Prevention is Better Than Cure
I was on duty at the hospital today. But something felt off. In all my time working at a general hospital, right on the cusp of my third year as a resident, I'd never had such a leisurely shift. It gave me time to think about all sorts of things.
I couldn't quite remember if I'd first learned the term preventive medicine back in pre-med or my first year of med school. "Prevention is more important than treatment," the professor had said at the start of the lecture. Who doesn't know that... But what I'd felt during my internship and residency was that prevention was a luxury. There was a patient right in front of me, with symptoms, and a prescription to match those symptoms. Sometimes I couldn't read the symptoms accurately, or I read them but didn't know the treatment. With help from professors and seniors, I'd barely, just barely managed to treat them. No, honestly, it was like that almost every day.
In that kind of situation, I couldn't afford to think about prevention. But now, I had no choice. Because on my laptop screen, in King Munjong's clinical record #5, there was a line I'd written myself:
'Expanding from clinical medicine to preventive medicine (hygiene).'
I stared at the laptop screen for a while. Setting medicine aside, I pondered the essence of "prevention." Prevention means defending in advance. In other words, blocking it beforehand. I'd prevented Munjong's death. No, that's imprecise. I'd prevented Munjong from dying in the Imjin year. I'd prevented the Gyeyu Rebellion. No, that's also imprecise. I'd prevented Prince Suyang from launching a rebellion in the Gyeyu year. Ah, it's not entirely certain yet, but probably. Even if Prince Suyang's coup happens and succeeds now, the odds are high it'll be the "Gapsul Rebellion" instead.
Of course, it wasn't medical prevention. I'd mentioned remarriage to Munjong. It took him several days, but he finally agreed. Come May, they'd start selecting a new queen. Unlike the Gyeyu Rebellion, this was already recorded in the annals. That was prevention too. Though not medical prevention, either.
For the first time in a while, I thought about Sejo—no, Prince Suyang—and the Gyeyu Rebellion. In the original history, there was the soon-to-die Munjong, and then Danjong and Prince Anpyeong. Amid those thoughts, a fact suddenly came to mind.
'When Prince Anpyeong was forced to commit suicide on Ganghwa Island, didn't he have a son who died even earlier and thus never got the poisoned sake?'
I didn't remember the details exactly. But there was a way to check.
Danjong Annals, Volume 4, 12th Month 19th Day (Gyeomi), Danjong's Accession Year
Dukyangjeong Yi U-ryang passed away. Court sessions and markets were halted for two days. A coffin, burial accoutrements, and 40 seok of rice and beans, along with 100 rolls of paper, were provided.
December 19, 1452—Prince Anpyeong's second son, Dukyangjeong Yi U-ryang, died. No cause of death listed. Just a simple announcement of his passing.
Now it was the first month of the Imshin year. Yi U-ryang would die in the twelfth month. About ten months from now. I calculated his age. Prince Anpyeong was born in 1418 and married in 1429. The eldest son Yi U-jik came first, so Yi U-ryang was probably born around 1432–1435. Seventeen to twenty years old now. Way too young by modern standards.
A death with no known cause. Probably some disease beyond Joseon's medical knowledge.
Of course, no night shift stays leisurely forever. I was pulled away thinking about Yi U-ryang, and the rest of the night was a blur.
The next morning, after finishing my shift and getting home, I sent a Gatong message to Munjong.
In my mind, that nephew was definitely Dukyangjeong Yi U-ryang.
How is the nephew's condition?
I felt like I'd said something unnecessary. Prince Anpyeong's eldest son, Uichun-gun Yi U-jik, would be very "healthy," since he'd end up drinking poisoned sake alongside his father from Sejo. As for the second son, Dukyangjeong Yi U-ryang, he never even got the chance. He'd died before the Gyeyu Rebellion.
Your Highness, there's no need. Thanks to you, Do-yoon, my condition has improved, so I intend to inquire about the nephew once.
Munjong wouldn't summon Prince Anpyeong right away. Nor would he keep messaging me without asking about Yi U-ryang, given his personality. So, for the first time in ages, I slept soundly from morning after my shift until the next dawn. Of course, I'd already texted Seo-yeon that yesterday's shift had been brutal, so I'd rest today.
It wasn't until the weekend that I heard back from Munjong.
My third brother says the second nephew's throat swells so much he struggles to swallow food. Pus comes out sometimes. He also has bouts of extreme high fever.
I'm no ENT specialist, but... recurrent tonsillitis?
Swelling since childhood. Sudden high fever and chills, dysphagia, seizures... Enough to suspect recurrent tonsillitis. In modern times, you rarely die from recurrent tonsillitis alone. But it often comes with complications. Recent frequent swelling suggests cervical lymphadenitis.
Your Highness, the most important thing when the throat swells is rest.
And garlic. Jwagye (fried chicken) with raw garlic could burden a swollen throat patient. Need another method.
What method?
Put garlic in a jar and ferment it under the ondol for over a month. It turns black, mellows in potency, and loses most of its odor. Extract the juice and have him drink it daily.
Black garlic really does have more antioxidants and anti-inflammatory compounds than regular garlic.
The odor fades significantly?
Yes. Long fermentation nearly eliminates it.
Then why didn't Do-yoon use black garlic in jwagye?
'Ah, he really suffered from the smell after eating jwagye...'
I prostrated myself flat. I'm sorry.
I shall bestow black garlic juice on the nephew and order the royal kitchen to make black garlic jwagye.
For the first time in Gatong history, I felt Munjong's anger toward me. Still, I added one last thing.
Your Highness, please bestow toothpaste on your nephew and have him brush three times a day—within one-fifth of a gak after meals, for one-fifth of a gak.
The tonsils are direct targets for oral bacteria. No matter what else you do, poor oral hygiene means high risk of recurrence.
In December 1452, Yi U-ryang probably suffered complications from recurrent tonsillitis and cervical lymphadenitis—pus buildup blocking his airway or bacteria spreading via the jugular vein to sepsis. Neither treatable in Joseon.
As I pondered my answers to Munjong's questions, I offered silent thanks to a long-forgotten mentor whose name I couldn't recall. "Prevention is more important than treatment." From now on, I wouldn't think of prevention as a luxury. If the outcome is good, I'd have saved another life today.
A whole week passed. I was too swamped to pay much attention to Gatong. Being on the verge of third-year residency made it worse.
Then a message came from Munjong.
My third brother Yi Yong's second son has started taking black garlic juice. Jeon Sun-ui says the garlic's energy, combined with the ondol's heat, suppresses the evil qi in his throat. The black garlic isn't fully ripened yet.
Yi U-ryang's condition seems worse than I thought. And as royalty, they'd rushed the fermentation at the Royal Medical Clinic, Jeonuisang, or the royal kitchen.
That's fortunate. When his throat swells, he must rest.
I couldn't bring myself to argue with Munjong. If he'd been born modern, he'd be the uncle killing multiple nephews with job and marriage pressure every holiday.
Why does Do-yoon worry about this child?
It was a bewildering question. To introduce preventive medicine to Joseon? To strengthen ties between Munjong and Prince Anpyeong, preventing any lingering Gyeyu Rebellion threat from Prince Suyang? Just for the fun of watching the annals change? I wasn't even sure myself.
So I answered as a resident. That's how we'd met from the start—Munjong as king, me as resident.
I learned that frequent throat swelling can lead to serious illness later.
Did you leave your homeland to learn that?
'What kind of misunderstanding is this...' My hometown is Cheonan, but I played along with Munjong's rhythm.
I came far away to become an excellent physician.
Munjong replied faster than ever before.