Age six. Kim Bomin.
A couple who looked to be in their forties came in with a small little girl. Judging by their clothes, they weren’t villagers but tourists.
The girl was smaller than most children her age. Beneath her wide-brimmed hat, her face was red and blotchy; it seemed her atopic dermatitis was severe.
The reason for the visit was an injury.
“About an hour ago, she cut herself on a rusty iron plate while rafting on the river. The bleeding has stopped now, but we were worried about tetanus.”
Taeho asked his precious second patient gently.
“Let’s see. Did Bomin hurt her hand?”
Looking as if she might burst into tears at any moment, the child held out her hand. Her right palm had a cut about three centimeters long.
Rema’s voice sounded.
-The patient’s health indicators have been detected. Shall I run scan mode?
Taeho adjusted his glasses and asked,
“At six years old, she should be due for a tetanus booster. Has she had it?”
“Yes. She’s had all her vaccinations on schedule.”
“Then you don’t need to worry too much. Bomin, the doctor will treat your wound.”
When Taeho said that, the child, whose face had gone pale with fear, nodded.
After confirming that the wound was not deep, Taeho disinfected it and covered it with sterile gauze.
“Bomin is being so brave.”
At Taeho’s praise, Bomin relaxed a little and smiled.
But when he looked at the child’s forearm, the real problem didn’t seem to be the injury. Once her tension eased, the child kept scratching her neck and stomach even while her wound was being treated.
Taeho carefully examined the skin on her neck and arms. She had scratched her delicate skin so much that fluid was seeping out, and scabs had formed in several places.
“Does she have atopic dermatitis?”
“Yes. For the past two years, we’ve gone to every famous hospital there is for treatment, but it just won’t get better. We’ve used steroid ointments, and we’ve tried every folk remedy we could.”
The child’s mother spoke with a sigh, as if pouring out her troubles.
“Do either of her parents or either side of the family have a similar condition?”
“No. That’s why it’s even more upsetting.”
“Then we’ll have to check her skin tissue response and immune information.”
Taeho pretended to adjust his glasses and tapped them lightly. Rema responded immediately.
-Checking skin tissue response and immune information······.
Soon, Rema’s analysis results came out.
-Collected data: skin surface imaging, body temperature patterns, microsecretions.
-Epidermal keratin differentiation marker “K-14,” decreased exocrine gland function detected.
-Estimated blood immunodeficiency score (MDSI): 1.7±0.2, approximately three times higher than normal. Epidermal barrier activity reduced to 52%.
-Probability of NID onset: 82%.
‘NID—Neotopic Inflammatory Dermatosis?’
It was a rare disease Taeho had only encountered in papers during his immunology rotation. Unlike ordinary atopic dermatitis, it was closer to an immunodeficiency disorder, so steroids alone were ineffective.
The problem was that among currently available drugs, there was no particular cure for it······.
Even then, Bomin was scratching fiercely at her neck and limbs. She looked as if no matter how much she scratched, it gave her no relief.
“Stop that, Bomin.”
Unable to watch any longer, the child’s mother grabbed Bomin’s arm, and Bomin writhed in distress.
Just then, Rema’s voice reached Taeho’s ears.
-Shall I recommend a treatment?
‘There’s a treatment?’
Taeho’s eyes flew open.
-As a response to NID, a Remaderm-X compounded medication is recommended.
-Beta peptide concentration: 0.5% or lower.
-Using Tristerol at a low dose of 0.01% can reduce epidermal irritation.
Text blinked as a hologram outside the lenses of his glasses.
‘It can be made well enough with a combination of existing ointments.’
When he searched, they were all ointments that could be used together. Unlike Rema’s conclusion, there was a chance it might not be effective, but it didn’t seem likely to worsen her condition from where it was now.
‘At this level, it’s worth trying.’
Taeho said to the child’s parents,
“In my opinion, Bomin’s skin condition is not simple ‘atopic dermatitis,’ but a rare disease called Neotopic Inflammatory Dermatosis. That’s why applying steroids alone hasn’t worked.”
The child’s mother asked in a trembling voice,
“Then does that mean it can be treated?”
“Yes. Since it’s such a rare disease, it won’t be easy, but we’ll try as much as we can.”
“Oh my!”
The child’s mother let out a sound close to a scream. Then, tears streaming down her face, she said,
“Really? Doctor, can Bomin really get better? Every time my child suffered, I felt like it was my fault, and I was so sorry to my baby. Sob, sob.”
When her mother covered her face with both hands and cried, Bomin’s face crumpled as well.
“Mom, don’t cry······. Waaah.”
“Doctor, just a moment. I feel like we absolutely have to record this moment.”
Even the child’s father behind them became excited and raised his phone high.
Taeho was slightly flustered by the sudden reaction from the whole family.
Were they a family rich in emotion? Well, considering how much the child must have suffered all this time from a skin disease that wouldn’t heal, it was understandable.
“For my prescription to be effective, you must keep the ointment dosage exact. It will be specially adjusted so that it applies only to Bomin, so you must follow it without fail.”
“Of course. There’s nothing we haven’t tried by now. We’ll keep the ointment dosage so precisely it won’t be off by even 0.1 grams.”
After receiving the promise from the child’s mother and father, Taeho wrote the prescription.
“If you live in Seoul, it will be hard to come all the way back here, but even so, it would be best to come once you’ve used up the ointment. I’ll need to see Bomin’s condition and prescribe again.”
“Of course we’ll come. Distance isn’t the problem. If only our child can get better, we can travel from Seoul to here every single day.”
The child’s father vowed as he recorded the video.
