Chapter 16
The house was peaceful when I visited after so long.
Our old dog lay quietly under the sofa. But whenever it heard the family talking, its ears would perk up.
A noisy racket.
Two cats wandered around the living room near the dog. They seemed to be young cats my parents had recently brought home.
One white, one black.
Jimmy Carter was talking on the television. He'd been elected president this year.
As I sat quietly, the white cat wandered over and climbed onto my lap.
As if asking who this human was.
I turned my gaze toward my parents.
“I bought a house in Palo Alto this time.”
“With what money?”
My family stared at me with wide eyes. They looked genuinely incredulous.
I scratched my head.
“I sold a patent for a new injection method to a pharmaceutical company. I got $100,000 for selling the patent to Syntex.”
“Does that even make sense?”
It does! That was something I'd often thought since coming to America. If you knew how and had the skills, anything was possible here, wasn't it?
“I did it.”
I nodded, triumphant.
“I didn't realize being a doctor was such a big deal. How much does a house in Palo Alto even cost?”
“$100,000.”
It was still too early to be surprised.
I chuckled to myself. I hadn't even received the royalties yet, and I had more than one future medicine or invention in mind.
“You must take after your mother and be smart.”
We weren't related by blood, so our brains couldn't be alike. It was an American joke.
“If you need money, too, just tell me.”
The cat sitting on my lap meowed. Our dog, lying down, twitched as if it had heard the sound in its sleep.
“I don't know if we'll need it, but thank you.”
My parents were frugal.
I stroked the white cat sitting on my lap. What was its name?
“What's the cat's name?”
My mother looked at me.
“Oh, the cats. The white one's Cookie, and the black one's Cream.”
Shouldn't those be the other way around?
“They're cute. Where'd you get them?”
“The neighbors gave them to us. They had too many.”
The white cat stretched out its legs. I'd better head back to the hospital as soon as the sun came up tomorrow.
***
Professor Ellison was sitting in a bar with several other Stanford Hospital professors. The dean, Professor Rich, was among them.
It was an upscale bar near the hospital, so it wasn't noisy. They were just having an ordinary conversation.
The dean spoke first.
“We have a big one this time. I heard that the Asian doctor who came here on a full scholarship is receiving this year's Lasker Award.”
The professors immediately began murmuring.
“Really?”
A resident—not even a PhD—was receiving a Lasker Award? They'd never heard of such a thing.
Was that even possible?
Professor Rich continued, as if telling a ghost story. He was talking about that Asian doctor.
Professor Ellison poured the champagne.
“The hospital got a call. They asked if that resident had really done this research. When I said he had, they told me they were giving him the Lasker Award.”
Professor Ellison furrowed his brow.
“That's strange.”
“Professor McDevitt did brag about it. He said it was research that could completely change academia. Something about an enzyme that can cut genes.”
Rumors spread fast.
The medical community wasn't that big.
Even if the Lasker Foundation did its best to keep things secret, it couldn't stop rumors or speculation about who might receive the award.
The doctors gathered there began a heated discussion. What papers had the resident written, and what research had he been involved in, for a doctor who wasn't even thirty to receive a Lasker Award?
“But what kind of paper was it?”
Whatever it was, it had to be research that could significantly change the direction of academia.
“The Lasker Award, huh? I'm jealous.”
“I suppose the student has surpassed the teacher... That fellow will become a better researcher and doctor than most of us here.”
Professor Ellison nodded.
He'd seen it firsthand.
That Asian doctor was far beyond the level of other doctors in knowledge, observation, and reasoning. Maybe even Professor Ellison himself.
Once that resident had accumulated as much experience and professional standing as a professor, it was almost inevitable that he'd become a better doctor than Ellison.
At least, that's what Professor Ellison thought.
***
There were a lot of patients to see on the internal medicine ward.
I scratched my head. If there was one way America in this era differed from modern Korea, it was that residents were given a lot of autonomy.
Maybe it was because they didn't have smartphones, or maybe American culture was more individualistic.
