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Sensechapter 30: transcendental diagnosis(5)

Ha Sang Joong, who was headed to his office after an informal meeting full of irritation and quarrels, stopped at the door when he saw Choi Hoo waiting for him.

He wondered if Choi Hoo was upset because he suddenly cut off his schedule in the morning as Choi Hoo quickly approached him.

“Choi, Choi Hoo. Stop. You’re not trying to hit me, are you?”

“If you need an effective injury, you should take hold of a scalpel. We’re all skilled with knives here.”

It was something that made him automatically take a step back.

“Uh, that’s right. Surgeon. That’s a funny joke….you are kidding, right?”

“Chief.”

When Choi Hoo took another step forward, Ha Sang Joong flinched back.

“From now on. Half of the surgery assigned to me will be performed by Park Dowook.”

“Ok, I under….whaaat?”

Ha Sang Joong’s eyes widened in surprise.

“Not just one or two, but half? How can a fellow perform the surgeries assigned to a professor? There’s no such regulation in our hospital.”

“Why can’t it be done? I have performed surgeries since I was an intern.”

“Hey you, that was just possible because it was you. The way you held a knife was different from others. The professors who coveted you rushed you to the OR.”

“Park Dowook is the same.”

Choi Hoo wasn’t known for saying nonsense, but Ha Sang Joong looked at him in incomprehension.

“You’re comparing Dowook to yourself? Huh. Ok, let’s say you’re right. Giving him half your surgeries means you’re giving up that much clinical experience. Why? Do you want to step down and become a full-time professor?”

“If Park Dowook continues to grow, we can have a perfect surgery room. I won’t say anything about you messing up my schedule so allow me to do as I mentioned.”

“This isn’t something I can do just because I say….”

“If the chief can’t do so, I’ll take care of it.”

Stating his point, Choi Hoo disappeared down the hall.

Ha Sang Joong looked at Choi Hoo’s leaving back with an expression which displayed he couldn’t understand what he wanted and shook his head.

“I really don’t know what he wants to do. So stubborn.”

He turned a corner to continue walking to his office.

“You’re here, sir.”

“Huh?”

As soon as he saw Dowook waiting at the door, Ha Sang Joong was about to ask about his last conversation with Choi Hoo when he saw a beautiful woman standing next to his student.

Lim So Yool, with a pale face and a neck brace, bowed her head slightly in greeting.

“Good afternoon.”

Seeing Chief Ha, who was so shocked he couldn’t even say hello, Dowook quickly explained the situation.

“Director Lim is here to cooperate with the neurosurgery department for financial coordination. Director, this is the chief neurosurgeon’s office. Chief, hurry up and take her inside. It’s time for me to get off work, good-bye.”

Ha Sang Joong watched with a stunned look on his face as Dowook left a bomb behind and disappeared. Then he turned to look at the bomb in front of him.

“I-inside….”

Opening the door to his office, Ha Sang Joong ran in like lightning and stuffed the financial accounts spread on his coffee table and desk into a cabinet.

"Please sit down. Would you like a cup of tea?"

"That's fine."

Sitting across from Lim So Yool, Ha Sang Joong had a nervous expression on his face as he didn't know what she was going to say.

She stated her purpose in a calm voice.

"I've been giving some thought to the possibility of Myeong Sae Hospital's improvement over the past week. And I've compared it with hospitals that have high profits. There were many missing numbers."

Thinking it was time for the deficit to be mentioned, Ha Sang Joong swallowed his saliva.

"At first I thought of a financial model to fill in the gaps. But then past those numbers, I saw a method of increasing benefits. The neurosurgery department was one of them."

Thinking he'd misheard, HaSang Joong asked.

"Benefits? In our neurosurgery?"

"Yes. It's a tremendously beneficial model that could grow to represent Myeong Sae Hospital."

Ha Sang Joong couldn’t believe Lim So Yool’s words, which painted a positive future for the neurosurgery department.

