Chapter 9
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Translator: MadScientist
Chapter: 9
Chapter Title: Villain
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Late at night, in the president's office at Korea University Hospital, people who normally wouldn't even have time to see each other's faces due to their busy schedules had gathered. Leading the group were Chair Professor Hwang and the hospital director, with department heads from various fields exchanging words.
The topic of their conversation was the patient now to be called Seol A-yeon. The clash between the newly emerged personality and the original one. Unlike before, after the personalities collided, she lost consciousness and collapsed. During that time, they had run several tests.
These were tests they hadn't been able to perform due to her resentment toward the hospital. They couldn't risk triggering her trauma, not knowing what the other personality might do.
They had even tried during sleep, but the slightest noise woke her, leading to repeated failures. They had just decided to secretly administer sedatives and proceed when the patient collapsed on her own. It was a fortunate mishap amid the chaos, all things considered.
[NAME Seol A-yeon / F / AGE 10+- / RH+ AB / Dissociative Identity Disorder, Cardiomegaly, Albinism, Laron Syndrome]
Chair Professor Hwang, looking over the chart, asked the Endocrinology Department Head, Shin.
"So, Department Head Shin, you're saying her blood sugar was 40 right after she collapsed?"
"Yes, we administered glucose in a hurry... Normally, it should have corrected immediately, but it didn't. We had to give her excessively high concentrations before it finally stabilized. Professor Lee, does the other personality emerge by burning through sugar? Is that how DID works?"
Shin turned to Psychiatry Professor Lee, who shook his head.
"It's ambiguous to even call it DID in the first place. This patient defies everything we've learned in medicine... There's no case of a split personality manifesting by consuming glucose. It's unheard of—would be a world first."
"But there's no reason for her blood sugar to plummet like that... She had no major adverse reactions to basic blood tests, so we did them daily, right? They were completely normal then..."
"...I've reviewed at least a hundred recent papers on DID alone. Nothing like this."
Pediatrics Department Head Kim Se-yeon, listening while reviewing the chart, asked Shin.
"Hmm... She was originally 25, right? I remember her coming up in multidisciplinary conferences multiple times since she was such a tough case, but I didn't attend as Pediatrics. Can't recall her exact age."
"Yes, that's correct. I was her attending physician before she died."
Kim pressed a hand to her forehead, frowning. It was a case she'd never seen in nearly 20 years of practice.
"Does this even make sense...? The tests, my direct observation—her physical age is around 10 at most. This is... impossible..."
"That's why we're all here. One patient like this could spawn dozens of case reports and papers. We could even get into NEJM or The Lancet."
The hospital director smiled faintly at Kim, whose face flushed slightly at the mention of the world's top journals. Chair Professor Hwang frowned at the sight.
"What do you take the patient for? We're doctors—always remember that. Director Yu, her cardiac function has declined. Looks like hypoglycemic shock is the cause... Problem is, it didn't correct easily. Echo shows definite deterioration. If it keeps dropping, time's short. Meds have limits too—in my view, six months max. Last resort is ECMO, but you know it can't be used long-term. Any donors yet?"
"...Pediatric hearts don't turn up quickly. Everyone knows transplants are tough."
"Seems doable if we transplant... Department Head Shin, no issues with other organs?"
"Well... Lab Medicine sent results today. This patient has Laron Syndrome. That's partly why we're meeting now."
"Laron Syndrome? What's that?"
Shin began explaining for the non-endocrinologists.
A type of dwarfism where growth hormone is secreted but not received by the body. An extremely rare disease, affecting only about 350 people worldwide.
"There's treatment—IGF-1... But the problem is her cardiomegaly."
"Ah, treatment would make her body grow by accepting growth hormone, so her heart could enlarge further here?"
Kim, familiar with it as a pediatric condition, answered. Chair Professor Hwang's voice rose.
"Can't do that! Any more enlargement and it's cardiac arrest for real!"
"But without treatment before puberty, she'll stay like this forever."
"Hah..."
The doctors—top in their fields in Korea—sighed in unison.
Case reports and papers aside, save the patient first. They had lost her before despite countless tests, unable to even find the cause.
"Save her life first. No Laron treatment until after heart transplant. Her body's around 10 anyway—plenty of time before puberty, right?"
The others nodded at Chair Professor Hwang's words. Shin glanced around cautiously, squeezed his eyes shut, sighed, then carefully asked Kim.
"Department Head Kim, do you know about Laron Syndrome?"
"Huh? Not exactly, but roughly, yeah. It's pediatrics territory."
"Do you know it's nearly immune to cancer and type 2 diabetes?"
"Vaguely—something about not receiving growth hormone. I've seen they use Laron patients for cancer drug research. But why bring it up suddenly?"
"...You know Jin So-yun, right? You're her attending in PICU."
"So-yun? Why her all of a sudden?"
"Well... Um."
"You're beating around the bush. Get to the point. Laron immunity to cancer and diabetes—and why So-yun? Why stop mid-sentence?"
