A competent doctor can cure everything

The call from the obstetrics fellow came two days later.

At that time, I was tidying up after the morning rounds in the treatment room.

‘It’s been 10 days since Ms. Kang Eun-jeong had a bowel movement…’

Given that she hasn’t been eating much, it’s not surprising.

While I was feeling a bit disheartened, a call came in from an unknown extension number.

“Hello, this is Intern Seon-Joon…”

“Cute Intern~! That difficult herbal medicine you gave me worked wonders!”

Before I could finish my sentence, a cheerful voice echoed in my ears.

It was Lee Hyun-seung’s friend, the disheveled-haired fellow from the obstetrics department.

Cute…?

Before I could even ask why my nickname was “cute,” the obstetrics fellow quickly chattered on.

“After taking that medicine, I didn’t have any stomach pain the next day even after going into the operating room. It was so amazing~. What’s the secret?”

The medicine I prescribed was called ‘Bulhwan Geumjeonggisang.’

“It’s made from warm herbs, and it also removes unnecessary moisture.”

“Really? But it seems like my digestion has improved after taking it. Am I just imagining things?”

“That medicine is in the same category as a digestive aid called ‘Pyeongwi-san,’ so that might be why.”

“Wow, so it works not only on the intestines but also on the stomach? That’s great!”

“Well, yes. The digestive system is interconnected.”

After I answered her persistent questions with enthusiasm, she gave me this nickname.

“I’ll call you ‘Cute Master’ from now on.”

“……”

I began to understand a bit why she and Lee Hyun-Seung were friends.

After a brief pause, the fellow asked again.

“But is it okay to stop taking this medicine right away? Won’t things get worse?”

“I think it would be better to take it steadily for two to three months.”

“Just as I thought. Then I can’t keep bothering you, cute master. How can I get this prescription?”

I gave her Professor Ko’s name.

“You can visit his outpatient clinic in the future.”

“Oh, I’ve had such a hard time every time I went into the operating room. It was the first time I felt this comfortable. Thank you!”

She ended the call with an enthusiastic thank you.

Well, I’m glad it was helpful.

‘Not only did it help with diarrhea, but also improved digestion.’

I briefly reflected on our conversation.

The digestive organs are interconnected….

‘So, if we target diarrhea for treatment, it could also improve overall digestion.’

In that case, could treating constipation also improve digestion for Eun-Jeong?

‘Wait a minute, what if…’

Suddenly, a thought flashed through my mind.

What if the order was reversed?

If the problem in the lower digestive tract affecting the upper digestive tract?

Eun-jeong has severe constipation along with nausea and vomiting after meals.

In what cases could this happen?

‘When there is bowel obstruction.’

If the bowel is obstructed and food is pushed through, it would naturally lead to reflux.

And if the bowel is obstructed, not passing stool would also be expected.

‘In other words, bowel obstruction?’

My mind started racing.

I stopped my hand as I was organizing the round tray.

However, if the bowel is obstructed, there is usually severe pain in the lower abdomen.

Even the most patient person would not be able to endure such intense abdominal pain.

‘But Eun-jeong doesn’t have abdominal pain.’

Stuck in thought, I ran to the intern training room.

I took out the internal medicine textbook from the shelf.

‘Bowel obstruction…’

I quickly skimmed the table of contents and turned to the relevant pages.

I felt the rough texture of the paper under my fingertips.

“!”

Having found the information I was looking for, I slammed the book shut.

Yes. This makes sense.

It explains Eun-jeong’s symptoms.

However, to confirm this, an abdominal X-ray would be needed.

‘For that, the attending resident would have to request a consult with a specialist.’

At times like this, being just an intern feels very inconvenient.

‘I want to become an attending doctor as soon as possible.’

Kim Pyeong-hwa has always treated me with courtesy, unlike Choi Jin-seong who would get frustrated.

‘The conversation should go smoothly without any issues.’

With that thought, I went to find Kim Pyeong-hwa.

It didn’t take long to realize how naïve that thought was.

* * *

I headed to the internal medicine office, where the internal medicine residents worked.

Kim Pyeong-hwa greeted me with a look of surprise.

“Dr. Seon Joon? Please, come in.”

Kim Pyeong-hwa sat me down in front of the office table and began preparing green tea in a paper cup.

Szzzz—

The coffee pot now turned on, started to boil loudly.

As I watched the back of her head, I organized my thoughts.

As soon as I received the green tea, I spoke directly.

“I’m talking about Kang Eun-jeong. We’ve been assuming that her constipation is due to reduced food intake.”

“Yes.”

“What if it were the opposite?”

“What do you mean?”

Kim Pyeong-hwa, who had been quietly sipping her tea across from me, raised her eyebrows.

“Even if a bowel obstruction occurs, constipation can be accompanied by nausea and vomiting.”

She immediately dismissed my statement.

“But if it were a bowel obstruction, the patient would have complained of colicky pain (pain that comes in waves due to spasms in the abdominal organs).”

“Yes. If it were a mechanical bowel obstruction, that would be the case.”

Bowel obstructions are classified into two main types: mechanical bowel obstruction and paralytic ileus.

The decisive difference between them is this:

‘Is the bowel physically blocked?’

Mechanical bowel obstruction refers to a state where the bowel is physically blocked, whether by adhesions or a mass like a tumor.

As a result, it shows severe abdominal pain, nausea, and vomiting.

“But in paralytic ileus, such severe pain is not present.”

On the other hand, paralytic ileus is a condition where the bowel is not physically blocked but is paralyzed and unable to move.

