[MHS: Episode 75] Part I: The Beginning of the Disease
[MHS: Medical Human Story]-Episode 75
Prologue | Part 1 | Part 2 | Part 3 | Part 4 & Epilogue
Part I: The Beginning of the Disease
"No one believed his pain."
"Disease does not begin overnight.
We simply fail to notice it.
The body has been sending signals for a very long time."
The Illusion of an Ordinary Life
The reading room of the Department of Radiology is always bathed in the
cold glow of diagnostic monitors, their screens crowded with an endless stream
of biological data.
Every day, I open dozens—sometimes hundreds—of CT scans and MRI studies,
peering into the hidden interiors of people's bodies. On one screen, an
aggressive malignant tumor bares its claws. On another, the faint remnants of
an intracerebral hemorrhage linger like crimson echoes across the brain.
Yet after meeting countless patients over the years, I have come to
understand a different truth.
The most difficult diseases to diagnose—and often the ones that inflict
the deepest suffering—do not exist only within the images captured by
sophisticated medical equipment.
They also reside within fragments of memory that patients have carried
silently for decades, buried beneath years of pain that no one has ever fully
understood.
Min-jun (pseudonym), thirty-two years old, was one such patient.
Until recently, he had believed himself to be one of the healthiest, most
diligent young professionals in the world.
He worked as a planning team manager at one of Korea's leading IT
corporations, overseeing critical enterprise projects.
His life moved at a relentless pace.
Working late into the night was the default rather than the exception.
To fight off exhaustion, he routinely drank more than five cups of coffee
a day.
Lunch was usually nothing more than a hurried sandwich or fast food
swallowed within ten minutes while keeping an eye on the rest of the team.
Leaving the office before ten o'clock at night was a luxury he rarely
enjoyed.
To his colleagues and supervisors, Min-jun embodied the image of a rising
corporate star—a hardworking professional with exceptional stamina and
limitless potential.
No one suspected otherwise.
Not even the coworkers who stayed beside him through countless late nights
knew the truth.
Every day, while everyone else returned to work after lunch, Min-jun
quietly slipped into a stall in the office restroom.
There, alone, he would fight a wave of overwhelming nausea until he could
no longer resist.
He vomited everything he had just eaten.
That had become his routine.
That was the price he paid simply to make it through another workday.
Childhood Memories and the Secret Hidden Within His
Body
Whenever relatives gathered and childhood stories resurfaced, Min-jun's
mother would inevitably say the same thing.
Her voice always carried a mixture of resignation and quiet sorrow.
"Min-jun has always been like this.
Even as a baby, he vomited so easily and never had much of an appetite."
The faded photographs in his first-birthday album told a very different
story.
The baby in those pictures smiled with radiant innocence.
Dressed in colorful traditional hanbok, he sat proudly while family
members applauded around him.
There was nothing in those photographs to suggest that anything had ever
been wrong.
He looked like the picture of perfect health.
Yet hidden behind those cheerful images lay memories no photograph could preserve.
Long nights spent rushing to emergency rooms.
Parents pressing emergency call buttons with trembling hands.
Sleepless hours filled with fear and helpless tears.
The family remembered them all.
The very first day he was fed infant formula, he vomited every drop with
explosive force, like water erupting from a fountain.
When solid foods were introduced months later, the result was exactly the
same.
Whenever he ate too quickly—or simply ate a little more than usual—his
face would turn pale, followed almost immediately by violent vomiting.
Back then, the neighborhood pediatrician would wave away his mother's
concerns with reassuring confidence.
"Don't worry so much.
Babies have immature digestive systems.
They all spit up while they're growing.
He just has a sensitive stomach.
He'll outgrow it."
His mother wanted desperately to believe those words.
But the years passed.
The little boy became a teenager.
The teenager became a university student.
Yet the symptoms never truly disappeared.
More accurately, they had never improved at all.
His body had simply learned to survive.
