Medical Inquiry
I'd finished my night shift yesterday and met up with colleagues for drinks in the evening. The side dish was oden—wait, eobyeong. On my way home, I searched online and found people even calling stir-fried oden "eobyeong bokkeum" now. My mom's delicious stir-fried oden would have to be renamed eobyeong bokkeum too. Because she'd start calling it that herself.
Lying in bed, I stared blankly at the ceiling. It was past midnight. I'd caught some sleep after the shift, but now it wouldn't come. Something kept nagging at me.
Ventilation. Bosinsijok. Eobyeong. Exclude pheasant meat. I mentally reviewed everything I'd passed on to King Munjong so far. None of it was bad. His health was clearly improving. I couldn't read Jeon Sun-ui's inner thoughts, but he was interpreting my messages in his own way. Munjong had said the eobyeongtang broth was good.
Yet something felt off. Uneasy. Like something was missing.
Staring at the ceiling light, it hit me. I'd never done a proper medical history with Munjong. I'd gone in assuming lung issues from the start. Records from the Annals of the Joseon Dynasty. Inferences from Jeon Sun-ui's prescriptions. All indirect info.
Sure, I'd heard it straight from Munjong that first day via Gatong. But I'd never systematically questioned him myself first. As a respiratory resident, I hadn't done the most basic thing.
Late as it was, I got out of bed and sat at my desk. It was nearing 1 a.m. Munjong was surely asleep. I'd do it tomorrow. I set my phone down and lay back. This time, sleep came easily.
Thursday afternoon, December 5th. I had a brief window. I slipped into the break room, locked the door, and opened the mobile messenger app on my phone.
Read. Ask away. I planned to proceed just like in a modern hospital.
"When did the fever start? When is it worst?"
"Since my Crown Prince days. Worst at night. My clothes are soaked when I wake."
Night sweats. Doan. Sweat you don't notice at night, discovered in the morning on damp clothes. Classic TB symptom. I typed it into my laptop on the tea table.
"What kind of cough? Phlegm?"
"Mix of dry and productive. More productive days."
"Blood in phlegm?"
A pause, though read. No reply at first.
"First this spring. Rare now."
Hemoptysis. First in spring, now less—key sign of treatment response. But spring debut meant the bug had quietly multiplied in his lungs before. TB progresses slowly over months to years post-infection. Exposed as Crown Prince, latent long, surfaced this spring.
I pressed on. "Much weight loss this year?"
"Uncertain. My gonryongpo waistband loosened a lot. No more recently."
Significant loss, clearly. Records noted him thin and frail since Crown Prince days. Baseline low, then more drop.
"Periods of no appetite?"
"Almost none all last summer."
Anorexia. Three-plus months.
"Pain or pulling in chest on deep breath?"
"Right side pulls sometimes on deep breath."
Possible right pleural irritation. Inflammation causes friction pain on inhale. CT would confirm, but symptoms only for now.
"Anyone close who died of similar symptoms?"
Long silence again. I typed up the history while waiting.
"Yes. A palace maid I saw often as Crown Prince. Cough lingered, then hemoptysis and collapse. Dead in under half a year."
Enclosed space. Prolonged close contact. Same symptoms, course. TB spreads airborne via droplets in coughs, infects in confined areas over time. Maid died of TB after long time in Crown Prince's chambers. Munjong's symptoms followed.
Fever since Crown Prince days. Textbook epidemiology.
I read Munjong's reply over and over. He knew. Or sensed it. That his symptoms were being documented somewhere. Not asking meant he knew and allowed it anyway. The king permitting unrestricted records of his body.
Responsibility hit hard. Munjong was always like this. Did bosinsijok right there when first told. Had the royal kitchen make eobyeong same day on my recipe. He pondered suggestions, but once decided, acted fast.
Same now. My laptop held our fresh Gatong exchange. Applied pulmonary TB clinical criteria:
All criteria met. Diagnostic tests impossible in our setup. As a first-year resident on internship, prof said: No tests? Treat clinically. Assume most likely diagnosis, act, observe response. Good response confirms; no? Rethink.
Munjong was responding. Fewer fevers. Less cough. Appetite back. Weight loss halted. Positive.
I added two lines atop the Word file:
Suspected diagnosis: Pulmonary Tuberculosis
Treatment response: Favorable. Continue monitoring.
Saved as "Clinical Record: Yi Hyang (1451.12.)".
I stared at the screen. What a doctor should've done first, finally done. Lucky it aligned, but not proper medicine. From now on, different. Clinical records build gradually. I'd add bit by bit each Gatong talk. Vowed it.
Closed the laptop, stood. No word from busy Munjong.
Saturday half-day. Nutrition directly impacts TB recovery speed. History sorted, plan clear. Vitamin D deficiency raises TB risk—studies abound. It modulates immune response to TB bacilli. Low D slows suppression.
Two ways up: supplements (none in Joseon), sun (available). Opened Gatong.
Read.
"Jeon Sun-ui says avoid cold winter air."
"He's not wrong. Avoid wind, just sun. Eaves in sunlight—no chill. Warm rays boost vital energy."
"Shall have inner servant take me under eaves briefly."
"No cough yesterday. Ate eobyeong jeongol this morning."
Entering hospital gate, I chuckled alone. The king ate eobyeong broth this morning. And I got the report.
Next: Vitamin A. Boosts respiratory mucosa immunity. TB invades via lung lining. Stronger mucosa slows spread. Rich sources: dark green veggies. 15th-century Joseon: mucheong, spinach-like. Mu available winter.
He'd passed my advice to Jeon Sun-ui before. This time, he asked first. Sensing need for coordination?
"Consulting Jeon Sun-ui best, Your Highness."
"Understood."
Before rounds, added to clinical record. No Annals for Dec 1451-Jan 1452. History vital, but fill those gaps too. Tomorrow: sleep quality.
Then, intern sprinting from hall end.
"Doctor, Room 7 patient's SpO2 dropping!"
I ran.