Morning sunlight shone brightly through the window.
Kim Miran sat on the edge of the bed, staring at the vanity.
The syringes were laid out neatly.
“I’ll have another allergic reaction anyway…”
Her fingertips were as cold as ice, and since yesterday her legs had been numb with a heavy, aching pain.
This tiresome pain, this repeated suffering.
Did she have to get the injection again today?
Her husband, getting ready for work, spoke indifferently as he tied his necktie.
“Honey, you still have to get treatment. It might be okay this time.”
“What do you mean, okay? I’m telling you, my body is rejecting the medicine.”
The words shot out before she could stop them.
Her husband flinched.
Kim Miran bit her lip hard. She felt sorry for baring her thorns at him, but she was also deeply hurt that even after watching from beside her for the past year, he spoke as if it were someone else’s problem.
Twice every week, she had endured suffocation and hives all over her body because of the injections. She had even been rushed to the emergency room before.
Her husband added one more thing.
“Still, for our children’s sake…”
At those words, Kim Miran’s eyes wavered.
Their children, Haeun and Minjun.
Whenever she thought of her daughter in middle school and her son about to graduate from elementary school, it felt as if her heart were being torn to pieces.
Overcome with emotion, Miran ended up lashing out again.
“You say that because you don’t know what that pain is like. I can’t breathe, my whole body swells up and itches like crazy, and I feel like I’m going to die. You’ve never felt it yourself!”
Her voice grew increasingly agitated.
Her husband avoided her gaze without saying a word, and in the end, left the room with heavy steps. The sound of the front door slamming shut rang out as if tearing through her heart.
Left alone, Miran sank down, hugging her knees. It wasn’t that she didn’t understand her husband’s heart. If she wanted to get better, there was no choice. But in the end, she was the one who had to pass through hell every time.
She picked up the syringe, but she simply could not muster the courage.
‘Would it be better if everything just ended like this?’
At that moment, her eyes fell on the photo of her two children in the frame. Haeun was smiling brightly after receiving an award in class, and Minjun was proudly making a V sign while hugging a soccer ball.
‘Mom, when will you be all better?’
Minjun had asked her that yesterday. What had she said then?
‘I’ll get better soon.’
That had been a lie.
Tears quietly, slowly, flowed down her cheeks. She could not leave these children behind. Never.
Just then, the phone beside the bed rang. The name “Lee Sunyeong” appeared on the screen. She was one of the few friends Miran had.
‘Miran, how have you been lately?’
“Same as always. I’m just hanging in there.”
‘Have you ever heard of Geumsan Clinic? I heard about it from someone at my office. She went there because of atopic dermatitis, and she said she got a lot better. Apparently the doctor there is really incredible. They say he’s good at treating intractable diseases too…’
Miran let out a sigh.
“I’ve been to every famous hospital in Korea. This is probably just another false hope too.”
“No, they say it’s real this time. The doctor’s name was… Kang Taeho, I think? I heard he even received an award overseas.”
The moment she heard that name, Miran froze.
“What? Kang Taeho?”
“Yeah. Why?”
“Did he perhaps work at Seyoung Hospital?”
Before she even heard Sunyeong’s answer, Miran sprang to her feet and went to the desk.
‘Kang Taeho’
As soon as she typed the name into the search bar, countless articles poured out. The man in the photo was indeed the person she knew.
『The Miracle Doctor of Geumsan, Medical Skills Recognized by the World』
『Successful SSPE Treatment, Praised by New York Medical Community』
『Korean Doctor Who Saved the President of Gambia』
『Hero at the Geneva Traffic Accident Scene』
With each article she read, her heart pounded as if it would burst. She felt proud. It seemed even more remarkable that the young doctor she had once worked with had come this far.
“This man, as I remember, was famous even back when he was at Seyoung Hospital.”
Stories that had endlessly circulated among the hospital staff back then came back to her.
‘How can a third-year resident be this good at surgery?’
‘Did you see how calm he gets during operations? He’s a complete monster.’
‘Some people say he’s better than the specialists.’
‘Wouldn’t he become Seyoung Hospital’s representative doctor someday?’
After quietly ending the call with Lee Sunyeong, Kim Miran looked again at the photo of her children.
‘Could this time be different?’
***
Kim Miran brought it up when her husband, home from work, was eating a late dinner. After listening to everything, her husband said,
“Honey. Then why don’t we go there once?”
“I don’t know…”
“They said there’s nothing more they can do here. They said enzyme replacement therapy is the only option. They just keep saying there’s no choice even if the side effects are too strong and hard to bear. Maybe that doctor can find another way.”
“I’ve never actually spoken to that doctor, but I saw him a few times inside the hospital.”
“What was he like?”
“He was truly impressive. Even though he was a resident, his surgical skills were as good as any specialist’s, and the patients really trusted him.”
“Then doesn’t that make him even more reliable?”
“Yes, but… there was a medical accident, and something about it was strange. There was definitely something hidden, but… I don’t really know what it was. Everyone kept it quiet.”
Her husband looked at her and said,
“Right now, what matters isn’t that. What matters is whether you can get even a little better. We don’t have any other options left. Let’s just go once.”
At those words, Kim Miran nodded. For some reason, emotion surged up from deep within her heart. Perhaps all of this was fate.
