A competent doctor can cure everything - Chapter 66

On my first day in obstetrics and gynecology, it felt like a kind of initiation, as we even had an emergency patient come in at night.

‘It’s been quiet for the past few days.’

After all the daytime duties were done, it was evening time.

I was currently at the hospital café, working on the draft of my paper on my laptop.

Next to me, there was a glass with droplets of water beading on it.

When I touched the glass, I felt a refreshing coolness.

The bitter, cool aftertaste of the Americano was satisfying.

For the time being, I don’t have any business trips to Blue Whales.

The whole team is already in Suncheon ahead of the KOVO Cup tournament.

I plan to go watch the game this Saturday morning.

It’s probably the first time I’ll be doing a long-distance drive since my time as a public health doctor, when I used to travel from Gyeongnam to Seoul.

‘I should get my car checked before the trip.’

Anyway, thanks to this, I now have the time to take a paper-writing class with Shim Ji-seop.

Shim Ji-seop is surprisingly good at teaching me.

“First, choose the journal that fits your paper’s topic. Then, check the submission guidelines for the journal. You don’t necessarily have to start with the ‘Introduction.’ It’s often easier to begin with the ‘Methods,’ which doesn’t require as much subjective content. Don’t wait until the end to look up references—be sure to add footnotes as you go along.”

I had secretly wondered if he’d make fun of me or get annoyed while teaching, but he explains things very calmly and clearly.

‘Shim Ji-seop would have made a great teacher.’

I occasionally hear from Kim Jin-ah that this senior is also working hard to treat her.

Kim Jin-ah is always so happy to see me, it almost makes me feel embarrassed.

Whenever I appear, she calls my name from far down the hallway with a big smile.

“Seon-Joon, Doctor!!”

“Kim Jin-ah.”

Jin-ah smiled proudly, leaning against a large walker.

“Today, I walked for 15 minutes straight without resting!”

“That’s impressive!”

“Thanks to Professor Jeon Jae-wook extending my hospitalization, I’ve been able to keep getting treatment, and I’m really happy about it.”

“That’s great. How about Doctor Shim Ji-seop?”

“Ah! I’m so grateful to Doctor Shim too; he’s been really helpful.”

Jin-ah looked around before lowering her voice.

“But still, I like you more, Doctor Joon. If you hadn’t started this treatment, no one would have done it for me.”

…That was a moment too.

It wasn’t like the “Yellow Cow and Black Cow” story from the Joseon Prime Minister Heung, but it was a fun memory, whispering secrets.

Let me stop the random thoughts and focus again.

I stretched my arms and turned my gaze back to the laptop screen.

That’s when a young woman, who was wiping down a table next to me, spoke up.

“Excuse me, are you Doctor Seon-Joon from the Oriental Medicine department? You work with Doctor Ye Wonil, right?”

“Yes, that’s me.”

She was the daughter of the café owners, if I remember correctly.

It seemed she often helped out at the café with her parents.

“Hello~. My name is Jo Na-kyung, and I’m the daughter of the café owners here. Oh, you used to treat a patient named Na Ye-jin, right? She’s my mother.”

Na Ye-jin was a patient I had seen when I was on the gastroenterology rotation.

She had been referred for collaborative treatment due to indigestion caused during chemotherapy for endometrial cancer.

At that time, I had diagnosed her with a condition similar to nervous exhaustion, called ‘Simbi Heojeung’, and had prescribed herbal medicine.

“Yes, I remember. How is your mother doing?”

“Thanks to you, Doctor. She responded really well to the herbal medicine, and her condition is great now. Our whole family is really grateful to you.”

Na-kyung greeted me warmly before getting to the point.

“As you might have heard, I’m getting married, and I wanted to ask you about dieting. A lot of my friends have been doing herbal medicine weight loss treatments.”

She shyly brushed her hair behind her ear as she mentioned her wedding.

“Yes, many people use herbal medicine for weight loss.”

“Is it effective?”

“There was a study conducted by a family medicine team at another hospital analyzing effective weight loss methods. Out of 8 weight loss methods, herbal medicine ranked first in terms of success rate.”

“Wow, that’s interesting.”

“But you’re not overweight now.”

“Oh, Doctor! I have a lot of hidden fat here and there. And when it comes to wearing a wedding dress, I realized I need to be much thinner than I expected to look good.”

