A competent doctor can cure everything - Chapter 68

It was still early morning, with the faint light of dawn just beginning to lift.

The residents of the Oriental Obstetrics and Gynecology Department blinked their eyes and gathered in the hospital conference room.

The interns and first- and second-year residents were already seated, leaving only the third-year residents and the professor’s seats empty.

Despite their sleepiness, everyone seemed tense at the thought that Professor Bu Yeo-jung would soon arrive.

“Hello, everyone.”

“Hello, Professor.”

The tense air was broken by the appearance of a third-year resident, who entered while yawning.

“Our Yang Hi-sseom is so cat-like, I wonder how she ended up with the name ‘Yang Hi’?”

The third-year, who was holding a thick textbook under her arm, lightly pinched Lee Yi-won’s cheek.

Then, she noticed the man sitting next to Lee Yi-won.

“Ah, the intern who’s joining the study today?”

“Hello, I’m Intern Seon-Joon.”

“Ah, I know you. You’re famous for being the ace intern.”

The third-year grinned and pretended to pray by putting her hands together.

“You’re going to be part of Bu Yeo-jung’s study? I offer my condolences in advance.”

“You’ll probably get scolded a lot during the study, so don’t take it too hard. But hey, it’s a rare chance to get a lecture directly from the author, right?”

The second-year, sitting next to her, spoke sympathetically to the intern.

The “author’s direct lecture” referred to the fact that the primary author of their main textbook was Professor Bu Yeo-jung.

Amidst this, Lee Yi-won, a first-year resident, suddenly burst into laughter while looking at Seon-Joon’s chest.

Everyone looked at Lee Yi-won, puzzled.

“?”

“Seon-Joon, your ID badge.”

Lee Yi-won pointed to the ID badge hanging on Seon-Joon’s gown collar.

“You should have smiled in the picture, you know.”

“Ah… yes.”

Was this the “sudden laugh” that Haet-nim had mentioned?

Seon-Joon thought to himself.

At that moment, the conference room door opened, and the sound of high heels clicking echoed.

“Good morning.”

“Good morning, Professor!”

Despite the early hour, Professor Bu Yeo-jung’s appearance was immaculate, with not a hair out of place.

After a brief greeting, the professor immediately got down to business.

“Alright, let’s start with the third-year residents.”

The study session was structured around the patients that each resident was responsible for, whether inpatient or outpatient.

Since Seon-Joon, the ward resident, had not seen any outpatient cases, there were some names he was hearing for the first time.

However, as he listened to the presentations from the residents, he realized just how much his perspective had expanded.

‘After acquiring Professor Bu Yeojung’s knowledge, everything seems different.’

It felt as though a diagnostic algorithm had been entered into his mind.

He realized that his previous diagnoses were merely based on guesswork.

Following this meticulous algorithm, he could make a diagnosis with no omissions, and that would lead to accurate treatment.

It was needless to say that accurate diagnoses result in better treatment outcomes.

‘I can see how frustrating it would be to miss something so obvious.’

As he listened to the presentations, he thought he understood why Professor Bu often lost her temper.

While he was marveling at himself in this way…

Professor Bu Yeo-jung’s arrow shot toward Joon.

“Hey, intern. Don’t you have anything to say?”

This came after the second-year resident had just presented a 30-year-old patient with endometriosis.

Endometriosis is a condition where the endometrial tissue, which should be inside the uterus, grows outside the uterine cavity. It can cause lower abdominal pain, abnormal bleeding, and infertility.

This patient had come in due to severe menstrual cramps and pelvic pain.

The second-year resident had proposed a treatment plan based on blood stasis and suggested a prescription to invigorate the blood and eliminate stasis, which would promote circulation.

“Hmm, my thought is…”

Joon felt all eyes on him, sensing their pity, and began to speak.

“With the current information, we can’t establish a proper treatment plan. The diagnosis needs to be redone from the beginning.”

“So, you’re saying the second-year’s diagnosis is wrong?”

“Not that the diagnosis is wrong. The basic pathology of endometriosis is indeed blood stasis. However, the most important thing is ‘what does the patient want?’”

Professor Bu Yeo-jung, who had initially scoffed at the intern’s cocky statement about starting from scratch, paused for a moment.

“Go on.”

