A Doctor’s Clinical Diary_28- Between Shadows and Light-Part II
CHAPTER
6 — The Quiet Battles of Doctors
People think doctors are invincible.
That we do not fear, do not break, do not question.
But the truth?
Doctors are human long before they are healers.
After 민준’s case, exhaustion catches
up with me like a wave.
The Burnout No One Sees
One night, I am reviewing abdominal CT scans for a
67-year-old woman when my vision blurs.
My head throbs.
My chest tightens.
Ji-hwan notices.
“선배님? Are you okay?”
“I’m fine,” I answer automatically.
Doctors say “I’m fine” the way others breathe.
But Ji-hwan doesn’t buy it.
“You haven’t slept properly in days. You’ve been here every
night. You’re human, not a machine.”
His words land heavier than he expects.
Because the truth is—
Radiology is a lonely battlefield.
No patients remember your face.
No one sees your hands tremble.
No one understands the burden of knowing your oversight can destroy a life.
Even among physicians, radiologists are the ghosts of the
hospital—present everywhere, seen by no one.
I lean back in my chair.
“You know, Ji-hwan… When you’re a resident, burnout feels
like drowning. But when you’re fifteen years in… it feels like drying out.”
He blinks.
“Drying out?”
“Yes. You don’t feel overwhelmed anymore. You feel… empty.
Like someone wrung out all the emotion from you. And you’re left with
grayscale, not color.”
He swallows.
“Is that… how you feel now?”
I stare at the hundreds of images awaiting my
interpretation.
“I don’t know. Maybe.”
Ji-hwan stands.
“선배님, you need a break. Even
machines need maintenance.”
I smile faintly.
“How ironic, the radiologist being told to rest.”
The Patient Who Gave Back
Two days later, as I drag myself into the hospital, a nurse
rushes toward me.
“선생님, 민준이 어머니가 판독실 찾으셨어요!”
My heart skips.
Did something go wrong?
I hurry to the floor.
When I open the door, 민준 and his
mother are standing there with a box.
“Doctor!” 민준 waves excitedly.
“I walked all the way here by myself! No dragging leg. No dizziness!”
His mother steps forward.
“We wanted to give you something. Just a small thank-you.”
She hands me the box.
Inside lies a homemade tangerine pound cake, wrapped carefully with ribbon.
“It’s silly,” she says shyly. “But I wanted to give you
something warm, something made with my own hands. Because you… gave me my son
back.”
I freeze.
Sometimes gratitude hits harder than grief.
I swallow, trying not to show how deeply this affects me.
“Thank you,” I manage. “This means… more than you know.”
민준 grins.
“Doctor, can I tell you something?”
“Sure.”
“When I was inside the MRI machine… I was really scared.
But I remembered what you said. That you’d find out what was wrong. And… it
made me brave.”
I feel something crack open in my chest—
the dryness Ji-hwan spoke about.
This boy.
This kid.
He patched something inside me without even knowing.
I place a hand on his shoulder.
“You were brave long before I walked into your room.”
His grin widens.
A Quiet Promise
As they leave, I remain in the hallway for a long moment.
The sunlight spills across the polished floor.
Warm. Human.
I whisper to myself:
“This is why you stay. This is why you endure the dark
rooms. This is your purpose.”
My burnout doesn’t disappear.
But it softens.
Sometimes, a single patient
—a single medical human story—
is enough to reignite a fading flame.
CHAPTER
7 — When One Light Fades, Another Shadow Forms
민준’s recovery had brought warmth into the gray hallways of
my mind—
but hospitals never allow joy to linger too long.
The following Monday, at precisely 9:12 a.m., a new case
arrives.
“선생님, 응급실에서
priority CT 요청입니다. 환자 만 72세
여성. 갑작스러운 복통과 구토.”
복통.
The most deceptive of symptoms.
Sometimes harmless, sometimes lethal.
I load her CT scan into the system.
A standard contrast-enhanced abdomen study.
At first glance: nothing obvious.
Bowel loops mildly dilated.
Mesenteric fat slightly streaky.