“That attitude is very admirable, sir.”
Rejoicing that he had gained a long-distance regular patient, Taeho praised the efforts of all parents in the world.
After sending Bomin’s family out, Taeho called Boram Pharmacy. He explained the ointment mixture to pharmacist Gu Hyejeong and asked her to explain it once more when giving them the medicine.
‘Mixing three different ointments? That’s an unusual prescription.’
Gu Hyejeong murmured as if intrigued, but said she would provide the medication counseling accurately.
After hanging up, Taeho asked Rema,
“How far do your abilities go? Can you treat even rare diseases like NID?”
-If the disease can be analyzed, it is possible.
“But no treatment for NID has even been announced in academia yet.”
-Rema can discover treatments for diseases that have not been identified at the current point in time.
“How is that possible? You must have a database too. How quickly is it updated?”
-Rema monitors every stage worldwide, from Investigational New Drug (IND) application for new drugs, to Phase III clinical trials, New Drug Application (NDA), and release.
“You’re even better than I thought.”
Taeho couldn’t hide his surprise.
-Thank you. If you need Rema, please use me anytime, for anything.
Rema answered in a confident tone.
“Then what’s this number floating at the lower right of my glasses? When I turned them on yesterday it said D-1000, and today it’s D-999, so it seems like a countdown. What happens in 999 days?”
-Detailed information on this item is currently inaccessible.
It was the same stiff answer as yesterday.
‘Strange. Whenever I ask about this countdown, this thing seems to get prickly······.’
Just then, a notification came on the computer. It meant a new patient had been registered.
Taeho organized the electronic chart records and waited for the new patient.
The person who opened the door and came in was Park Jeonggyu, a friend of Taeho’s father. His father and Park Jeonggyu had grown up together in the village and had become miners together.
When Taeho was young, Park Jeonggyu had also been a welcome guest who often gave him money for snacks.
“Uncle Jeonggyu?”
When Taeho approached, Park Jeonggyu lifted his head and confirmed it was Taeho.
“Well now, ain’t you Taeho? So the quack doctor the village chief was talking about was you, Taeho?”
‘Did even the village chief go around spreading rumors that I’m a quack?’
While Taeho was smiling awkwardly, Park Jeonggyu, whose face had brightened with delight, began to cough.
“Cough, cough.”
At a glance, it did not look ordinary.
Taeho thought of his father. Taeho’s father had also always lived with a cough.
-The patient’s health indicators have been detected. Shall I run scan mode?
Taeho lightly pressed the frame of his glasses and said,
“Uncle, please sit down first.”
Park Jeonggyu let out another bout of severe coughing, then wiped the corner of his mouth with the tissue he was holding.
Taeho studied Park Jeonggyu’s face carefully.
His complexion was dark and dull; it did not look good.
‘His color looks very bad.’
More than that, Park Jeonggyu was so glad to see Taeho that he kept trying to smile.
“After yer father went like that, I never heard a thing from ya, so I wondered how you was living. And now you’ve become a doctor! Yer father’d be happy even in the afterli······ cough, cough.”
“Speak slowly, Uncle.”
“Thank ya for growing up so well, Taeho.”
“I came all the way here, but I didn’t even get to greet you first.”
“No, no. I’m only sorry I couldn’t take you in back then, when you was left all alone in the world. Seeing you succeed like this, I······.”
Thick tears spilled from Park Jeonggyu’s eyes and seeped into his dry skin.
“I’m fine. I lived safely and well.”
“You’re admirable. You really are.”
Park Jeonggyu held Taeho’s hand tightly.
After calming Park Jeonggyu down, Taeho continued the examination.
“Uncle, have you also been having shortness of breath or tightness in your chest lately?”
“It ain’t like it’s real serious, but if I climb just a few stairs, I get all short of breath. Sometimes I wake up at night gasping too.”
Taeho nodded and took out his stethoscope. He slowly listened to his heart and lung sounds, checked Park Jeonggyu’s pulse and respiratory rate, and organized his thoughts.
‘It looks like his pneumoconiosis has progressed considerably. To leave it alone until it worsened this much.’
Taeho frowned.
“Uncle, when did you stop working in the mine?”
“Well, must be about ten years now. When the mine closed, they cleared us all out.”
“Then have you ever had an X-ray or CT scan at another hospital before? For your respiratory system or lungs.”
“Ah, the doctor who was here before said if it got bad, I should go to a big hospital, but I didn’t. Going back and forth is far, too.”
“Pneumoconiosis requires long-term management. Looking at you now, your condition isn’t ordinary. You absolutely need to have a high-resolution CT scan. If you leave it like this, complications could develop.”
But Park Jeonggyu waved his hand and refused.
“No need. I know my own illness best. Going to a big hospital would just waste money. Like the doctor before, just prescribe me a bronchodilator and that, what was it, ah, an antitussive expectorant or something······ cough, cough. That’ll do.”
Just then, Rema presented the scan results.
-Subject body scan complete.
-Pulmonary fibrosis in progress. (Type 1 confirmed)
‘Type 1? At this level, it’s the mildest stage of pneumoconiosis progression. But his complexion is this bad? Something’s strange.’
As Taeho was growing suspicious, Rema presented another result.
-Unknown toxic reaction detected.
‘Toxic reaction?’
When Taeho was startled inwardly, Rema analyzed it in detail as if it had understood him.
-Lead (Pb)-based absorption signals have been confirmed in the user’s exhalation analysis and skin reflection spectrum.
-Possibility of heavy metal contamination exposure: 78%.
‘Heavy metals? Where was he exposed to heavy metals?’