Chapter 1 : The Protagonist of a Regression Story (1)
Chapter 1 - The Protagonist of a Regression Story (1)
One day ago.
Samah University Hospital, Ward 9, Consultation Room.
"How many times do I have to tell you? I'm not crazy! Please, let me be discharged!"
The patient wore the most aggrieved expression in the world.
"Discharge is still difficult at this point. First, please calm down..."
And the doctor was doing his best to dissuade him.
It had already been thirty minutes.
The conversation between the two was running in parallel lines.
"Calm down? Do I look like I can be calm right now? My family is in danger! I have to go out and save them right this instant!"
The patient looked as if he would kick down the door of the closed ward and charge out at any moment.
Sihyeon avoided the patient’s smoldering gaze and glanced at the chart.
[Jung Moon-su M/34 R4 Cheon Si-hyeon / Attending Prof. Jin Cheol-yeong]
– Day 33 of hospitalization.
– Delusions that an unknown force is monitoring and tormenting him and his family.
– Accompanying extreme anxiety.
– Repeated requests for discharge.
‘The PANSS score hasn't improved at all.’
The scale used to evaluate the severity of delusions was not much different from when he was first admitted.
A considerable amount of time had passed since his admission.
A significant amount of effort had been put into the consultations.
Despite that, the patient's condition had not improved at all until now.
No, to be honest, it had worsened.
Tremble, tremble.
The patient's fingertips were shaking faintly.
"Since when have your hands been like that?"
"It's been a few days. My hands aren't what's important right now! My wife... my child..."
The patient choked up.
However, Sihyeon’s gaze was directed elsewhere.
Hand tremors, an expressionless face, and a hunched posture.
It was clearly Extrapyramidal Syndrome (EPS) caused by Paliperidone, the medication being prescribed to treat his persecutory delusions.
At one point, Sihyeon had even suspected the patient might be secretly throwing the pills away.
But EPS was a side effect that could never appear if one was not taking the medication.
‘Antipsychotic medication is already at the maximum dosage...’
The medication had been changed several times, but the patient did not respond to any treatment.
He had treated numerous patients with delusional disorders, but this was the first time he had encountered a patient like this.
– Administer Procyclidine 5mg BID for EPS control.
Sihyeon wrote down on the chart apathetically.
"What is the reason you think your family is in danger? You’ve never properly talked about it until now, have you?"
Sihyeon asked, sounding frustrated.
"I cannot tell you that."
"Why?"
"If you were to find out... even you, Dr. Cheon Si-hyeon, would not be safe. I’m serious."
Sihyeon had thought it was strange that the patient had consistently shown a defensive attitude during consultations, but to think it was because he was worried his doctor might be in danger.
Setting aside the way he kept stubbornly insisting on being discharged, he didn't seem like a bad person to begin with.
“I will be fine. Please, tell me. I guarantee confidentiality regarding the contents of our consultation.”
Sihyeon spoke as if trying to reassure the patient as much as possible.
“…….”
How much time had passed?
After a long silence, the patient spoke with difficulty.
“It might sound strange, but I know a lot about things that will happen in the future.”
“If it's things that will happen in the future, is it a kind of precognition?”
Sihyeon asked, sounding interested.
Occasionally, patients seized by megalomania would confidently claim to see the future clearly.
“It's obvious I'll be treated like a crazy person if I say this, but... I know too many things I shouldn't know. And I'm suffering like hell right now because of that damn information.”
The patient burst out in resentment.
Until now, he had only demanded discharge and had been extremely sparing with his words.
‘Suffering because of information about the future, huh.’
Although it was all words difficult to understand, even getting this far was a huge step forward.
“Your family members who came with you to the emergency room are doing well. Even yesterday, they called the ward wondering if you, Mr. Jung Moon-su, were doing okay. So, rest assured for now.”
“Those people aren't my real family! They're all fakes! You're being fooled too, Doctor!”
He beat his chest in frustration.
‘Capgras syndrome?’
