Chapter 95 - I'm not hungry
Inside a dimly lit PC café.
Numerous people wear headsets, each focused on their monitors.
A group of middle school boys occupies one corner of the PC café.
“Hey! Kill him, kill him!”
The boys are laughing and fully engrossed in their game.
“Ah, I lost.”
“This guy plays so dirty.”
“Thanks for the compliment.”
When the game ended, they each made a remark as they took off their headsets.
“But why did Myung Gyu-Beom actually come here today?”
“Yeah, you always say you can’t come because you have to go to cram school.”
One boy spoke up, and another chimed in.
Gyu-Beom responded, slightly annoyed.
“I like games too.”
“Whoa~ I thought you were just a bookworm who only studied.”
“Turns out, you’re pretty good at games?”
Listening to his friends, Gyu-Beom felt an unexpected sense of pride.
At that moment, the boy sitting next to Gyu-Beom nudged his arm.
“Hey, isn’t that your dad?”
A stern-looking man had entered the PC café and was glancing around.
Seeing the man, Gyu-Beom’s heart started pounding like a drum.
The man spotted Gyu-Beom, furrowed his brow, and began walking toward him with deliberate steps.
“Myung Gyu-Beom. Stand up.”
Hearing the whispers of his friends around him, Gyu-Beom slowly rose to his feet.
Time felt unbearably slow, as if each second stretched into minutes.
His father’s piercing glare felt so intense that Gyu-Beom instinctively lowered his head.
“Skipping your cram class to come to a place like this? Acting so irresponsibly.”
With tiger-like eyes, his father’s cold words cut through the air.
Then his father’s hand shot up toward the ceiling.
Without thinking, Gyu-Beom tightly shut his eyes and shrank back.
Slap!
The sharp sound reverberated through the room, followed by the gasps of his friends.
* * *
“Ahh!”
Myung Gyu-Beom woke up in his room, gasping for breath.
It was that dream again. He absentmindedly touched his cheek.
Even though it was something from long ago, his cheek still felt like it stung.
“Sorry, but your dad was terrifying. What if he scolded us too?”
After that incident, his friends stopped inviting him to play games with them.
Because of that, he had no choice but to go back and forth between school and cram school.
His father, on the other hand, was pleased with the change.
“To be fair, my grades did improve after that.”
He had even managed to gain admission to a prestigious high school as the top student.
That’s how he ended up being assigned to deliver the freshman address at the entrance ceremony.
…Of course, his life had fallen apart after that day.
“Damn it.”
As the nightmare of the freshman address came to mind, he unconsciously cursed.
At times like this, he needed an escape.
Out of habit, Gyu-Beom picked up his phone and accessed a web novel site.
“Huh?”
He noticed there were new comments on his story from the night before.
It seemed someone had been binge-reading his work and leaving comments.
The username was ‘Seon1226.’
– I enjoyed reading this.
The comments were rather dry and straightforward.
Still, it felt nice that someone had read his work.
The dirty feeling left by last night’s nightmare eased a little.
“Let’s write something.”
Muttering to himself, Gyu-Beom sat down in front of his computer.
* * *
“Teacher Seon-Joon? Professor So Cheong-Yeon is asking for you to come down to our department clinic now.”
A few days later, Seon-Joon received this message from Heo Son-Hwi over the phone.
Judging by the lack of his usual strange speech habits, it seemed he was currently with the professor.
When Joon arrived at the clinic, he found Heo Son-Hwi assisting the professor as expected.
‘It looks more like a playroom than a clinic.’
The pale green wallpaper and numerous animal illustrations adorning the walls were exactly what one would expect from a pediatric department.
In the corner, there was a crib for babies and a box filled with various toys.
“Ah, come in, take a seat.”
I flinched for a moment when I noticed the professor wearing rabbit-ear headbands.
I sat down on the chair she gestured toward.
Thankfully, he didn’t offer me a headband as well and quickly explained why he had called me.
“The reason I called you, Dr. Seon, is because of a patient who’s scheduled to come in soon. He’s a five-year-old boy with severe loss of appetite. Since you’ll also be his primary physician in our department, I thought you should observe the consultation and learn from it.”
Shortly after, a boy entered the consultation room, holding the hand of his elegantly dressed mother.
I immediately recognized them, and it seemed the mother recognized me as well.
“Oh my, it’s that big brother from before. Morgan, you should say hello to him.”
She shook the boy’s hand as if to encourage him to greet me.
It was the same boy I had seen back in August during the ‘Sambok-cheop’ session.
