Chapter 53
I was wandering around the huge venue to carry out Lee Minjae's merch-raid mission.
In my hands were already a ballpoint pen stamped with a pharmaceutical company logo and two ridiculously high-quality character sticky notes.
Not a bad haul.
At this rate, I looked like I'd be able to supply a year's worth of stationery with ease.
‘Next is that medical device booth.’
Conference? Presentations?
None of my business.
Just as I was about to head to the next booth, burning with worldly desire, I briefly checked the Gallery and felt it start buzzing.
It was because of the 'Merch Midterm Settlement.txt' post I'd just uploaded.
Back in My Day : What kind of lunatic goes all the way to a conference and still doesn't study, only coveting freebies! Kids these days have no academic zeal, none at all!
Hippocrates' Descendant : O living one! How can you indulge such worldly greed in this sacred hall where a feast of knowledge unfolds! Are a few pens really worth that much to you! Hurry to the grand ballroom at once and receive the wisdom of the scholars!
Cardiology Wraith : The topic of the Plenary Lecture is the latest findings on septic shock. You ER folks see sepsis multiple times a day. Stuffing one more piece of knowledge into your brain will help save patients a hundred times more than some pen.
Ugh, quit nagging already.
I swallowed my curse words and tried to ignore their clamor. But they were persistent.
In the end, I surrendered.
There was no way to beat these insane, study-obsessed ghosts.
With tears in my eyes, I trudged toward the massive grand ballroom.
The grand ballroom was enormous and dark.
On the giant screen was the face of a white-haired old professor from Johns Hopkins, blown up huge.
I took a seat in the far back corner, as inconspicuously as possible.
The perfect place to sleep.
But the ghosts would not allow me to fall asleep.
Respiratory Ghost : From now on, relay everything the professor says and everything on the slides, word for word.
I reluctantly straightened up and stared at the screen.
Hell Joseon Slave 1 : It's about a new phenotype of sepsis. The old SIRS criteria have high sensitivity but low specificity, so it's important to look at changes in the SOFA score along with qSOFA... basically that kind of thing.
Back in My Day : Hm, back in our day, SIRS was practically the Bible. The world has changed a lot.
Hell Joseon Slave 1 : Next slide. Meta-analysis results on HAT therapy, where high-dose vitamin C, thiamine, and steroids are administered together. The conclusion: 'Insufficient evidence yet, so not recommended.'
Hippocrates' Descendant : A wise conclusion. Rash belief is the greatest enemy of the learned.
It felt like I was a near-real-time simultaneous interpreter.
In Gallery, the ghosts held a heated debate among themselves over what I was relaying.
‘That data is too unreliable’
‘That concept existed in our day too’
‘No, that's a completely new approach’ and so on.
Cardiology Wraith : Take a screenshot of that slide from earlier. Tracking the numbers over time to decide when to stop antibiotics seems important. Rather than overprescribing antibiotics and breeding resistant bacteria later, study stuff like that instead.
I rubbed my sleepy eyes and forced the important-looking slide contents into my head.
After the boring plenary lecture ended and I tried to escape....
Unfortunately, the ghosts wouldn't let me go.
Hematoma Is Hell : It's just getting started. The oral presentation session you chickened out of earlier. Critical care medicine. Let's go there. An ARDS prognosis prediction model. Sounds interesting, right?
In the end, I headed to the small seminar room next door.
A young professor went up on stage and began presenting on a topic dizzying enough just to hear: 'Developing a Prognostic Prediction Model for Patients with Acute Respiratory Distress Syndrome.'
Scalpel God : The variables shown there are the key.
***
I felt like I was about to cry.
My hand was moving like crazy over the notes app on my phone.
My head was on the verge of bursting with all sorts of statistical terms and data I didn't even understand.
'I'm fucking exhausted...'
Only after being forced to attend a few more sessions like that was I finally able to break free.
My brain... it feels like it's been fried.
I sank into a chair in a corner of the venue and stared blankly at the notes I'd just frantically taken.
The new definition of sepsis, antibiotic use strategies, prognostic factors for ARDS, post-resuscitation treatment protocols....
‘...But this is really...’
Amid the awful fatigue, a tiny realization sprouted.
‘...This is tutoring you couldn't even buy with money.’
I let out an empty laugh and checked the time. 1:45 p.m.
It was almost time for me to stand awkwardly in front of my poster.
I headed to the giant hall where the posters were displayed with Kim Jihoon.
Hundreds of panels stood in endless rows, and in front of them, young doctors with the same soulless eyes as mine were milling around, having turned their own research results into exhibits.
We stood in front of the huge sheet bearing our names.
“Hey, aren't you nervous?”
Kim Jihoon asked, swallowing hard.
“What?”
“I mean, professors are going to come by later and start asking questions and stuff, right? What if we can't answer properly.”
“No one cares about a first-year resident's poster anyway. Just stand there, and when the time comes, take it down and go home.”
My only goal was to stand here like a ghost for the next two hours, survive on minimal energy expenditure, then the instant it hit 4 o'clock, tear down the poster and sprint back to the hotel.
That was when it happened.
“Oh, hey, guys!”
A bright voice came from behind us.
It was Professor Cheon Eunjeong.
“Professor! Good afternoon!”
Jihoon and I bowed at the waist almost reflexively, a full ninety degrees.
