The Birth of Sikryo Chanyo
The professor from Sikryo Chanyo class summoned me the moment he arrived at work. This was the third time I'd been called to his office for the spring conference presentation.
"Do-yoon, have a seat."
The professor spoke without taking his eyes off his monitor. I pulled up a chair and sat down. On his desk lay a printout of the abstract I'd submitted.
"The spring conference is less than two months away. How far along are you with the data?"
"IRB approval came through last week, so I'm pulling EMR data right now."
Only then did the professor look away from his screen.
"You're already in your third year. You know how crucial one solid paper is for your career. We need results this time."
"I know."
"Knowing isn't enough—doing is what matters. Stay at the hospital even on days without on-call duty. Weekends too. The sooner you show me something, the sooner I can give feedback."
The meeting didn't last long. But its weight lingered heavily.
Now I had hospital duties, Munjong's affairs, and this paper on top. I'd gotten Munjong's permission, but I still wasn't sure if juggling all three was even possible.
That night, I logged into the EMR and entered the parameters: community-acquired pneumonia, severity above a certain threshold, last three years. Relevant cases popped up on the screen—ages, blood pressure, pulse, oxygen saturation, initial blood work. I transcribed values from within the first 24 hours of admission into a spreadsheet, one by one.
By the time my eyes started to feel dry, patterns began emerging from the numbers. Patients with rising lactate levels and steeply climbing inflammatory markers mostly crashed into septic shock within two days. When coagulation markers tied to blood clots were unstable too, it happened even faster.
Existing scores like CURB-65 for pneumonia severity or SOFA for organ failure were useful for assessing current states. But I wanted signals from even earlier—before the clinical collapse. Variables we could check before things worsened. That was my goal.
The spark for this study came last month while drafting the abstract, inspired by Munjong. I couldn't treat his tuberculosis. I couldn't even meet him, and even if I could, Joseon had no anti-TB drugs. So I'd broadened my approach to preventive medicine, starting with toothpaste. This research was the same.
Modern pulmonology differed vastly from Joseon's, but one thing was identical: the hidden tipping point inside the body, even when the outside seemed to hold. I wanted to pin that moment down with numbers—to find the metrics that bought breathing room.
My scrolling finger froze. Seventy-four. Male. Community-acquired pneumonia. It was Mr. Park, who had passed three days ago.
The sounds from that hospital room—and from within me—echoed like an auditory hallucination. Looking back now, Mr. Park had been sending the exact danger signals I was trying to uncover in this paper. I'd seen them but failed to read them.
My fingertips trembled.
I stepped out for a walk. It takes years for a paper to impact real wards—getting published, cited, into guidelines. No guarantee mine ever would.
Either way, the 74-year-old in Room 3 had died when my research existed only as an abstract.
I thought it was inevitable. But from now on, I'll make sure nothing is.
May air felt chilly despite the season.
Jeon Sun-ui had been wielding his brush since early morning. Five months straight, every day. He'd started on the first month of the Imjin year, the night before presenting the toothpaste to the king as ordered.
Mixing familiar ingredients that cleaned teeth effectively—that's when he began recording. Those notes had grown into the book he wrote now.
The framework of 45 chapters was taking shape. He'd culled practical entries from existing texts. Rare, expensive herbs were noted, but he focused more on everyday foods and herbs anyone could obtain. This book had to be for everyone.
He added novelties from the invisible physician, absent from prior works.
'Eobyeong (fish cakes). For those weakened by heoro* exhaustion, they restore energy without digestive burden.'
'Moryeom (oysters). Boosts vital essence, balances the five viscera. Nourishes yin and clears heat—ideal for the feverish, parched exhaustion patient.'
'Cheongeo (mackerel). Tonifies blood and energy. Its oils replenish fluids, fattens the emaciated. For pale, listless blood deficiency; even better as eojeonghwan pills.'
'Hodo (walnuts). Moistens lungs, tonifies kidneys. Oils relieve fluids in dry cough and constipation.'
He included only what he'd witnessed. The invisible physician provided king-suited recipes first; results followed. Jeon Sun-ui took the same path: food first, outcomes next.
'Proper foods before disease deepens can delay the need for decoctions.'
He'd always known food preceded medicine. Yet for him, prescriptions came first—pulse diagnosis, then scripts. No longer.
Jeon Sun-ui rummaged his desk for a blank sheet with an unfinished preface. He wrote one line, then set down the brush.
"In living upon this earth, food comes first; medicine second."**
'Physicians are scarce across Joseon's eight provinces. Many folk lack one nearby; even when present, pockets aren't always full. But food differs. Know what to eat before decoctions, and one heals without aid. That is why I write this.'
Jeon Sun-ui took up the brush again.
Nearly ten days passed.
Jeon Sun-ui, separate attendant (rank 5) of the Royal Medical Hospital, reported a book to the Chief State Councillor.
"I have compiled sikchi*** into a volume and wish to present it to Your Highness. Please accept and deliver it."
The Chief State Councillor nodded.
"Understood. I'll present it personally."
That afternoon, he entered the throne hall and offered the book to Munjong.
Munjong took it, flipping slowly through. After some time, he commanded:
"Summon Jeon Sun-ui to the throne hall."
Soon after, Jeon Sun-ui entered.
Munjong held up the book.
"I shall name this work by the Royal Medical Hospital's separate attendant: Sikryo Chanyo. Let it originate from my care but serve all Joseon's people henceforth. Order the Office of Editorial Review to print and distribute widely. Even without physicians, the folk shall heal themselves thereby."
Jeon Sun-ui bowed deeply.
"Your benevolence overwhelms. I shall exert my utmost to fulfill Your Majesty's will."
It was past 2 a.m. when I wrapped up paper work—and Gatong arrived.
Sikryo Chanyo. Eight years from now, in Sejo 6, Jeon Sun-ui's book.
It was past midnight—May 14th, the day Munjong died.
Paper work had made me forget. I checked yesterday's annals first.
2nd year of Munjong (1452), 5th month, 13th day (eulsa)
Jeon Sun-ui of the Office of Royal Physicians submitted a compilation on sikchi. The king reviewed it and decreed: "Better to heal with food than drugs; name this book Sikryo Chanyo." He personally bestowed the title and ordered Jeon Sun-ui: "Write the preface yourself to expound its purpose."
Jeon Sun-ui bowed and replied: "Your Majesty has graciously named it; I am profoundly grateful."
My mother is his direct descendant, so in a way, I carry Jeon Sun-ui's blood too.
Thanks to Munjong, we moved in parallel across time—different yet aligned. Had I aided him, or did his existence enable mine? Unknowable.
Perhaps sequence didn't matter.
Joseon's Jeon Sun-ui wrote to save lives. Modern Korea's Lee Do-yoon wrote papers for the same.
He served in the Royal Medical Hospital; I was just a resident. Still, I resolved anew to follow his path.
Fatigue-lifted motivation surged back.
The next Mr. Park, I'll protect.
And today—May 14th—the annals remained as checked January 1st. No record of Munjong's death, only queen selection.
Returning to the Annals of the Joseon Dynasty home screen, Danjong's records were gone.
* Heoro: In traditional Korean medicine, a fatigue syndrome with reduced appetite, mental dullness, and body-wide aches in joints and muscles.
** Opening line of Sikryo Chanyo's preface.
*** Sikchi: Methods of preventing and treating disease through diet.