A small fluid pocket near the right colon.
But nothing dramatic.
Ji-hwan looks over my shoulder.
“Maybe gastroenteritis?” he suggests.
I shake my head slowly.
“Something doesn’t fit.”
He sighs.
“Not everything is a hidden tumor, 선배님.”
“That’s the problem,” I say quietly. “After 15 years in
radiology, you learn that danger often hides where you expect simplicity.”
I zoom in further.
The mesenteric streakiness—slightly asymmetric.
The fat around the ascending colon—too concentrated.
The adjacent bowel loop—slightly thickened.
My pulse quickens.
“Wait… Where is the epiploic appendage?”
Ji-hwan blinks.
“The what?”
“The fat-filled peritoneal pouches along the colon,” I
explain. “If they twist, they infarct. Looks like appendicitis, diverticulitis,
or even ischemic bowel. But it’s epiploic appendagitis.”
He looks again with new eyes.
“Damn… I never would’ve caught that.”
“That’s why radiology is a language,” I reply.
“It’s not just seeing. It’s interpreting.”
We finish the report.
Diagnosis: Likely epiploic appendagitis.
Recommendation:
Conservative management.
As I fill the clinical diary entry, I pause.
The scan feels familiar.
Too familiar.
Because the first case I missed as a young resident—
my first painful diagnostic error—
was exactly this.
A Memory That Never Heals
Fifteen years ago.
A 65-year-old man.
Right lower quadrant pain.
CT taken late at night.
I read it quickly, exhausted, overconfident.
I diagnosed “mild appendicitis.”
It wasn’t.
It was epiploic appendagitis.
He didn’t need surgery.
But because of my misread, he was taken to the OR.
The surgeon removed a normal appendix.
He suffered a post-op infection.
He stayed in the hospital for weeks.
He didn’t die—
but his trust in the system did.
And it was my fault.
That case became the first line in my handwritten clinical
diary:
Entry #1
— Diagnostic error.
Never rush. Never
assume. Shadows demand humility.
Seeing this new patient reminded me that medicine is not
about pride—
but penance.
Meeting the New Patient
I visit the ward to speak with the 72-year-old patient.
Her daughter greets me nervously.
“Doctor… I heard you identified something unusual?”
I nod kindly.
“Yes. It’s called epiploic appendagitis. It can mimic more
dangerous conditions. But the treatment is simple. Pain control, rest,
hydration.”
The daughter sighs, tears welling.
“Thank you. They told us it might be surgery. My mother has
heart issues… I was terrified.”
Her gratitude humbles me.
“We avoided unnecessary surgery thanks to your careful
reading,” she says.
If only she knew how much that means to someone who once
made the wrong call.
I place a gentle hand on her shoulder.
“She will recover well.”
When I leave the room, I pause.
Today, I rewrote a mistake from my past.
Not erased—nothing in medicine is ever erased—
but rewritten.
The Weight of Being Invisible
As days pass, 민준 improves
remarkably.
He walks the hallways with newfound confidence, joking with nurses, waving at
me whenever he spots my white coat.
But even joy comes with shadows.
One afternoon, while in the radiology reading room, Ji-hwan
says:
“선배님, 민준이가 퇴원 후에도 계속 thank-you notes 보낼 것 같아요.”
I smile.
Then he adds,
“Too bad no one else really knows what radiologists do.”
I pause.
“What do you mean?”
“I mean… you saved that boy’s life. But his entire family
probably talks about the surgeon, right? Not the guy in the dark room.”
His words land heavily.
Because he is right.
Radiology is a specialty where victories are silent and
anonymous.
When you save someone, only a few colleagues know.
When you miss something… the whole hospital remembers.
I lean back and look at the dim room—the glowing screens,
the lonely hum of machines.
“We’re the ghosts of medicine,” I say quietly.
“Always present, rarely seen.”
He looks at me with sympathy.
“Doesn’t that bother you?”
“It used to,” I admit.
“But now… I think of it differently.”
“How?”
