When Gihwan stopped by again, Taeho was still looking after Jeong Miyeong.
Jeong Miyeong had fallen into a light sleep thanks to the sedative's effects, and Taeho was organizing her chart while establishing a treatment plan.
"What about Hayul?"
"I sent her to kindergarten. I told her to rest today, but she insisted on going."
Worry was laced in Gihwan's voice.
Taeho nodded. He had expected it, but actually experiencing it weighed heavily on his heart.
Gihwan took out an old notebook.
"What's this?"
"I found it while dropping Hayul off. It was lying on the bench where Ms. Jeong Miyeong had collapsed. I think it must have fallen out of her bag."
Taeho took the notebook. Its cover was tattered, and the pages were warped from moisture.
Most of the writing inside the old notebook had smudged beyond recognition. However, a few phone numbers remained clearly legible.
010-3847-****
Mr. Kim
010-5692-****
For emergencies
010-2159-****
Absolute safety
The other pages were blurred from water damage, but on the last page, there was a note written in trembling handwriting.
'I miss our Hayul...'
"What are these numbers?"
As Taeho muttered to himself, Rema searched the numbers.
—Analyzing phone numbers…….
—010-3847-****: Kim Yunmo, head of private moneylending company 'Kim's Finance'
—010-5692-****: Unknown
—010-2159-****: Unknown
A loan shark?
Taeho thought for a moment, then took out his phone.
"Hello, Reporter Kim? This is Kang Taeho."
"Ah, Director Kang! Hello. What brings you to call?"
Reporter Kim Jeonghun's voice was bright.
"I know you're a medical specialist reporter, but if you have time, could you check a few phone numbers for me?"
"Of course. What numbers are they?"
Taeho recited the three phone numbers.
"Could you find out what these numbers are? There's something suspicious regarding a patient."
"Understood. I'll contact you as soon as I find out."
***
While conducting morning examinations, Nurse Park Geumja urgently called for Taeho.
"Director! Patient Jeong Miyeong is right now……"
Taeho immediately rushed over. Jeong Miyeong's face was turning pale, and cold sweat was streaming down.
"Where does it hurt?"
"My lower abdomen feels like it's being stabbed with a knife."
At that moment, Jeong Miyeong suddenly screamed and curled her body up.
"Ugh!"
A scarlet bloodstain appeared on the bedsheet.
"Bloody stool!"
Taeho immediately palpated her abdomen. The abdominal wall had hardened, and rebound tenderness was severe. Signs of peritoneal irritation were clear.
"She's showing symptoms of peritonitis. The possibility of intestinal perforation is high!"
"Shall I prepare emergency endoscopy?"
"Yes, right away!"
The endoscopy room was urgently activated.
"Nurse Park, prepare the endoscopy cart and draw the sedatives in advance."
"Yes, Director!"
Park Geumja skillfully prepared midazolam and fentanyl.
"Ms. Jeong Miyeong!"
"It hurts so much."
"We need to perform an endoscopy now for an accurate diagnosis. Please bear with it a little longer."
"Nurse Park, please monitor her vital signs continuously."
"Yes, blood pressure 90/55, pulse 112."
Taeho began inserting the endoscope. Park Geumja observed the patient's condition while preparing the necessary instruments in advance.
The inside of Jeong Miyeong's intestines appeared on the monitor. After passing through the duodenum and jejunum, his expression changed upon entering the ileum.
On the monitor, an unusually shaped ulcer was visible at the ileocecal region (where the ileum and cecum meet).
"This is……"
Taeho carefully observed the endoscopy screen.
The ulcer's shape was peculiar. It was deep and round, as if punched out. The edges were cleanly cut, and the surrounding mucosa was relatively normal.
"Punched-out ulcer."
Taeho muttered.
Even with thirty years of nursing experience, Park Geumja was seeing this type of ulcer for the first time.
"Director, is this different from a Crohn's disease ulcer?"
"If this were Crohn's disease, there should be deep ulcers of irregular shape and cobblestone-patterned mucosal changes, but this isn't like that, is it?"
The presentation was clearly different.
Deep and round, shaped as if a hole had been punched through.
And the surrounding vascular dilation and inflammatory response.
He had already strongly suspected through the Precision Diagnostic Bio Vision that Jeong Miyeong's condition might not be Crohn's disease. But objective evidence was needed for medical certainty.
What appeared on the monitor was a finding that exactly matched what Taeho had already seen beforehand through the Precision Diagnostic Bio Vision.
"This is the typical ulcer shape of intestinal Behcet's disease. We need to take a biopsy for confirmation."
Taeho used endoscopic biopsy forceps to collect tissue from the ulcer margin.
"I'll take samples from two sites: one for pathological examination, and one for immunohistochemical testing."
Finishing the endoscopic examination, Taeho summarized.
"Based on these findings, rather than the longitudinal, irregular ulcers seen in Crohn's disease, these are circular punched-out ulcers. This type of punched-out ulcer is a pathological feature only seen in intestinal involvement of Behcet's disease. This illness is intestinal Behcet's disease."
Jeong Miyeong asked with a surprised expression.
"Then the Crohn's disease diagnosis I received at other hospitals all this time was wrong?"
"That's right. Intestinal involvement in Behcet's disease is often misdiagnosed because it's difficult to differentiate from Crohn's disease. Now we can start accurate treatment."
The moment her true diagnosis was finally revealed. And this meant a completely different treatment strategy.
"Nurse Park, first we need to control the bleeding and pain. Start with pantoprazole 40mg IV, and prepare octreotide as well."
