Chapter 73 – Wealthy Coal Mine Town, Moeundong Village (3)

‘Huh? No sweat is flowing? In that case, anhidrosis??’

After checking the pupillary reflex, Kim Ji-hyuk examined both hands of the old woman.

‘Red spots are spread across her palms… Even in this situation, no sweat is flowing at all? Furthermore, even corneal opacity?’

“Guardian! By any chance, does the patient have poor eyesight?”

“No! My mother had extremely good eyesight when it came to her eyes! Usually, when people reach that age, their vision drops and they have to use reading glasses, but my mother could easily do things like sewing even without glasses.”

The man shook his head firmly.

“What about this? What happened here?”

At that, Kim Ji-hyuk showed the man both palms of the old woman.

“Sigh, that… Since a few days ago, she said her palms and soles felt hot as if they were burned by fire, so she has been soaking her hands and feet in cold water every day! What is going to happen to my mother?”

‘Her vision is good, but there is corneal opacity, anhidrosis, and her limbs feel hot as if burned by fire? The red spots on her palms must be angiokeratoma, and if so?’

“Guardian, has the patient complained of diarrhea and abdominal pain recently?”

“Yes, yes! Since last week, she has been going to the outhouse as if it were the main bedroom! She had diarrhea every single time she ate and did not eat much, but she said her stomach hurt tremendously.”

‘Dark red spots, which means angiokeratoma, and anhidrosis, plus corneal opacity! Frequent diarrhea and abdominal pain! If so, this patient has Fabry disease, meaning Fabry disease!?’

The disease of the old woman diagnosed by Kim Ji-hyuk was Fabry disease.

Fabry disease was first discovered in 1898 by German doctor Johannes Fabry and English doctor William Anderson, and was a disease also called Anderson-Fabry disease. It was known to occur in about 1 in 120,000 people.

It was a kind of genetic disease caused by a mutation in a specific gene, a rare disease where the enzyme alpha-galactosidase A fails to perform its role, causing a specific fatty substance to accumulate in the body, which leads to various symptoms such as angiokeratoma, anhidrosis, abdominal pain, and diarrhea.

‘It must be Fabry disease! But as far as I know, the time when Fabry disease became known in Korea was 1989! I know that about two hundred patients have been reported since then. If so, as of 1954, there will be no treatment for Fabry disease… But even so, I cannot just leave the patient alone, can I?’

“Guardian, let’s take your mother and go to the clinic together!”

“Yes, Doctor!”

In that way, Kim Ji-hyuk ran toward the clinic along with the old woman.

A moment later.

Scuffling, bang!

“Is anyone here?”

Kim Ji-hyuk, the old woman, and her son opened the door of the clinic and went inside.

“Who is it?”

Then, a woman rushed out. It seemed to be the nurse Park In-seon whom Professor Jeong Gi-ryeo had mentioned.

Thud!

Tripping over the threshold as she rushed out, she fell.

“Ah!”

“Are you alright?”

Kim Ji-hyuk asked, dumbfounded.

“I am fine! By the way, who are… Grandmother Munsandaek! What is wrong with you, Grandmother?”

Rising from her spot at the speed of light, she looked at the grandmother and was at a loss for what to do.

Looking at her appearance, it seemed she was already acquainted with the grandmother.

“There is no time to explain now. A bed! Please guide me to where there is a bed.”

“Are you a doctor?”

“Yes! I am indeed a doctor! So do not worry and please guide me to a place to lay the grandmother down.”

“Yes, yes. Come this way! Grandmother Munsandaek, it is alright! You will be alright!”

The woman, with tear-rimmed eyes, guided Kim Ji-hyuk to the examination room.

And immediately, Kim Ji-hyuk laid the patient down on the bed.

‘The patient has Fabry… No, not only is there no time to explain that now, but they probably would not even know of the existence of Fabry disease. I must perform first aid first!’

“You are Nurse Park In-seon, right?”

“Yes. I am indeed Park In-seon! How do you know my name?”

Park In-seon asked in surprise.