“There are other departments that are profitable. Our department has never been one of them.”

At that, Lim So Yool actually made a questioning expression.

“The best doctor in this hospital is in the neurosurgery department, though.”

“Well, it is Choi Hoo, but he’s not easy to cooperate with because of his temper. He even rejects invitations to perform surgery at medical conferences regularly. If you’re planning on pushing him to the forefront, I don’t know what kind of troubles you would encounter……”

“It’s not Prof. Choi.”

“Then there’s no other doctor in particular…… what? You don’t mean me, do you? You are correct in your assessment, but I’m satisfied with my teaching role. Hahaha. Though when I was younger, every time I went into the OR……”

Lim So Yool waited until Ha Sang Joong finished praising himself. Then, she smiled brightly.

“I’m talking about my attending physician. Dr. Park.”

“Dowook? Park Dowook?”

“Yes, I believe Dr. Park is able to make patient-centered diagnoses that no other hospital is able to do. I’m the only case that I know of so I can’t provide objective evidence to prove this yet, however, I’m sure other cases will be added in the future.”

Ha Sang Joon laughed in disbelief. He was about to ask why exactly she thought so when his office door suddenly burst open.

"Chief Ha! Where’s Park Dowook? Why isn't he answering my call?"

It was Prof. Lee Won Seok of Neurology who suddenly barged inside.

“Why are you also asking for Dowook?”

“He needs to come with me to check a diagnosis. Everyone's waiting right now.”

“You have to explain everything clearly for someone to understand. Do you think people can understand you if you just bang open the door?”

“No!”

Prof. Lee, who walked closer to Ha Sang Joong, briefly glanced at Lim So Yool and said quickly.

“We have an important patient being filmed in the clinic right now, Park Dowook did this. He wrote this. Neither I nor Prof. Yoon from ENT even considered surgery. It was impossible in the first place. But looking at this, I feel like someone bludgeoned me in the head. I need a surgical diagnosis.”

“Why are you asking Dowook about that? If it’s an important patient, you should consult with the professors.”

“Do you know this method of analysis? It’s my first time seeing this.”

A piece of paper was placed on the table. Ha Sang Joong saw the mix of numbers, formulas, and medical terms and frowned.

“What is this?”

“It represents the predictive interval of a variable about hearing abnormality.”

The one who provided the explanation was surprisingly Lim So Yool. Prof. Lee turned to look at her.

“Do you know what this is?”

“The upper part is the probability variable for hearing loss, and the lower part is the continuous stress variable for hearing recovery. It’s a logistic function, one for future predictions.”

“It seems you know it very well, however, I can’t seem to understand.”

“That was the easiest explanation I can think of…… um, Dr. Park Dowook can most probably explain it better.”

“Right.”

Recalling the reason he came here, Prof. Lee asked Ha Sang Joong.

“Where's Dr. Park, Chief Ha?! I'm in a hurry! I had them pause the recording and ran out!”

“The recording, for our Dowook?”

“If you know, hurry up and bring him out!”

Ha Sang Joong gave a faint smile.

He wondered why there were so many people insisting Dowook was a great doctor today.

They were more convinced about his student, who he had been teaching for 10 years.

One said he was the perfect OR companion.

One called him the savior of Myeong Sae Hospital.

One considered him able enough to diagnose a patient great enough to appear on TV.

“This is driving me crazy, really.”

Entering a dark office, Dowook turned on the lights.

‘Is Prof. Choi not here? Wow. There’s a day he leaves work early.’

He had been prepared to hear a scolding about the unauthorized schedule change but guessed that would have to wait for tomorrow.

He walked to the surgical training table in the center of the room, and he skimmed its surface with his hands.

The cold touch of metal woke him up.

If he went back and forth between this room and the OR training his skills, he would be able to perform surgeries like Choi Hoo each time.

‘2 years of Fellowship. Let’s die trying, Dowook.’

