The section chief’s hearty laughter echoed.
Only after that massive hand patted my shoulder a few more times did the chief leave with the fellow doctor, a satisfied look on his face as he said, “Good. Keep working hard like that.”
I did not straighten my back from its ninety-degree bow until they had completely disappeared from sight.
Senior Choi Sumin was looking at me with a complicated smile, a mix of shock, pity, and a little bit of respect.
“Hyeonjae… you’re really good at office politics….”
All I could do was give a weak smile.
In the corner of my vision, the quest window was still blinking as it shouted, “Time remaining: 00:52:17.”
I’d blown eight precious minutes on socializing with the section chief.
Clinging to my tattered mind, I pulled over an empty station chair and sat down.
I had to find the patient.
Area A, the resuscitation room, the isolation room.
Every critical-care zone in the ER was empty.
Then there was only one possibility left. A patient who had been classified as mild or moderate in terms of triage, but whose condition was in fact deteriorating rapidly.
There had to be a patient who had been left unattended because the doctors or nurses had not yet noticed.
I logged into the EMR system. Along with the familiar hospital logo, a list of every patient currently staying in the emergency room appeared on the screen.
Scrolling down with the mouse wheel, I began opening the charts of the patients lying in the general beds in Area B one by one.
First patient. Female, 24 years old. Chief complaint: abdominal pain.
She had come in saying her lower abdomen had been aching slightly since yesterday evening.
Vital signs stable.
All blood test results normal.
The doctor who had seen her first had written in the chart, “R/O (*Rule out, exclusion diagnosis) simple gastroenteritis.”
Suspected simple enteritis.
This is just constipation or menstrual cramps. Pass.
Second patient. Male, 38 years old. Chief complaint: Common cold.
Cold?
A cold?
Runny nose, cough, mild fever since two days ago. When asked why he came in, he said the hospital was near his office, so he stopped by after work.
This is the emergency medical center of a tertiary hospital.
Does he even know how much he’ll be paying out of pocket if he comes here?
He could have just gone to an ER at a neighborhood hospital. If it were me, I’d never come. If only because my money would be too precious.
Seething inwardly, I moved on to the next chart.
Third patient. Male, 45 years old. Chief complaint: intoxication.
The police had brought him in after finding him collapsed on the street.
Blood alcohol concentration 0.25%. Vitals stable. He was just sleeping. Pass.
Fourth, fifth, sixth….
Cold, body aches, headache, indigestion, dizziness, cold, cold, cold.
“Ha… fuck.”
The curse slipped out before I knew it.
The strength gradually drained from my fingers as I scrolled through the screen.
Something was wrong.
Not a single one of these patients was dying.
Most of them were people who could honestly be discharged right this second without any problem.
I stopped the mouse and leaned my stiff neck back. The red quest window filling my vision appeared even clearer.
“Time remaining: 00:41:03”
Time was passing, but far from finding a clue, my suspicions were only deepening.
Ugh…. Is the status window bullshitting me?
Maybe all of this was just an elaborate show happening inside my head.
The VEXAS syndrome diagnosis had only been a lucky coincidence, and this urgent quest was fake bait the system had thrown at me to mock me.
Wasn’t that a reasonable suspicion?
But… but I was far too curious about the reward of “1,000 LP” and “Hidden Trait Unlock.”
And what if there was a patient I hadn’t properly noticed?
“Again, from the beginning.”
Pressing down the doubts in my heart, I scrolled back to the very top.
The patient’s age, sex, underlying diseases, current medications, presence or absence of allergies….
I compared every single blood test value to the normal range and to previous test results, examining the trend of any changes.
I reopened the X-ray and CT readings and strained my eyes to check whether there were any tiny lesions the radiology department might have missed.
But the result was the same.
Clean. Far too clean.
A procession of textbook mild cases.
Nowhere could I see the shadow of death.
In the end, I leaned back against the chair in emptiness.
Time flowed on helplessly, and now there were not even thirty minutes left. The adrenaline had been completely depleted, leaving only deep fatigue and a sense of defeat in its place.
Where on earth is this person?
“A patient dying while left unattended within the hospital.”
The sentence from the quest circled in my head.
Was I missing something extremely basic?
Or was the patient not in the emergency room to begin with?
In the end, I closed the EMR window.
I could not find the answer from the letters and numbers on the screen alone.
I got up and began walking slowly through the ER.
I looked around, sweeping my gaze over each of the beds in Area B. The time remaining for the quest was now just over twenty minutes.
Impatience was tightening around my throat, but on the outside, I tried to act as calm as possible, playing the part of a doctor leisurely making rounds (*Rounding, ward rounds).
Approaching one bed, I yanked open the curtain of a sleeping patient.