“I will explain that to you later… By any chance, do you have anticonvulsants?”

Kim Ji-hyuk thought that although a fundamental cure was impossible, symptomatic treatment would be viable.

“If it is anticonvulsants…”

“Phenytoin, valproic acid, carbamazepine, clonazepam, and so on—if you have any of them, please bring them. Quickly!”

“Ah, okay. We should have phenytoin!”

In that way, Nurse Park In-seon rummaged through the cabinet and brought the anticonvulsant.

“You can perform a subcutaneous injection, right?”

Kim Ji-hyuk instructed Park In-seon to administer the injection.

“Of course! I can do it.”

“Then please inject it for now!”

“Yes.”

Now, when neither the latest treatment, ERT (enzyme replacement therapy), nor gene therapy could even be imagined. For now, recovering consciousness and then alleviating the symptoms was the best course of action.

“Guardian, please close all the windows, and since we must maintain the patient’s body temperature, find some blankets or whatever to cover her and bring them!”

“Uncle Man-seok! If you go up to the quarters upstairs, there should be something to cover her with.”

“Yes, yes. I got it.”

In that way, the guardian hurried toward the quarters.

“What about an Ambu bag? By any chance, do you have an Ambu bag?”

He asked Park In-seon, who had administered the subcutaneous injection.

“We have one.”

A moment later, Park In-seon brought the Ambu bag and connected the tube with clean, efficient movements.

“Do you know how to squeeze the Ambu bag?”

“Yes. Tolerably. I just need to do it slowly matching the breathing cycle, right?”

Without even needing a separate explanation, Park In-seon followed the standard manual exactly. Just as Professor Jeong Gi-ryeo said about her roaming battlefields, she was certainly swift and precise.

“Ah, yes. You can do it that way. I will check if the grandmother has any other discomfort. By any chance, are there analgesics and antiemetics?”

“If you open Cabinet 1, I have organized the medicines!”

Park In-seon said while diligently squeezing the Ambu bag.

‘What? It is organized neatly and clearly?’

Opening the cabinet, various medicines were arranged in an orderly fashion.

Kim Ji-hyuk immediately brought the analgesic and antiemetic and injected them into the patient.

In that way, as Park In-seon skillfully squeezed the Ambu bag to supply oxygen, and pumped it a few more times.

“Haah, haah. Man-seok…”

Finally, the old woman’s breath broke through.

“Grandmother Munsandaek! Are you alright?”

Park In-seon asked, wiping the sweat trickling down her forehead.

“Is, is that you, In-seon?”

“Yes. I am In-seon from the clinic! Are you coming to your senses a bit?”

“……….”

The old woman nodded her head weakly. It was the moment her breathing finally returned.

“Phew, the dangerous crisis has passed. For today, it seems we must stay here and watch the progress!”

“Yes. That would be good. We should move her to a big hospital tomorrow, right?”

‘No. Fabry disease is an illness that cannot be cured even if she goes to America!’

“No. After watching the progress for a few days, I think we should go up to Seoul and start with kidney and heart examinations. Since the medicine is quite well stocked here, let us treat her here for a few days.”

“Yes. I understand.”

“Guardian! Your mother has passed the dangerous crisis for now.”

“Thank you! Thank you so much, Doctor!”

“Yes. Since the patient needs to stay here today, you may head back for now.”

“Still…”

At Ji-hyuk’s words to return, Man-seok examined Park In-seon’s reaction.

“I will be with the grandmother all day today, so please go back, Uncle. You are busy with coal mining work too, aren’t you?”

“Th-then… I will do so. Doctor! Nurse! Thank you, truly! I will never forget this favor in my lifetime.”

Man-seok bowed his head and greeted repeatedly, then went out of the clinic.

“Nurse, I will stay here, so if you have any urgent matters, please attend to them.”

Once the patient’s condition had improved to some extent, Kim Ji-hyuk said, catching his breath.

“No, no. There is no need for that. I can just stay here. And the clinic director is coming tomorrow.”

“Pardon?”