***
The car arrived in front of Geumsan Clinic. The village scenery beyond the car window was quieter and more peaceful than she had expected.
Her husband murmured,
“It really is the countryside.”
“It is. Can treatment really work in a place like this?”
Doubt still clung to Miran’s voice. It felt somehow absurd to expect a disease that even the large hospitals in Seoul had given up on to be cured at a rural clinic like this.
When she opened the clinic door, warm air mixed with the scent of wood brushed the tip of her nose. The interior was small but tidy. It was far more orderly and welcoming than she had expected. And there were several pieces of advanced equipment that caught her eye. To the point that she felt ashamed of herself for having looked down on it as a rural clinic.
“Welcome.”
A familiar voice. The moment she turned her head, Miran’s breath stopped.
“Hello, I’m Kang Taeho.”
In that instant, it felt as though time had stopped. It was him. The young resident from his Seyoung Hospital days, always rushing busily from place to place. But now his atmosphere was very different. In place of impatience, there was composure; in place of unease, a weighty confidence filled his eyes.
‘He’s changed a lot.’
Emotions she could not identify rose in her chest. It was hard to believe that this person she had known had now become a doctor recognized by the world.
“I’m Kim Miran. I have Fabry disease… I’m a patient.”
As she gave her name in a trembling voice, she suddenly became afraid that he might remember her.
But Taeho merely nodded calmly.
“Yes. Please explain your situation to me step by step.”
His voice was warm. That single sentence strangely loosened her tension. Slowly, Miran began to speak of the past year.
“When the recently developed enzyme replacement therapy first came out, I had high hopes for it. I received injections twice every week. But things kept getting worse.”
Her voice lowered with a sigh.
“The side effects are too severe every time I get an injection. I can’t breathe, and my whole body swells up. My vision goes dark, and I feel like I’m going to die.”
Thirty minutes after receiving an injection, the fear would slowly tighten around her—itching, vomiting, hives across her entire body, and panic just before losing consciousness.
“That’s why I’ve reached the point where I just want to give up.”
The end of Miran’s sentence trembled.
Taeho skimmed through her medical records. His expression grew increasingly serious.
“It certainly isn’t an easy case. But I don’t think it’s time to give up yet.”
At those words, Miran let out a faint laugh. She had heard that countless times.
“Everyone said the same thing. But in the end, it always ended with ‘there’s nothing more we can do.’”
“We’re going to try a slightly different approach. It’s a method of developing a patient-specific enzyme.”
Miran’s eyes widened.
“A patient-specific enzyme? Is something like that actually possible?”
She was a pharmacist. She knew the theory. But it was something that only appeared in research papers; in reality, it was an almost impossible attempt.
Taeho nodded.
“Theoretically, it has already been verified. In cases like yours, where there is a strong immune response to existing enzymes, a customized design is necessary. We analyze your genotype and create a protein structure that your body can accept.”
Miran stared at him with a face where surprise and skepticism mingled. She had not thought he would know this much about Fabry disease.
“Can you really do that?”
“We can do it here. We have an R&D center, analytical equipment, and partner institutions. Of course, the process won’t be easy… but it’s a challenge worth taking.”
At those words, Kim Miran felt something cautiously begin to bloom inside her chest. This might be another false hope. But strangely, this time, she wanted to believe.
***
Two weeks later, Kim Miran returned to Geumsan Clinic.
Kim Miran’s genetic analysis data was displayed on the monitor. Taeho looked at her and carefully began to speak.
“The results of your genetic analysis are in, Ms. Kim Miran.”
Kim Miran steadied her breathing and nodded.
Taeho moved the mouse and enlarged the screen. The GLA gene. The key gene responsible for Fabry disease.
“Ms. Kim Miran, you have a rare missense mutation called p.R356Q in your GLA gene.”
“Is that… the problem?”
“Yes. This mutation distorts the tertiary structure of the alpha-galactosidase A enzyme, causing the existing enzymes administered intravenously to be recognized by the body as ‘foreign proteins.’ As a result, your immune system reacts strongly. Repeated allergic responses and antibody neutralization made the therapeutic effect almost disappear.”
Kim Miran’s face hardened. Only now did she understand the cause of the suffering she had endured until this point.
“Then the injections I’ve been getting all this time…”
“Rather than treatment, they were essentially tormenting your body over and over. That is why the existing treatment has to be stopped, and a new method was necessary.”
Taeho moved to the next screen and continued explaining in a calm voice.
“So we redesigned the enzyme specifically for you. Reflecting the mutation in your GLA gene, we created a similar enzyme structure that bypasses the R356Q mutation. This structure is designed not to cross-react with your existing antibodies.”
Kim Miran swallowed and asked,
“Will there really be no side effects?”
Taeho chose his words for a moment before answering carefully.
“I can’t say it is one hundred percent safe. Protein therapeutics can inherently trigger immune reactions. But among the enzyme preparations used so far, this has the lowest predicted immune response.”
He quietly added,
“What matters most is that this treatment is a customized Fabry disease treatment that takes both your genes and your immune type into account.”
Kim Miran stared silently at the monitor, then slowly turned her head to look at Taeho.
No matter how hard she tried to calm herself, emotion kept rising, and her voice trembled.
“Then please begin.”
Kim Miran felt as though, if this young doctor could only make her well again, she would be willing to do anything.