Kkomi's Closed Heart
Lee Jun smiled at Yeo Un-hyeok's words and answered with a gentle little grin.
"I'm grateful you think so highly of me, Dr. Yeo — but I believe you're the one who can soothe Kkomi's heart."
"That's…"
Yeo Un-hyeok had been about to say, Please, Director, you should take the case — and then he closed his mouth.
He had remembered why he had come here in the first place.
The reason I left the university and came here was because Director Lee is supposed to communicate so well with animals — I wanted to watch him and learn. But Kkomi is also exactly the kind of case I've been looking for.
The Maltese in front of him was a clear case of stress-induced self-harm. Precisely the topic he had been considering for his research paper.
"If you take the lead on treatment, I'll be right there to support you."
Which meant he could treat the patient himself and still observe Lee Jun's gift for communication at the same time.
I might even get to see whether the Director is using some kind of suspicious medication.
Yeo Un-hyeok nodded.
"Understood. I'll take Kkomi's case."
Lee Jun smiled at him, offering his support for the decision, then turned his gaze to Kkomi's guardian.
"Kkomi's guardian."
"Yes, Director."
"Dr. Yeo Un-hyeok, standing here beside me, used to practice at the Animal Behavior Clinic at Cheil University."
"Oh my, is that so? I've heard they do excellent work there…"
"They do. Right now, I think Kkomi needs Dr. Yeo more than she needs me."
"…She is a pretty severe case, I know."
"I'll be looking after Kkomi as well, so how would you feel about Dr. Yeo and me treating her together?"
"As far as I'm concerned… as long as Kkomi can get better, that's all that matters."
The guardian stroked the Maltese in her arms with a look of aching pity, and added,
"I'm not even hoping the separation anxiety will go away completely. I just don't want her hurting herself anymore."
"Then let's work on this together. Could you tell us about Kkomi?"
A short while later, the three of them stepped into the consultation room.
The consultation room was nothing like the other exam rooms. A wide yellow sofa occupied an entire wall, with a set of pet stairs so animals could climb up and down at their ease. Non-slip mats covered the floor, and a small table sat nearby. There was a cave-like hidey-house and an open-style cushion, along with a scattering of toys — so many of them that it hardly felt like a clinic at all. Naturally, it was a shoes-off space.
The guardian changed into slippers as she came in, and let out a breath of wonder.
"Oh my, this is such a comfortable space."
"We set it up so they can feel as much like home as possible," Lee Jun said, looking at the little Maltese.
"This is nicer than my house, honestly."
The guardian sat down on the sofa and spoke to Kkomi.
"Kkomi, go on — walk around a bit."
But Kkomi showed no intention of climbing down from her guardian's lap.
"That's how she is. She's so timid she can't adjust anywhere we go."
The guardian sighed the words out, and then she poured out Kkomi's story.
Kkomi was a textbook case of separation anxiety — and it had grown so severe that she had begun to harm her own body.
"Even putting a cone on her doesn't help. Then she scrapes the walls with the cone, and I'm terrified she'll hurt her eyes… She actually did injure herself once, and it was awful. I'm so worried her body will get even worse. I've heard a lot of Maltese have weak hearts."
Lee Jun nodded as he watched Kkomi from the side, and Yeo Un-hyeok spoke up.
"Before we start treatment, we'll need to run some tests. Animals will cling to their guardians when they're in physical pain, too."
"What kind of tests?"
"A basic workup. A musculoskeletal exam, and the cardiovascular screening you mentioned — and, well, at the university we even examine the head."
Meaning an MRI would be needed as well, in case something was wrong in the brain.
"Have you ever seen Kkomi's body go rigid? Foaming at the mouth, or drooling, for instance. I'm asking whether she's ever lost consciousness, as if she were fainting."
The guardian shook her head.
"I wouldn't know about when I'm not home, but… no. I've never seen foam or drool on her mouth."
"Then we'll put the brain MRI off for now."
Yeo Un-hyeok examined Kkomi by the book. Bloodwork, a hormone panel, X-rays, an abdominal ultrasound to check the internal organs, an echocardiogram to examine the heart…
Echocardiography was Yoo Mu-hwan's domain. Yoo Mu-hwan performed Kkomi's cardiac ultrasound himself.
"The mitral valve has thickened into a club shape. There's mild regurgitation on the left side… LVIDDN 1.3, LA/Ao ratio 1.4… At these numbers, observation should be enough."
Meaning every indicator of left ventricular enlargement, left atrial dilation, and elevated pressure was within normal range.
"Mitral valve insufficiency, Stage 1. B1. We can just monitor her without medication."