Despite being born with intestines that had never assumed their proper
anatomical position, his body gradually adapted to its own abnormality.
Within that twisted anatomy, it painstakingly carved out a narrow passage
through which food could barely pass.
For thirty-two years, his digestive system maintained a fragile
equilibrium.
An impossible balance that could collapse at any moment.
The First Warning—and the Wrong Assumption
That delicate balance finally began to break during his sophomore year in
college.
It happened during a departmental gathering at a bustling Korean barbecue
restaurant near campus.
The grills sizzled with thick slices of pork belly.
Laughter filled the room.
Beer glasses clinked as classmates joked and celebrated another exhausting
semester.
At first, nothing seemed unusual.
He laughed with his friends.
Accepted drinks from his seniors.
Enjoyed the carefree excitement that only youth can bring.
Then—
without warning—
an icy sensation spread upward from deep within his abdomen.
Goosebumps raced across his skin.
Cold sweat poured down his forehead and the bridge of his nose.
The food he had just eaten refused to move.
Instead, it felt as though an iron bar had been driven across the pit of
his stomach, sealing it shut.
A crushing pressure built beneath his sternum.
His abdomen expanded until it felt ready to burst.
Breathing became difficult.
The overwhelming urge to vomit surged upward with terrifying force.
He bolted from the table.
Inside the restaurant restroom, he gripped the toilet and violently
emptied everything he had eaten.
When he finally emerged, his face had turned ghostly white.
His friends, already flushed from alcohol, burst into laughter.
"Hey, Min-jun! What's wrong with you?"
"You've had plenty more to drink than this before!"
"Don't tell me a little pork belly defeated you."
"You've become a terrible drinker."
"You're way too weak."
Min-jun forced himself to smile.
"Yeah...
I guess I just got indigestion today."
He wanted to believe that explanation.
It was far easier to blame indigestion—or a weak stomach—than to imagine
that something fundamentally abnormal had been hidden inside his body since
birth.
Sometimes denial is simply the easiest way to survive.
An Endless Pilgrimage Through Hospitals
After that day, hospitals became another permanent fixture in Min-jun's
life.
The attacks returned periodically.
Each episode was more severe than the last.
Whenever he overworked himself or ate slightly more than usual, the
familiar pattern followed:
Upper abdominal fullness.
Intense nausea.
Violent vomiting.
He would leave work early, cancel weekend plans, and search for yet
another internal medicine clinic that promised answers.
Within only a few years, he had visited five different gastroenterology
practices.
Yet despite seeing different physicians in different hospitals, the
conclusions were remarkably identical.
"This is functional dyspepsia.
Your stomach isn't emptying properly."
"You have mild chronic superficial gastritis.
Stress-related stomach disorders are very common in young professionals."
"There may also be some irritable bowel syndrome.
Try not to worry so much."
Each hospital ordered another series of examinations.
Upper endoscopy.
Blood tests.
Abdominal ultrasonography.
Again and again.
Every gastroscopy showed little more than mild gastritis.
His laboratory values—including inflammatory markers and hormone
levels—remained entirely within normal limits.
Ultrasound examinations found no structural abnormalities in the liver,
gallbladder, pancreas, or other abdominal organs.
Even when severe attacks landed him in the emergency department, only the
medications changed.
The diagnosis never did.
Nor did anyone discover the true cause of his suffering.
Every consultation ended with nearly the same advice.
"Mr. Min-jun, there's no evidence of any organic disease."
"This appears to be functional."
"Try to reduce your stress."
"Get plenty of rest."
"Eat slowly and keep your meals small."
"Avoid spicy, salty, and fatty foods for the rest of your life."
He believed every word.
He convinced himself that his personality was simply too sensitive.
That his irregular eating habits were to blame.
That his inability to cope with stress had somehow brought all of this
upon himself.
But deep inside his body...
Every twisted loop of intestine...
Every cell...