“Radiologists see truth before anyone else does. Even
before the patient feels it. Even before the surgeon touches it. We are the
first witnesses. And sometimes… the first protectors.”
Ji-hwan nods slowly.
“That’s… poetic.”
“It’s reality.”
CHAPTER
8 — A Story That Demands to Be Told
The next week begins quietly.
Too quietly.
Quiet weeks in hospitals are suspicious.
Like the stillness before a storm.
Around noon, a nurse calls the reading room.
“선생님, 신경과에서
urgent MRI consult 들어왔습니다.”
A teenage girl with sudden right-sided weakness.
Possible acute stroke.
My heart sinks.
Pediatric stroke is rare—and devastating.
I open the MRI urgently.
DWI sequence loads.
And then—
A bright, glaring lesion in the left hemisphere.
Large.
Sharp.
Radiating from the basal ganglia.
Ji-hwan gasps.
“A kid? Stroke? At her age?”
“Not stroke,” I say quietly.
“There’s something else.”
FLAIR confirms it.
Ring-like edema.
Subtle enhancement.
Mass effect on midline structures.
“What is it then?” Ji-hwan whispers.
“A tumor,” I answer.
“A high-grade one.”
The words leave a bitter taste in my mouth.
Just as one child escapes the darkness, another is
swallowed by it.
The Family Meeting
The girl’s parents arrive within minutes.
Her mother is trembling.
Her father tries to be strong, but grief cracks his voice.
“Doctor, please… tell us it’s nothing serious.”
I force myself to stand tall.
“I’m afraid the MRI shows a lesion that is concerning for a
high-grade tumor.”
The mother collapses into her husband’s arms.
“Why her? She’s only fourteen!”
No matter how many years pass, this question never gets
easier.
I continue calmly, though inside I feel my heart
tightening.
“We will involve neurosurgery and oncology immediately. She
will get every treatment she needs.”
The father looks at me with hollow eyes.
“How did this happen? Could we have seen it earlier?”
I shake my head gently.
“These tumors grow silently. There is no way you could have
known.”
But inside, I know the truth:
The shadows of the brain often grow unnoticed—
until the day they decide to announce themselves with violence.
A Radiologist’s Guilt
That night, I remain in the reading room long after
everyone leaves.
The image of the girl’s DWI brightness burns in my mind.
Why couldn’t it have been early like 민준’s?
Why couldn’t I have caught it at the whisper stage?
Why does fate choose randomly who gets a miracle and who gets a tragedy?
I stare at the monitors.
Two images appear side by side in my imagination:
민준’s tiny dot of hope.
The girl’s devastating blaze of white.
Both stories—
both medical human stories—
arrived in my hands.
And yet the outcomes diverge like light and shadow.
I feel a familiar ache.
The ache of responsibility without control.
Ji-hwan quietly enters the room.
“선배님… You stayed late again.”
I don’t respond.
He steps closer.
“You did everything right. You’re doing everything right.”
“Then why does it feel like I’m losing?”
He hesitates.
“Because you care.”
I close my eyes.
Radiology is not supposed to feel personal.
But after thousands of scans, the patterns imprint themselves onto your soul.
The Unexpected Visit
As I prepare to leave, someone knocks softly.
It’s 민준.
He’s holding a notebook.
“Doctor… I’m writing a school essay about my experience.
And I wanted to include you.”
I blink.
“…Me?”
“Of course!” he says brightly. “You were the first person
who believed something was wrong. The first one who didn’t ignore me. The first
who… saved me.”
His words pierce through the heaviness in my chest.
“I wanted to show you this part,” he adds, flipping the
notebook open.
In childish, sincere handwriting:
The
doctor in the dark room saw what no one else saw.
He heard what was
silent.
He didn’t just see my
MRI—he saw me.
I swallow hard, unable to speak.
민준 grins.
“You’re my hero, you know.”
Something breaks inside me.
But this time—
it’s not a fracture.
It’s a healing.
CHAPTER
9 — The Girl Who Arrived Too Late
The day after diagnosing the young girl with the aggressive
lesion, the neurosurgeons request an emergency tumor board meeting.
