Chapter 231

Translator: Dreamscribe

“You’re saying we should reorganize all the data from scratch?”

Killian, a Johns Hopkins researcher, could not hide his displeasure. The sheer volume of genomic and medical data was almost beyond imagination.

Saying they would refine all of it again was little different from refusing to acknowledge the research the medical community had conducted until now.

“I....”

Seo-ha raised his head and looked around.

His lips moved briefly as if he were about to say something, but then pressed firmly shut again.

“....”

Stern, the center director, looked at him with a gentle expression and spoke.

“It’s all right, Director. Please tell us. From an outsider’s perspective, what do you think of the current state of the medical field?”

Seo-ha was conflicted.

If Pancreatic Cancer were his only objective, he could simply endure the discomfort for a while. Clara’s data alone should be enough to produce meaningful results. But was that really the right thing to do? He nodded as if he had made up his mind.

“I know a little about medicine out of personal interest. So I understand why all of you might feel uncomfortable with me and my team.”

Killian furrowed his brow.

“You say you understand?”

“Yes. Because the state of the data isn’t anyone’s fault.”

The researchers’ expressions softened slightly.

“Medicine has advanced through constant clinical practice in the field. Patients don’t wait. Treatment can’t be postponed until every mechanism is completely understood.”

“Ugh.”

Stern pressed a hand to his forehead in distress.

“It really is a dilemma. If there was a paper saying something worked, we had to try it out of sheer desperation. And so the data kept piling up without us even knowing why it worked....”

Seo-ha nodded.

“The same applies to classification systems. In the early 2000s, the standards used to classify KRAS Mutations (a common genetic mutation in Pancreatic Cancer patients) were created based on the technology available at the time.”

Clara bit her lip and said,

“...That’s right. There was no other way back then.”

“But technology advanced. Single-cell Sequencing emerged, allowing us to track mutation heterogeneity at the individual cell level. The amount of information we could see suddenly increased hundreds of times over.”

It was an approach that had been taken for granted in medical practice for far too long.

But to Seo-ha, the way they handled information was the very height of inefficiency. It was as though unrefined gold and silver had been indiscriminately mixed together with piles of stone.

“Maybe they didn’t know how. Or perhaps they simply didn’t have the time. Doctors forced the information revealed by new technology into old standards. Any values that didn’t fit were treated as noise.”

Stern stroked his chin as he spoke.

“You’re saying we failed to make proper use of the data?”

“That’s right.”

Seo-ha looked warmly at the doctors.

“The data itself was gathered diligently. I’m sure it was the result of everyone doing their best on the front lines. The classification methods simply failed to keep up.”

“So the data....”

Clara murmured as if she had finally realized what he meant.

“Yes. There’s a high probability that important signals are hidden among the values that were treated as noise.”

The conference room fell silent.

Seo-ha stood, bowed his head to them, and said,

“I know it will be a painful process. But I sincerely ask that you give it serious consideration.”

“....”

The first meeting ended.

After Seo-ha and his team left, the Johns Hopkins researchers remained in the conference room and continued their discussion. Killian spoke with a dissatisfied expression.

“Isn’t this getting far too big?”

The other researchers were thinking much the same thing.

Single-cell RNA Sequencing.

Ever since the technology had emerged, refining data had become extraordinarily difficult. A single cell could generate tens of thousands of genetic data points.

The biggest problem was that the data formats were different.

Hospitals used different Electronic Medical Record (EMR) systems, while each research institute used different sequencing equipment and analysis software. The reality was that the enormous amounts of data held by individual hospitals were being sent to the medical hub in this chaotic jumble of incompatible formats.

“On top of that, the sheer volume of the raw data is catastrophic.”

There was no end to the reasons not to do it.

Stern stroked his chin and said,

“There are legal issues as well. Even if the data is anonymized, sharing the raw data with people who aren’t authorized to access it requires IRB approval.”

Killian placed a hand on the table.

“I’m worried about those kids. Mathematics isn’t medicine. No matter how intelligent they are, they can’t possibly know every detail of what happens in clinical practice. A lot of the values treated as noise are contaminated data. Equipment errors, sample contamination, mistakes during processing, library bias. Sorting those things out requires experience, not mathematics.”

More people began nodding.

But Stern kept his eyes closed and showed no particular reaction. After he remained that way for quite some time, the researchers began murmuring quietly among themselves.

At last, he opened his eyes, looked around at everyone, and spoke.

“So.”

“Yes?”

Killian looked puzzled.

“So are you saying we should keep going exactly as we are, without changing anything? The five-year survival rate for Pancreatic Cancer patients is currently around ten percent. What do you think it was fifty years ago?”

“....”

“The same ten percent.”

Groans of dismay sounded from around the room. Stern spoke with a self-deprecating expression.

“If we keep repeating the same methods, I simply can’t imagine that number improving. Even our hospital alone has three different standards, doesn’t it? We became so accustomed to it that we stopped seeing it as a serious problem. But how must this have looked to those mathematicians? Embarrassingly enough, it must have looked like a contradiction in itself.”

The survival rate for Pancreatic Cancer had remained stagnant for fifty years.

That cruel number pierced the doctors’ hearts like a dagger.

“I believe we have always done our best. And I’m sure we truly did. We stayed up through the night beside our patients, and whenever a new drug appeared, we repeated clinical trials in the hope that perhaps we could save even one more person.”

He paused for a moment.