Yeo Un-hyeok said it from the side, and Yoo Mu-hwan nodded as he answered.
"R…ight."
The look on Yoo Mu-hwan's face as he said it was faintly sour. It was the correct assessment — but wasn't the person who had actually performed the exam supposed to be the one who delivered the conclusion?
A slightly unpleasant feeling crept over him.
He's good with prescriptions and he reads an ultrasound decently enough, I'll give him that — but shouldn't he have at least asked me?
Yoo Mu-hwan felt a simultaneous sting of disappointment and a sense of being slighted. Until now, every cardiac exam, diagnosis, and prescription at Mongmong Animal Hospital had been his responsibility.
He had thought the competitive spark he felt toward Yeo Un-hyeok was gone. But in this moment, that little creature called competitiveness lifted its head again, just a fraction.
Yoo Mu-hwan was still watching Yeo Un-hyeok with that uncomfortable feeling when Yeo Un-hyeok turned to Lee Jun.
"Director, looking at the results, there's nothing wrong on the bloodwork. It shouldn't be a problem to prescribe medication."
"So what prescription are you thinking of?" Lee Jun asked him.
Yoo Mu-hwan's face tightened a little at that.
The Director seems to trust Dr. Yeo an awful lot.
Whether or not he noticed, Yeo Un-hyeok answered.
"Well, the most important thing is to bring Kkomi's arousal down. Scratching until her paws are covered in blood means she's extremely overstimulated."
"That would follow."
"So getting her settled has to come first. Otherwise it could put a strain on the heart."
"It would."
"I'd like to start her on Adaptil Calm, and since there's nothing wrong with her kidney function, I'm thinking of prescribing gabapentin as well."
Calm her with a pheromone, and because that alone wouldn't be enough, add gabapentin for neurological settling. Lee Jun nodded.
"Let's do that. Lowering the intensity of her arousal will be good for the cardiovascular system, too."
A spike in blood pressure from excitement was a minus for Kkomi's current heart condition. Mental and physical calm was the priority.
Lee Jun responded so readily to Yeo Un-hyeok's decision that a slow sense of crisis began to uncoil in Yoo Mu-hwan. The fact that the Director had sided with Yeo Un-hyeok without even asking him could only mean he considered their skills more or less equal.
Yoo Mu-hwan, who wanted to become someone Lee Jun truly needed, made a quiet vow.
I have to get better.
He would make his own words carry more weight than Yeo Un-hyeok's.
Lee Jun, with no idea how large a vision that small exchange had just planted in Yoo Mu-hwan, stepped outside and went to the guardian.
She had left the consultation room and was sitting in a waiting chair in the lobby, watching the dogs wandering about. Kkomi, tucked in her arms, was looking only at her.
The moment Lee Jun approached, Kkomi pressed herself even closer to her guardian and turned her face away from him.
Most of them, even if they were in the middle of something else, couldn't wait to come to him.
Watching her, Lee Jun's eyes narrowed.
The others paddle their front paws trying to get to me, and this one is still looking away.
Kkomi had put up a wall from the instant she first saw him.
Then again, Hoesaegi and Gkamnyangi are pretending they don't notice me either…
This was exactly why he had asked Yeo Un-hyeok to take the case.
Even the most timid animals reacted when Hoesaegi or Gkamnyangi spoke to them. They might not answer at first, might even try to avoid it — but after a little while, they would start to talk. If it was a dog terrified of cats, they would still speak with the other dogs coming in and out of the hospital. One way or another, a conversation happened. Even Aji, whose past had been so painful, had asked Gkamnyangi for help the moment she saw him. Sapsaree, who had kept his mouth shut around Lee Jun, had still spoken with Hoesaegi and Gkamnyangi.
She's only looking at her person. She won't even meet my eyes… For now, all I can do is watch Dr. Yeo treat her.
In a case like this, they would have to rely on medication. Lee Jun intended to wait until Kkomi opened her heart.
"Dr. Yeo. I'm counting on you."
Lee Jun gave Yeo Un-hyeok a pat on the shoulder, then went into an exam room and moved on to the next appointment.
One week later, Kkomi came in for a follow-up, and her condition had improved.
Because Lee Jun had told the guardian he would be keeping an eye on the case himself, he sat in on the consultation as well.
"Doctor, look at Kkomi's paws. They're clean."
The guardian was beaming — the paws that had been covered in blood were spotless now.
"Two days ago the man who services the water purifier came, and she still stayed calm. She barked a little, then stopped."
"Oh, that's wonderful."
"You have no idea how much of a relief it is. And she even sleeps by herself at night now."
"So she used to sleep with you, then."
