Chapter 26 - What does an intern know?
Yes.
This is the future at the point when Professor Ko has completed the confirmation and is writing the chart.
The professor’s hand was moving the pen, writing out each prescription.
Moreover, it’s not just the scene that’s visible.
The sound of the pen scratching on the paper, the sensation, even—
‘I can feel what the professor is thinking as he writes this prescription.’
A future seen entirely from the professor’s perspective.
Just as I had imagined, I could naturally understand the composition of the prescription.
After a brief blackout, the real reality unfolded before my eyes again.
“…Gasp.”
Overwhelmed by the new experience, I realized I was inadvertently breathing heavily.
‘It’s a good thing no one is around.’
I cleared my throat and took a deep breath.
Just as I thought I was getting used to this strange ability, another anomaly appeared.
Perhaps the bright light I saw earlier… if it indicates a change in the ability.
Could it be that instead of seeing a further future, the scope of what I can observe has expanded?
Not just the patients, but also the professors, in other words, people around me?
‘If that’s the case, the things I can do with this ability have increased enormously.’
Just being able to indirectly experience the knowledge of professors across various departments during my internship would be an immense gain.
Realizing this, an overwhelming sense of exhilaration washed over me.
I took off my glasses and splashed my face with cold water.
It felt like winning the lottery, no, it meant something even greater to me.
Before I knew it, I could hear the sound of my own heartbeat in my ears.
What I need to figure out now is:
‘The activation conditions and applicable targets.’
How the ability is activated and who it can be used on.
Up until now, when I conducted examinations according to the “Four Examinations” (seeing, hearing, asking, and touching), I could see into the future.
This time, even though I didn’t examine the professor, the ability was triggered.
It’s likely that this new ability doesn’t deviate significantly from that rule.
I should be able to see future medical details only for individuals I’ve directly interacted with.
‘Wait, let’s calm down.’
As my thoughts scattered, I suddenly checked the time and snapped back to focus.
‘It’s still working hours. There’s a lot to do, and more importantly, I need to go back to the professor’s office by 4 o’clock.’
I set aside the contemplation and decided to revisit the case of patient Park Young-jin.
A 33-year-old young man. His main complaint is frequent abdominal pain and diarrhea for the past 10 years.
He reports needing to use the bathroom two or three times a day as a baseline, and sometimes up to ten times a day when it’s severe.
“I’ve always had a weak digestive system since I was young. I used to have diarrhea frequently as well.”
He has a slender build, looks physically weak, and has a sensitive demeanor.
He describes himself as a worrywart with a timid personality, who gets anxious over trivial matters.
“I think it’s stress-related. During my student days, my diarrhea worsened during exam periods. Recently, it’s flared up again while I’m preparing for a job change.”
He has visited several hospitals but was told there’s no significant issue with his intestines.
In other words, it’s ‘Irritable Bowel Syndrome’ with recurring diarrhea or constipation without any specific disease.
“I’ve already decided to change companies, but I want to get this fixed as soon as possible before I start the new job.”
It’s understandable how difficult and frustrating it must be for him, considering he even had to be hospitalized.
The goal is to find a suitable treatment within the planned 7-day hospitalization period, if not a complete cure.
This way, even after discharge, he can continue taking appropriate herbal medicine to manage his symptoms.
So, after much consideration, I chose the prescription “Gui Zhi Jia Shao Yao Tang.”
It’s a simple prescription consisting of five ingredients: cinnamon, peony root, ginger, jujube, and licorice.
“In short, it’s a common remedy for diarrhea-type irritable bowel syndrome.”
However, in the vision, the professor added one more ingredient to the prescription.
That ingredient is “Jiao Yi,” which is malt syrup.
Malt syrup is made by fermenting starchy grains like brown rice.
“It’s used to strengthen the spleen and stomach, or to mask the bitterness in pediatric herbal medicine.”
Here’s why I’m puzzled.
When prescribing herbal medicine, you first set the most important treatment goal and select the herbs accordingly.
After that, additional or fewer herbs are added based on the accompanying symptoms reported by the patient.
This process is referred to in technical terms as “adjusting the original prescription,” where “adjusting” means adding or removing ingredients.
The customized prescription born from this process is named something like “Gui Zhi Jia Shao Yao Tang Jia Gan Fang” if it’s based on “Gui Zhi Jia Shao Yao Tang,” but in this case, the prescription name changes entirely.
It becomes “Xiao Feng Zhong Tang.”
A change in the prescription name signifies that the prescription has a distinct character.
And why is this surprising?
“Xiao Feng Zhong Tang is… a prescription used for children.”
It is commonly prescribed for pediatric issues such as poor appetite, frequent abdominal pain and constipation or diarrhea, night terrors (in children aged 0-2), nocturnal enuresis, and general weakness.
It’s renowned as a highly effective remedy in pediatrics due to its versatility for various conditions.
However, Park Young-jin is an adult male.
So, it’s understandable that I would be surprised.
But having just seen the future in a new way…
In short… after ‘possessing’ the professor, I was able to understand the reason.
The parts that the professor emphasized with underlines on the chart I created were:
– Frequent nosebleeds, dry mouth, palpitations, and feeling of heat in the middle of the palms and soles at night.
These symptoms are evidence of severe “Xu Lao” (exhaustion or deficiency), which indicates that the body’s essence and Qi-blood are impaired.
If Xu Lao is severe, even for an adult male, it is appropriate to add “Jiao Yi” (a supplementing ingredient) to provide Xiao Feng Zhong Tang.
