“I’m going to perform a neurological examination. Please close your eyes and tell me if you can feel this vibration.”
Taeho placed a tuning fork against Kim Jeonghun’s ankles and wrists to check his sense of vibration. Next, he proceeded with a pain sensation test using a pin, followed by a tactile sensation test using cotton.
“Common forms like metabolic or diabetic neuropathy are generally symmetrical on both sides, but in your case, it’s quite asymmetrical and sporadic.”
“Is that so?”
Kim Jeonghun tilted his head.
“Do you happen to have diabetes?”
“No, my blood sugar is normal.”
“Then how is your kidney function?”
“My creatinine levels were within the normal range as well.”
Taeho briefly lifted his gaze and met Kim Jeonghun’s eyes.
“Do you work in a medical-related field?”
“Pardon? No? What made you think that...?”
Kim Jeonghun looked momentarily flustered, then shook his head.
Taeho caught the instant Kim Jeonghun’s eyes darted quickly to the right.
A shift in gaze that appeared instinctively when someone was hiding a lie.
It was certain the patient was hiding something.
But why would he go out of his way to hide something when he’d come for treatment?
“I’ll check your muscle strength, so please raise your arm like this.”
Taeho checked the strength in Kim Jeonghun’s arms and legs.
Rema’s analysis window appeared before his eyes.
-Analysis results...
-Mononeuritis multiplex pattern
-Predominant sensory nerve involvement, with proximal involvement more prominent than distal involvement
-Classified as idiopathic peripheral neuropathy.
It sounded plausible, but something felt off.
Taeho’s intuition was telling him there was more to it. But he didn’t know what that something was.
Taeho asked casually.
“Did the other hospitals call it idiopathic peripheral neuropathy?”
Kim Jeonghun startled and asked back.
“What? How did you know that?”
“The symptoms look that way.”
Taeho answered calmly.
Kim Jeonghun shook his head once, then asked again.
“No, I mean how did you know I’d been to other hospitals?”
“From your clothes and the way you speak, you don’t seem to be from around here. And it’s unlikely you came all the way here from another region for your very first consultation, isn’t it?”
“Ah...”
It was a reasonable inference, so Kim Jeonghun had nothing to say.
“Mm. I think we’ll need a more detailed examination.”
Taeho took out a penlight and began shining it into Kim Jeonghun’s eyes. His pupillary response was normal.
“Please turn your head slowly from side to side.”
As Kim Jeonghun turned his head, Taeho carefully observed the movement of his eyes. Taeho’s intuition distinguished a subtle difference.
“Wait, this is strange. Please look all the way to the right.”
“Pardon?”
“There seems to be a problem with your visual field. Do objects ever appear double?”
“Uh. How did you know? I’ve had that symptom sometimes recently.”
“Since when?”
“About two weeks, I think. I thought it was because I was tired...”
Taeho nodded and proceeded with several more tests.
“Have you recently had sinusitis or rhinitis?”
“How did you know that too?”
Kim Jeonghun was startled once again.
“About a month ago, I had severe sinusitis and received treatment at an ENT clinic.”
Kim Jeonghun felt goosebumps rise on his back, but Taeho himself remained composed.
“Diplopia. Especially intermittent diplopia that only appears in a certain direction is highly likely to be due to a cranial nerve abnormality.”
Taeho combined all the examination results and organized the diagnosis in his head.
“With asymmetrical neurological symptoms like this, along with diplopia and a history of an upper respiratory tract infection, microscopic polyangiitis, or MPA, can be suspected first.”
“Microscopic polyangiitis?”
“Yes. It’s also called MPA. It’s a disease where inflammation develops in small blood vessels and affects various organs. The nerves, kidneys, and lungs are commonly affected. Of course, an accurate diagnosis needs to be confirmed through ANCA antibody testing and detailed kidney function tests. But based on the findings so far, the possibility of MPA is high.”
“To be honest, I went to three university hospitals in Seoul before coming here. All three of them said it was idiopathic peripheral neuropathy.”
A complicated expression appeared on Kim Jeonghun’s face.
He looked flustered, yet intrigued.
Of course, Director Kang Taeho could be wrong. But this country doctor had guessed even the diplopia symptom and his history of sinusitis, things he hadn’t mentioned at all.
It felt like sitting face-to-face with some uncannily gifted fortune-teller.
Until now, no doctor had clearly connected this many circumstances into a single disease.
“We’ll begin with blood tests for now.”
Taeho said calmly.
“We’ll check MPO-ANCA, CRP, ESR, and kidney function values as well. If necessary, we’ll also consider a chest CT or nerve conduction study.”
“Can I get better if it’s treated?”
“Fortunately, we found it early, so it can improve sufficiently with immunosuppressive treatment. For today, let’s start with the blood tests. Come back tomorrow. We’ll talk again once the results are out.”
“I’ll see you again tomorrow, Director.”
Taeho watched Kim Jeonghun leave closely, then called Rema.
“Rema, do a search.”
-Please speak.
***
“Huh?”
Bak Geumja’s steps came to a halt in the second-floor hallway. Kim Jeonghun was standing in front of a patient room door, staring at something.
Bak Geumja approached quietly and observed Kim Jeonghun’s actions.
Kim Jeonghun was carefully examining the medical equipment layout chart posted on the wall.
“Patient Kim Jeonghun?”
“Huh?”
Kim Jeonghun turned around in surprise.
“What are you doing here?”