There were no computerized records, either.
It was too cumbersome to ask professors about everything. Of course, I didn't need to ask anyone, anyway.
The responsibility I carried might have been much heavier than that of doctors today. In Korea, a resident would have to ask a fellow, who would then ask a professor.
I held the paper medical records and fiddled with my ballpoint pen. Let's think this through.
This patient's legs were swollen, so they needed a diuretic. That patient had diabetes and was going to have surgery, so they needed insulin.
It was routine patient care.
“Hm?”
There was one unusual patient.
As I flipped through the medical records,
-Fever and pain persist despite adequate treatment with appropriate antibiotics.
A 22-year-old female patient. She was being treated for a urinary tract infection and pyelonephritis, but from her records, it seemed the treatment wasn't working properly.
Treatment failure! In a patient in her twenties, no less. It was a bad sign.
I should go take a look.
***
University hospitals usually received patients who couldn't be treated at lower-level medical facilities.
At a place like Stanford, patients who couldn't be treated at other university hospitals came here, too.
Strange illnesses were common here.
I walked to the nurses' station on the patient's ward. Alice was hunched over an internal medicine textbook, her head in her hands.
She greeted me as soon as she saw me.
“Hey, long time no see.”
“Hi.”
I waved at her.
“Do you want to come to my family's vacation home this winter? We're going to see a pod of whale sharks migrating to warmer southern waters. I heard a few family friends are coming along.”
I scratched my head.
Suddenly asking me to go see whale sharks?
No matter how I looked at it, Alice's family seemed like Dagon worshippers. I'd heard there were occultists in American high society...
“I'll think about it. More importantly—”
Anyway, that wasn't important.
I was here because of the unusual patient admitted to our ward. I picked up the clipboard with the patient's information and sat beside Alice.
“There's a strange patient.”
Alice tilted her head.
“Which patient? Oh, you mean Sophia. I was just thinking about her.”
“Yeah.”
She took out her notebook.
“Let's see. Her urinary tract infection is persisting despite antibiotic treatment. They're checking for stones or structural problems, and she has some nonspecific symptoms, too.”
Were they really nonspecific?
That was the kind of claim I had to approach skeptically. It was hard to believe.
What were the nonspecific symptoms?
Headaches? Coughing? Fatigue?
Symptoms usually called nonspecific could be highly specific and worth taking seriously, depending on the context.
When people said ‘nonspecific symptoms,’ they usually meant symptoms the doctor didn't think warranted attention.
Maybe that wasn't entirely wrong.
There were symptoms that didn't help with a diagnosis or didn't need attention.
But if treatment had failed, shouldn't we go back to square one? We couldn't hide behind the word “nonspecific” anymore.
Alice flipped through the medical records beside me.
“Nonspecific symptoms?”
“Since she was admitted this time, she's had a nonspecific fever, fatigue, and back pain. She's also been treated for gastritis a few times in the past.”
See? They weren't all that nonspecific, were they?
Something was definitely wrong, and I felt like the pieces might connect in the back of my mind.
Gastritis, nonspecific symptoms like colds, urinary tract and kidney infections. I felt like something might come to mind, but I couldn't reach a clear conclusion yet.
Let's get a little more information.
“Anything else come to mind?”
“I'm looking through the records. Uh... you're right. It says several people in her family have suffered from kidney stones.”
Although Alice sometimes came across as odd or like a sheltered rich girl... she was serious when it came to patients.
At least, she never seemed lazy or halfhearted about her work.
A family history of kidney stones?
Things got complicated here. Kidney stones by themselves were more likely to be caused by diet or living conditions than by genetics.
This wasn't going to be easy.
Maybe Sophia's doctors hadn't failed simply because they lacked insight.
A family history of kidney stones and recurring gastritis.
If the family history pointed to an inherited condition, maybe thinking through what underlying problem could cause kidney stones would lead me to the answer...
Ah, I thought of something!
“Let's go see the patient.”
I got up, and Alice hurriedly gathered her clipboard and followed me.