But no matter how carefully he looked, Dr. Whitman wore the expression of someone offering a warm welcome.
Then what was it? This feeling?
An inexplicable unpleasantness rose from deep within his chest.
Taeho found it difficult to understand the signal his intuition was sending him.
Whitman was clearly a capable doctor. His tone was full of confidence, and judging by the way the medical staff around him treated him, he seemed to be an authority of considerable standing.
“I’ve heard the rumors about Dr. Kang even here. In particular, the SSPE treatment case at Mount Sinai was truly groundbreaking.”
“You flatter me.”
Taeho replied modestly.
“Dr. Kang, if you don’t mind my asking, which hospital in Korea are you from?”
Dr. Whitman asked. His voice was still friendly, but Taeho detected a certain emotion in the question.
“I’m from a local clinic called Geumsan Clinic.”
“Ah, I see.”
Whitman’s smile did not change. But Taeho did not miss something that flickered through his eyes for an instant.
Was that a look of disdain?
Dr. Whitman nodded, still smiling.
“But I understand you achieved results at a large hospital. Truly impressive.”
It was praise, but Taeho felt a strange sense of discord in those words.
“From my experience treating thousands of people in Africa over the past twenty years, the situation here is truly unique.”
“You’ve worked here for twenty years. That’s genuinely admirable.”
Taeho spoke sincerely. In truth, spending twenty years providing medical care in Africa was an extraordinary feat.
“Do you have experience providing medical care in Africa, Dr. Kang?”
“No, this is my first time.”
“Then you may find it difficult to understand the situation here. African medicine differs from ordinary medicine in many ways.”
“I’ll learn as much as I can.”
Taeho answered humbly.
“This place is practically my second home. Shall we go to the patient’s room, then?”
Dr. Whitman took the lead.
Taeho followed him, continuing to analyze his own feelings.
Why do I feel this way?
Whitman was clearly a capable doctor. His career was impressive, and he had the trust of the local medical staff. His attitude toward Taeho was also perfect on the surface.
But something was out of place.
There had to be a reason his intuition was reacting so strongly…
A little while later, Taeho realized why.
When they arrived in front of the patient’s room, Dr. Whitman stopped.
“Dr. Kang, I am the one in overall charge here. If you happen to have any opinions, please relay them through me.”
Dr. Whitman’s gaze as he looked at Taeho was overbearing.
Taeho knew that type. The type who thought their opinion was their authority and their very character.
If you worked under a superior like that, you couldn’t offer an opinion that went against theirs. Even if you phrased it as tactfully as possible, they would regard it as an attack on themselves.
It was certain that the doctors here were not exchanging opinions horizontally, but were moving under Dr. Whitman’s command.
A bitter taste filled Taeho’s mouth.
“Do you understand, Dr. Kang?”
“I understand.”
Only after Taeho answered did Dr. Whitman begin the briefing.
“The patient is President Ibrahim Sanyang. Male, sixty-two years old. Fever and headache began after a visit to Chad four weeks ago, and he has currently progressed to stage-three Trypanosoma brucei gambiense infection.”
Trypanosoma is a single-celled protozoan transmitted mainly by insects, capable of infecting both humans and animals. It is best known as the causative agent of African sleeping sickness and Chagas disease.
A stage-three infection caused by Trypanosoma brucei gambiense meant the protozoa had already passed through the blood and lymphatic systems and infiltrated the brain and spinal cord.
Dr. Whitman added,
“So far, we’ve administered pentamidine, eflornithine, and nifurtimox, but there has been no response. We don’t have an MRI, but even on CT, the cerebral edema is clearly visible.”
“Wait a moment. There’s no MRI here?”
When Taeho asked, Dr. Whitman shook his head as if he had expected that reaction.
“As expected, you don’t know much about the situation here. Even among African nations, Gambia has poor medical conditions. There isn’t a single MRI machine in the entire country. If you want an MRI scan, you have to go overseas.”
Dr. Whitman lifted his chin slightly, as if feeling a sense of superiority.
Taeho, who had not known much about the situation in Africa, let alone Gambia, understood that grasping the circumstances was important.
“I see.”
“His current GCS is 8. Intermittent convulsive seizures are also occurring. To be honest…”
Dr. Whitman paused for a moment.
“He is on the verge of brain death. This is closer to management than treatment.”
Taeho took the chart and slowly flipped through it, analyzing the contents.
From the blood tests and cerebrospinal fluid tests to the CT images, the patient’s condition was extremely critical. A GCS of 8, which quantified the patient’s level of consciousness, meant he was incapable of voluntary communication or following commands.
Taeho asked,
“May I examine the patient directly now?”
“Very well. However, Dr. Kang, please focus only on observation. I will make the treatment decisions.”
Dr. Whitman drew the line clearly once again.
When the door to the patient’s room opened, the noise from various machines pierced their ears.
Taeho instinctively tensed.
President Ibrahim Sanyang, whom he had seen in photos and videos aboard the private jet, was lying on the bed. His face was far more gaunt than in the photos, and his breathing was irregular and shallow.
“Blood pressure 90 over 60, pulse 120, temperature 38.5 degrees.”
The nurse reported to the medical staff who had just entered.
As Taeho tried to take a step closer to the patient, Whitman blocked him with his hand.
“I will perform the examination. Dr. Kang, please observe from behind.”
Whitman picked up his stethoscope and placed it against the patient’s chest. He briefly listened to the lung and heart sounds, then lifted the eyelids to check the pupillary response.
“No response. Heartbeat maintained, but spontaneous respiration is weak, and pupillary response is sluggish. A typical stage of progressing brain death.”
It was the tone of someone who no longer held any expectations.
Then, suddenly, the patient went into severe convulsions. The monitor alarm blared loudly.