A woman in her twenties who had been sleeping soundly woke with a start.
“What is it, doctor…?”
Her eyes were full of wariness, as if to say, “What the hell is this lunatic?”
I scanned her face and the vital signs on the monitor beside the bed for one second. Stable heart rate, normal oxygen saturation. No problem at all.
“…Ah, it’s nothing. I came to check whether your blood pressure was being maintained well. Please, just go back to sleep….”
I awkwardly made an excuse and hurriedly closed the curtain again.
My face burned at the dumbfounded gaze I felt from behind me.
I repeated that insane behavior a few more times.
I lightly pinched the foot of a middle-aged man sleeping off his drunkenness to see his reaction, and approached a patient complaining of a headache only to suddenly shine a light in his eyes and check his pupillary reflex.
The complaints of the patients and the puzzled gazes of the nurses stabbed into my back like daggers.
As I wandered through the emergency room like that, my steps stopped in front of bed 17 in Area B.
On the bed lay a middle-aged man who looked to be in his mid-fifties, groaning in pain. Cold sweat had gathered in beads on his forehead, and his face was pale. He looked like a typical patient with acute gastroenteritis.
It was a patient I had seen earlier in the EMR.
He had come in with vomiting and abdominal pain, and they were observing his progress while administering IV fluids under the assumption it was food poisoning.
Hmm, this patient… was there anything special about him?
I took my phone out of my pocket, opened the EMR again, and checked his chart.
Male, 54 years old. Chief complaint: vomiting, diarrhea, abdominal pain. R/O Acute gastroenteritis (*suspected acute gastroenteritis)
His vital signs were stable, and there were no notable findings in the blood tests aside from slight dehydration.
In other words, there was nothing much to see. A textbook case. There was no way a patient like this was dying.
Just as I was about to turn away in disappointment, the man called out to me with difficulty.
“Excuse me… doctor.”
“Yes, sir. Are you all right? Is your stomach very upset?”
“No, it’s not that. It’s a bit hard for me to get up. Could you maybe bring me a cup of water? My throat is so dry….”
Well, the water dispenser is right near the station, so I can do that much.
I nodded and headed to the water dispenser. I filled a paper cup with cold water.
I returned to the patient with the cup of water and handed it to him.
“Here you go. Please drink slowly.”
The man bowed his head in thanks, took the cup, and drank a mouthful. Then he said something very strange.
“…Ah! Doctor, you could’ve given me cold water instead of warm water, haha. Anyway, thank you.”
“……?”
I doubted my ears.
Warm water?
Something was strange.
I had definitely pressed the blue cold-water button on the dispenser.
I had not drunk it myself, but just from the droplets forming on the surface of the cup, this was obviously cold water.
And yet the patient had felt it as warm.
“Sir, does the water feel hot to you?”
“Hm? No, well, not hot like lava or anything. It’s just lukewarm. I prefer cold water, you see. Haha.”
The man laughed as if it were nothing.
But I could not laugh.
Warning lights began to blare in my head.
For now, I muddled through the situation and said, “Understood. I’ll bring it cold next time,” then returned to the station.
My heart started pounding again.
I went straight to Senior Choi Sumin and explained what had just happened.
“Senior, the B-17 patient. The gastroenteritis patient. I gave him cold water, but he called it warm. I think there’s something wrong with his temperature sensation.”
After hearing me, Senior Choi Sumin’s eyes gleamed with interest.
She opened the EMR and carefully reviewed the patient’s chart again.
“Abnormal temperature sensation…. It’s a really unusual symptom, but it’s hard to do anything with just that one thing. Severe dehydration or an electrolyte imbalance could temporarily cause paresthesia…. Or, very rarely, it could be a neurological issue.”
Resting her chin on her hand, she thought for a moment, but in the end came to a textbook conclusion.
“For now, let’s run labs (*Lab, blood tests) again and put in a consult to neurology. Let’s ask the on-call neurologist to take a look at the patient.”
As expected.
There was no real solution at the moment.
The symptom was too vague and nonspecific, so there was not enough basis to immediately suspect something and dig into it.
I answered, “Yes, understood,” but inside, I felt as if I were burning up.
“Time remaining: 00:08:43”
How long would it take to request a neurology consult, see the patient, run tests, and find the cause?
Would this patient—and my quest—be all right until then?
I stood alone in the corner of the station, anxiously staring at bed B-17.
Ah, I don’t know why, but I think it’s that patient… What do I do….
Should I post something on the “Dead Medical Scholars Gallery” in my head? But what would I even write?
“54-year-old male shows symptoms of gastroenteritis along with abnormal temperature sensation. What do you think it is?” Like that? There was no guarantee a clear answer would come back like it had with VEXAS.
…Screw it, I don’t know.