It was a type of delusion where one believes another person has disguised themselves to look exactly like their family and is going around acting as them.
Persecutory delusions, megalomania, and even Capgras syndrome.
— Let a 4th-year handle this patient.
He recalled the words the attending professor had said on the day of admission.
Indeed, even in the eyes of Sihyeon, a 4th-year resident, he was a formidable patient.
“You must have your reasons. You must be very worried.”
Sihyeon offered sincere words of comfort.
The patient truly believes his family is in danger.
Even if it was a delusion, the suffering he experienced because of that false belief was undoubtedly real.
“I want to at least check if my family is alive or dead, but I just can't... so please discharge me quickly! Right now!”
“I understand your situation, but discharge is impossible right now. I'd like you to receive treatment here in this ward for the time being.”
But he couldn't back down.
Because if he were discharged like this, the patient would spend the rest of his life wandering around looking for ‘real family’ that didn't exist anywhere.
“And I'm sorry, but I no longer have the authority to discharge you, Mr. Jung Moon-su. The doctor in charge will be changed starting tomorrow.”
“No, what do you mean by that?”
The patient seemed quite flustered by Sihyeon's words.
“Tomorrow is our specialist exam, so today will be my last day on duty. Please understand that the doctor in charge is changing in the middle of your treatment.”
When he first took charge of Jung Moon-su, he didn't know he would be treating patients until the day right before the exam.
Because the exam was less than 24 hours away, Sihyeon was also starting to feel nervous.
“That’s right. All right.”
Was it because he thought there was no use in talking anymore?
Surprisingly, the patient seemed to accept it immediately.
“I hope you make a full recovery as soon as possible. Although I don't know the full details, I hope your family is safe too.”
Sihyeon after saying goodbye to the patient, began to leave the future treatment plan on the chart.
– Maintaining dosage after increasing Paliperidone to 12mg, but delusions remain firm and there is no partial response.
– It is believed that a change in antipsychotic medication will be necessary in the future.
“Dr. Cheon Si-hyeon.”
The patient called out to Sihyeon while in the middle of opening the consultation room door.
“Please, be careful. If my thoughts are correct, you might be in danger as well.”
“What do you mean by that? Me being in danger?”
“Thinking about it now, that’s right. It was all because of me that the people around me suffered. In truth, they were people who knew nothing. Please don’t think of it as a delusion and definitely be careful for the time being...”
The patient’s voice trailed off as he left the consultation room.
……
“What are you doing staying at the hospital until now when your exam is tomorrow?”
As he stepped out of the consultation room, a man wearing a white coat spoke to Sihyeon.
Kim Seok-yong, a psychiatry fellow.
The silver name tag attached to his coat pocket stood out especially today.
He was Sihyeon’s senior by one year and was currently working as a fellow in the psychiatry department of Samah University Hospital.
“It's because of a severe patient. Somehow, I ended up working until today.”
“You’ve worked hard. Still, you should get going quickly. Is it the Grand Hillon Hotel?”
“Yes. It’s the same this year.”
For a few days before the exam, 4th-year residents from all over the country would rent out hotels and stay together.
It was to wrap things up by sharing topics that had been issues at academic conferences during the year and making final summaries of information that comes out right before the exam.
“By the way, who is the patient that gave our Dr. Cheon such a hard time? Mr. Jung Moon-su?”
“Yes. It’s the first time I’ve seen a patient who shows such a lack of treatment response until now.”
“I see. He did seem a bit unique to me as well. While he seems like a typical delusional case, something is a bit different. He has a strange vibe, I should say.”
“I’ve handed him over to the 3rd-year for now, but I’m worried.”
“Really? Then should I take over and see him?”
Sihyeon’s eyes widened at the unexpected proposal.
If it was Kim Seok-yong, who was already a specialist and second to none in terms of diligence, he could rest easy.
“I’d be grateful, of course.”
“Alright. Don’t worry about the patient and go finish your preparation well.”
Kim Seok-yong gave a thin smile.