Na-kyung smiled, as if to dismiss any concerns, and waved her hand.

“Actually, I’ve had a feeling that my boyfriend might propose to me soon, so I’ve been dieting for a few months now. But after losing some weight, it’s been hard to lose any more.”

But there’s something that has been bothering me for a while now.

Na-kyung’s face has been flushed the entire time.

I let it go last time, but seeing it again today, something feels off.

“Are you feeling hot right now?”

“Huh? Oh, yes, my face is a bit red, right?”

She seemed slightly embarrassed and fanned her face with her hand.

“Actually, this has been happening a lot lately. Maybe it’s because of the summer?”

“When did this start happening?”

“Hmm… maybe about a month ago?”

“Do you also wake up at night feeling hot? Sweating or anything?”

“Well… now that you mention it, I have been sweating a bit and tossing and turning, but I just thought it was because of the summer.”

And then I noticed her hand. The skin on the back of her hand looked dry.

She kept scratching her arm as if it was itching.

Could it be…?

“By the way, how old are you?”

“Huh? I’m 28 years old.”

“This may be a bit of an awkward question, but I need to ask it for your treatment.”

“Oh, sure, go ahead.”

When I asked seriously, Na-kyung’s face also became more serious.

“Are your periods regular?”

“Huh…? How did you know? Actually, they’ve been really irregular this year.”

“What do you mean by irregular?”

“Well, sometimes I skip a few months, or my cycle gets shorter…”

A bad feeling starts to creep up on me.

I asked about her LMP (Last Menstrual Period).

“So, when was the last time you had your period?”

“It was a few months ago, so I forgot, but let me check.”

She looked something up on her phone and then answered.

“Four months ago.”

“So, you haven’t had a period in the last four months?”

“Yes, but I’ve always had irregular periods, so I just thought it was normal. And since I’ve been dieting, it could be because of that, right?”

Secondary Amenorrhea.

This refers to when a woman, who previously had regular periods, misses three or more consecutive periods.

There are many potential causes, so it’s important to distinguish them.

“It would be a relief if it were just from dieting or stress, but there’s something that worries me.”

“Huh? Why do you sound so ominous, Doctor?”

When I spoke in a serious tone, Na-kyung awkwardly laughed.

But when I didn’t smile, her own smile faded as well.

“Is this serious?”

“Well, to be certain, we would need to do a blood test.”

“Why? What’s wrong?”

“…I suspect something, but it’s not confirmed yet, so please don’t take it too seriously.”

I cautiously began to explain.

“I’m concerned about the possibility of premature ovarian failure.”

“Premature ovarian failure…?”

“Simply put, it means menopause occurring earlier than usual.”

“What? Menopause!?”

Na-kyung exclaimed loudly, causing nearby customers to glance over.

She seemed to realize this and immediately lowered her voice.

But there was still a look of shock on her face.

“Doctor! I’m only 28!”

“Premature menopause can occur even in your early 20s. It’s considered premature menopause if it happens before the age of 40.”

“Why did you think of that?”

“Frequent hot flashes, cold sweats, dry skin. And doesn’t your skin feel like it’s crawling sometimes? You’ve been scratching your arm unconsciously.”

“!”

“In addition, you might frequently feel the urge to urinate or experience incontinence. Emotionally, you could have anxiety, depression, and significant mood swings.”

She nervously bit her nails.

It seemed that the symptoms I mentioned weren’t completely out of the blue.

“So, what should I do?”

“To confirm the diagnosis, you’ll need to go to an obstetrics and gynecology clinic and get a blood test.”

“Ah…”

“It’s just a simple blood test, so you don’t have to wait for an appointment with a famous professor. Dr. Jeong Daun at the OB/GYN clinic will probably help you with it.”

I thought of the cheerful OB/GYN fellow who was friends with Lee Hyun-seung.

Na-kyung still seemed to not fully understand the situation.

I, too, hoped that my suspicion was wrong.

Premature ovarian failure is a hard-to-treat condition with an unknown cause.

* * *

Jo Na-kyung went to Hanbit University Hospital with her mother.

After receiving advice from the acupuncture intern she had met at the café, she went for a same-day consultation.

Today, she had come to hear the results.

Na-kyung and her mother sat silently in the waiting room.

Then, a message arrived on Na-kyung’s phone.

[My Goldie♥: Babe, what’s up? hehe]
[My Goldie♥: Are you working? Should I pick you up after work?]