"Yes, I'll prepare it right away!"
Park Geumja moved quickly to prepare the medications. Her hand movements were precise and swift.
"We need to request an HLA-B51 test and a tissue biopsy to confirm Behcet's disease. But let's start treatment based on clinical diagnosis for now."
Park Geumja asked while preparing the medication.
"What treatment drug will you use?"
"For Behcet's disease, TNF-alpha inhibitors are the first-line choice. But the problem is that it takes a long time to obtain anti-TNF agents through official channels. We need insurance approval first."
"Then what will you do?"
"We have to find a way."
Taeho answered after thinking deeply.
***
The phone rang. When Taeho answered, Reporter Kim Jeonghun's voice came through.
"Director. The investigation results for those phone numbers you mentioned are out, and the contents are quite serious."
"Reporter Kim. I'm listening on speaker with Mr. Gihwan right now."
"Yes. Understood."
"What are the contents?"
"The first number belongs to a man named Kim Yunmo, the head of a private moneylending company called Kim's Finance. There are fifteen reported filings with the Financial Supervisory Service alone, and he's been investigated multiple times for illegal loan sharking."
Taeho and Gihwan exchanged glances.
"The second number is even more problematic—it's the actual owner of a labor supply company called 'Hope Manpower.' On the surface it looks like a legitimate business, but it actually supplies workers to entertainment establishments. There are dozens of illegal employment reports filed as well."
"I didn't mishear, did I? Entertainment establishments, you said?"
Gihwan asked back in surprise.
Taeho nodded and asked Reporter Kim.
"The third number?"
"It's presumed to be an unregistered private moneylender. I checked with a colleague who covers the police beat, and they said organized crime connections are suspected."
Taeho spoke in a voice filled with anger.
"Then they're connected to each other?"
"That's right. It's a typical connection between loan sharking and forced labor. The loan shark seems to be systematically operating in connection with the labor supply company and entertainment establishments."
Gihwan looked at Taeho with a shocked expression. To think something you'd only see in movies was still happening blatantly even now…….
"Do you have more detailed information?"
"I asked colleagues at the social affairs desk, and they said these tactics have been increasing lately. They mainly target women who urgently need money due to medical expenses or living costs—especially single mothers with underage children."
"What is the pattern of damage?"
"They start by lending small amounts, then rapidly inflate the debt with compound interest, eventually forcing them to work at entertainment establishments. They confiscate IDs, cut off outside contact, and threaten to harm their families so they can't run away."
Taeho clenched his fist.
"What's more serious is that over the past three years, there have been seven missing persons reports connected to this Kim's Finance. All are women in their twenties to forties, and the common denominator is a history of using private loans."
"What about the police investigation?"
"The Metropolitan Investigation Unit of the National Police Agency is conducting an investigation, but they've hit snags because the victims are reluctant to testify. They can't speak because of the threats."
Taeho looked at Gihwan and spoke.
"Director Kang, could she be a victim of that organization?"
"We don't know for sure, but I think so. She's currently under treatment."
"If so, she could be a very important witness. I hope she will testify for the sake of other victims as well."
"Reporter Kim, could you keep this data safe? I think we'll need it later."
"Of course. I'll organize all the materials and keep them safe. If you need any additional investigation, please contact me anytime."
"Thank you. This was a great help."
After hanging up, Gihwan sighed.
"Good heavens! They're truly awful people. I hope they all get thrown in prison."
"Yes. But treating Ms. Jeong Miyeong is the priority right now. Dismantling organized crime comes next; we have to save the patient first."
"You're right. But how will you treat the Behcet's disease? Obtaining TNF inhibitors won't be easy."
Taeho fell into thought for a moment. Common TNF inhibitors such as infliximab, adalimumab, and etanercept all had complicated insurance approval procedures that took considerable time. Approval for intestinal involvement of Behcet's disease was especially tricky.
"It will take at least two to three weeks through official channels. The patient's condition could worsen in the meantime……"
"It'll be dangerous if the acute bleeding continues."
Gihwan was worried about the same thing.
Then Taeho suddenly recalled Gihwan's research. Research data Gihwan had shown him a few months ago flashed through his mind.
"Wait, Gihwan, that protein you were developing before. Revival-beta, I mean. You said it targets the TNF pathway, right?"
"I thought of that too, but there are some problems. Clinical data is insufficient, and above all, the protein's stability hasn't been resolved."
"Stability?"
"Revival-beta denatures easily at body temperature, so its half-life is too short. Most of it breaks down within thirty minutes of injection, making it difficult to expect therapeutic effects."
Taeho fell into thought for a moment. Then he quietly activated Rema.
'Search the Project Asclepios database for research materials related to protein stabilization.'
—Accessing Project Asclepios future database…….
—Search keywords: protein stabilization, in vivo half-life extension
—Search complete: 847 related studies found
—Comprehensive analysis result: Cooling-stepwise administration method
—Required equipment: Temperature-controlled infusion pump (held by Geumsan Research Institute)
—Stabilizers: Trehalose + mannitol (immediately obtainable)
—Estimated success rate: 87.3%
Taeho's eyes gleamed.
"Then what about cooled administration? Or couldn't we make it into a sustained-release formulation?"
"Cooled administration?"
"Slowly infusing it at a low temperature around fifteen degrees while simultaneously administering trehalose and mannitol as stabilizers."
The blank expression on Gihwan's face, who had been staring vacantly for a moment, brightened.
"That's right! And there's also a method of increasing the half-life by binding it with albumin…… Why didn't I think of that?"