“But if the outcome has remained unchanged for fifty years, shouldn’t we admit that we were wrong?”

The researchers lowered their heads.

Every one of them knew all too well how hopeless Pancreatic Cancer could be.

Even after successful surgery, it recurred.

A drug might appear to work, only for resistance to develop a few months later.

Doctors searched for new treatments every time, but the words they ultimately had to say were always similar.

“I’m sorry, but there is nothing more we can do.”

Clara murmured in a low voice.

Those were the words she had been forced to hear while standing before her mother, who had grown so emaciated that she looked like a mummy. A doctor, who should have been a patient’s final source of hope, had told her to give up on life. No one who had not experienced it themselves could ever understand the despair she had felt then. She had devoted her entire life to making sure those words would never have to be repeated.

“I’ve done nothing but fail for a very long time. Sometimes I felt like I had become an undertaker. Or perhaps a priest listening to someone’s final confession.”

The mood turned solemn.

Everyone knew how many years she had devoted to this. Her eyes were red, and tears mingled with her voice.

“Let’s be honest with ourselves for once. Have none of us really ever thought that the data was a mess? I always did. And yet I couldn’t do anything about it. The reason is simple. Because I wasn’t capable of fixing it!”

Clara, usually quiet by nature, poured out her emotions. The doctors were overwhelmed by the intensity radiating from her.

“Not just me. No one in the medical community could do it.

“Even so, no one blamed us. Maybe we’re specialists not in treatment, but in making excuses. It was detected too late, the metastasis was too fast, the disease naturally has a poor prognosis. Patients understand, and their families nod through their tears. But how much longer are we supposed to keep repeating those same words!”

It was almost a scream.

Her anguished cry, as if she were spitting blood, froze the air in the conference room.

Clara returned to a calmer voice and said,

“Who did we meet today? The greatest mathematician in the world, someone regarded as possessing the most formidable intellect of our time. And he says he can accomplish what we have failed to do for decades. Maybe this is the medical community’s last opportunity. Even if I have to do it alone, I intend to devote everything I have to helping him.”

Silence followed.

No one in the conference room could easily bring themselves to speak.

Then someone suddenly shoved back his chair and sprang to his feet.

Everyone’s eyes turned toward him.

“I... I’ll do it too!”

It was Orson, one of the younger researchers.

His face flushed with embarrassment, but he soon clenched his teeth and continued.

“I want to save patients too!”

Several researchers rose from their seats after him.

“I’ll participate as well.”

“Me too.”

Killian sighed and rubbed both hands over his face. Then he slowly rose from his seat and said,

“Damn it.... I’d like to stop having to say those words to patients too.”

They had reached a consensus.

Stern watched them and sank into thought. Perhaps what Seo-ha was trying to cure wasn’t Pancreatic Cancer, but the antiquated medical system itself.

Even after Seo-ha left, the system would remain.

And with that as a foundation, perhaps they might find clues toward solving other incurable diseases as well.

Stern suddenly realized something.

Seo-ha had not been criticizing the medical community.

If anything, he understood it more deeply than anyone else. He understood how desperately doctors had fought all this time with obsolete, outdated weapons in their hands.

That was probably why.

Why the young man’s words had contained compassion rather than arrogance.

***

“Seo-ha, did you see the email?”

That evening, Sri said while looking at his laptop.

“What email?”

“Johns Hopkins says they’re going to request joint IRB approval. Looks like they intend to give us full access to the data.”

Cecilia strode over and looked at the screen.

“They agreed to that?”

“Yes. There’s a clause saying we need to consult with medical staff while refining the data, but at this point, I’d say they’ve done everything they possibly can.”

One of the world’s finest hospitals had effectively granted them virtually unrestricted access to its data.

Theo casually walked over and examined the email.

“That’s a massive amount.”

“Johns Hopkins alone has around ten million records, but this place also serves as a data hub for other hospitals. More than ten hospitals are connected to it. And there’s also a European consortium that shares clinical data.”

Seo-ha smiled happily.

“They’ve gone this far for us, so we definitely need to produce results.”

Su-jeong, who had approached without anyone noticing, looked at Seo-ha with concern.

“But will this really be okay? There are sixteen different formats. Five kinds of EMR systems and four sequencing equipment manufacturers. All the raw data formats are different. And the records from the 1990s use legacy formats, so we’ll have to convert them before we can even read them.”

“The inefficiency is almost unbelievable.”

“Something like this would be unthinkable in mathematics.”

Everyone added a comment of their own.

But Seo-ha was confident. There was a reason he had been able to make such a proposal despite knowing the reality of the medical field.

“Theo.”

“Yeah.”

“You can do it, right?”

Theodore’s ST Compression specialized in extracting meaning from enormous quantities of data.

He nodded with a serious expression.

“Of course. I’ve already integrated data from all of New York City. This is nothing.”

Traffic, weather, pedestrian information, patterns of consumption and leisure. On top of that, there had been data from countless city departments. Needless to say, all of it had been in different formats.

“Every single person’s role is important in this project. I want to clean up this entire mess properly. Everyone, please help Theo as much as you can.”

Seo-ha looked around at his teammates as he spoke. His voice carried profound trust in them.

“Okay.”

“Got it.”

“Looks like there’ll be a lot of computational work. I’ll make sure I’m ready.”

“I have something in mind too,:

Not one of them wore an expression that suggested failure had even crossed their minds.

*****

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