Was desperately telling an entirely different story.
There was simply no one yet who knew how to listen.
The Moment His Mask Fell Before the Person He Loved
Even Min-jun had one person who represented the only light in his life—the
one person who gave him a sense of hope and salvation.
Her name was Ji-eun.
They had met in a university club and, after years of dating, had promised
to build a future together.
Ji-eun had known for a long time that Min-jun struggled with food.
She knew that he could never eat as much as others and that even ordinary
meals often left him uncomfortable.
At first, she simply thought he had a small appetite and a sensitive
stomach.
So she cared for him with patience and affection.
Whenever they planned a date, choosing a restaurant was always a
thoughtful process.
"How is your stomach today?
Let's avoid spicy tteokbokki or hot chicken dishes."
"Yeah. Let's just have something gentle today—maybe soft tofu stew or
egg porridge. We'll eat slowly and just have a little."
It became their quiet rule.
A small but loving routine shared only between the two of them.
Ji-eun always watched him carefully—not with suspicion, but with
warmth—making sure he could eat comfortably.
She adjusted their meals around his condition.
She avoided places where he might suffer.
She never made him feel different.
But tragedy arrived during the most ordinary and peaceful moment.
One weekend evening, the two of them were sitting across from each other
at a cozy restaurant.
For the first time in a long while, they ordered pasta and steak.
They talked about their upcoming wedding preparations.
They laughed.
They shared small jokes about the future.
It was supposed to be an ordinary, happy evening.
Then suddenly...
Min-jun's expression changed.
The color drained from his face.
The fork he was holding slipped from his hand and struck the floor with a
sharp metallic sound.
Clatter.
He grabbed his upper abdomen and lower abdomen with both hands.
His body folded inward as he curled over in his chair.
He could neither breathe in nor breathe out properly.
Only rough, desperate gasps escaped from his throat, as if his chest and
airway had been completely blocked.
"Min-jun! What's wrong?
What happened all of a sudden?!"
Ji-eun jumped up immediately.
Her face turned pale with fear as she rushed to his side.
But Min-jun could no longer answer.
He pushed himself up and stumbled toward the restroom at the far corner of
the restaurant.
The sounds coming from inside the stall were not those of ordinary
indigestion.
One minute.
Five minutes.
Ten minutes.
Time continued to pass.
Twenty minutes went by.
The restroom door remained closed.
From inside came only painful groans and the desperate sounds of
vomiting—as if someone was silently begging for help.
Finally, the door opened.
Min-jun slowly walked out.
The reflection in the mirror revealed a face completely drained of color.
His skin was pale like blank paper.
Cold sweat streamed down his forehead, soaking his hair and leaving it
disheveled.
The sight was unbearable.
Ji-eun could no longer hold herself together.
She collapsed into her seat and burst into tears.
"How can we get married like this?"
"Does this look like someone who just has indigestion?"
"Please, stop being stubborn. Let's go to a university hospital
emergency room right now."
"Please..."
Min-jun tried to smile.
His lips trembled.
He gently held her shaking hand.
"No, Ji-eun..."
"I'm really okay."
"This happens all the time."
"It'll calm down soon."
"Don't worry."
Those words were meant to reassure her.
But they were also a desperate attempt to hypnotize himself.
A lie he needed to believe.
Because deep inside, he was terrified.
Terrified that if he collapsed...
everything would collapse.
His relationship.
His future.
The life he had struggled so hard to maintain.
The Invisible Years and the Truth of Anatomy
There are moments when I look at CT images on the monitor in the radiology
reading room and find myself becoming unusually quiet.
Modern high-resolution CT technology captures the human body with
extraordinary precision.
It reveals the current condition of a patient's internal organs.
The shape and position of structures.
The pathways of blood vessels.
Every anatomical detail.
Cold.
Accurate.
Unforgiving.
Yet an image can only capture a single moment in time.
A CT scan shows the present.
