Chapter 11 - Causes of Facial Paralysis
The photo that was attached to the employee ID case of Go Min-hwa earlier.
A face is as small as a child’s with porcelain-like white skin.
Her glossy, long hair was swept behind one ear.
The ‘Mika’ in that photo is right here.
But.
“Why does her face look like that?”
Despite having all the elements of attractiveness, the reason it’s hard to say she’s pretty is….
“Facial paralysis?”
That’s right.
Originally, she would surely be recognized as a beauty by anyone, but currently, her face was severely distorted.
Only the right half, though.
“Next weekend is the Purple Angel concert, and her mouth has suddenly twisted…. Professor, this hospital is the best in our country, right? Is there anything that can be done before the concert? I saw on a drama, “Huh Joon”, that they cured Bell’s palsy in three days.”
The woman with glasses, who appeared to be a manager, was pacing back and forth.
Her bobbed hair is all tangled as if she had been tugging at it, but she doesn’t seem to care at all.
Professor Kim frowned with concern.
“Well, you see… The treatment period for facial paralysis varies greatly depending on the cause. Rapid recovery is typical for what is called ‘Bell’s palsy,’ but our… Miss Mika?”
“It’s Mika, Mi! Ka!”
Mika, who had been holding a compact mirror and anxiously examining her face, snapped back sharply.
“Yes, um, Miss Mika’s facial paralysis is likely caused by a virus. Are you familiar with Ramsay Hunt syndrome? The treatment generally takes about 6 months. Moreover…”
Ramsay Hunt syndrome.
It is a neurological disorder caused by the varicella-zoster virus (VZV).
When children are infected with the VZV virus, they develop chickenpox, and adults develop shingles.
When VZV causes shingles in the facial nerve, it leads to blisters around the ear, ear pain, loss of taste, and acute facial paralysis.
The disease usually occurs in older adults.
In contrast, what people commonly think of as facial paralysis is idiopathic facial paralysis, also known as Bell’s palsy.
“Idiopathic” means simply “unknown cause.”
It occurs when facial paralysis happens without a specific cause, not due to a virus or a stroke.
It often manifests after a period of fatigue, high stress, or exposure to cold wind.
The condition is more common in relatively younger individuals.
“Yes… I’ve heard that the condition can leave residual effects, so the face might not fully return to its original state.”
“This is so frustrating; why did she have to get such a terrible disease!”
The manager let out a deep sigh as if the ground had collapsed beneath her.
At those words, Mika threw the compact mirror she was holding onto the bed in frustration.
“Well, once a virus infects you, it can remain dormant and symptoms might appear again when your immune system is weakened.”
The professor’s explanation provided no comfort to Mika.
Mika had started to thrash around on the bed.
“Ahhh! I had this when I was a trainee and it was such a nightmare!”
“Mika! You shouldn’t use such language in front of the professor! I’m sorry; she lacks social experience…”
When Mika cursed, her manager hurriedly bowed and apologized.
“Wahhh! My beautiful face! What am I going to do!”
Ignoring everyone, Mika began to cry loudly.
…Wow, this is overwhelming.
The resident, Choi Jin-seong, who had been with the professor for three years, and I were all at a loss for words.
Soon, the professor gathered himself and addressed the situation.
“Well, we’ll need to start treatment to see how it goes, but a full recovery by next weekend will be difficult.”
“Professor, then what about wearing a mask and performing on stage? Would that be okay?”
“Well, to that extent? Of course, resting is best.”
“This situation is quite complicated… We can’t cancel the concert now. The higher-ups in the company said if necessary, we should at least wear masks…”
“Ugh, everyone’s coming to see my face. If I wear a mask, they’ll be thrilled, won’t they?”
Mika, who had stopped crying and was now sniffing, interrupted.
Her confidence in her face is astounding… It’s almost remarkable at this point.
“However, it is indeed a crucial factor. If Mika performs with her face covered, we’ll need to make an announcement beforehand.”
The manager awkwardly agreed with Mika’s comment.
Mika sneered at the word “announcement.”
“Then the fans will definitely go crazy.”
“Yeah, there will probably be a ticket refund uproar. The best scenario would be to recover before then… We have photoshoots and other schedules lined up afterward, and you can’t do a photoshoot wearing a mask. I’m not sure how to handle this…”
The manager muttered, looking pale and dazed.
After leaving the patient room and waiting for the elevator, the professor and Choi Jin-Seong were chatting.
“Tsk, tsk, it’s unfortunate, but what can we do about Ramsay Hunt syndrome? Choi, what does the neurology department say?”
“They share our opinion. They’ve detected VZV in the patient’s tears. The neurology department has prescribed steroids and antiviral medications.”
“Alright, let’s start treatment right away. Acupuncture should be done twice a day—I’ll handle it during the morning rounds, and you’ll take care of it in the afternoon.”
“Yes, Professor.”
When the elevator arrived on the 5th floor and the professor disappeared down the hall, Choi Jin-seong gave me instructions.
“Prepare the initial chart for the inpatient. Within 30 minutes.”
Gone was the earlier look of concern, and Choi Jin-seong now seemed quite excited.
“Wow, Mika is making headlines with her hospitalization. I’ll need to get an autograph later.”