After deeply engraving his resolution, he arrived in front of a desk in the corner. He put the box he’d brought yesterday to the side and brought up the surgery schedule on the connected laptop.

[06:00 D-rosette OR #2 -surgeon Choi Hoo, 1st asst. Park Dowook]

[10:30 D-rosette OR #2 -surgeon Park Dowook, 1st asst. Choi Hoo]

[13:20]……[16:30]……[20:50]…….

“It’s pretty packed. There probably won’t be any time for a breather.”

Adding the ones scheduled today, it was a series of surgeries that forced him to live in the operating room from dawn to evening.

Nevertheless, his heart was pounding because he knew it was a great opportunity to gain clinical experience.

It was clear that Chief Ha would yell about the alternating main surgeons in the operations, but it would proceed anyway. The surgical thug in the area had made the order.

Lifting the office phone to his ear, Dowook called the patient ward of the first surgery’s patient.

-Yes, this is ward nurse Shin Soo-jung.

“This Park Dowook. How is the patient, Yoon Bok-man, in Room 705?

-The prospective craniotomy patient? Uh, the 2 o’clock vitals were blood pressure 90/120……

While receiving the status of the surgery patient, a loud voice from the hallway rang in Dowook’s ears.

-Park Dowook! Where’s this punk hiding?!

Chief Ha’s shout. Thanks to years of habit, Dowook flinched and shrank down. It seemed things got messed up as he expected due to the changes in the surgery schedule.

“Ms. Nurse. I’ll call you again later.”

Dowook hung up and quickly stuck himself to the wall.

He held his breath and waited for Chief Ha to pass by, but the door burst open.

“Found you, brat.”

Chief Ha entered with glaring eyes.

“Why aren’t you answering your calls?”

“You told me to leave for the day and I wanted to follow that order properly. If I answered the call, I wouldn’t have been able to.”

“Ha. Since when did you listen to my words that well?”

“Today?”

“Shut up!”

It didn’t seem like he was here to discuss the change in surgery schedule, but he stepped back to the laptop and changed the screen.

During that time, Neurology’s Prof. Lee came in. It was the professor whose sense he had borrowed and made good use of throughout the morning.

‘Why here……’

Before he could finish the question, Prof. Lee spoke.

“Dr. Park. I have some questions about this chart you wrote.”

“My chart?”

Dowook looked at the paper Prof. Lee handed to him in wonder.

It was the complex function that started with ‘lo’ Lim So Yool had been fixated on a while ago.

He was staring at it blankly, wondering why Prof. Lee was holding it, when the professor continued asking with urgency.

“As you know, Jeong Woo-seok’s cerebral deformity is a congenital problem. Even if it is assumed to be pre-psychotic hypertrophy, there is a high risk of complications if one removes more than 2cm. Do you think surgery is still possible?”

Dowook, who was looking at the paper, widened his eyes in surprise.

“Perform surgery? That’s…….”

The lower portion was not written by himself. It was just a mathematical solution drawn by Lim So Yool.

He didn’t even think that he could make a diagnosis based on this since it was written without any practical consideration in mind.

‘How the hell do I explain that this is a hypothetical diagnosis based on numbers only?’

While he was at a loss on how to explain, one more person stepped into the room.

“Why is everyone here?”

It was the owner of the office, Choi Hoo.

Choi Hoo came in holding a bag containing some triangular kimbap and a bottle of water in his hand.

‘So it was his meal time.’

Prof. Lee nodded his head in greeting once his eyes met Choi Hoo’s.

“It’s been a while, Prof. Choi.”

“What brings you here?”

“Because of a patient. We were listening to Dr. Park’s opinions about a diagnosis.”

“Dr. Park’s opinions?”

Choi Hoo’s gaze naturally turned to Dowook.

Chief Ha, who had been glaring at Dowook, spoke.

“Dowook. Quickly say something. Prof. Lee, Director Lee, even Choi Hoo. They all want to do something with you. I’m the only one who wants nothing to do with you. It wasn’t like this yesterday. Why do I feel left out here? Neurosurgery is one body.”

