The Crown Prince That Sells Medicine - Chapter 172
The Crown Prince That Sells Medicine Chapter 172
Episode 172 Patients and medical personnel (1)
Wilson’s disease.
E83.0 in the International Classification of Diseases (ICD-10).
Korea’s special calculation code V119.
This is a genetic disease that causes abnormal copper metabolism in the body, also called hepatolenticular degeneration. To be more precise, it is a disease in which the body is unable to excrete copper due to a mutation in the gene.
‘Originally, copper is as essential to the human body as vitamins. However, as is the case with the human body, when copper is consumed excessively, the body naturally excretes copper.’
Normally, copper is lost through bile produced by the liver. But what about Wilson’s disease patients? Ceruloplasmin, which is responsible for transporting copper in the body, is lacking or almost absent. Therefore, copper cannot be moved and cannot be discharged.
In other words, the courier company in charge of copper has declared an indefinite strike.
‘If copper accumulates in the body like that, many problems arise.’
Liver disease mainly occurs.
Copper that cannot escape into bile accumulates in liver cells. It causes continuous cell damage and eventually leads to chronic hepatitis and tubular dysfunction accompanied by cirrhosis.
That’s not all.
‘Nervous symptoms may occur. The basal ganglia are mainly affected, which can lead to dysarthria, dysphagia, abnormal eye movements, and fine motor disorders. If it gets worse, it can lead to muscle dystonia, chorea, emotional anxiety, manic depression, and schizophrenia.’
What if symptoms appear like that and no treatment is given? It gets dangerous quickly. When fulminant liver failure occurs, the fatality rate can soar to 70%.
Rachiel’s gaze turned to Mr. Fabio. A golden ring made around Mr. Fabio’s blue eyes. That was the strongest evidence of Wilson’s disease.
“This is a classic symptom of Wilson’s disease called the Kaiser-Fleischer ring.”
Fabio flinched at Rachiel’s words.
Prospective doctor Valentino was also shocked.
‘Wilson’s disease? ‘Kaiser-Fleischer ring?’
It was my first time hearing it. It was also a symptom I had never learned about in medical school.
“Is there… such a thing?”
“Hmm. You might not believe it, though. Mr. Fabio?”
“…Meet His Royal Highness Crown Prince Hua!”
Fabio showed courtesy with a hasty and awkward movement. Rachiel smiled faintly and helped him stand up.
“There is no need to show respect. “Now, the relationship is not between the crown prince and the people, but between a medical professional and a patient.”
“Ha, but…”
“If you’re just being polite and doing things for no reason, when will you get treatment? “I hate that kind of thing.”
It was an honest feeling.
The search for formality and etiquette actually interfered too much with the treatment. I don’t know if I’m treating one or two patients, but since I deal with dozens of patients a day, the time it takes to be polite is quite a bit.
‘You people just have to be polite to yourself, but I have to accept that dozens of times every day, you people.’
So it was.
When treating patients, be thorough as a medical professional. It was convenient to throw the crown prince’s identity beyond the universe. The efficiency of medical treatment also improved noticeably.
Rachiel asked.
“Anyway, Mr. Fabio? Your eyes. “Are you aware?”
“That… Kais….”
“Fleischer ring. A gold ring engraved around the rim of your eye. “How long has it been since it happened?”
“That…”
Fabio, who had been remembering for a moment, spoke slowly.
“I don’t know when… I first discovered this. One day, while I was working as usual, one of my co-workers pointed to my eyes and said something strange had happened. So I looked in the mirror… and saw a gold line drawn above my eye, like a crescent moon.”
“What about after that?”
“The gold line grew longer and longer. It also appeared below the pupil and merged with the golden crescent moon that appeared above. So like this…”
“A round ring has come to surround the pupil?”
“Yes yes, His Royal Highness the Crown Prince.”
Fabio shook his head.
