Chapter 8 : All Charts in the World (1)
Chapter 8 - All Charts in the World (1)
A notification window that suddenly popped up.
Is this what it feels like to experience augmented reality with smart glasses?
It felt as if a bezel-less, translucent tablet PC were floating in mid-air.
“Your first patient already got discharged?” asked Kim Seok-yong, who was writing charts in the ward.
“Pardon? Ah, she just left.”
“Good work. She seemed to get better quickly. You must have looked after her diligently.”
Kim Seok-yong only offered words of encouragement and said nothing about the notification window. As expected, it seemed others couldn't perceive it at all.
‘A vivid... hallucination.’
Specifically, it was clearly a visual hallucination. Sihyeon had no time to examine the contents of the notification window. The mere fact that he was experiencing a visual hallucination was a huge shock.
‘Schizophrenia, Lewy body dementia, delirium... and even epilepsy could cause visual hallucinations if it affects the visual cortex.’
Since he had been clutching his specialist exam materials until just a few days ago, diagnostic names that could cause visual hallucinations automatically began to spring to mind.
Knowledge is power, but it can also be a curse. Before the notification window appeared, there had also been a headache unlike anything he had ever experienced.
‘Could it be a stroke? Should I get an emergency MRI?’
Stroke. A disease caused by the blockage or rupture of cerebral blood vessels, which could be life-threatening if treatment is delayed.
‘Wait a minute... I’m far too fine for it to be a stroke.’
Thinking it over, there were no other symptoms at all. His consciousness was clear, and there was no discomfort in sensation or movement. Not a single thing met the diagnostic criteria.
‘Let's stay calm for now.’
Sihyeon calmed his racing heart and began to examine the contents of the notification window.
……
[system: System activation successful.]
[Loading 'All Charts in the World']
[A significant portion of the chart contents has been modified. Would you like to check? Y/N]
When Cheon Si-hyeon touched 'Y', Kim Su-yeong's medical records began to appear. First, the admission note was exactly as Sihyeon knew it. There were also no changes in the personal history or initial outpatient records.
The major difference was in the progress notes.
– HD#30 (Hospital Day 30) Shouting in the ward and arguing with another patient.
– Quetiapine dosage increased to 600mg.
‘30 days of hospitalization?’
The patient had been discharged after only two weeks. In other words, these were prescriptions that could not exist as of now.
‘These are previous records, aren't they? "All Charts in the World"... could it be?’
Looking closely, it was the medical record written by Sihyeon four years ago—that is, before the regression. These records were in light gray text with strikethroughs drawn across them.
On the other hand, the events that occurred during this hospitalization were well-organized in normal black text. While he was examining the medical record in admiration, a patient leisurely passed by in front of him.
‘What was that just now?’
When he turned his head toward where the patient had passed, Sihyeon once again couldn't help but doubt his eyes.
[Park Seong-gyu M/56 Attending R2 Kim Seok-yong / Attending Prof. Lee Gwang-seop]
‘Text in mid-air?’
Basic personal information and the names of the doctors in charge were floating above the patient's head. When he touched '▼View More' next to the text, the window expanded downward.
[Lexapro 15mg, Ativan 1mg, Trazodone 25mg HS HAM-D scale* 17 points]
‘Good heavens.’
This time, he saw the medications currently being taken and the psychological test scores evaluating the severity of depression.
But it was too early to be surprised.
[Treatment Progress 67/100 Time until discharge: 7 days 2 hours 10 minutes 29 seconds]
‘What is this?’
Treatment progress. It was an item that looked suspicious at a glance. In fact, medications and depression severity are things that can be sufficiently confirmed in medical records.
However, at this point, there was no way to know how much better a patient could get or exactly how much time remained until discharge. He was certain that he hadn't simply pulled up the EMR (Electronic Medical Record) server from the medical records department.
“Doctor, do you happen to know when patient Park Seong-gyu will be discharged?”
As it happened, the patient’s attending doctor, Kim Seok-yong, was at the ward station.
“Well? I don’t know yet. He did say he feels a bit better than before... Is there a patient transferring from another department? Do they need a room?”
Even the attending doctor didn't know the exact discharge schedule. Psychiatric illnesses have significant individual variations. Even if two people are diagnosed with the same depression, one patient might be discharged in a week, while another might stay for over a month.
Predicting an approximate duration of hospitalization is difficult enough; counting down such a schedule by the second is virtually impossible.
“Um, Doctor?”
