Perfect Blind Spot
The eighth hour of the morning in General Surgery Ward 4 at Korea University Hospital resembled a battlefield swept by a massive bombardment. Before the treatment records from the night shift could even be organized, new orders from the staff and chief residents who had finished morning rounds poured down like a waterfall through the electronic medical record system. The screen was filled with a list of red, unconfirmed orders. This was the workload that first-year resident Baek Ijun had to digest before the end of the morning.
Dressing changes for thirty patients, L-tube replacements, blood draws for arterial blood gas analysis, and the endless stream of consultation requests from other departments. It was a tightrope schedule where not only physical limits were tested, but a single misjudgment could directly cost a patient’s life.
At the station desk, nurse Jeong Dain set down a heavy stack of charts and looked at Ijun.
“Doctor Baek. The elderly patient in 402 keeps trying to pull out his nasal tube, so it needs to be resecured. And you’ll have to redo all the dressings from 408 through 412. You saw how many orders came flooding in after the professors finished their morning rounds, right?”
Ijun flipped through the tablet PC screen and answered in his characteristically gentle, composed voice.
“Yes, I just checked the full order list. I’ll start with the central line dressing changes for patients at high risk of infection, then move on to check the nasogastric tube in 402. If any patient’s vitals become unstable in the meantime, please call me immediately even if it means postponing other tasks. I’ll run right over.”
Dain organized the chart labels and replied briefly.
“Understood. I’ll let the floor nurses know in advance so your route doesn’t get tangled.”
Ijun immediately pushed the heavy dressing cart and entered the ward corridor. His route was meticulously calculated. He combined each patient’s severity and the estimated time required for their procedures with the physical layout of the rooms to create the most optimized path. There was not a trace of hesitation in Ijun’s movements as he moved between rooms.
His hands were mechanical in their precision as he opened sterile packs, removed contaminated gauze, and applied fresh sterile dressings, yet infinitely gentle when they touched the patients’ skin.
“It must have stung quite a bit, but you endured it well. The wound site is healing very cleanly with no signs of inflammation. Please avoid straining yourself and rest exactly as you are.”
The patients receiving treatment quickly relaxed at Ijun’s generous voice and confident explanations, showing clear relief. Even amid the overwhelming workload, Ijun was steadily eliminating the ward’s errors one by one without faltering. The system appeared to be under perfect control.
The fifteenth patient to receive treatment was in room 410. The patient was a man in his sixties named Kim Seongcheol, who had undergone a partial colectomy for colon cancer three days earlier. His chart showed vitals hovering at the edge of normal range, with a slight low-grade fever.
Ijun positioned the cart and approached the patient’s bedside.
“Sir, how did you sleep last night? You seem to have a bit of a fever.”
The patient let out a heavy sigh, his face pale, and answered.
“The surgical site keeps throbbing and hurting, so I couldn’t sleep well. Even after the painkiller, it feels really stiff.”
Third day after colon resection. It wasn’t yet time for the pain to fully subside. However, the patient’s slightly shallow breathing and the cold sweat beading on his skin felt too irregular to dismiss as simple postoperative effects.
Possible early sign of anastomotic leak. If the joined section of the intestine has a microscopic opening and intestinal contents are leaking, the first signs before peritonitis develops would be this unexplained low-grade fever and persistent abdominal discomfort.
Ijun’s analytical circuits turned coldly. Palpation alone could not perfectly detect a microscopic leak deep beneath the skin. As usual, Ijun lightly placed his hand on the patient’s abdomen and focused his consciousness beyond the visual cortex of his brain.
Activate T-00 Leonardo da Vinci.
T-00 Leonardo da Vinci
The perfect visualization layer that converted the complex organ structures and tissue tension distributions beneath the skin into a three-dimensional color map. Ijun naturally expected a cascade of red and blue data to pour across his retina.
But nothing happened.
His field of vision remained fixed on the room’s white fluorescent lights and the patient’s pale hospital gown. No tension mapping, no pathways of entangled blood vessels, no visual data of any kind was output.
What is this? A system error?
Ijun squeezed his eyes shut and opened them again. He applied slightly more pressure with the hand resting on the patient’s abdomen and refocused his consciousness. But the Archive remained utterly silent. Even the translucent interface window that always hovered in the corner of his vision had vanished without a trace.
Total blackout. It was as if the system inside his brain had been completely powered down, like a massive machine whose plug had been pulled. This was the first malfunction he had ever experienced.
Ijun’s breathing faltered for the briefest moment. The field of vision that had grown accustomed to an overwhelming sea of information suddenly felt a crushing sense of isolation, as if trapped in a narrow darkroom.
“Doctor. Is there some big problem with my stomach?”
The patient’s anxious voice forcibly dragged Ijun’s consciousness back to reality. Ijun quickly composed his expression and offered his usual generous smile.
“No, not at all. I was just concentrating a little to carefully check whether the surgical site is healing well.”
If the Archive was unavailable, all that remained was the shallow clinical experience and primitive senses of first-year resident Baek Ijun. Ijun gently pressed the patient’s abdomen with both hands and began a traditional physical examination. He moved from the right upper quadrant to the epigastrium, then the left lower quadrant, finally reaching the area near the colectomy site.
When he applied pressure, the patient frowned slightly.
“Does it hurt a lot when I press here?”
“It hurts, but it’s about the same as yesterday. It’s not unbearable—just feels like steady pressure.”
There was no clear rebound tenderness. Nor did he feel the board-like rigidity of abdominal guarding. The inflammatory marker (CRP) on the chart was only slightly above normal based on last evening’s test, and the white blood cell count showed no sharp increase.