"Hrm..."
As Shin kept hemming, the mood grew awkward. Frustrated, Chair Professor Hwang shouted.
"So-yun—I know her too. They've been hanging around PICU lately. One-sided from her side, but anyway. Why bring her up?"
Shin clenched his fist and forced out the words, as if saying something forbidden.
"Look... Purely from a medical standpoint. She's had glioblastoma surgery—malignant brain tumor—plus chemo and radiation. Still on chemo."
"...Yes. Stage 4 when we tested, brain location limited resection. Chemo and radiation barely worked... Glioblastoma progresses fast, especially in kids with rapid tumor growth... Wait. No way. You're not suggesting...?"
Kim tried to cut him off, a chill running through her, but Shin continued.
"Organ transplants are taboo in cancer patients, but brain tumors are different, right? Blood-brain barrier protects the brain, so heart, lungs, kidneys are viable. Confirmed with Transplant Surgery head."
"What nonsense! Only for low-malignancy brain tumors! Glioblastoma's the worst of the worst!"
Chair Professor Hwang yelped. Shin nodded.
"Right. Impossible for glioblastoma patients. But this one's different. Laron Syndrome—nearly fully immune to cancer and type 2 diabetes. In her case, couldn't we transplant organs from a malignant brain tumor patient?"
"No, even if... We'd have to leave Laron untreated? Pediatric cancers grow with the body, progressing fast."
"Yes. Abandon Laron treatment. But heart transplant saves her life. You said abandon Laron too, Professor Hwang."
"Department Head Shin, have you lost your mind?! How can you talk about taking a heart from a still-healthy kid?!"
Kim exploded. Shin replied calmly, as if anticipated.
"As I said upfront—purely medical facts. No other intent."
"You're insane... Department Head Shin. Be honest: world-first resurrection with gender swap in Laron patient, plus brain tumor patient's heart transplant? Impressive. NEJM? Lancet? They'd publish on sight. Wow, amazing. Bravo, Department Head Shin."
Kim sarcastically clapped aloud, but Shin remained expressionless.
The hospital director's lips twitched upward uncontrollably.
A being worthy of papers just by existing: undefined mental disorder, rare disease with ~350 cases worldwide. Brain tumor patient's heart transplant.
How many top-journal papers if she survives a year post-transplant? Uncountable.
"...I was her attending till death. Ran dozens, hundreds of tests. Watched a patient my son's age wither away in real time. I ordered CPR halt. Chance came again—I want to save her, any way. She's on the transplant list, but AB blood. Donors must be AB too... Only 11% in Korea. Realistically, within six months? I doubt it."
Kim and Shin locked eyes in a tense stare-down. The room froze; others glanced nervously. The director cut in slyly.
"Now, now, enough bickering. Department Head Kim, how's rapport with Seol A-yeon and Jin So-yun's guardians? Record of one meeting before. Guardian visits often. Coming today?"
"...Director, what are you even...?"
"...Hah. Director Yu, you aware of what you're saying?"
"Professor Hwang knows too. Glioblastoma max 18 months; post-surgery chemo, no shrinkage—12 months tops. Six months since surgery. Seizures and LOC shortening, right?"
"I know. Too well..."
"You said Seol A-yeon won't last six months either."
The director pressed Hwang for confirmation. He replied, baffled.
"But Director Yu."
"...Go on."
"How do you know So-yun? Her surgery date? You and Shin never set foot in PICU."
Hwang's fury chilled the room again. The director scratched his forehead awkwardly.
"Does it matter?"
"Answer. 'No medical flaws'? I know better. But this sounds like killing healthy Jin So-yun to save Seol A-yeon. What? Rapport with guardians? What the hell?! You two are crazy!"
Hwang roared, face red. Shin spoke cautiously.
"Idea was mine, Professor Hwang. You know no other way."
"Hah... How do you justify killing a terminal patient? If using So-yun's heart, find another surgeon—I won't!"
As Hwang stormed toward the door, the director blocked him.
"Must save who can be saved, right? I'll cover all future So-yun treatment costs. Refund past ones too. Department Head Kim—use non-covered chemo freely. If no improvement, I'll persuade personally. Just sit tight. Condition: appear in our PICU promo video. Got a docu proposal too—perfect. Great story, both patients."
"Uh... What?"
Kim stammered blankly. The director drove the wedge home.
"Heard Jin So-yun's guardian working nonstop for a month to pay bills. With little time left, let her spend it with So-yun."
"Director Yu, you bastard! You're doing this thinking So-yun exposure builds rapport with Seol A-yeon's guardian for easy persuasion!"
"Exactly. What's the problem?"
"What? You bastard! Story? You... Hah!"
Hwang glared at the director, then stormed out. Kim glanced around, bowed once, and followed.
"Department Head Shin, we look like the villains here."
"Villain or not, doesn't matter."
"Alright, other heads—got the gist? Today's all confidential. Leak it, and... expect consequences."
With the director's light but pointed threat, the meeting ended.