“Good, good. Is the preparation going well?”
Professor Cheon gave our poster a quick glance with a very satisfied expression, then delivered terrible news.
“I just got word from the organizing committee. The poster session time was adjusted a bit. You and Jihoon, it's been changed from 2 o'clock to 4 o'clock!”
…
…Huh?
4 o'clock? Two more hours from now?
“Why did the time suddenly...”
Jihoon asked in a dazed voice.
“It looks like the oral presentation session in front ran a bit long. Anyway, that's how it is. Works out well!”
Works out well? Is this guy even in his right mind right now?
“You've got two hours free, so go watch more presentations! I saw there's a separate resident oral session over there too, and there were lots of interesting topics. Go watch that if anything. You can learn a lot from watching presentations, too. Anyway, I've got to go! Bye!”
Professor Cheon made a 'fighting!' gesture at us one more time, then disappeared into the crowd without a trace of hesitation.
I just want to stand here quietly.
I don't want to watch any more presentations.
It feels like my brain is melting.
Aaaagh.
“Fuck....”
Jihoon spat out a curse beside me.
“Can't I just go sleep on that lobby sofa over there?”
I gazed wistfully at the leather sofas in the hotel lobby far away, which looked cozy.
“If you get caught by the professor, you'll be forcibly nominated as an oral presenter at next year's conference.”
Jihoon said.
“Jihoon.”
“What.”
“I'm probably already going to get dragged into an oral presentation next year anyway because of that laparotomy case....”
Our conversation ended in silence.
Two hours.
I had no idea how I was supposed to endure this meaningless time.
“What are we supposed to do?”
Kim Jihoon asked in a dazed voice.
“What do you mean, what are we supposed to do? We just have to keep breathing.”
“No, I mean are we really just going to stand here for two hours? Should we go back to that critical care session earlier instead?”
I shook my head.
“Look over there.”
Where I gestured with my chin was a small seminar room with a sign that read [Resident Oral Presentation Session].
“There aren't many professors over there either. It's a place where people at our level give presentations and listen to each other, so the pressure's lower too. It's perfect for hunkering down and killing time.”
At my reasonable suggestion, Jihoon reluctantly nodded.
Inside, a new presentation was just beginning.
I took a seat in the far back corner and casually read the title on the screen.
[Stress Cardiomyopathy: A Typical Case Report of Takotsubo Cardiomyopathy]
Oh, interesting.
Takotsubo. A rare disease in which, after extreme emotional stress, the movement of the tip of the heart suddenly worsens and it presents like a myocardial infarction.
It was named that because the heart's shape changes to resemble a Japanese octopus pot, a takotsubo.
The presenter read through the case in a trembling voice.
“A 65-year-old female patient came to the ER complaining of sudden chest pain a week after the death of her husband...”
I began relaying the presentation to Gallery.
But the ghosts' reaction was cold.
Back in My Day : Why are you watching something so boring?
Cardiology Wraith : It's Takotsubo. A painfully obvious case. The EKG looks like STEMI, the vessels are clean, and on ultrasound only the apex moves pathetically. Yawn.
Because I might get dragged over there as a resident oral presenter next year, too.
I need to see in advance how they give presentations, how they make slides, and how they answer questions, don't I?
It's not someone else's problem.
The presentation went smoothly. The patient's test results appeared on the screen one after another.
The electrocardiogram showed clear ST-segment elevation.
Cardiac enzyme levels were slightly elevated.
But in the coronary angiography images shown next, the coronary arteries were spotless, with no blockages at all.
Hmm, a classic finding.
Finally, the echocardiogram footage appeared.
In the video, the patient's heart really was weakly writhing, with only the lower part ballooned out like a textbook illustration.
It was practically definitive evidence of Takotsubo cardiomyopathy.
The presenter concluded.
“Therefore, this case could be diagnosed as a typical Takotsubo cardiomyopathy occurring after extreme stress.”
Yeah, yeah.
A textbook case.
Good work.
I thought that and started considering whether I should move seats for the next session.
Right then.
The comment from Cardiology Wraith, after seeing the photo I'd posted in Gallery, slammed into my mind.
Cardiology Wraith : That's not Takotsubo.
???
What the hell are you talking about.
From the EKG to the angiography and even the echocardiogram, all the evidence points to Takotsubo, so what do you mean it's not.
Has this old fossil finally gone senile?
Or is he just trolling because he's bored?
Cardiology Wraith : Can't you see the thickness of the heart muscle there?
Muscle thickness?
Takotsubo is a disease where the movement of the heart muscle becomes abnormal; it has nothing to do with thickness.
I couldn't understand what he meant.
I looked back at the screen showing the echocardiogram.
…Huh?
Something was off.
Normally, heart muscle paralyzed by stress should stretch out like a balloon and become thinner.
But in that video, the apical muscle looked far thicker than the other parts of the heart instead of thinning out.
A faint memory of a cardiology lecture from med school rose in my mind.
A disease in which the apical muscle thickens.
A hereditary heart disease with a completely different mechanism from Takotsubo.
One that can worsen under stress and is often difficult to distinguish from Takotsubo...
At that moment, all the pieces in my head started clicking toward one horrifying conclusion.
This presentation, from beginning to end.
Was completely wrong.