in outdated customs and prone to dumping unreasonable workloads. Yet the advice was a razor-sharp practical tip only someone who had survived the brutal frontline of a university hospital could offer.
Teacher Oh Jae-hyeong just taught me. Without making a show of teaching, in the most efficient way possible.
Without delay, Ijun approached ward nurse Jeong Dain. “Nurse Dain, would you happen to have the direct number for the in-hospital social work team?”
Dain read the situation at once and began skillfully flipping through the directory. She wrote the number on a sticky note, handed it over, and lowered her voice slightly. “It’s about the patient in room 11, isn’t it? I saw the guardian walk past earlier. His complexion was awful.”
“It seems he has reached his limit with the hospitalization fees.”
“That guardian has his own story.”
“What sort of story?”
Dain glanced around cautiously before adding in a careful tone, “I heard his mother was also hospitalized in the ICU of another hospital for a long time last year. I don’t know the details myself—just overheard other guardians talking in the lounge.”
“I see.”
“Of course, that doesn’t make the forced discharge demand acceptable. Still, it’s true that fees at a university hospital like ours are a heavy burden. It’s not entirely incomprehensible. Though as medical staff, I probably shouldn’t say that.”
Ijun pocketed the note and offered Dain a relaxed smile. “Consecutive long hospitalizations for both parents… That may not be the whole story, but it certainly explains the behavior I saw in the room this morning.”
Ijun picked up the station phone and dialed the social work team. Not the reason, but the explanation. The practical approach Oh Jae-hyeong had given him resonated with that truth.
At two o’clock in the afternoon, a social worker came up to Ward 4 and sat with the guardian of room 11 in an empty consultation room. Ijun deliberately did not attend. The presence of the attending physician in a discussion of financial support could wound the guardian’s pride.
Thirty minutes after the consultation ended and the guardian returned to room 11, Dain approached Ijun while he analyzed another patient’s chart and gave his arm a light tap.
“Doctor, why don’t you walk past room 11 now?”
Ijun rose and moved slowly toward the room. The sliding door was firmly closed. Through the small rectangular window he observed the interior. Kim Young-tae lay on the bed; his son sat beside him. The same son who had spent the morning stiff-faced and shouting now held his father’s emaciated hand tightly in both of his own. Whatever conversation passed between them was inaudible through the glass. Yet the son’s broad back was clearly slumped more heavily than usual. And Kim Young-tae’s gaze, which had wandered the empty space outside the window all morning, was now fixed entirely on the son before him. A faint but warm light had spread across the once-expressionless face.
Ijun stood in the corridor and watched the scene in silence.
“Matters outside of medicine,” Dain whispered beside him, having approached unnoticed. She gazed through the glass. “The patient’s vital signs have definitely improved, haven’t they? There are always elements in the ward that medical treatment alone cannot explain.”
Ijun withdrew his gaze from the window and agreed. “Indeed. It seems data like that—data never written in the charts—has been accumulating.”
Dain gave a faint smile. “It looks as though the patient is comforting his son in the same way one would perform a treatment. How is something like that possible?”
“The saying ‘There are no dutiful sons in prolonged illness.’ I don’t think it’s spoken by undutiful sons, but by dutiful ones like him. The patient understands that his son acted that way because he was driven into a corner by harsh reality. He’s telling his son it’s all right first, so the boy won’t be crushed by guilt.”
With those words, Dain walked back toward the station. Ijun stared once more at the closed door of room 11. Even the Archive system, which visualized the mechanical tension on the patient’s body and the progression of inflammation, could not read the emotional trajectory existing beyond that door.
During evening rounds, Ijun knocked lightly on the door of room 11 and entered. Only Kim Young-tae lay on the bed; the guardian was absent. Ijun approached, took out the blood-pressure cuff and thermometer, and began the routine check.
“Did the meal go down comfortably?”
“Yes. Thanks to you, Doctor, it settled well.”
After recording the vital signs on the tablet and exchanging greetings, Ijun was turning to leave when—
“Doctor.”
Kim Young-tae’s low, hoarse voice caught him from behind. Ijun stopped and turned to face the patient fully.
“My son was rough with you earlier. I’m sorry.”
“Not at all. From a guardian’s perspective, it was a sufficiently frustrating and hopeless situation. I understand.”
Kim Young-tae slowly shook his head at Ijun’s reply. After taking a measured breath, he continued in a calm tone.
“I’ll stay here and lie down for those two more days. I’ll do exactly as you instruct.”
Ijun waited silently for the next words.
“I want to cross the hospital threshold and go home as soon as possible, too. But the thought of leaving and then being carried back into this room because something went wrong is terrifying beyond words.”
A faint moisture gathered in the wrinkles around Kim Young-tae’s eyes.
“Understand that my son made a mistake with you because, unintentionally, both parents in our family have suffered serious illnesses in succession since last year, leaving him with no margin left. Fortunately we’ve found a way. Now I just need to receive treatment diligently, recover completely, and go home. I don’t want to come back here again.”
It was no longer the lethargic face from that morning. Ijun offered his characteristic warm, generous smile.
“You truly are recovering well. I will help you both to the very end so that the day after tomorrow you can leave smiling together.”
Kim Young-tae gave a small, comfortable nod.
After leaving the room, Ijun walked the quiet corridor, unraveling his thoughts. There definitely exist data that are never recorded on charts.
External circumstances rather than medical ones. The inner calluses formed by long-term illness. And the primal fear a living being feels toward complications.
The detour route Teacher Oh Jae-hyeong showed me, the guardian’s background Nurse Jeong Dain pointed out—both were ultimately processes for handling these invisible data.
Ijun continued calculating without slowing his steps. Whether such emotional exchange and human persuasion belonged outside of medicine or inside the domain of guiding a patient to complete cure. A clear result had not yet been derived.
Back at the station, Ijun pulled out a chair and sat. The EMR monitor’s glow lit his face. The final case of the day blinked on the screen. Without hesitation, Ijun placed his hands on the keyboard. He could not yet define the exact boundary of medicine, but the trajectory of what he needed to do right now was crystal clear.