What Doctors Carelessly Overlook

The wail of an ambulance siren grew louder outside the ER. Through the frosted glass doors I saw the red lights freeze in place. A moment later, the security guards at the reception desk swung the doors open. A blast of February air rushed into the lobby. Paramedics came in carrying a woman on a stretcher, a lady in her sixties. The last to enter was a medic in an orange uniform, a file folder in his hand. I approached him.

“What do we have here?”

“Sixty-two-year-old woman, no known medical history. About twenty minutes ago she developed sudden dizziness and shortness of breath. Her current BP is 110 over 63, oxygen saturation 97%.”

“Alright, thank you. This way.”

I guided the stretcher to an empty bed, watching her carefully. To my relief, she could still speak. She said she felt better now than she had at home, less dizzy, less breathless. Once she settled in, I asked a few questions. She told me she’d lived without any chronic illnesses, took no regular medications, had no heart or lung disease.

I noted her words in the chart and examined her for anything unusual. That was when I saw it—reddish blotches around her knees, like insect bites. I asked about them. She looked away and said she didn’t know, that it was the first time she’d noticed them. But her tone betrayed her. It wasn’t the honest ignorance of surprise; it was the strained denial of someone hiding something.

She wasn’t the only one acting strangely. Nearby, a man with long graying hair tied back in a ponytail, dressed in a traditional-style robe, circled around. He had been lingering since she entered. I approached and asked if he was her guardian. Startled, he admitted he was, then cautiously asked about her condition.

I told him we would run a chest X-ray and asked if there was anything else I should know—particularly about the marks on her knees. He hesitated, touching his finger to his upper lip, then finally spoke.

He introduced himself as a man who had long studied “natural therapies” while traveling Korea’s mountains. Just before calling 119, he had performed a bee venom procedure—injecting her knee with “apitherapy.” Suddenly she had clutched her throat, struggling to breathe. Alarmed, he had called the ambulance. Yet he reassured me with a smile: “It’s only a temporary healing reaction, nothing to worry about.”

Bee venom therapy, or apitherapy, involves injecting venom extracted from a bee’s stinger into the skin, supposedly for health benefits. The problem is that many who practice it are unlicensed, using unrefined venom that can trigger life-threatening anaphylaxis.

Anaphylaxis is a systemic allergic reaction—hives or swelling in skin and mucosa, respiratory distress, hypotension. With immediate treatment, patients usually recover; without it, about one in a hundred may die. This woman had narrowly escaped that fate.

I hurried to the prep room, drew up an epinephrine shot, and drove the needle into her thigh. Epinephrine relaxes the airways, the standard first-line treatment when anaphylaxis is suspected. Even without a confirmed diagnosis, the benefit outweighs the risk.

We placed her on oxygen and fluids, monitored closely for hours. The chest X-ray revealed nothing else. As expected, her symptoms eased rapidly. It had been an acute allergic crisis after all.

Half an hour later, I found her propped up, speaking into a phone. She reassured someone on the other end not to worry, not to come. Her companion, the ponytailed man, sat nearby scrolling on his smartphone. He motioned me aside. “I think I’ll head out now. I don’t see why I need to stay longer. My research center is open, other clients may be waiting.”

I said gently, “As her guardian, shouldn’t you remain until she’s discharged?” But he had already slung his bag over his shoulder and was halfway out the door. The woman turned her eyes toward me, now left alone.

Later I returned. She worked at a neighborhood diner, she explained, not as a cook but helping with dishes and tables. Fourteen-hour days, six days a week, for about 1.2 million won a month. Recently her knees had begun to ache. Standing for more than an hour became unbearable. She had planned to see an orthopedic clinic, but another worker warned her that “they’ll just push surgery.” That same coworker recommended the man who gave bee venom injections. Others, she was told, had been “cured.” So she went.

I asked why she hadn’t told me from the beginning. She admitted she couldn’t say it in front of him, that she had felt strangely guilty. I took her hand firmly. “You have nothing to feel sorry for. He does. Please don’t ever go for those injections again.” She nodded, promising she would not.

Later, as I passed her bed, she was gathering her things. Soon she walked out on her own feet, through the same doors she had entered on a stretcher.

Yet her image lingered. The poor are more easily swayed by promises. They spend scarce money and time on false remedies, missing the chance for real treatment until it is too late. And at the heart of that tragedy stand the charlatans—like the man with the ponytail—cloaking superstition in the name of healing.

But then another truth struck me, one I would rather not admit. I, too, had acted on faith rather than certainty. When I injected epinephrine into her thigh, it wasn’t because I perfectly understood every mechanism. It was because my seniors had taught me: in suspected anaphylaxis, give epinephrine first. I acted out of training, out of habit. In that sense, I too had relied on incomplete knowledge and experience.

This is the hidden shadow of medical education: memorization without critique. No physician can ever know more than a sliver of medical knowledge. New papers are published every 40 seconds; even reading nonstop, one could grasp only a fraction. Yet many doctors are reluctant to admit ignorance. They see disagreement as a threat to their identity, their years of sacrifice. As they grow older, with more knowledge and experience, they often grow more rigid.

Perhaps that rigidity is what drove this woman to an unlicensed healer instead of a clinic. If doctors had listened more carefully, shown that they did not know everything, maybe she would not have believed “surgery is the only option.” The blame rests not only on charlatans but also on doctors like us.

The real line between quack and physician is not who claims more knowledge. It is who admits what they do not know. Charlatans insist they are always right. A true doctor recognizes the limits of his knowledge and remains open. Medical training, I realized, is not only about gathering knowledge and experience. More importantly, it is about cultivating the humility to admit that what you know is never all there is.