It was from Na-kyung’s fiancé.

Because of his sturdy build and simple, kind nature, Na-kyung had taken to calling him “Goldie,” comparing him to a golden retriever.

Na-kyung couldn’t bring herself to reply, so she didn’t open the message.

With a trembling voice, she asked her mother.

“Mom, do you think it’s better not to tell Ye-rang yet?”

“The test results aren’t out yet, so don’t say anything for now. You don’t want to worry his family before the wedding.”

As she entered the consultation room, her heart raced with anxiety, as if it might burst from her chest.

As the door opened and the doctor’s face appeared, Na-kyung’s heart sank.

The obstetrics and gynecology fellow’s expression was somber.

It was clear that the results weren’t good.

“Jo Na-kyung, please have a seat, and I’ll explain the test results.”

Na-kyung sat down, feeling as though she was being sentenced by a judge.

”Well… to be honest, the test results aren’t good. There’s a hormone called FSH (Follicle Stimulating Hormone). It rises when ovarian function decreases, and when it exceeds 40 mIU/ml, it can indicate that you’ve reached menopause. But for you, Na-kyung, it’s over 50 mIU/ml.”

“Ah…!”

“And there’s another hormone called AMH (Anti-Müllerian Hormone). At your age, it should be around 4 ng/mL, but yours is in the low 2s.”

“So what does that mean?”

“It means your ovarian age is in the late 30s to early 40s.”

“……!!”

Na-kyung covered her mouth with her hands, stunned by the fellow’s careful explanation.

“The standard diagnostic criteria for premature menopause is having no period for more than six months and having FSH levels over 40 mIU/ml on two separate tests a month apart. You haven’t quite reached the diagnostic threshold yet, but it’s nearly certain, and I recommend starting treatment as soon as possible.”

“……”

A heavy silence hung in the air inside the consultation room.

Na-kyung opened her mouth with a faint voice.

“Why is this happening to me?”

“The cause is unknown. It could be due to chemotherapy, radiation therapy, or autoimmune diseases, but none of those apply to you. It seems that your ovarian function is simply weaker than most people’s. When we looked at both ovaries on the ultrasound, the size was smaller than average.”

Na-kyung’s mother, Ye-jin, asked with a glimmer of hope in her voice.

“Doctor, surely there must be some treatment options?”

“Well… if you start treatment, you’ll be taking female hormones to alleviate menopause symptoms, until you reach the normal age for menopause.”

“So is pregnancy still possible? My daughter is about to get married…”

“Unfortunately, pregnancy will be very difficult. The treatment will only supplement the insufficient female hormones, but it won’t stimulate ovulation.”

“What? So, in the end, the treatment won’t work!”

Ye-jin suddenly became upset and raised her voice.

The fellow calmly responded to Ye-jin, who was upset.

“Please also see a Korean medicine obstetrician. For conditions like premature menopause, you should try everything possible, whether it’s Western or traditional medicine. Some people’s ovulation can recover with treatment, so don’t lose hope.”

“What should I do…”

The fellow spoke to Na-kyung, who was on the verge of tears, trying to comfort her.

“At least you came to see a doctor quickly. Most people don’t even think it could be premature menopause and end up neglecting it for years. They just assume that irregular periods are normal because they still get their period occasionally.”

“Phew, actually, I came here because an intern at this hospital told me to.”

“An intern?”

“Yes. His name is Seon-Joon, a doctor in Korean medicine…”

“Ah, that guy. He’s sharp. Thanks to him, you came in early, so at least that’s a blessing in disguise.”

However, Na-kyung didn’t seem to hear the fellow’s comforting words.

She took heavy steps, forcing herself to leave the consultation room.

Mother and daughter, overwhelmed by shock, headed toward the café on the first floor.

“It’s my fault, Na-kyung. I had uterine cancer before, didn’t I? Maybe because of me, you have issues with your uterus too. It’s all my fault.”

“Mom…”

After a long silence, Ye-jin began to blame herself, and Na-kyung tightly gripped her mother’s hand.

Just then, Na-kyung’s phone in her pocket vibrated.

[My Goldie♥: Are you busy? You haven’t replied to my messages today.]

“Mom… What should I tell Ye-rang?”

Na-kyung, her face streaked with tears, looked up at her mother, who was holding back her own tears.