The mistake was initially excluding Xiao Feng Zhong Tang due to the belief that it was a remedy only for children.
The key is not age but the extent of physical weakness.
I feel a sense of accomplishment for having acquired this valuable knowledge.
‘…….’
As I gathered the chart to return to the professor, I hesitated for a moment.
There was something on my mind.
‘What was that passing thought the professor had when I possessed him earlier?’
I think it was something about ‘replacing Jiao Yi with something else.’
Because of this, other tasks have piled up, and I’m not in the most relaxed situation.
Actually, since the prescription already listed Jiao Yi, it doesn’t seem like the wrong answer.
“Phew.”
After some thought, I finally sat down in front of the intern training room’s computer.
I know from the start that it’s not a perfect answer, but I can’t just let it slide.
‘Then let’s quickly find the perfect answer.’
With a short sigh, I accessed the hospital’s EMR.
* * *
“Professor, I’m here to get confirmation again.”
Fortunately, I was able to knock on Professor Ko’s door before the clock struck 4.
“…Therefore, since the patient’s condition of deficiency (Xu Lao) appears severe, I will prescribe Xiao Jian Zhong Tang with Jiao Yi added to the Gui Zhi Jia Shao Yao Tang.”
“Why add Jiao Yi?”
“Jiao Yi is a medicinal herb that supports the spleen and stomach, and its main component is maltose. Maltose serves as food for beneficial gut bacteria, which then convert the herbal ingredients into alkaloids, enhancing the therapeutic effect.”
“Hmm.”
The professor’s expression was ambiguous.
It was an answer, but not the right one.
As soon as the professor began to speak, I jumped in.
“Additionally.”
The professor’s eyes widened in surprise.
I could sense an expectation of ‘perhaps.’
“In this patient’s case, I will use brown sugar instead of Jiao Yi.”
“……! Why?”
“Brown sugar is sweet and warm in nature, which is beneficial for diarrhea. In contrast, white sugar can cause abdominal bloating.”
The professor’s face then relaxed into a satisfied smile.
“Hmm, excellent answer.”
I smiled inwardly with satisfaction.
‘The hard work paid off.’
The hospital EMR system has a search function.
By setting the doctor’s name, treatment period, and target disease…
‘I was able to view the charts of patients treated by Professor Ko for diarrhea or irritable bowel syndrome during a specific period.’
So, I extracted a list of patients from nearly the past year and went through each chart one by one.
Fortunately, the tedious manual work didn’t take long.
‘I found it quickly after opening a few charts.’
In the notes on the herbal prescription, there was a memo indicating to substitute brown sugar for Jiao Yi.
Next, finding the reason for substituting with brown sugar was straightforward.
“‘Different words mean different things,’ as the saying goes. This perfectly illustrates the relationship between Gui Zhi Tang, Gui Zhi Jia Shao Yao Tang, and Xiao Jian Zhong Tang.”
Gui Zhi Tang is used in the early stages of a cold for people with weak constitutions.
Adding just 2 grams of ‘Peony’ to each dose can make it Gui Zhi Jia Shao Yao Tang, which relaxes the smooth muscles in the intestines and alleviates pain.
And by adding Jiao Yi to Gui Zhi Jia Shao Yao Tang, it becomes Xiao Jian Zhong Tang, a renowned formula in pediatrics.
“Isn’t it fascinating that changing the dosage slightly or adding just one more ingredient can turn a formula into something completely different? The relationships between these three formulas truly exemplify the essence of traditional Chinese medicine. That’s why studying herbal medicine is so enjoyable.”
Professor Ko, usually as solemn as a heavy boulder, had become excited and began to expound on his theories about traditional Chinese medicine.
I watched him with a sense of wonder.
‘It reminds me of how Dr. Ko was when discussing the Purple Angel…’
There was a palpable enthusiasm in his lively eyes and energetic, fast-paced speech—a characteristic of someone deeply engrossed in something.
It seems that to be a professor, one must genuinely find joy in their studies.
Well, in any case, the confirmation with the primary physician has been successfully completed.
* * *
After various twists and turns, I managed to send the prescription to the hospital’s pharmacy before it closed.
Now, it’s time to explain the future treatment plan to the patient.
I headed to Park Young-jin’s hospital room.
“So… you’re saying that this medicine will not only treat my diarrhea but also address my weakness?”
“That’s right. We will adjust the prescription gradually based on your condition. The goal is to find the optimal formula before you are discharged.”
“Ah, please just make me better. I thought my stomachache was just a normal part of having diarrhea, but that’s not the case, right? I’d like to have normal bowel movements like everyone else.”
The patient, overwhelmed by their frustration, began to lament their situation.
“After having diarrhea several times, I lose so much energy that it affects my daily life. I’m always anxious when I go out because I never know when my stomach will hurt, and at work, I feel self-conscious about constantly going to the bathroom.”
“Don’t worry. Both the professor and I, along with the nursing staff, will do our utmost to take care of you.”
The patient seemed reassured by my confident response and started to chat more lightly.
“I didn’t know there were specialists in traditional medicine. I found out that Professor Ko Yo-han is famous, so I came here. You’re a resident learning under Professor Ko, right?”
“To be precise, I’m not a resident; I’m an intern. It’s true that I’m currently working under Professor Ko’s guidance as the attending physician.”
There was no need to lie, so I corrected the patient’s misunderstanding.
“Ah… an intern?”
The patient’s expression suddenly darkened.