The conference room smells of coffee and fluorescent
lights—
a combination every hospital physician knows too well.
Around the table:
·
Dr. Han Ji-won, neurosurgery
·
Dr. Cho, pathology
·
Dr. Lee from pediatric oncology
·
Myself from radiology
·
Several residents and nurses
The girl’s MRI fills the monitor.
FLAIR swelling like storm clouds.
DWI brightness like a burning signal.
Contrast enhancement forming an incomplete, irregular ring—
the kind that radiologists dread.
Han folds his arms.
“This is high-grade. Likely a diffuse midline glioma.
Surgery won’t cure this.”
The room falls silent.
Dr. Lee adds quietly:
“Median survival is around twelve months… less with diffuse
infiltration.”
Silence again.
Stories like 민준’s—the miracles—are
rare.
Stories like this girl’s are tragically more common.
Someone asks me:
“Dr. Jun-young, when exactly do you think the tumor began?”
I zoom out on the MRI.
“This pattern… maybe six months. But she might have had no
symptoms until recently.”
The parents will never forgive themselves for “missing”
something invisible.
Someone else asks:
“Could we have caught it earlier with a routine check-up?”
I shake my head.
“No. There’s no screening tool for healthy children. Even
if she had a CT scan for another reason, this tumor might not have shown. This
is not anyone’s fault.”
But even as I say it, I know it won’t ease the parents’
pain.
A Family in Collapse
I go to speak with her parents again.
The father is staring blankly at the wall.
The mother is collapsed over a table, hands shaking.
Their daughter sleeps under sedation in the ICU.
When they notice me, they rise quickly.
“Doctor,” the father whispers, “please… please tell us
there’s hope.”
I steady my voice.
“There is always hope. But we must also be honest. The
tumor is serious. It is high-grade.”
The mother sobs uncontrollably.
“But she’s only a child!”
I place tissues on the table, my own throat burning.
“Your daughter is extraordinarily strong. And we will give
her every possible chance—chemotherapy, radiation, all supportive care. But
this type of tumor behaves aggressively.”
The father swallows.
“How long…?”
I look down.
“We can’t predict exactly. But we will fight with her.
Every day.”
His shoulders tremble—
a grown man devastated beyond words.
The mother grips my sleeve.
“Please, doctor… please don’t let her be in pain.”
“I won’t,” I promise.
“And neither will the team.”
Medical human stories are not always miracles.
Some are storms that refuse to lift.
But I will not abandon her.
Even when science cannot save, humanity can still comfort.
The Radiologist Who Stayed
Radiologists aren’t required to follow up at bedsides.
Our work usually ends when the image is interpreted.
But some stories refuse to let you stay in the dark room.
I visit the girl daily.
Not because I am her primary physician—
but because I feel compelled to witness.
One afternoon, her father finds me examining her images
again.
“Doctor… why do you keep coming?” he asks softly.
I hesitate.
“I don’t want you to feel alone,” I answer honestly.
“And I want to be with her story until the end—whatever that end may look
like.”
He surprises me by placing a hand over mine.
“You may be a radiologist,” he says, “but you have the
heart of a pediatrician.”
I smile faintly.
“No. I’m just a doctor who knows that silence can be loud.”
CHAPTER
10 — What We Carry, and What We Let Go
One evening after rounds, I walk past the oncology floor
and see a familiar figure sitting alone on a bench.
Ji-hwan.
His posture is slumped.
His face pale.
I sit beside him.
“You okay?”
He exhales slowly.
“I read the girl’s MRI again today. I don’t know how you do
it. I don’t know how you don’t break.”
I let the silence sit.
Breaking is normal.
Breaking is human.
“Ji-hwan,” I say quietly, “you think I don’t break? I break
all the time. Just… quietly.”
He looks at me.
Really looks.
“Then why keep doing this?”
“Because sometimes,” I say, “a boy like 민준 walks in. And you see that what you do matters.”
He nods slowly.
“I think… I want to be like you. Someone who listens to
shadows.”
I chuckle.