“In Western medicine, the treatment for endometriosis usually involves oral contraceptives or surgery. But the reason this patient came to the Oriental Medicine Department, instead of undergoing conventional treatment, must be clear. We need to understand the reason first.”

“What is it?”

“The main desires of endometriosis patients can generally be divided into two things: relief from pain or the ability to conceive. If this patient is seeking treatment here because she wants to conceive, we should not use excessive blood-invigorating herbs. Overuse of these can interfere with embryo implantation.”

Blood-invigorating herbs improve blood circulation in the pelvic area and help prevent vascular regeneration and tissue adhesion. However, if used excessively, they can be detrimental to pregnancy.

“However, the presentation just now did not mention anything about the patient’s desire to conceive or why she came to Oriental Medicine. So, I can’t decide on the treatment direction yet.”

Everyone, including the professor, was speechless.

Professor Bu Yeo-jung’s arms, which had been crossed tightly, gradually unfolded.

The professor tried to mask his surprise, but inwardly, he was taken aback.

‘This is something that’s difficult to grasp unless you’re a gynecologist.’

At the level of a resident, just getting the diagnosis and prescription for endometriosis right would already be impressive.

So, Professor Bu decided not to scold the second-year resident too harshly.

However, given the situation, he couldn’t hold back the harsh words.

“For a second-year resident to miss something that even an intern notices…”

“…I’ll conduct additional questioning and present it again.”

The second-year resident lowered his head, face flushed with embarrassment.

“Next, first-year intern Lee Yi-won. Please give your briefing.”

“Yes. First, a 32-year-old postpartum patient, Ryu Ji-hye, who was admitted after a cesarean section.”

After summarizing the patient’s basic information, Lee Yi-won presented her treatment plan.

“…Since this is a cesarean section and not a natural birth, the uterine contractions and recovery may be slower, so we need to be cautious. I will administer ‘Seonghwa-tang’ for a week to help expel the lochia (postpartum discharge), and then switch to ‘Boheo-tang’ to supplement postpartum weakness.”

At that moment, Seon-Joon quietly raised his hand.

“Intern? Do you have something to say?”

“I went to take the patient’s history this morning, and while checking the hospital room, I noticed there were many snacks. When I asked about her usual diet, she said she enjoys greasy foods and snacks. Consuming high-fat, high-calorie foods can block the milk ducts, leading to mastitis. Therefore, we need to be especially cautious about mastitis and postpartum fever caused by it.”

“!”

“Yi-won, did you know about this?”

Yi-won, who hadn’t thought to check the snacks in the patient’s room, became speechless, as if she had eaten honey and couldn’t speak.

Professor Bu turned his attention fully to Seon-Joon now.

“Intern. What is the most common cause of postpartum fever?”

“The most common causes of fever after delivery are usually genital infections. Mastitis occurs in about 33% of cases, and breast engorgement is also quite common, affecting about 15%. These are the three most frequent causes.”

Seon-Joon didn’t just stop at stating the causes—he also suggested solutions.

“Currently, the patient’s nursing intervals are quite wide, around 4 to 5 hours. To prevent breast engorgement, it’s important to encourage more frequent feedings, every 2 to 3 hours. We also need to be cautious about infection at the cesarean incision site and monitor the lochia to ensure there are no signs of intrauterine infection.”

Hmm. Professor Bu was secretly impressed.

She had never seen a resident answer this thoroughly, especially not one who wasn’t specializing in obstetrics and gynecology.

“…So, coming to obstetrics and gynecology, huh? You’ve studied a bit.”

As Professor Bu nodded, the residents exchanged astonished looks with one another.

The fact that such praise came from Professor Bu’s mouth was essentially a high compliment.

Lee Yi-won cleared her throat and began presenting the next patient.

“Next is a 28-year-old patient, Jo Na-kyung, who was admitted for premature ovarian failure.”

“For premature menopause, the main treatment is herbal medicine. What prescription did you come up with, Yang?”

“I chose ‘Yulinju’.”

“What’s your take on this, intern?”

In traditional Korean medicine, a weak reproductive system is referred to as ‘shinhe’, or kidney deficiency.

‘Yulinju’ is a representative prescription for ‘shinhe’ and is commonly used for infertility or habitual miscarriage.

Everyone now looked at Seon-Joon with a kind of expectation.