‘Even now, he looks way too thin.’
He was small and frail, appearing younger than his age.
Although his clothing was clearly expensive, his pale and gaunt face made the outfit seem awkward, almost like it didn’t belong to him.
“Oh? Dr. Seon-Joon, you know each other?”
“He’s the doctor who administered the ‘Sambok-cheop’. Honestly, it’s because of his recommendation that we came here, Professor.”
“Ah, I see. And what’s our little friend’s name?”
“…It’s Ahn Morgan.”
“Wow~ That’s such a cool name. Morgan, do you like the ‘Banana Choo Choo’ song?”
The professor waved a teddy bear and spoke in a high-pitched, playful voice.
The boy shyly nodded his head.
“Shall we sing it together then? Banana Choo Choo~ Banana Choo Choo~.”
I was inwardly horrified, while Heo Son-Hwi, seemingly used to it, hummed along and mimicked the gestures.
At first, the boy looked around awkwardly, but soon he started smiling and joined in the singing and dancing.
Thanks to the lighter atmosphere, the consultation began more comfortably.
“Morgan, do you not like eating?”
“I’m not hungry.”
“The child has a very small appetite,” the mother interjected, adding further explanation. “He takes a few bites, says he’s full, and refuses to eat more. He’s always been like that, but it’s gotten worse over the past few months. He also complains about stomach aches quite often.”
The professor showed interest in the mother’s comments and asked follow-up questions.
“How often does he complain about stomach pain?”
“Well… about once or twice a week, I’d say.”
“Has he been saying this for a long time?”
“Yes, for quite a few months now. It’s hard to pinpoint exactly how long, but it’s been a while.”
“If abdominal pain occurs at least once a week for over two months, it can be diagnosed as chronic functional abdominal pain. It’s something we’ll need to address together.”
Nodding, the professor moved on to another question.
“Does he eat on his own?”
“If I spoon-feed him, he’ll eat, but he’s not very proactive. He doesn’t swallow his food and keeps it in his mouth for ages. Every meal feels like a battle—a real war. It takes one or two hours just to feed him.”
“What about his bowel movements?”
“Probably because he doesn’t eat much, he’s always constipated. He has hard stools every two to three days.”
“Any other conditions, like rhinitis, pneumonia, or atopic dermatitis?”
“Not really. He had a general check-up at a pediatric clinic recently, and they said there’s nothing major wrong with him. They advised improving his eating and daily habits, but we’ve already tried everything. Using an appetite stimulant or other medications feels too uncomfortable.”
The professor nodded empathetically at the mother’s lament, showing understanding.
“You must be very worried. Are you the primary caregiver?”
“Yes, I am. His father is always busy with work, so I’m the one taking care of him most of the time. I’m concerned that since his weight isn’t increasing, his height might be stunted later. I also worry he might be bullied by his peers or that his physical strength could deteriorate.”
“What methods have you tried to encourage him to eat so far?”
“I’ve tried coaxing him, scolding him, even nagging. I’ve also given him nutritional supplements.”
The mother shook her head wearily, looking visibly exhausted.
“Professor, do many children like mine come here?”
“Absolutely. This is one of the top three reasons parents bring their children to a pediatric Oriental medicine clinic.”
“What kind of treatments do you provide?”
“We primarily use herbal medicine. We also incorporate acupuncture and moxibustion therapy.”
“Please do everything you can. My husband said the cost doesn’t matter.”
I glanced at the young mother’s appearance.
Her handbag, necklace, and rings—all were luxury items.
Like her son, her attire exuded an air of sophistication and wealth.
“What could possibly be lacking for him to be like this?”
The mother sighed deeply as she looked at her son.
The boy sat quietly, but his gaze lacked the lively curiosity typical of children his age.
“Let’s proceed with an Oriental medicine assessment. Afterward, we’ll review the results and wrap up our consultation.”
“An Oriental medicine assessment?”
“It’s called the ‘Suyangmyeong Meridian Function Test’, which measures the balance of the autonomic nervous system. Simply put, it’s a stress test. Don’t worry, it doesn’t involve drawing blood or anything painful.”
After the mother and son headed to the examination room, Professor So turned to face me and Heo Son-Hwi.
His demeanor shifted completely from the gentle, nurturing one he showed Morgan.
…The combination of his rabbit ears and his commanding presence almost made him look like a theatrical villain.
“What’s the treatment plan you’ll suggest for this patient? Heo, you first.”
“I’ll prescribe herbal medicine in 10- or 15-day cycles and recommend one or two acupuncture sessions per week. The treatment period would be approximately one to three months.”