“At first I thought it was a little strange. I was also worried about what would happen if my eyesight worsened. But I didn’t feel any discomfort. So…”
“I guess I just left it alone. I’m busy working right now. Because I had to earn living expenses to take care of my elderly mother. Right?”
“Yes, Your Highness…”
“Then can I take a look at your hands for a moment?”
“Yes?”
“It will only take a moment.”
“I… can I do that?”
“Sure.”
Rakiel grinned. Fabio wiped his hands diligently on his pants. And, not knowing what to do, he held out his hand. As if daring to show such unclean hands to the royal family was a sin.
But Rachiel didn’t care at all. I grabbed Fabio’s hand full of calluses and pointed at his wrist.
‘Jinmaek.’
Ding dong!
[Begin taking pulse.]
[Scanning.]
[3… 2… 1…]
[The pulse results are in.]
[Please check the
below.]
Steadily rotated pulse skill The results came out. Rakiel focused her attention on the ‘comprehensive findings’ item, which could be called the core of the examination sheet.
[Comprehensive opinion: The body is suffering from chronic fatigue. Wilson’s disease was detected. The patient’s symptoms began to appear in earnest around the age of 34, and a mutation occurred in the ATP7B gene on chromosome 13, which resulted in an obstruction in the excretion of copper from the body. As of now, approximately 2 years and 7 months have passed since the first onset of symptoms, and the necrosis of liver cells due to copper accumulation has progressed significantly. If left untreated, progression to fulminant hepatitis (70% mortality rate) due to copper accumulation is strongly expected. Immediate and active treatment and care is needed.]
“….”
It’s worse than I thought.
As if to prove it, a warning message from the five organs and six parts immediately came to mind.
Ding dong!
[Your liver manager is shocked after finishing the consultation with the patient’s liver manager.]
[Soy chief: I met a shitty soy chief today….]
“….”
What do you want to say?
Rachiel listened to her inner self(?). I heard the story of soy sauce.
[Soy Sauce: That guy was armed with a soy sauce copper? ㄹㅇ Bronze Age level ㄷㄷㄷ]
‘…Bronze Age? ‘How long is it?’
[Soy Sauce: It’s no joke. Copper levels far exceeded 0.25 mg per gram of liver tissue. If the mine is dug up, copper mining will also be possible.]
“….”
Then, it is definitely Wilson’s disease. The comprehensive findings of the Jinmaek skill and the results of the consultation with the five organs, six organs, and liver were providing a clear answer.
It was then.
“Hey, Your Highness?”
Fabio’s cautious voice pierced my eardrums.
“Just in case… did I do something wrong and get this terrible disease?”
“….”
Did I do something wrong?
The moment he received Fabio’s question, Rakiel hesitated for a moment to answer. Soon, I told the other person a mix of lies to avoid hurting them as much as possible.
“It’s wrong. There is nothing like that at all. It’s no one’s fault. “It was just bad luck.”
“Is that so…?”
“yes.”
I nodded.
I cannot bear to say that this is a genetic disease. This is especially true if the patient’s mother is next to the patient diagnosed with a genetic disease.
‘I’m sure you’ll blame yourself a lot.’
Which parent in the world wouldn’t be like that? How heartbroken you would feel and how sorry you would be if you found out that your child became sick because of the genes you passed down.
So it was.
The fact that Wilson’s disease is a genetic disease, the incidence rate is approximately 1 in 30,000 people, and the fact that the number of carriers of Wilson’s disease is approximately 1 in 90 people was not mentioned.
Instead, I focused on much more important things.
“Anyway, if we leave this as is, it will become dangerous. So, you need to be hospitalized right away for treatment. And Valentino.”
“…yes?”
Valentino shrugged his shoulders.
Rachiel ordered him.
“You take care of Mr. Fabio’s mother.”
“…yes?”
He couldn’t believe his ears. myself? A grandmother with dementia?
“Isn’t that the area of nursing, not treatment or treatment?”
“uh. that’s right.”
“I am a doctor.”
“so?”
“Why do doctors have to do things like nursing…”
“Are you saying you don’t understand why they have to do this?”
