Dr. Ko Beom-seok, a professor of breast surgery at Asan Medical Center (AMC) in Seoul, is denying himself food. Professor Ko has survived on water and salt for more than 10 days now. He started fasting on June 23 but hasn't stopped seeing his patients. He performs surgeries as well as medical consultations. If he needs concentration during surgery, he drinks coffee.

Professor Ko looked gaunt on Friday when Korea Biomedical Review interviewed him. His waistline has shrunk by about four inches. His health has also begun to show signs of distress due to the fast. He has blurry vision, muscle aches, and trouble sleeping at night. His molar tooth suddenly started hurting and he had to have it extracted that afternoon. However, he smiled and said, "I feel at ease."

Ko’s coworkers are still disapproving. "What's the point of fasting if no one recognizes you?" they say, but he is determined to continue. He feels sorry for his patients and medical students suffering for a long time due to the medical-political conflict triggered by the expansion of the medical school enrollment quota.

When he saw breast cancer patients who had been coming to him for months and were not being treated in time, and when he saw his students leaving the medical field and not returning, he realized that Korean medicine and medical education, which are among the best in the world, are in disrepair.

Question: It's been almost ten days. How are you feeling?

Answer: So far, so good. I can’t make a mistake or misjudge a patient, can I? However, because of the underlying tiredness, I feel like lying down down all the time. My eyes are blurry, and I ache all over when I lie down to sleep at night. To avoid falling asleep during medical appointments, I drink strong coffee. I don't know if I'll make it through the next week because my condition seems to be changing rapidly. If things don't work out, I think I'll have to get fluids. I'm worried that my patients will get anxious when they hear about my fast.

Q: But why do you fast? Was there a trigger?

A: Many people are suffering from the prolonged healthcare turmoil. Patients and trainee doctors suffer due to this situation, albeit in different ways. If all the professors had resigned, the standoff would have ended but they didn't. They offered to resign but didn't follow through. In my defense, I had patients to take responsibility for, research to do, and family to support. I felt heavy that I couldn't take action. I've been working hard on the emergency committee of the faculty council to try to normalize things, but nothing has been solved.

Then I saw a comment on an article about a patient's mother shaving her hair in protest, saying doctors neither shaved their hair nor fasted to save themselves. I thought it would be disgusting to shave my hair, so I started fasting to show my support and empathy. I hope that when I'm in an extreme situation, people will understand my sincerity. My body is tired. However, I had a harder time in my mind due to feelings of guilt and helplessness piled up.

Q: There's no resolution in sight. What is your biggest concern at this point?

A: The disaster that 2,000 more medical students will bring is so clear that we're fighting to stop it. It's not a problem for the future. It's a problem at this moment. In the breast surgery department, it's not just breast cancer patients that matter. There are patients needing screening and those with non-cancerous but dangerous tumors. The number of surgeons has decreased, and the number of operating rooms has been reduced by half. We can't take all the patients that come in, so there are fewer new patients, forcing us to prioritize.

The government does not talk about it, but many doctors have left the field. Radiology professors and anesthesiologists left, so there are fewer screenings and surgeries. With fewer radiologists, there are fewer tests. If you can't read, you can't take a CT. We're not using the resources we have. It's serious, and the patients are suffering. The whole country has been victimized.

Q: Is that why the professors at Asan Medical Center voluntarily reorganized their care to focus on critically ill patients?

A: We have no other choices. Still, some patients are being missed. The prognosis is worse because the cancer is detected at an advanced stage and treatment is delayed. We'll have to wait for the data to come out, but I think the prognosis for cancer patients this year is worse than in previous years. It makes me angry to see these results are so obvious. I felt so bad for the patients I see in my office. I was angry at the government for creating this situation when my patients told me they had waited four months to see me. (Professor Ko sobbed for a while, unable to speak.)

I am so upset. I became a surgeon because I like solving problems quickly but I am now angry that I can't solve anything. So, I hope things get back to normal soon. I hope the government will take a step back and think about it.

Q: It's hard to treat patients normally now, but we’re also worried about next year. What is your outlook?

A: Right now, I don't think there will be anyone who wants to do internal medicine, surgery, obstetrics and gynecology, pediatrics, and cardiothoracic surgery next year. A professor of neurosurgery worries that there will be no pediatric neurosurgeons when he retires because there will be no successors. We are on night duty every other day. We are barely hanging on. But government officials don't know what's going on. I don't think they even want to know. They seem to think of doctors as a “cartel” that needs to be disbanded. Doctors are there for patients. I want the officials to know I'm struggling for patients this way.