“Should we get an X-ray and then adjust the herbal prescription to something like ‘Daekan Jung-tang’ for improving constipation?”

Kim Pyeong-hwa held the paper cup in her hand and remained silent.

She seemed to be thinking about what I said.

I waited with the cup at my lips.

‘Now we should get an X-ray through the consultation, right?’

However, what she said next was unexpected.

“I disagree with your opinion.”

Kim Pyeong-hwa clearly presented her argument.

“If it were a paralytic ileus, we wouldn’t hear bowel sounds on abdominal auscultation. But Kang Eun-jeong has bowel sounds.”

In other words, when listening with a stethoscope, the sound of the bowel moving was audible.

“I’ve been auscultating daily, not just when Eun-Jeong was first admitted a month ago. Therefore, I don’t believe it’s a paralytic ileus.”

Is my opinion being dismissed like this?

I was taken aback but knew I couldn’t back down now.

“That could be because it’s in the early stage of progressing to a paralytic ileus.”

“Yes, it could be, and it could not be. And that decision is for the attending physician to make.”

Kim Pyeong-hwa emphasized the word “attending physician.”

To an intern with no authority, it felt like a dismissal.

“She couldn’t even touch food at the beginning of her admission. I believe Eun-jeong is improving, albeit slowly. I have no intention of changing the herbal prescription.”

“But……”

“You can’t make decisions based solely on suspicious circumstances.”

As I tried to speak again, Kim Pyeong-hwa firmly stood up from her seat.

“Thank you for your opinion. I will monitor Kang Eun-jeong more closely. Now, please leave.”

In the end, I couldn’t persuade Kim Pyeong-hwa any further and was effectively kicked out of the office.

“Damn it. I underestimated the situation.”

I trudged back to the ward station, reflecting on the situation.

I hadn’t realized that Kim Pyeong-hwa from internal medicine was a more formidable opponent than Choi Jin-seong from the acupuncture department in some respects.

Choi Jin-seong, though quick to anger, is somewhat straightforward and can be gently persuaded.

But this second-year resident is, quite literally, a stickler for principles. She dislikes anything that deviates from the rules.

‘The intern must have ruffled her feathers by encroaching on the attending physician’s domain.’

That would naturally make her more resistant to my opinion.

I should have approached with a more cautious attitude but was too casual.

I clicked my tongue in frustration.

‘For now… let’s check the future charts.’

I accessed the hospital’s electronic medical records (EMR).

I clicked on Kang Eun-jeong’s chart with the mouse.

“Hmm.”

For now, there was no diagnosis of paralytic ileus in the charts for the coming week. Eun-jeong’s condition hadn’t worsened particularly.

‘But what if it’s in the stage of progressing to paralytic ileus?’

Isn’t it better to catch it early and prevent it rather than wait for a confirmed diagnosis before treating it?

If the bowel completely stops, severe vomiting and diarrhea will occur.

‘Such events would further reduce the already limited life expectancy of Kang Eun-jeong.’

This is maddening. I pressed my fingers hard against my temples.

Still, since there’s no major issue for the coming week,

I need to find a way to quickly change Kim Pyeong-hwa’s mind.

‘I’m stressed out and craving coffee.’

I swallowed a sigh.

I resolved to definitely go to the café during lunch break.

* * *

A few hours later.

At the hospital’s first-floor café, I saw an intern placing a poster on the café’s glass window.

Noticing my gaze, she turned her head toward me.

‘Ah.’

That lifeless look and expression.

‘It’s not Lee Haet-nim… it’s Lee Dal-nim.’

Wearing the same doctor’s coat made it really hard to tell them apart, except for their expressions.

Lee Dal-nim recognized me and gave a small nod.

I moved closer to her to read the poster.

‘Healing Concert for Cancer Patients?’

It looked like an event where a student volunteer club came to sing and provide foot baths for cancer patients.

“Why are you putting this up?”

“It’s our department’s event, and since I’m the youngest in our department?”

Lee Dal-nim replied indifferently.

The poster mentioned that the event was co-hosted by the volunteer club and the hematology-oncology department.

‘So, Lee Dal-nim must be on the hematology rotation now.’

It seems that Lee Dal-nim, who was an intern in Western medicine, is currently with the hematology-oncology department, treating cancer patients.

“Hmm. Surprisingly, they allowed the poster to be posted in the café.”

I looked at the colorful poster that broke the uniformity of the café’s upscale interior.

Since it’s a famous franchise café, I wouldn’t have expected them to allow just anything to be put up.

“Well, there are patients from our department who will be attending this café, so.”

“?”

Seeing my puzzled look, Lee Dal-nim shrugged lightly.

“The café owner’s wife is a patient from our department.”

“Oh, I see. No wonder the owner’s expression has been so grim lately.”

If it’s a hematology patient, it means they have cancer.

Lee Dal-nim responded dryly to my comment.

“It’s a tragic disease. Cells that proliferate endlessly without dying, eventually leading to the death of the host.”

‘…Her tone doesn’t seem very sympathetic, though.’

While Lee Haet-nim might speak with a musical tone, it’s hard to tell if Lee Dal-nim is sincere just from her voice.

Is it as if Lee Haet-nim absorbed all of Lee Dal-nim’s emotions before birth?

As I marveled at how different these twins were, I noticed that I wasn’t the only one in the hospital looking at the poster.

“Hm, a healing concert?”

In front of the bulletin board outside the Oriental Medicine outpatient clinic.

Someone who had seen the poster smiled and tapped their cheek with their finger.