“Diazepam 5 milligrams IV, now!”
At Dr. Whitman’s order, the nurse quickly administered the injection. The convulsions stopped, but the patient’s condition seemed even worse.
Taeho watched the entire process closely.
Dr. Whitman shook his head.
“There isn’t much time. Now we must prepare…”
“It’s too early to give up.”
Taeho said calmly.
“What did you say?”
“It’s true that the situation is serious, but there is still a possibility of recovery.”
Dr. Whitman’s eyes widened, and then he laughed as if he found it absurd.
“Dr. Kang, this fight is already over.”
Ignoring Dr. Whitman, Taeho approached the patient and took his hand. The moment he checked the pulse, he felt a subtle but definite movement.
“President Ibrahim Sanyang, can you hear me?”
To his surprise, the president’s eyelids trembled ever so slightly.
“There was a response.”
At Taeho’s words, Dr. Whitman shook his head.
“That was merely a muscle spasm. It’s a common reaction in brain-dead patients.”
“No. It was clearly a conscious response.”
“A conscious response? In a patient with a GCS of 8? Are you really a doctor?”
Taeho paid no attention to Dr. Whitman’s sarcasm and observed the patient carefully.
An incredibly faint response.
But he intuitively felt that the patient definitely had consciousness. Because Taeho’s intuition was unusual, other doctors might not have sensed it. But Taeho was certain.
Taeho asked Dr. Chen,
“May I see the vital sign records for the past twenty-four hours?”
Taeho quickly scanned the records Dr. Chen hurriedly handed over.
“The patient’s current condition is in a plateau phase, neither worsening nor improving. His body is fighting a desperate battle against the parasite. If we provide appropriate support, I think we can turn the situation around.”
Dr. Whitman shouted as though he could not understand.
“A plateau phase? What kind of nonsense is that? The patient is clearly dying right now!”
“That’s not how I see it.”
Taeho’s voice was filled with conviction.
The hospital room fell silent for a moment.
Dr. Whitman did not hide his displeasure.
“Dr. Kang, I cannot entrust this important patient to you. I am a professor of tropical medicine at Johns Hopkins and the chief of the WHO medical advisory team. And I am an expert who has seen countless patients in Africa.”
“I came here to save the patient, not to fight over authority.”
Taeho replied calmly.
Dr. Whitman glared at Taeho with a terrifying gaze as Taeho continued to offer objections point by point.
***
The medical staff moved to a temporary conference room. Their faces were filled with tension and fatigue.
Dr. Whitman was standing in front of the whiteboard, organizing the course of treatment. More than ten medical staff listened to him with grave expressions.
Taeho and Dr. Chen took seats in a corner of the conference room.
“Now, let’s review the current situation. The patient has stage-three Trypanosoma infection, and treatment has proceeded according to WHO standard protocol.”
Whitman spoke in a cold tone. On the board, the names of drugs were listed one after another.
“Pentamidine, eflornithine, nifurtimox. All are internationally approved treatments, but as you can see, the result is failure.”
Dr. Schneider from Heidelberg University Hospital in Germany raised his hand cautiously.
“Dr. Whitman, what about increasing the drug dosage?”
“We’ve already considered it, but given the patient’s liver and kidney function, it’s impossible.”
Dr. Laurent from the WHO medical advisory team cut in with a tense expression.
“Then what about using two drugs in combination?”
“That’s far too dangerous. The risk of side effects is high, and it is not a WHO standard treatment.”
At this point, every proposal that could be made had been made. There were no more cards left to play.
Silence settled over the conference room.
Then Taeho raised his hand and said,
“The reason all the treatments so far have failed may not be a problem with the standard protocol, but because regional characteristics were not taken into account.”
“What do you mean by that?”
Dr. Schneider showed interest.
“There is a high possibility that all the local characteristics of Gambia—its climate, environment, diet, and even the residents’ lifestyles—have influenced the parasite’s resistance and metabolism. That may be why the existing standard treatments aren’t working.”
The doctors gathered in the conference room were somewhat shocked by what the young doctor from Korea had just said.
It was because this was a new perspective no one had argued for until now.
Some of the doctors seemed to find Dr. Kang’s opinion plausible, nodding with interest.
At that moment, Dr. Whitman spoke with a stiff face.
“A parasite is a parasite, wherever it is. Such abstract, unfounded talk is nothing but a waste of time.”
“No. Environmental factors can clearly influence drug resistance. If unique natural components found here have affected the parasite’s drug metabolism, it would be difficult to expect results from existing treatments.”
Taeho countered.
Dr. Whitman was offended. Taeho’s confident expression irritated him even more.
‘What does that Korean bastard know? Is he saying he knows something I, who spent twenty years in Africa, don’t? A man from Korea, and from some mere local clinic at that?’
But what he could not ignore was that the other doctors were showing more and more interest in Taeho’s words.
The first to notice Dr. Whitman’s discomfort was Dr. Laurent. As a member of the WHO Africa medical advisory team, he had worked closely for a long time with Dr. Whitman, the chief of the advisory team.
Dr. Laurent asked Taeho,
“Assuming Dr. Kang isn’t simply making an absurd, forced argument, do you have any concrete cases that could support that claim?”
Everyone’s eyes turned to Taeho.
Some gazes were filled with pure curiosity, while others held mockery, as if asking whether he could really present a concrete case.
No matter how outstanding a doctor was, it was unlikely they would normally memorize such specialized cases.
Moreover, Taeho had just arrived here after departing from Korea. He had only learned President Ibrahim’s diagnosis a short while ago. For Taeho, who had not specialized in infectious diseases or tropical medicine, it was an absolutely unfavorable situation.
But Taeho was not worried.