Yeo Un-hyeok had assumed that a dog this attached to her guardian would of course be sleeping in the same bed.
"No, she doesn't sleep with me. She sleeps with Janggoon."
Yeo Un-hyeok's eyes widened a little.
"She's close with Janggoon, then."
"Very close. The two of them are always stuck together."
This was the first he was hearing of it. The week before, the guardian had only talked about her own relationship with Kkomi. She had said the problem was that Kkomi was hostile toward people from outside. So that first consultation had focused entirely on the guardian and Kkomi.
Having been told Kkomi was hostile to strangers, Yeo Un-hyeok had naturally assumed she would be hostile toward her housemate Janggoon as well.
I was going to ask about Janggoon and Kkomi's relationship today anyway.
He decided to shift the direction of the consultation, and asked,
"I see. And does Janggoon like Kkomi too?"
"Yes. Janggoon wants to be with her. He has such a sweet temperament. When Kkomi cries, Janggoon even paws at her to tell her to stop. Not that she listens."
Beside them, Lee Jun found himself worrying about Janggoon.
That Janggoon… he must be under a lot of stress.
While Lee Jun was turning over the relationship between the two dogs, Yeo Un-hyeok made a suggestion.
"What would you think about bringing Janggoon in as well? In cases like this, treating them together can help."
"Kkomi likes Janggoon, too — and if they came together, she might actually walk around the clinic," Lee Jun added, expanding on Yeo Un-hyeok's point. He was already thinking of how he would soothe Janggoon if the stressed little dog came in.
That was when Kkomi, still in her guardian's arms, suddenly let out a whimpering sound and started scratching at her.
The thing she scratched happened to be her guardian's arm.
"Ah — ow, Kkomi!"
Kkomi seemed too frantic, too busy raking at the arm, to even know what she was doing. But one phrase reached Lee Jun's ears.
Looking at her, Lee Jun felt a pang of apology.
So it wasn't that you weren't listening to me.
While Lee Jun was watching Kkomi, Yeo Un-hyeok continued the consultation without a pause.
"It seems Kkomi doesn't want her guardian taken away by Janggoon. For the time being, we shouldn't mention Janggoon in front of her."
It was a textbook conclusion.
"Ah. Yes."
The guardian answered, then spoke to Kkomi.
"Kkomi, we're not going to bring Janggoon. So don't worry."
She repeated the same words several times, and Kkomi's agitation finally subsided. Whether from the excitement or something else, her eyes were welling, shining and wet.
Yeo Un-hyeok looked into those eyes and fell into thought.
That look is far too sad.
Kkomi's gaze did not look like an animal seized by possessiveness. It looked like grief.
It's just like Bori's eyes, the night before Father packed his bags for a business trip.
Watching Kkomi cling so tightly to her guardian's arm, Yeo Un-hyeok found himself remembering Bori — his childhood companion, his friend, his brother.
I wonder if her guardian is doing something at home that makes Kkomi anxious. Maybe she shows Janggoon a little more affection, or…
Careful not to set the barely-settled Kkomi off again, Yeo Un-hyeok spoke in a low, even voice.
"Instead, would you be able to take some video of how you and the kids live together at home, and show it to us?"
He used the kids to mean Kkomi and Janggoon together — because he was afraid that hearing Janggoon's name would send Kkomi into another spiral.
"I will."
The guardian answered, then added one more thing.
"Thank you, Doctor."
It was gratitude for the fact that he had not used Janggoon's name.
"And I think I didn't hear enough about the kids last week. I treated it like an ordinary jealousy case. Would you be able to tell me more about that today?"
A consultation begins with trust. The moment Yeo Un-hyeok laid out the fact that he had misunderstood, Kkomi's guardian — already warmed by his choice of the kids over Janggoon's name — felt her confidence in him rise in a sudden, full rush.
Her face eased into something comfortable, and she answered.
"Yes, Doctor."
"You said the kids have been living together for a year, and this one's age is listed as approximately two years old. Then that means this one is also…"
"Yes. He's a foster."
"You fostered him. That's a wonderful thing to have done."
"Right now I'm only raising these two, and they both came in as fosters."
Yeo Un-hyeok looked at the guardian for a long moment. He thought it was remarkable — and the thought came out of his mouth on its own.
"…That's extraordinary."
"Oh, it's nothing."
"Don't say that. You have my respect."
He said it, then turned his eyes back to the chart.
"So that's why Kkomi's age is listed as around six. Then how long has Kkomi been with you?"
"Kkomi was the first one I ever fostered, five years ago."
The guardian stroked Kkomi's head, and went on with the story.