“I think any tonic for the kidney (‘bosin’ category) would be fine, but I believe ‘Yulinju’ should definitely include ‘Ossuyu’ and ‘Sokdan’.”

“Why?”

“’Ossuyu’ is a common herb used in infertility prescriptions, and it inhibits ovarian cell apoptosis. ‘Sokdan’ enhances the endocrine function and supports the growth of the uterine lining. These are essential herbs for this patient.”

“…?”

Looking at Professor Bu’s somewhat perplexed expression, the residents realized that once again, the intern had provided the correct answer.

Professor Bu turned his attention to Lee Yi-won and began his questioning.

“Yang, this is your first time handling a premature ovarian failure patient, isn’t it?”

“Yes, that’s correct.”

“What if this patient doesn’t menstruate for several months?”

“Uh… well, first I’d continue to follow up with blood tests every three months…”

“That’s obvious. Is there nothing else?”

“Hmm…”

“Don’t you understand what I’m asking? Do you not get my point?”

The atmosphere became as cold as ice.

Lee Yi-won bit her lip and stared at the floor.

“Intern, do you have any ideas?”

“I’d follow up with a bone density test.”

“Why?”

“Premature ovarian failure patients are exposed to low estrogen levels, which increases the risk of osteoporosis. So, the tests should be done regularly, and weight-bearing exercises (light strength training that puts weight on the bones) should be recommended.”

Ah, Lee Yi-won finally realized what she had missed.

Estrogen, a female hormone, also plays a role in maintaining bone density in women.

Therefore, osteoporosis is commonly seen in women after menopause.

Although Jo Na-kyung is in her 20s, she is currently in a menopausal state, so osteoporosis should be considered in her case.

“Look at that. Obstetrics and gynecology is running smoothly.”

Professor Bu Yeo-jung coldly muttered while placing one hand on her hip.

“What if a resident is worse than an intern?”

“…I’m sorry.”

“You don’t need to apologize to me, you should apologize to your patient. You made her see a doctor who lacks skills.”

Everyone was silent under Professor Bu’s sharp criticism.

Even though she was usually fond of Lee Yi-won, there was no mercy during study time.

But there was something Professor Bu didn’t realize.

The plan to shock the intern into studying had subtly shifted to shocking the residents with their inferiority to the intern.

* * *

Indeed, Professor Bu Yeo-jung’s morning study sessions were brutal.

I couldn’t help but shake my head as I remembered the atmosphere from that session.

‘I think Lee Yi-won might cry eventually.’

Yet, Lee Yi-won had endured it rather cheerfully.

She didn’t vent her frustration on me after the study session.

“Lee Yi-won, are you okay?”

“I didn’t study well, so I got scolded. What can I do? I’ll do better next time.”

She answered coolly, even when the third-year resident offered comfort.

Was it this down-to-earth attitude that Professor Bu liked?

Well, either way, since that was how she spoke during study, I figured the patient, Ryu Ji-hye, wouldn’t develop a fever.

Jo Na-kyung would need consistent treatment, though.

Now, the only thing on my mind was the Blue Whales game this weekend.

As I was walking around the ward, thinking about that, I passed the station in front of the ward when the nurse called me.

“Seon-Joon! Kim Jin-ah from the rehab department is looking for you.”

“Me?”

“Yes, she’s being discharged this afternoon. She said she must see you before she leaves.”

“Is that so?”

I had known that Jin-ah was going to be transferred to another hospital soon.

She still needed a walking aid for severely disabled patients, but compared to how she was at the beginning, her progress had been nothing short of remarkable.

Back then, her Barthel Index (MBI, Modified Barthel Index, a measure of a patient’s daily living independence in chronic illness) was zero, but now it was 60. That says it all.

“Kim Jin-ah.”

“Doctor!”

When I went to the patient’s room, Jin-ah greeted me with a loud voice.

Her family members and caregivers were busy packing her belongings.

Several moving boxes were already stacked around the bed.

It seemed she had accumulated a lot of things after her long stay in the hospital.

“Thank you so much for everything. It’s all thanks to you.”

“It’s because you worked hard at your treatment.”

I responded with a gentle smile, and Jin-ah shyly handed me something.

“I really wish I could give you all my savings, but please accept this at least.”

“This is…?”

I opened my eyes wide in surprise at the unexpected item.