Both objective indicators and palpation findings are ambiguous. The highest probability is gas distension and mild pain accompanying the normal postoperative recovery process. If I recklessly demand a CT from the third-year without the Archive’s certainty, I’ll only run into the same wall of hierarchy as yesterday.
Ijun covered the patient with the gown again and reached a conclusion.
“Sir, there is no severe rebound tenderness at the surgical site itself. It seems the intestinal motility hasn’t fully recovered yet, so gas is building up and making you feel stiff. I’ll adjust the painkiller infusion for now and monitor you closely today to see if the fever rises any further. Don’t worry too much and get plenty of rest.”
Ijun’s steps as he left the room were slightly heavier than usual. A diagnosis made without the perfect compass of the Archive. It was like driving blindfolded through thick fog—an overwhelming uncertainty.
But the deluge of tasks allowed Ijun no time to dwell on that uncertainty. His on-call smartphone rang mercilessly, and he had to race through the ward without a moment’s rest.
Three o’clock the next morning. Ijun, who had been dozing on the narrow bed in the duty room, was jolted awake by the piercing vibration of his call phone.
“General Surgery first-year resident Baek Ijun speaking.”
Nurse Dain’s urgent voice poured through the receiver.
“Doctor, Mr. Kim Seongcheol in 410 has unstable vitals! His temperature has hit 39 degrees, blood pressure has dropped to 80 over 50. He’s complaining of severe abdominal pain!”
Ijun sprang from the bed like a spring, still holding the phone. Room 410, Kim Seongcheol. The very patient he had judged yesterday morning—when the Archive was offline—as experiencing “normal postoperative effects” and decided to observe.
“I’m heading up right now. Open the patient’s IV fluids wide to stabilize his blood pressure first, and notify third-year Doctor Oh Jae-hyeong immediately!”
Ijun took the stairs three at a time and burst into the ward. The scene that greeted him was devastating.
Inside room 410, the patient was drenched in cold sweat, clutching his abdomen and letting out agonized groans. The monitor’s red numbers flashed wildly, signaling danger levels. It was the early stage of septic shock.
Oh Jae-hyeong, who stormed in right after, pressed firmly on the patient’s abdomen. The patient screamed and twisted his body. Perfect rebound tenderness and abdominal guarding.
“Fuck, the anastomosis has ruptured! Who checked this patient during dressings yesterday morning?”
Oh Jae-hyeong’s furious gaze landed squarely on Ijun.
Ijun offered no excuses.
“I performed the palpation during treatment yesterday morning.”
“You palpated him and still let it get to this point without reporting anything? He had a low-grade fever since yesterday! His belly was turning rigid as a board and you, a first-year, just pumped him full of painkillers saying it was gas? Put in an emergency CT order right now and call anesthesia for an emergency operation. Move!”
The entire ward shifted into emergency mode. While the patient was transferred to a transport bed and sent down to the operating room, Ijun stood silently in the middle of the chaos, unable to say a word.
A fatal misjudgment made at the cost of a patient’s life. His palpation had been wrong. He had missed the signs.
After the patient was taken to surgery, Ijun stood alone in front of the now-empty room 410 and leaned against the cool corridor wall. The tips of his fingers had turned faintly cold.
Yesterday morning—the low-grade fever and persistent abdominal discomfort. Those had not been simple gas; they were critical signs that the anastomosis was beginning to dehisce and inflammatory exudate was leaking.
If the Archive had been active then, if the visualization layer had shown the abnormal tension, Ijun would have reported to Oh Jae-hyeong without hesitation and pushed for the CT.
But the moment the machine shut down, the horrifying truth was proven: he was nothing more than an inexperienced, dull-sensed ordinary first-year resident.
The Archive is not a permanent miracle. It is an unstable weapon that can shut down at any time if the battery runs out or the system reaches its limit.
Ijun’s gaze drifted through the air. At that moment, a faint light seeped across his retina, and a translucent interface window rose silently.
The system that had been completely offline all day yesterday was now shining normally again, as if it had rebooted belatedly only after the patient’s crisis had erupted.
Looking at the now-active interface, Ijun swallowed a bitter, deep self-mockery.
The moment a doctor relies on machines, he becomes a slave to the system. Drunk on the overwhelming tidal wave of data the Archive provided, he had neglected to cultivate his own ability to read a patient’s subtle cracks with his own two hands and reason.
If he lacked the clinical intuition to find answers on his own when the machine offered none, then in the face of the countless deathly crises to come, he would forever remain nothing but a bystander.
What fills the blind spot when the system is off is ultimately the knowledge in my head and the sensation ingrained in my fingertips.
Ijun pushed away from the wall. In his eyes as he walked toward the emergency exit, the previous composure had been replaced by a profoundly cold and chilling resolve.
A fierce new trajectory was being drawn—one that vowed to perfectly control the vast universe of medicine using only his own power.
His classmate Kim Jinsu emerged from the duty room with a disheveled face, stopped abruptly when he saw Ijun’s expression.
“Hyung. Why do you look like that? I heard 410 went down for emergency surgery. Did Chief Oh Jae-hyeong tear into you again?”
Ijun walked past Jinsu and answered in a calm but infinitely heavy voice.
“It wasn’t that I got torn apart. I paid a very expensive tuition fee and saw my own limits with my own two eyes. In this damn hospital system, the only thing I can rely on is what’s inside my own skull.”
Ijun sat down at the station desk and pulled up the complete chart record for the patient in 410 from beginning to end. The minute fluctuations in lab values, the trajectory of vitals over time, the textual records of the patient’s complaints. He had to begin training right now—reverse-engineering the errors from all these printed characters without the Archive’s visual data.
In the ward at four in the morning, only the dry sound of mouse clicks echoed through the silence.