“Ah, I was just... curious. The facilities here are much better than I expected.”
“We remodeled recently. Are you looking for somewhere?”
“No, I’m not. It’s almost time for my appointment. I should go in and check my blood test results now.”
Kim Jeonghun smiled awkwardly, then hurried down the stairs.
Bak Geumja tilted her head, then went to take out the injection medication.
***
Taeho nodded as he looked at the blood test results.
“As expected, ANCA is positive, and your inflammatory markers are quite high. It’s definitely microscopic polyangiitis.”
“Then how exactly will the treatment proceed?”
“We plan to treat you with a combination of rituximab and cyclophosphamide.”
“Rituximab?”
“Yes. It’s a targeted therapy that suppresses B cells. When used together with cyclophosphamide, it’s very effective for vasculitis.”
As Taeho explained, Kim Jeonghun took out a small notebook and began writing notes.
“Are there any side effects?”
“The risk of infection may increase a little, and your immunity may temporarily decrease. But we’ll treat you while monitoring you regularly, so don’t worry too much.”
Kim Jeonghun diligently took notes again.
“We’ll begin right away today. Come back next time and we’ll check your progress.”
Taeho smiled gently.
***
Three days later, Kim Jeonghun visited the hospital again.
“How are you? Have there been any changes in your symptoms?”
Kim Jeonghun nodded and said,
“I can’t say it’s improved a lot yet, but the numbness at night seems a little less severe. Especially in my left hand, I feel like some sensation is coming back.”
Taeho performed the neurological examination again. Some sensation was still dulled, but pain and vibration sensation were recovering.
“Judging by the progress, it isn’t bad. It’s still early, but this is a sign that you’re responding to treatment.”
“You really are different, Doctor. You’re clearly skilled.”
Kim Jeonghun exclaimed in admiration as he took out his notebook.
“Doctor, how did you develop this kind of treatment method?”
“Rather than developing it... I combined existing known treatments according to the patient’s condition.”
“But it’s uncommon for effects to appear this quickly, isn’t it?”
Kim Jeonghun’s questions grew increasingly specific.
“Did you devise this combination therapy yourself?”
“Mm. I referred to overseas papers and adjusted the dosage to suit the patient’s condition. In particular, for Asians, a lower dosage than for Westerners is effective.”
Kim Jeonghun took notes eagerly.
“That’s truly impressive. Even such delicate adjustments...”
Taeho smiled generously and said,
“If you come back next week, we’ll run additional tests. Based on the current trend, I don’t think it will take too long for a full recovery.”
“Yes, thank you.”
As Kim Jeonghun stood up, he asked one more question at the end.
“Doctor, do you treat other patients this way too?”
“What do you mean?”
“What I’m curious about is, usually, there’s a treatment protocol for the same symptoms and doctors proceed according to that, but with you, Director, it feels like you tailor things very carefully to each individual patient.”
“Every patient is different. Even with the same disease, the treatment must be adjusted depending on the patient.”
“I thought so.”
Kim Jeonghun nodded and left.
Not long after he left, Nurse Bak Geumja came in.
“Director, I have something to tell you for a moment.”
“What is it?”
“It’s about patient Kim Jeonghun.”
Bak Geumja closed the door and sat in front of Taeho.
“Something feels strange. I don’t think he’s like an ordinary patient.”
“How so?”
“Earlier, I saw him looking around every corner of the hospital in too much detail. The consultation room layout, the research lab entrance... It was as if he was investigating something.”
As Taeho nodded and listened, Bak Geumja continued with a worried expression.
“And according to Yeonji, he asked an odd number of questions when he registered. Like how many staff members the hospital has and what your schedule is, Director.”
Taeho grinned and answered,
“I know.”
“What? You know?”
“Yes. That man is a medical trade journal reporter.”
Bak Geumja’s eyes widened.
“Really? How did you know?”
“He felt like a reporter from the first day he came in for treatment, so I looked him up.”
Of course, Rema had done the search.
Bak Geumja tilted her head as if she couldn’t understand.
“Then why didn’t he say that from the beginning? That’s what people usually do when they come to cover a story.”
“He probably would have if he intended to write an article in a positive direction.”
“Good heavens! Then he’s trying to find fault with our clinic?”
Bak Geumja gasped and covered her mouth with both hands.
Taeho said seriously,
“But it’s true that he’s sick. The microscopic polyangiitis is real, and he really needs treatment.”
“That may be true, but...”
“We just need to treat him and send him on his way. We have nothing to hide, so no bad article should come out.”
Bak Geumja nodded.
“He really is a tenacious person. To use his own actual illness for reporting...”
“A patient is still a patient. Whether he’s a reporter or whatever else, treating sick people is our job.”
At Taeho’s words, Bak Geumja looked moved.
“As expected of you, Director. That mindset is truly admirable.”
“It’s only natural.”
Taeho smiled modestly.
***
At the same time. The parking lot beside Geumsan Hospital.
As soon as Kim Jeonghun got into his car, he took out his cell phone and called someone.
“This is Reporter Kim.”
A deep voice came through the phone.
-How is it?
“It’s far more impressive than expected. That guy really seems to be a capable doctor.”
-Are you certain?
“Yes. When he diagnosed my illness, it gave me goosebumps. He found something even other university hospitals couldn’t. The treatment is showing effects quickly too. Also, the hospital management appears to be flawless.”
A brief silence flowed.
-That can’t be. Keep watching him and report back.
The call abruptly ended.