“That’s……”

Dowook, who was trying to figure out how this paper came out, paused as he recalled what Lim So Yool had said.

-The prediction model is finished.

Proof. Verification. Complete.

Since witnessing the dart function, Dowook had acknowledged her. Every phenomenon she calculated with numbers was true.

This number was hypothetical but it was not wrong.

This was why Prof. Lee was surprised enough to come here with just some information written at the bottom of the paper.

If a prominent professor at the neuro clinic admitted the diagnosis made by the mathematical predictive model, it would mean she made a diagnosis that a doctor was not able to.

‘It’s really amazing.’

Dowook believed in the numbers of Lim So Yool so he wanted to prove that all of this was not just a daydream he’d thought up.

He brought up Prof. Choi’s sense as he thought it would best be able to judge.

Cerebral cortex deformities, alternative surgery identified by numbers.

Thinking about it, the answer was unexpectedly simple.

“Surgery is fully possible. Though priority would have to be given to identifying hearing-killing factors like tumors.”

“It’s a deformed brain, so it’s different from a normal brain. Is there any risk of brain stem damage? Even if you succeed, you can lose a lot of sensory nerves.”

“All we have to do is pick out the brain tissue in question. Like some kind of brain plastic surgery.”

Chief Ha started pulling out his hair when he heard something impossible like ‘brain plastic surgery.’

“Prof. Lee! Are you going to suggest to a patient being filmed to do a surgery that has never been reported to the academic community? Does it make sense to have a brain job?”

“It’s possible.”

The one who answered was Choi Hoo.

“Dr. Park has just proposed an operation that requires a great deal of control from the surgeon.”

“Choi Hoo. It’s the cerebral cortex. If you mess with it, it’s complete paralysis of the connected nerves. How do you plan to get rid of the problematic areas?”

“With one’s eyes and hands.”

At Choi Hoo’s matter-of-fact answer, Dowook nodded while Chief Ha sneered in disbelief.

“So, if the patient agrees, you lot will perform the surgery?”

“I won’t do it.”

At Choi Hoo’s quick denial, Chief Ha nodded in understanding. But Choi Hoo’s reply was not yet finished.

“…….but I would not disagree if Dr. Park plans to do it.”

“Hey, Choi Hoo! You’re even going to hand over an unestablished operation to him?”

Choi Hoo didn’t pay any attention to Chief Ha’s yells and walked to his desk. Then he took a triangular kimbap out from the bag.

Prof. Lee, who’d been looking back and forth with his chin propped on his hand, looked back at Dowook.

“I also think it’s possible. Factors that cause hearing loss. I’ll definitely find them. I’ll tell the patient that you’re going to be coordinating with us on this.”

“Understood.”

Prof. Lee hurriedly left the room, and Chief Ha asked Dowook.

“Do you plan to do the surgery if they agree? Really?”

“Of course. If the patient wants to.”

“Phew~ I don’t know. I don’t know what’s going to happen to our neurosurgery department in the future.”

Chewing on a triangular kimbap, Choi Hoo turned his head.

“Dr. Park.”

“Yes?”

“I’m going to do a brain aneurysm simulation. Will you join me?”

“I have to. Today is a day without surgery.”

Then, a triangular kimbap flew toward him.

“Eat that and then we’ll start.”

“Thank you.”

While opening the wrapper, Dowook looked at Chief Ha who was standing with a half-conscious look.

“You must have been robbed a lot by Director Lim.”

Chief Ha opened his eyes wide.

“You’re robbing me right now, brat! Shake, shake!”

[T/N: Doesn’t make as much sense in English, but think of those scenes on TV where a kid is robbed during recess where a bigger kid holds him upside down and shakes him so all the money falls to the ground.]

—–

sync : a neurologist’s method of rapid examination

action : muscle resistance accurately identifies nerve abnormalities.