Hell.
If hell existed in the present world, wouldn’t it be this damned emergency room?
My name is Han Hyeonjae.
First-year resident in emergency medicine.
“Slurp—”
“Eat quietly, damn it. You’re loud as hell.”
My colleague Kim Jihun flipped me off with a face drenched in sweat.
Sprawled out like a corpse in the corner of the on-call room, barely getting by on cold convenience store lunchboxes and cup ramen—that was daily life.
As I was lamenting like that, the outside suddenly started getting rowdy.
Ah, please.
Please, no.
Thud—
“TA (*traffic accident) patient, ETA (*estimated time of arrival) eight minutes!”
Fuck.
“Ah, seriously.”
Kim Jihun stopped chewing his noodles, cursed, and bolted from his seat.
I too got up, half-mechanically.
My body, which had felt like lead just moments ago, reacted to that single sound like Pavlov’s dog.
The only skill I’d picked up from all this suffering, I suppose.
…
***
…
“Patient is a fifty-eight-year-old male, pedestrian struck! Eleven minutes since first contact, no BP, no pulse!”
“Epi (*Epinephrine, emergency medication for sympathetic activation) one milligram, please!”
“Starting compressions!”
“Dr. Yoon, get the Lucas!”
“Yes!”
Everything happened in perfect order.
And spun into chaos.
Someone climbed onto the patient’s chest and compressed until ribs cracked; someone else squeezed an ambu bag, forcing oxygen into his lungs.
I stared blankly at the scene for a moment.
A man with his hand on the door to the afterlife.
Could all this nonsense we were doing really pull him back from the other side?
Doubt.
Yes, doubt.
What the hell was I even doing this for?
That was when.
Right in front of my eyes, in the empty air, I thought I saw rainbow-colored noise flickering and rising for a brief moment.
‘…Am I seeing things from exhaustion?’
I rubbed my eyes.
But it didn’t disappear.
The noise soon began taking on a distinct form.
Like a semi-transparent system window you’d only see in a sci-fi movie.
『Congratulations! You have met the qualifications of a Savior.』
『A special skill is being granted. The skill you have received is [Gallery Pass]!』
What kind of bullshit is this?
I thought I’d finally gone crazy.
Overwork and stress had definitely melted some specific part of my brain.
Was I the only one seeing that?
I almost asked the nurse next to me who was securing an IV line.
‘Excuse me, do you see that blue text over there?’
If I did that, I’d be on the express train to the psych ward.
“Checking rhythm!”
Compressions paused momentarily.
“V-Fib!”
Fortunately or unfortunately, that ridiculous system window vanished without a trace in one second.
As if it had never been there from the start.
‘Yeah, it’s just a hallucination.’
When I came to my senses, defibrillator paddles were already in my hands.
“Clear! Charging to two hundred!”
“Clear!”
“Shock!”
Thwack!
The patient’s body convulsed upward.
The ECG graph on the monitor was still a mess.
He didn’t look like he planned on coming back.
Another thirty minutes passed like that.
In the end, everything was over with the declaration to terminate CPR.
…
***
…
Sweat and effort scattered meaninglessly into the air.
May he rest in peace.
I headed back to the on-call room.
The moment I threw myself onto the bed, the message I’d seen earlier came back to me.
Gallery Pass?
“What, what am I supposed to do with this?”
Was this one of those trending web novels these days?
Status window?
Skill?
Hunter?
Was a gate going to open here or something?
Half-hoping, half-embarrassed, I shouted inwardly like an absolute idiot.
‘Gallery!’
Nothing happened.
A snort.
A hollow laugh escaped me.
Yeah, as if I was some main character.
It was just my brain playing tricks because I was tired.
I closed my eyes and tried to force myself to sleep, but my head was a mess.
Gallery… Gallery….
Gallery has multiple meanings.
There’s the image app on smartphones.
And the art gallery we all know is a gallery too, but….
Pass?
Wait, could that word “gallery” mean THAT gallery?
At that moment, a semi-transparent window popped up before my eyes again.
This time was different.
It wasn’t a simple message window like before.
“…What is this screen?”
What unfolded before my eyes was an interface identical to a site I’d visited at least once before.