“Hmm, that’s pretty standard. And you, Dr. Seon?”
Professor So added, as though something had just occurred to him.
“I’ve heard you’re exceptional, but since you’re still an intern, I’ll keep that in mind and listen without pressure. Speak freely.”
“I would recommend hospitalization.”
I had already been contemplating the treatment approach as I observed the consultation.
At my confident response, Heo Son-Hwi looked startled and visibly displeased.
“What? Hospitalization is usually reserved for cases of severe abdominal pain, vomiting, or malnutrition. This patient isn’t at that level. Doctor, no matter how much you want to take charge of a case, suggesting hospitalization without justification isn’t right.”
“There is justification.”
When I calmly responded, the professor raised his hand to silence Heo Son-Hwi.
“Dr. Seon, go on.”
“First of all, An Morgan falls under the category of pediatric anorexia. He exhibits prolonged loss of appetite, reduced food intake, and food refusal.”
“What’s the criterion for anorexia?”
“There isn’t a definitive diagnostic standard yet, but it’s generally diagnosed in children aged 2–6 who refuse food for more than a month without any organic cause. It’s a common issue, affecting up to 45% of children in that age group. However, if left unaddressed, it can lead to malnutrition, impaired growth, cognitive issues, and reduced immunity.”
“Wow, as expected, you’re impressive. It’s like you swallowed the textbook whole. What’s next?”
Encouraged by the professor’s admiration, I continued.
“In Western medicine, the causes are often attributed to the child’s diet or lifestyle habits—things like an inappropriate weaning period, unbalanced meals, or sleep disturbances impacting their eating habits. But since these methods have already been tried, let’s examine this from an Oriental medicine perspective.”
“Alright. What are the diagnostic patterns for anorexia in Oriental medicine?”
“They’re primarily categorized as ‘Spleen and Stomach Qi Deficiency’, ‘Liver Qi Stagnation Invading the Stomach’, ‘Stomach Yin Deficiency’, and ‘Food Stagnation’. I’ll exclude ‘Food Stagnation’ for now, as it’s usually due to overeating.”
By now, even Heo Son-Hwi was paying close attention to what I was saying.
“Generally, ‘Spleen and Stomach Qi Deficiency’ is the most significant pattern for anorexia. However, we cannot rule out ‘Liver Qi Stagnation Invading the Stomach’, caused by stress, or ‘Stomach Yin Deficiency’, which includes conditions such as gastric mucosal damage, chronic inflammation, or poor digestive secretions.”
“And then?”
“Today’s consultation alone isn’t enough to make a definitive diagnosis. The child’s thin frame and sallow complexion suggest ‘Spleen and Stomach Qi Deficiency’. However, the dry skin, lack of appetite, and hard, compact stools align with ‘Stomach Yin Deficiency’. If the autonomic nervous system test shows high stress levels, ‘Liver Qi Stagnation Invading the Stomach’ could also apply.”
“So, what’s your plan?”
“In cases like this, I believe in a ‘diagnostic treatment’ approach. By treating based on the most probable pattern and observing the response, we can adjust the treatment direction accordingly. For this, hospitalization is more efficient than outpatient treatment, as it allows for daily adjustments to the herbal prescriptions instead of the typical 10- or 15-day cycles.”
After a long exchange, we finally reached a conclusion.
Professor So Cheong-yeon remained silent for a moment before speaking.
“Honestly, I’m impressed. Your thoughts align exactly with mine. While most cases of pediatric anorexia are managed through outpatient care, I also felt that short-term hospitalization would be better for this patient.”
He then nodded at me with satisfaction.
“Even though I’ve heard you’re a brilliant intern, I didn’t expect this level of insight. It’s almost like you’re reading my mind. Dr. Seon, you’ll take charge as the primary physician.”
Although I knew the “reading my mind” comment was just a figure of speech, it still startled me for a moment.
After all, during my time in this department, I had been diligently studying Professor So’s methods over the past few days. By analyzing his approach, I was able to deduce what he might have done in this situation.
“But you do realize that hospitalization is just the beginning, right? Will you be able to uncover the real cause?”
“I’ll do my best.”
“Good. First, try to bond with the child. I’m a little concerned about whether you’ll manage to do that. If all else fails, I’ll lend you my secret weapon.”
The professor pointed to the rabbit ears he was wearing.
“…Understood.”
Suddenly, I felt a surge of determination to care for Morgan.
Still, I resolved to do everything in my power to avoid ending up in the ward wearing rabbit ears and doing choreography.