“Yes, go ahead.”
In the midst of the confusion, the patient he had just seen spoke to Kim Seok-yong.
“I got a call from my son. He said he’s free next week and will come to handle the discharge process. I feel much better, so it should be okay, right?”
“Yes. I’ll discuss it with the professor and let you know. When did your son say he would come?”
“Next Wednesday. He’s coming after work, so he might be a bit late.”
Calculating it, it was almost identical to the time indicated in the ‘Treatment Progress.’
‘Is this really reliable?’
While Sihyeon was wondering, another notification sound rang out.
Ding-dong!
[system: Achievement rewards are being issued.]
[Safe and Sound - The first patient has been safely discharged. Fellow medical staff are relieved. (Normal difficulty, + 200P)]
[Publicity Ambassador - The patient evaluates psychiatric treatment positively. Contributed to reducing prejudice against psychiatry. (Normal difficulty, + 300P)]
[Express Discharge - Shortened the patient's hospitalization period by more than 3 weeks. A high bed turnover rate is good for both the patient and the hospital. (Hard difficulty, + 500P)]
[system: All 3 available achievements have been achieved, and an additional 100% bonus points will be issued. (Hard difficulty, + 1,000P)]
Sihyeon’s eyes widened as he checked the contents.
‘A status window... and rewards?’
The genre of the story in which he was the protagonist was turning into a medical game fantasy.
……
Achievement rewards.
Usually in games, it refers to rewards given when a scenario is cleared by fulfilling specific conditions. Sihyeon had resolved to live like a novel’s protagonist when he returned to his first year, but the sights unfolding before his eyes far exceeded his expectations.
If it were a novel, he had only thought of a regression story where he grew into a genius psychiatrist; this was going way too far.
‘The setting of returning to four years ago is unrealistic enough as it is, so I might as well accept this.’
He decided to simply accept everything. The first time is always the hardest; the second time is easy. He didn't want to repeat the mistake of slamming into the stabilization room door because he couldn't accept the regression.
The same went for the points. He had acquired 2,000P by achieving three achievements, but he didn't yet know how to use them.
‘Well, I’m sure there’ll be a use for them someday.’
At this point, he wouldn't even be surprised if a white-haired hermit suddenly appeared out of nowhere and handed him a secret martial arts manual.
In truth, he quite liked this system called ‘All Charts in the World.’ It seemed like it would be a significant help in treating patients.
‘It’s great because I won’t get patient names and medications mixed up, and it’s great because I don’t have to type while simultaneously conducting an interview.’
It wasn't just convenient; it was practically a cheat code. Specifically, the information regarding ‘Treatment Progress’ and the time remaining until discharge was excellent data for evaluating the current treatment being attempted on a patient.
‘I can see the response to treatment in real-time.’
If the treatment was going well, the progress would rise quickly; if there was a mistake or something overlooked, the hospitalization period would be extended. Normally, it would take weeks to start a new treatment and observe a response, but now he was essentially able to evaluate the treatment response almost in real-time.
‘I want to see the next patient soon.’
His body was itching with the desire to test out his newly acquired ability. It was an emotion he was experiencing for the first time, including his past four years. Just then, the ward door opened and Hwang Jin-ho entered.
“Your patient already got discharged? I’m so jealous....”
Hwang Jin-ho looked at Sihyeon enviously. The way he let out a deep, ground-shaking sigh suggested that things weren't going well with the patient in his charge. As Sihyeon remembered, Hwang Jin-ho’s first patient was a schizophrenic with severe persecutory delusions.
‘He was a patient who refused to eat.’
He was suffering from the delusion that someone might poison him. He was so wary of the people around him that he hadn't eaten anything at all even before being admitted. Even after admission, he was refusing both medication and IV fluids, leaving the path to treatment bleak.
The patient happened to be passing the station toward the bathroom.
[Lee Gong-ho M/29 Attending R1 Hwang Jin-ho / Attending Prof. Jin Cheol-yeong]
The sight of text floating above a patient’s head was still strange.
‘Let’s take a look.’
When he pressed ‘▼View More,’ additional information appeared. He felt he needed to adjust more to the sense of perspective, but he managed to touch it as intended.
[Underlying Diseases: Diabetes (+), Hypertension (+), Hyperlipidemia (+)]
[Risperidone 5mg, Benztropine 1mg, Clonazepam 0.5mg]
[Treatment Progress 13/100]
[Time until discharge: 32 days 23 hours 10 minutes 00 seconds]
‘The hospitalization period is about a month.’