Regardless of what Choi Jin-seong was saying, I was deep in my own thoughts.
‘I should test my hypothesis this time.’
I gathered the paper chart and pen and went back up to the 12th floor.
The manager was busy on the phone in front of the patient’s room door.
Inside the room, Mika was still glumly staring at her face in the compact mirror.
I started by checking the basic information on the chart.
“Name: Mun Deok-soon, Age: 23. Is that correct?”
“Oh, that name… Just call me Mika, Mika! And don’t mention my age. It makes me feel worse because I think I’m getting old.”
To my eyes, she still looked quite young, but she seemed horrified by the mention of her age.
“You’ve had Ramsay Hunt syndrome before, right?”
“Yes, I was a trainee back then, and maybe it was because I was stressed about not making the debut group.”
It’s really odd seeing her with a crooked mouth.
As I was filling out the chart, Mika suddenly asked,
“Wait, don’t you know me?”
“……?”
“Everyone who sees me asks for autographs, and photos, and can’t calm down. Why are you so calm?”
“I actually found out about it today. The… Purple? Angel.”
When I awkwardly mentioned the team name, Mika scoffed.
“Ha, stop joking. Did you come from North Korea? No, even North Korea would know me, right?”
“Patient.”
I stopped writing and looked directly at Mika.
“I need to complete this chart within 30 minutes. Please cooperate.”
“Ha, haha! You’re really funny!”
Mika burst into a bewildered laugh, but I ignored it and continued with the examination… I mean, the patient interview.
‘Hmm, this is a bit ambiguous.’
She said that since last night, her face had felt stiff and that it had worsened into facial paralysis by this morning.
The symptoms she is currently complaining about are ear pain and paralysis of the right side of her face.
I asked repeatedly.
“So, your hearing and taste are okay? No tinnitus, and no blisters around your ear?”
“Yes, that’s right.”
The diagnostic criteria for Ramsay Hunt syndrome include ear pain, facial paralysis, and blisters on the external ear or ear canal.
Mika does not have any blisters among these.
There’s no accompanying loss of hearing, taste, or tinnitus, which are commonly associated with Ramsay Hunt syndrome.
However, these symptoms can sometimes develop later.
“So, in reality, distinguishing between Ramsay Hunt syndrome and Bell’s palsy is tricky.”
If there’s no sign of improvement within 3 weeks, it’s likely Ramsay Hunt syndrome; if the condition recovers within 2 to 3 weeks, it’s likely Bell’s palsy.
In other words, the treatment will reveal what it is.
The reason the professors diagnosed Ramsay Hunt syndrome is probably because:
“It’s a disease she had before, so there’s a high possibility of recurrence, and most importantly, the virus was detected in the patient’s tears.”
They’re likely eager to have a clear diagnosis, even if it means looking into the future.
The future.
“Well, let’s start.”
I deliberately left out the pulse check while preparing the initial chart.
“I’ll check your pulse.”
My heart started pounding wildly.
Would it work this time?
The moment my fingers touched Mika’s wrist.
‘…It worked!’
The long-awaited sensation pierced through my brain.
Various scenes flashed quickly through my mind like a panorama.
I had to bite my lips tightly to hide my joy.
My hypothesis was ‘ask and see’.
In traditional Oriental medicine, there are four methods a doctor uses to diagnose a patient:
1. Observation (Mangjin) — examining with the eyes,
2. Listening (Munjin) — hearing with the ears,
3. Inquiry (Munjin) — asking about symptoms and conditions,
4. Palpation (Jeoljin) — taking the pulse or touching the body.
Looking back at the times I saw future visions,
I observed the patient’s appearance with my eyes,
Heard their voice or breath directly,
Asked about symptoms or the onset of the condition,
And touched the patient’s body.
In each of these situations, the four conditions were met, and visions of the future appeared.
The reason I could read the future only from my assigned patient’s chart can be explained by the same reason.
Anyway, from the vision I just saw, Mika showed improvement.
Her eyes were closing more naturally, and her crooked mouth was starting to return to its original position.
‘In that case, it’s likely Bell’s palsy.’
At that moment, the manager who had finished the call entered the patient’s room.
“Oh, intern, you arrived just in time. I just spoke with the company. Since the condition takes six months anyway, they’re questioning the point of staying in the hospital briefly… They’ve decided she’ll be discharged tomorrow, and she’ll receive treatment near the company instead.”
I realized my mistake. I couldn’t let her be discharged like this.
“But the concert is next weekend, right? Wouldn’t it be better to focus on treatment at the hospital until then?”
However, the manager’s response was indifferent.
“Doesn’t Ramses II syndrome or whatever take a month to show treatment effects? We plan to perform with a mask and will be posting an announcement soon.”
‘Oh… my words won’t convince them.’
To persuade them about treatment, it would be better if Professor Kim spoke directly rather than me.
The future I saw was only a week away this time.
And the concert date was less than two weeks away.
Even if there is improvement within a week, whether she will be fully cured by the concert will depend on receiving intensive treatment.
‘If she is discharged tomorrow as planned, her improvement will likely slow down.’
As the 30 minutes given to me were almost up,
Choi Jin-seong would soon call me for the briefing.
To change the professor’s mind,
‘I need to persuade Choi Jin-seong first during the briefing…!’