“That…”
He couldn’t answer.
Rakiel spoke as if cutting with a knife.
“Does a doctor who cannot even take care of patients and their families qualify as a medical professional?”
“….”
“I will watch. “I hope I don’t disappoint you this time.”
“Oh, I understand.”
Valentino reluctantly nodded. Actually, I still couldn’t quite believe it. What is Wilson’s disease? Is there really such a disease? I wonder if the crown prince is doing this just to scold himself. The situation itself became suspicious.
But I couldn’t help it.
‘If it wasn’t for the employment contract…’
Crack!
As soon as I graduated from medical school, I was forced to get a job at Byeongung Oriental Medical Clinic. I remembered the contents of the employment contract I signed when I came here.
Generous compensation? Adequate welfare? That wasn’t that bad. However, the clause prohibiting employment at another hospital for three years from the first day of work felt too vicious. Even if you decide that you don’t like the oriental medicine clinic at the villa, you will still have to be unemployed for three years.
‘Isn’t that too toxic a clause?’
This is truly a vicious provision.
It is tyranny by the employer.
But I didn’t dare to protest. Because the opponent is the crown prince. Because he is the one who reigns at the pinnacle of power in the entire empire, whether it is for everyone except the emperor.
“…Let’s go this way, ma’am.”
Valentino became sullen and took the old woman to the hospital ward. But the more I did, the more dissatisfaction piled up in my heart. This was because caring for a grandmother suffering from dementia was never easy.
“What? “What are you doing now?”
“huh? meal.”
“But you shouldn’t eat flowers from flower pots!”
…or.
“Where did our Fabio go?”
“yes? “Your son is in another hospital ward…”
“Where has my son gone?”
“I am hospitalized. Instead of doing this, please sit down for a moment.”
“Where has my baby gone?”
“….”
“It’s time for our baby to come home. “I even bought you a present.”
“A gift?”
“Our Fabio wanted a toy horse for his birthday. But I couldn’t buy it because my circumstances weren’t good. “You have to buy that.”
“Yeah? “Your son’s age now…”
“Seven years old.”
“….”
“Where has my baby gone? I bought you a gift. “Why aren’t you coming?”
“He won’t come today. “You will be fine in the hospital ward, so don’t worry too much.”
“But honey? “Why did you leave so early, leaving me and the child alone?”
“…yes?”
“Tell me, honey. “It was very difficult for me to raise my child alone.”
“….”
Valentino closed his mouth.
If this continues, there will be no end and no answer.
‘Let’s just ignore it.’
After making up his mind, he sat down on the caregiver’s chair. No matter what my grandmother said, I didn’t respond and just looked out the window. I also thought it would be better this way since talking about it itself would be meaningless.
As a result, I felt dizzy.
Fatigue that I had forgotten about came to me.
‘You paid too much attention today.’
A patient cries out for treatment for dementia that cannot be cured. A precious gown that was torn. I got scolded by the crown prince. Like this, I end up dealing with a grandmother with dementia.
It was a tiring day.
I felt drowsy.
‘Wait a minute…’
Should I close my eyes? Anyway, my grandmother is not in any pain right now. That was the indulgence that Valentino gave himself at first glance before falling into drowsiness.
♣
“…Ugh.”
A long time had passed and the sun was setting when Valentino, who had fallen asleep leaning against the window, opened his eyes again.
‘Did I sleep too much?’
He watched the sunset outside the window and rubbed his tired eyelids. Judging by the time, dinner in the hospital ward would begin soon.
‘I guess I should get some food.’
When I thought about ordering a meal for my grandmother with dementia, I sighed.
“Grandma, I’ll get the food now, so just be quiet here for a moment…”
He turned his head and asked.
And then it just stopped.
I couldn’t finish my sentence.
There was none.
There was no trace of where his grandmother, who was with him in the hospital room until just now, had gone.
‘uh?’
Belated realization came to me.
Valentino’s heart sank.