Private Tutoring (3)

Fuck. Do these bastards never sleep? Right, they're dead, so of course they don't. Dammit.

Yes, today was a god-given day off. My off-duty day. But apparently, my day off meant absolutely nothing to these gallery ghosts.

I was utterly speechless. The concept of rest simply did not exist to these crazy, workaholic ghosts.

"Fine, let's do it! Let's fucking do it, you bastards!"

And just like that, my sacred day off was hijacked and transformed into a forced study group run by deceased medical geniuses.

How much time had passed? Dozens of ECG waveforms flashed through my mind. CardiologyGhost relentlessly pushed me, throwing all kinds of bizarre and atypical EKGs my way.

"Yes, yes! I see it! I see it!"

Before my scream could even fade, NephrologyGeezer snatched the baton.

"Hypophosphatemia caused by insulin driving both glucose and phosphate into the cells! Treatment is phosphate supplementation, either orally or intravenously!"

I practically wailed as I typed out the answer.

Before I knew it, RheumatismGrandma was barking at me to recite the antibodies associated with rare autoimmune diseases. Without giving me a single second to catch my breath, PulmonologyGhost shoved dozens of ABGA (arterial blood gas analysis) results in my face, demanding immediate interpretations.

In between all this, GodOfScalpel ordered me to fetch the pork rind.

I staggered over to ‍‍‌‌⁠​​⁠‌​​‍​​‍​‌​⁠‍‌‍⁠⁠‌⁠‌‍‌‍‌‌‌‍⁠​‌​‌​‌‍‌‌‌⁠‍​​‌‍⁠‌‌⁠⁠the dining table and picked up the needle again. My hands felt ever so slightly better than yesterday.

How much longer did this go on? Just as my soul was about to detach from my body...

GodOfScalpel said, acting as if he were granting a grand favor.

I barely managed to type out my reply.

Phew... I can finally rest. It's finally over. A sweet sense of liberation washed over me.

I dragged my battered, exhausted body up. Outside the window, darkness had already settled heavily.

In a daze, I picked up my phone. What time is it?

The moment I checked the numbers on the screen, my brain ground to a halt.

Seven... PM?

I roared with pure, unadulterated rage, loud enough to shake my entire studio apartment.

"You fucking piece-of-shit ghost bastards!!!!!!!!!!!!!!!!"

I opened my eyes to the blaring sound of my alarm.

Ding, ding, ding. Good morning. Pa-pa-pa-pa-pa, pa-pa-pa-pa.

"Fuck..."

A raspy, hoarse voice escaped my throat. Yesterday's day off was no day off. It was torture, it was captivity, it was nothing but a study group from hell.

I dragged myself up like a zombie and stumbled toward the bathroom. In the mirror stood a first-year slave whose complexion was, if anything, even worse than the day before.

I flipped off my own hollow, sunken eyes in the reflection.

You bastards... Give me back my day off.

I changed my clothes and boarded the bus to the hospital, my face completely sour. I thought this forum was a cheat code, but I never expected it to be one of the main factors ruining my life. These lunatics were way too serious about education.

I briefly contemplated opening the shop to buy a fatigue recovery potion, but securing the Possession skill was my absolute top priority, so I closed the window immediately.

8:00 AM. The Emergency Medicine conference room. I had crammed myself into the farthest corner of the room, trying my absolute best to remain invisible.

"Alright, let's begin. This is a case from last week."

The presenter was the chief resident, R4 Lee Min-jae.

"A forty-eight-year-old female patient. She presented with a high fever of over thirty-nine degrees Celsius, myalgia, and arthralgia persisting for a week. Initial lab results showed no remarkable findings other than elevated white blood cell counts and liver enzymes. Blood cultures and imaging studies also failed to identify a clear source of infection. It was a classic case of FUO—Fever of Unknown Origin."

The screen was packed with the patient's complex lab results and chart records. The chief systematically ruled out various differential diagnoses, explaining the entire process logically without stumbling once. His presentation was incredibly clean and concise.

Sure, the guy is an ECG freak with a bizarre personality, but when it comes to clinical skill, he really is top-tier among the residents.

"...Therefore, based on the clinical symptoms and the blood test showing an extreme elevation of ferritin levels—exceeding twenty thousand—we ultimately diagnosed the patient with AOSD (Adult-Onset Still's Disease) and initiated high-dose steroid therapy. The patient showed dramatic improvement and is currently being treated stably in the rheumatology ward."

As the presentation concluded, Department Chair Park Ung, who had been listening quietly with his arms crossed in the front row, spoke up in a low voice.

"Excellent presentation. It's a good case. The ferritin level was indeed a crucial clue in diagnosing AOSD."

The chief nodded in satisfaction, then suddenly turned his head to scan us juniors.

My heart sank. I knew that look. It was the harbinger of a pop quiz. Please, not me. Anyone but me. Please.

"It's well known that ferritin rises abnormally in AOSD. However, in an ER setting, when we see such extreme hyperferritinemia exceeding twenty thousand, there are a few other life-threatening conditions we must differentiate. This is something an emergency physician must absolutely know."

The chief's gaze drifted through the air before locking onto my eyes with laser precision.

"Dr. Han Hyeon-jae."

Oh, fuck me.

"Why don't you give it a try? What else could it be?"

Every eye in the conference room turned to me. My mind went completely blank.

Ferritin? Hyperferritinemia? I had definitely heard of it. But to name multiple other diseases besides Still's disease? Right now?

My mouth went bone-dry. Cold sweat trickled down my back. Seeing my panicked expression, a look of pity flashed across the chief's face.

Wait... Huh? Hold on. Ferritin... hyperferritinemia... Didn't one of those ghost bastards nag me about this yesterday? Was it the hematology-oncology ghost? I think he was shoving all kinds of cancer patient cases in my face, emphasizing the importance of ferritin levels.

The hazy memories of yesterday began to piece themselves together. I opened my mouth, stammering slightly.

"Uh... first, we must consider systemic inflammatory response syndrome associated with sepsis."

At my answer, the chief's eyebrows raised slightly.

"And... uh... MAS (Macrophage Activation Syndrome) can also cause an extreme rise in ferritin levels. Especially in patients with underlying rheumatic diseases..."

The fragments of memory fell into place one by one. To think the knowledge those ghosts had forcefully crammed into my brain yesterday was saving my skin in a conference today.

"Additionally, in hematologic malignancies like lymphoma or leukemia, tumor cells can release massive amounts of ferritin. Severe hepatocyte damage, such as fulminant hepatic failure, can also cause a large amount of ferritin stored in the liver to leak into the bloodstream."

As I finished speaking, silence fell over the conference room. I held my breath, waiting for the department chair's reaction. Please, let that be right. Just let me live.

The chief stared at me intently for a moment, then nodded with a satisfied smile.

"Yes. That is correct. Excellent. Mentioning MAS in particular is highly commendable."

Phew. The tension drained from my body, leaving me limp. The chief resident was staring at me with his mouth slightly agape, and the eyes of the other seniors and peers were filled with astonishment. It felt like my hellish yesterday was finally being rewarded.

Of course, it would come with the shitty side effect of making them absolutely certain that 'he really is a crazy bastard preparing for a double board in internal medicine,' but still.