It matched his previous memory. The fact that the ‘Treatment Progress’ had risen to 13 despite almost no therapeutic intervention taking place after admission was because the patient had perceived the ward as a safe place.
In reality, if someone had intended to harm him, something would have happened while he slept. Lee Gong-ho was currently relieved simply to be alive after over a week. However, his anxiety regarding food and medication was still great.
“If only he would at least take his meds... no, at least eat some food, but there’s no way.”
Hwang Jin-ho shook his head.
“What does Professor Jin Cheol-yeong say?”
Sihyeon asked, suddenly curious. If it were that Jin Cheol-yeong, wouldn't he have tried something with the patient using some sort of novel approach?
“He said to wait and see. Asked if he wouldn't just eat when the time comes.”
“Really?”
“But I don't know how long we can wait. I’m worried he’ll get dehydrated at this rate.”
“Dehydration....”
[10:28 AM - Visited bathroom]
[10:28 AM - Visited bathroom]
[12:31 PM - Visited bathroom]
[01:44 PM - Visited bathroom]
Sihyeon was stroking the tip of his chin while examining the patient’s nursing records through the system window.
“It won’t happen for the time being.”
He then answered as if telling him not to worry.
“Huh? Why?”
“His urine output is probably normal. Just looking at how often he goes to the bathroom.”
“He could just be going to wash his face.”
“No. Look over there. Look at what the patient is holding in his hand.”
Hwang Jin-ho’s gaze followed where Sihyeon was pointing.
“Ah! Is he perhaps drinking tap water?” Hwang Jin-ho said, clapping his hands.
“Exactly. It’s a rinsing cup, but there’s no toothbrush.”
“That means...”
“The fact that the patient is refusing medication might not just be because of the medicine itself. Maybe he’s wary of the drinking water provided in the ward.”
“Right. Now that you mention it, he wasn't refusing his meds every single day.”
“You’ve increased the Risperidone to 5mg now, right? And you added Benztropine starting two days ago.”
‘He has the medication schedules of other patients memorized?’
Hwang Jin-ho looked at Sihyeon with a look of surprise.
“But since there are days he spits out the medicine, I don't think it's actually having the effect of 5mg...”
“For starters, it would be better to go with an orally disintegrating tablet.”
An orally disintegrating tablet (ODT). It was a formulation that dissolves immediately upon entering the mouth, allowing it to be taken without water.
“Oh? I thought of that too, but they said production of the ODT was discontinued...”
“There’s still one domestic pharmaceutical company that produces it. Inquire with the pharmacy department.”
“Uh... okay, I’ll do that.”
It was a strategy well worth a try. Though he wondered how Sihyeon, a fellow first-year, knew such specific details.
‘The medicine is one thing, but what about food?’
Hwang Jin-ho still looked at Lee Gong-ho with a worried gaze. After coming out of the bathroom, the patient was sitting at the central table in the ward, watching TV. He saw other patients attempting to strike up a conversation with him.
It was then.
Ding-dong!
[system: Lee Gong-ho's treatment progress is rising!]
[Treatment Progress 13/100 -> 15/100]
‘Just from being spoken to... the treatment progress rose?’
Sihyeon’s eyes widened at the new notification window. And simultaneously, images of the patient before the regression flashed through his mind.
‘The first food the patient ate in the ward was definitely...’
Sihyeon grinned as he looked at the patient.
“Will the delusions improve just by getting the medication right? He’s a patient with diabetes too; I hope he doesn't get hypoglycemia at this rate.”
On the other hand, Hwang Jin-ho still had a worried expression.
“It’s not like there’s no way at all to get him to eat...”
Sihyeon spoke up cautiously while looking at Hwang Jin-ho.
“What? There’s a way? We have to try everything we can for now!” Hwang Jin-ho asked, brightening up.
With his colleague Sihyeon’s patient having improved so quickly and being discharged, he couldn't just let his own first patient starve to death.
“Will you be okay with it? It’s a method that might cost a bit of money.”
“Of course! Is there some new non-reimbursable drug or something?”
Sihyeon shook his head.
“What is it? Tell me. Don't keep it to yourself.”
“When you’re on call, order delivery food to the ward. A very generous amount.”
Huh? Hwang Jin-ho seemed a bit flustered by the unexpected answer.
“I think chicken would be good. Don’t forget the carbonated drinks.”
Sihyeon said with a completely serious expression.