“Head Nurse, please open the ward door quickly. Dr. Cheon Si-hyeon couldn’t study because he was seeing a patient, so if things go wrong, he’s going to fail his exam.”
He then said while looking toward the Head Nurse.
The psychiatric closed ward was a place where various patients were hospitalized, from those with suicidal ideation to those with severe behavioral problems.
In order to leave the ward, the door had to be opened from the nurse station.
“Eh? I don’t want to send Dr. Cheon away. Why don’t you do four more years of residency here and then go? Hahaha.”
The Head Nurse joked as if she was disappointed.
‘Just curse at me instead. Curse at me...’
Do four more years? Just the thought of it was horrifying.
Sihyeon shuddered and shook his head.
“Huh? But why won’t this open?”
The Head Nurse pressed the button repeatedly, but the ward door did not open.
“Don’t do that and open it quickly. Our Dr. Cheon is really busy, I tell you.”
“The opening mechanism is completely unresponsive?”
“What? Why so suddenly... let me take a look.”
Click.
Only after Kim Seok-yong and the Head Nurse struggled and strained for a long while did the ward door open.
“Phew, it’s working now. Dr. Cheon, do well on your exam.”
“You know our hospital's psychiatry department has had a 100% pass rate for 39 consecutive years, right? Let's make it 40!”
Kim Seok-yong showed a clenched fist.
“Yes. Well then, I'll see you after the exam.”
Sihyeon also gave them a grin and then hurriedly left the ward.
……
7 : 30 PM
Grand Hillon Hotel.
After meeting residents from other hospitals to exchange materials and chat, Sihyeon returned to his room and plopped down on the sofa.
Outside the window, landscaped trees decorated with light bulbs were shining.
The new year had dawned, but it still felt like the end of the year.
‘I want to relax and rest. If it weren't for the exam.’
The neatly arranged bedding tempted him.
Sihyeon closed the book he was reading, lay on the bed, and quietly closed his eyes.
It had been a very long time until this day arrived.
‘Has it been 11 years?’
From entering pre-med to graduating from med school. From being an intern at Samah University Hospital to becoming a psychiatry resident. The countless night shifts spent fighting drowsiness. The memorable patients.
It was a really tough time, but looking back now, a smile came to his face.
The tension before the exam was considerable, but more than that, he desperately wanted to rest after the exam was over.
Once tomorrow passed, his life as a psychiatry specialist would begin.
Of course, there was still the second exam, and some time would be needed until the announcement of successful candidates.
For now, he fell into happy imaginings, believing so.
It was like that right until the phone rang.
[R3 Kim Won-gi]
The caller was his junior resident, Kim Won-gi.
Since they had already exchanged well-wishes for the exam, a call at this hour was a bit unexpected.
“Won-gi, what's up at this hour?”
“Doctor, it’s an emergency. There’s been an accident in the ward...”
Kim Won-gi choked up and couldn't continue his words.
“An accident? What does that suddenly mean...”
“The ward caught fire. Right now, Dr. Kim Seok-yong and the Head Nurse are in critical condition. According to the ICU staff, their vitals are too unstable.”
“Why the ward, all of a sudden? What on earth happened?”
It was the ward he had been working in just a few hours ago.
“They still haven't found the cause. It seems like something exploded, and room 904 is completely blown away. They told us not to contact the 4th-year doctors separately, but I thought it would be on the news soon anyway...”
“…….”
[Breaking News] Fire in Samah University Hospital ward. Total casualties...
When he turned on the TV, the news of the fire was coming up as a breaking news report, just as he said.
‘What is this...’
A sense of unreality.
There was no other way to describe it.
He simply couldn't believe that his colleagues, with whom he had been laughing and chatting until just a while ago, were lying there unconscious.
“I'll be right there. Are you in the medical office?”
“I think it’s better if you don’t come. Everything is closed off because it’s under investigation anyway, and you have your exam tomorrow...”
He tried to calm his heart, but he couldn't settle down.
Before Kim Won-gi could even finish speaking, Sihyeon left the hotel room and ran to the parking lot.