It does not contain the decades of history that came before it.
It cannot directly show the years a patient spent suffering.
The childhood memories.
The countless nights of pain.
The fear.
The uncertainty.
The invisible timeline of a disease.
That hidden history is what makes certain conditions so difficult to
recognize.
Min-jun's condition—adult intestinal malrotation—was exactly such a
disease.
During normal fetal development, the embryonic midgut must undergo a
complex process of rotation and fixation.
As the fetus grows inside the mother's womb, the intestine rotates
approximately 270 degrees and gradually settles into its proper
anatomical position within the abdominal cavity.
This process is not random.
It is a precisely coordinated developmental event.
However, if this rotation or fixation process is interrupted, incomplete,
or abnormal for any reason, the intestine may remain in an abnormal position.
Instead of settling into a stable arrangement, the bowel remains twisted,
misplaced, and vulnerable throughout life.
Most patients with intestinal malrotation develop symptoms shortly after
birth.
Because the abnormal anatomy can cause severe neonatal intestinal
obstruction, many are diagnosed during infancy and treated surgically by
pediatric surgeons.
But a small number of patients are different.
Patients like Min-jun.
In rare cases, the intestinal twisting may be incomplete.
The obstruction may not be severe enough to cause immediate
life-threatening symptoms.
The body gradually adapts.
The intestine finds a fragile balance.
And the patient grows into adulthood without ever knowing the hidden
abnormality exists.
These individuals may experience only vague symptoms:
Occasional bloating.
Mild discomfort after meals.
Intermittent episodes of indigestion.
Symptoms that appear, disappear, and return.
Because the symptoms are not always dramatic, many patients live their
entire lives unaware of the congenital abnormality inside them.
For this reason, adult intestinal malrotation remains one of the most
challenging and dangerous diagnostic traps in clinical medicine.
Typical symptoms include:
- Recurrent
chronic vomiting
- Upper
abdominal bloating and discomfort, especially after meals
- Intermittent
sharp, cramping abdominal pain
- A fluctuating
pattern in which symptoms improve temporarily before suddenly worsening
again
Because these symptoms overlap with common gastrointestinal disorders,
even physicians in gastroenterology clinics or emergency departments may
initially suspect:
Functional gastrointestinal disorders.
Stress-related gastritis.
Simple indigestion.
If endoscopic findings appear normal, it becomes even more difficult to
consider a hidden anatomical abnormality.
The patient may desperately try to explain that something feels wrong.
But without visible evidence, the medical system often has difficulty
hearing what the body is saying.
And so the years pass.
Sometimes decades.
During that long delay in diagnosis, patients continue to suffer silently.
Their quality of life slowly deteriorates.
Their confidence disappears.
They begin to question their own experiences.
They wonder whether the pain is real.
Whether they are simply weak.
Whether they are somehow responsible.
But the truth has always been there.
Hidden.
Waiting.
Recorded within the anatomy of the body itself.
[🩺 Medical Insight] Adult Intestinal
Malrotation: When a Congenital Anomaly Remains Hidden for Decades
[🩺 Medical Insight]: The Embryologic Origin of Intestinal Malrotation
[🩺 Medical Insight] Why Some Patients Survive Until Adulthood
[🩺 Medical Insight] The Diagnostic Challenge in Adults
[🩺 Medical Insight] The Role of Contrast-Enhanced CT
[🩺 Medical Insight] The Human Meaning Behind the Diagnosis
For Min-jun, the CT scan was not simply a medical examination.
It was a message sent backward through time.
It connected every unexplained episode from childhood to adulthood.
The vomiting.
The abdominal pain.
The hospital visits.
The self-blame.
All of them had been chapters of the same story.
A story that had existed since before he was born.
And finally...
someone had learned how to read it.
Prologue: The Man Who Could Never Stop Vomiting☜ Previous Chapter
Next Chapter ☞Part II: The Moment of Diagnosis
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