A dingy blue.
A crude UI.
And the gallery name plastered in the top-left corner of the screen.
[Dead Doctor Gallery]
“Pfft!”
I burst out laughing without realizing it.
Dead doctor?
Ah, that kind of setting?
My brain really must have finally lost it.
For a delusion conjured up by the brain of an overworked, insignificant excuse for a doctor, it had quite a convincing B-movie aesthetic.
‘Fine, my brain is throwing a complete fit. Then let’s see you solve this.’
I happened to recall a patient that a friend in internal medicine had been agonizing over lately.
I sent him a text to get the patient’s chart number and decided to try writing about it in the gallery.
‘How do I write a post? Do I just imagine typing on a keyboard?’
When I mimicked typing on a keyboard in my mind, characters began inputting into the gallery’s writing window as if by magic.
Oh.
It works.
Maybe my imagination was higher quality than I thought.
[Dead Doctor Gallery]
===============================
FUO (*Fever of Unknown Origin, fever of unknown cause) patient. Take a look
Writer: HellJoseonSlave1
68-year-old male. Sustained fever over 38.5°C for four weeks. Has rash. Suspected relapsing polychondritis, under treatment but not improving.
===============================
I then copied down the lab results below.
===============================
Patient keeps having fever and is weak. Can’t find the cause. What else should I look at?
===============================
Done.
This should be enough.
I uploaded the post by thinking about the submit button.
Who would reply in this crazy delusion?
That thought was shattered in less than a second.
[A new comment has been posted.]
ㅇㅇ (118.235): Autoimmune? I think it’s something like VEXAS. Send for testing.
The IP address even showed up—a delusion with vivid details.
118.235—that was a Korean IP, wasn’t it?
But VEXAS?
“What the hell is VEXAS, fuck.”
A disease name I’d never heard in my life.
My brain was truly amazing to make something like this up.
Dumbfounded, a hollow laugh came out, but my fingers unconsciously picked up my phone and opened UpToDate (*physician wiki), the bible for doctors.
I typed “VEXAS” in the search bar.
And the moment the search results appeared on the screen, I felt my heart drop to the floor with a thud.
[VEXAS Syndrome]
Vacuoles E1 enzyme X-linked Autoinflammatory Somatic syndrome
The search results shockingly indicated a condition similar to the patient my colleague had been struggling with.
An adult-onset autoinflammatory disease caused by somatic mutation in the UBA1 gene.
Major symptoms include recurrent fever, anemia and other hematologic abnormalities, skin rash, chondritis, vasculitis…
I stopped breathing.
The letters on the screen and the patient’s chart details I’d casually glossed over just moments ago began swirling together in my head like a storm.
‘The patient has an erythematous rash on his face.’
‘CBC results: everything else was normal, but the red blood cell count was subtly low. Mild anemia.’
‘He complained of red swelling in his ear cartilage.’
‘Fuck?’
No words other than curses came to mind. The words “VEXAS Syndrome” floating on my phone screen were seared into my retinas.
And what had told me that was the crazy delusion called [Dead Doctor Gallery] inside my head.
I immediately picked up my phone.
[Int Med (But Doesn’t Know Int Med) R1 Kang Taejin]
Beep—
Brrrrrm—
Brrrrrm—
Click—
“Hello?”
[Yeah, what? Hyeonjae, what’s going on?]
“You know that patient you were frustrated about last time.”
When I asked, Kang Taejin questioned me back, sounding puzzled.
[What patient? Hey, I have tons of patients like that. The patients I see…]
“The one you suspected Sweet Syndrome (*a type of skin disorder) with vasculitis! And recently you said you suspected relapsing polychondritis!”
[Ah… yeah. That patient. Why? Is something… is something wrong? It’s not like she’s in the ER?]
“No, it’s just….”
Ah, shit.
What excuse should I make?
I think I know the definitive diagnosis for a patient hospitalized in your department, but actually, it was told to me by something presumed to be a delusion… or something similar in my head.
I couldn’t say that.
“I found it while looking through papers. I think it matches that patient’s diagnosis.”
[What is it? What disease?]
“VEXAS Syndrome.”