“Don’t. It’s too lonely.”
He smiles weakly.
“But meaningful.”
I pause.
“Yes. Meaningful.”
He stands up.
“Thank you, 선배님. For teaching me.
For showing me the hard parts too.”
I watch him walk down the hallway.
Maybe he will be better than me.
Maybe that is the point.
Two Families, One Hallway
Three days later, a surprising encounter unfolds in the
hospital lobby.
민준 and his mother come for a follow-up check.
As they pass the oncology wing, they notice the girl’s
parents standing outside her room, grief heavy on their faces.
민준’s mother hesitates.
“Is that… the girl you told us about?”
I nod.
She approaches the parents gently.
“I’m so sorry,” she says, bowing.
“We don’t know your daughter, but… we understand fear. We understand pain.”
The girl’s mother begins to cry again, clinging to her.
“Your son survived,” she whispers. “That must be such a
blessing.”
민준’s mother shakes her head softly.
“It is. But… I want you to know something.”
She looks over at me—
as if asking permission.
I nod.
She turns back to them.
“This doctor,” she says, pointing to me, “saved my son. But
he also stayed with our fear. He cared about us. He’s doing the same for your
daughter. You’re not alone.”
The father wipes his tears.
“Thank you,” he whispers.
“Thank you for saying that.”
It is one of the most human moments I have ever witnessed.
Two families—
one rising from despair, one falling into it—
binding together in sorrow and compassion.
Medical human stories are woven by patients—
but also by the families who dare to share their grief.
The Last Scan
Two weeks later, the girl deteriorates rapidly.
Palliative care consults are ordered.
Pain medication is adjusted.
She becomes less responsive.
One morning, the oncology team requests a final MRI—not for
treatment, but to understand the rapid progression.
I load the images.
The tumor has doubled.
Midline shift worsened.
White matter tracts compressed like bent wires.
Contrast enhancement now complete and aggressive.
I stare at the screen.
Every radiologist knows how to stay clinical.
But sometimes the images cut deeper than scalpels.
I close my eyes.
For the first time in years, I feel tears slip down my
face—warm, silent, uninvited.
This is the part of radiology no one teaches.
The pain of seeing the truth before anyone else can bear it.
Her Final Morning
When I visit the family, the girl is breathing softly,
peacefully.
Her mother strokes her hair.
Her father holds her hand.
I speak softly.
“She’s not in pain.”
The mother looks up.
“Thank you, doctor… for staying with her. Even though
you’re not her main doctor.”
I swallow.
“I couldn’t leave her story unfinished.”
The father whispers:
“She liked you, you know. She said you had kind eyes.”
My chest tightens.
“She had a kind heart.”
A few hours later, she passes away—
quietly, gently—
as if stepping out of the world on tiptoe.
I write the final line in her chart:
She was
not alone.
Then, in my clinical diary:
Entry
#11,437 — 14-year-old female.
Aggressive tumor.
Rapid progression.
Lesson: Even when we
cannot cure, we can still care. Empathy is also medicine.
EPILOGUE
— The Doctor in the Dark Room
Weeks pass.
민준 continues to thrive—
he joins a soccer club, returns to school, laughs loudly in the hallways when
he comes for check-ups.
The girl’s parents send a handwritten letter:
Thank
you for being with us in our sorrow.
Thank you for seeing
her as more than a diagnosis.
You helped her leave
this world gently.
I keep the letter in my desk drawer.
Radiology is still a dark room—
but it no longer feels lonely.
Because now I know something I didn’t know for years:
Light doesn’t always come from the patient who survives.
Sometimes it comes from the courage of the patient who doesn’t.
My
clinical diary is full—
not of cases, but
of human beings.
Not of diseases,
but of stories.
Not of shadows,
but of light.
I sit in the reading room, open a new page, and begin:
A
doctor’s clinical diary-Between Shadows and Light.
Because medicine is
not about erasing darkness.
It is about standing
in it—until light returns.
I turn to the next CT scan,
the next human story waiting in the grayscale.
And I listen.
Always,
I listen.
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