“I said the clinic director is coming. So you may head back, Doctor. Phew. Heaven really helped us. Meeting a doctor in this neighborhood is like catching stars in the sky, how could we meet a doctor at this exact critical moment!”

Park In-seon, sighing in relief while brushing her chest. Once again, her previous calm appearance vanished, and she returned to being a chatterbox.

Kim Ji-hyuk looked at such a nurse in bewilderment.

“The new clinic director who is coming, is his name by any chance Kim Ji-hyuk?”

“Oh my? How do you know that?”

Park In-seon was startled.

“Because I am Kim Ji-hyuk.”

“Pardon? You have the exact same name as our clinic director. How could there be such a connection… Huh?? Wait. You are Dr. Kim Ji-hyuk?”

Park In-seon gasped in surprise.

“Yes, I am Kim Ji-hyuk. And I met that patient on my way into the clinic.”

Kim Ji-hyuk had a face that turned rapidly fatigued, as if he had spent all his energy.

“Oh my! Wasn’t it tomorrow?”

Startled once more, she examined the calendar. A circle was drawn around the 18th.

And then.

“Oh dear! Then what is this circle? A circle is clearly drawn on the 18th?? What is this?”

She pointed to the calendar with her fingertip.

“How would I know that?”

Kim Ji-hyuk, with a troubled expression, shrugged his shoulders.

“What is it? What is it?”

She tilted her head.

“Sigh, it must be someone’s birthday.”

Kim Ji-hyuk snapped bluntly.

“That is right, that is right! Look at my mind! It is my Min-cheol’s birthday!”

As if she just remembered now, she hopped up and down in joy.

“I guess it is your son’s birthday?”

Kim Ji-hyuk stared blankly at that sight, feeling hollow.

“Son? Well, he is indeed my son! Anyway, so it was my Min-cheol’s birthday? Oh dear, look at my mind. I forgot it entirely, didn’t I?”

His mind was dazed due to the incidents bursting one after another from the very first day of his dispatch.

He had an intuitive feeling that his dispatch life in the future would not be smooth sailing.

“By the way, Doctor, what about dinner? You must be very hungry, would you like to go to your quarters for a moment?”

Once the situation was settled to some extent, Park In-seon offered a meal to Kim Ji-hyuk.

“No. Today was so eventful that I do not even have an appetite.”

Phew, Kim Ji-hyuk let out a sigh.

“Hohoho, indeed! It will be a memorable day.”

“Sigh, I do not care much for this kind of memory.”

“Yes. Then please rest. The quarters are prepared on the second floor. If you need anything, please let me know right away.”

“Yes.”

It was hard to believe it was only the first day of his visit to the village.

Kim Ji-hyuk had a haggard appearance with dark circles hanging down to his chin.

“Yes. Then please rest well.”

“Ah, you need to administer the anticonvulsant to the patient on time, and for today, she must fast. In case she vomits…”

“Hehehe. Yes, yes. I got it. Even though I am a coal mining village nurse, I know at least that much. So please go in and rest quickly, Doctor!”

Nurse Park In-seon pushed the back of Kim Ji-hyuk, who was worrying about the patient until the very end.

* * *

‘Phew, it is at the level of a general hospital emergency room. No. It is probably just for today.’

Plodding, dragging his exhausted body, Kim Ji-hyuk went up to his quarters.

Click. The moment he opened the front door.

Seeing the sight unfolding on the second floor, Kim Ji-hyuk rubbed his eyes.

The reality of the quarters, which he thought would be at the level of a military barrack or, if they were generous, a boarding house near school, was beyond imagination.

A neatly arranged cozy bedroom and a small wooden floor where the red sunset filtered beautifully through the modern living room curtains.

It was a clean and neat quarters.

‘Wow, normally quarters are not to this extent, are they? Moreover, it is the 1950s now… Is it because they mine black gold, as the Professor said? They said even the dogs carry paper bills in their mouths!’

Seeing the clean and neat quarters, he felt like the stress accumulated today was blown away at once.

Before he knew it, the dark night arrived, and as soon as he laid his body on the bed, he fell into a deep sleep.