Fifth Vital [EN]: Chapter 6

Fifth Vital- Episode 6 (6/502)

Episode 6. Anaphylaxis

With his consciousness fading, Tae-kyung’s eyelids fluttered open.

‘Right. I died.’

He blinked again.

‘Is this heaven…?’

Tae-kyung momentarily thought he had come to heaven because he had saved a young child. He looked around as his vision gradually cleared.

‘Wait a minute!?’

Something was strange. The scenery before him was too familiar to be heaven.

“Oh! It’s my place.”

Indeed, Tae-kyung had opened his eyes in his rooftop room. There was another odd thing.

‘How did this happen?’

He felt none of the weakness and lethargy from being diagnosed with cancer, nor the pain of his bones shattering in the accident.

“My body is fine.”

Not only was he in good condition, but in front of the mirror, he saw his face with a healthy complexion.

“Huh? This is!”

While examining his body, he found a small scar on his hand. This scar was where he had been stabbed by a piece of metal while saving the child. Moreover, the keychain that had been flung away in the accident was still in his pocket.

“Am I dreaming right now?”

He was trying to figure out what had happened when.

“Hey, Mr. Kim? Are you inside?”

A vivid voice called out to him.

“Doctor Kim, it’s me, Jang Deuk-chil. Come out for a bit.”

Clang!

Tae-kyung went outside, dumbfounded. As he opened the door, a strong, unpleasant ammonia smell hit his nose.

‘Ugh! Ammonia smell.’

Soon, he realized that the smell was coming from Jang Deuk-chil’s group.

“Wow! Our Kim Tae-kyung… no, Dr. Kim Tae-kyung, it’s been a while. How have you been?”

‘It’s been a while?’ That wasn’t something someone who had come to his house right before the accident should say.

“Anyway, Dr. Kim, you look much better than the last time I saw you. Right, Deok-soo? This bastard is spacing out again.”

“Sorry, hyungnim [older brother/term of respect]. I’m not feeling well today. But Doctor, you really do look much better.”

Jang Deuk-chil’s subordinate, Kim Deok-soo, stared at Tae-kyung and replied.

“I know you’re not happy to see my ugly mug, but at least say hello when you see someone.”

“What brings you here… !”

Tae-kyung stopped speaking abruptly.

‘Could it be!’

Tae-kyung, suspecting that the situation was returning to how it was before the accident, asked Jang Deuk-chil.

“Did you come because of the debt?”

“How did you know?”

“Are you going to tell me that my brother is addicted to gambling and borrowed money again, so I have to pay it back?”

“What? No. What nonsense are you talking about?”

Unlike his confident tone, Jang Deuk-chil denied it. Tae-kyung asked again.

“You’re saying my brother didn’t borrow money?”

“Yes, I’m telling you, no.”

“Didn’t you two come to my house earlier?”

“Me? Come on. What kind of nonsense is that? Deok-soo, have we ever been to Dr. Kim’s house?”

“No. I think the last time we saw him was six months ago.”

“Stop talking nonsense. Anyway, Dr. Kim, thanks for working hard to pay off your brother’s debt. Take this.”

Jang Deuk-chil handed Tae-kyung a piece of paper, leaving him completely confused.

“Take a look.”

「This is to certify that all debts borrowed under the names of Kim Tae-hoon and Kim Tae-kyung as of X month X, 2021 have been fully repaid.」

The A4 paper was a receipt with Jang Deuk-chil’s seal, stating that the debt had been repaid.

“You’re saying I paid off all the debt?”

“That’s right.”

That couldn’t be. It wasn’t just a small amount; it was a debt of hundreds of millions of won. It wasn’t something he could pay off overnight, or even in a few hours.

‘I died and came back to life, and all the debt is paid off. Am I dreaming?’

Tae-kyung wondered if all of this was a dream.

“Can you slap me once?”

“Why? Are you wondering if it’s a dream? I’ll give you a good slap. Close your eyes.”

With a smack, Tae-kyung’s cheek stung.

‘Wow! That really hurts.’

Feeling the pain, he knew for sure it wasn’t a dream.

“To be exact, Dr. Kim, your patient paid off the debt for you.”

“Patient?”

“Yeah. They said they lived because Dr. Kim performed the surgery well.”

Jang Deuk-chil said he had gone to the hospital to see a debtor who was hospitalized. While he was there, he had been looking for Tae-kyung to explain the changed interest rate when he happened to meet an old man.

“The old man’s name was Kim Cheol…”

“Patient Kim Cheol-gi?”

“That’s right, Kim Cheol-gi!”

Kim Cheol-gi was the colon cancer patient Tae-kyung had last operated on at Shinhwa University Hospital. He was a small old man who was polite to everyone, doctors and nurses alike.

“But why would he pay off my debt…?”

“I don’t know. Why are you asking me that?”

To Tae-kyung’s question, Jang Deuk-chil said he had immediately agreed because it meant a lump sum of money coming in for the remaining interest.

“He said he’d contact you, so ask him for details directly.”

With those words, Jang Deuk-chil gave his final greetings with his subordinate.

“Anyway, Dr. Kim, thanks for your hard work. Let’s not see each other again.”

Tae-kyung had many questions, but he decided not to ask. Judging from Jang Deuk-chil’s reaction, it seemed like he really didn’t know. There was something more important to do first.

“I need to go to the hospital first.”

He wanted to check his current physical condition.

* * *

“He suffered like a dog because of his immature brother, but now his life will finally get better.”

Watching Tae-kyung enter his house, Jang Deuk-chil wore a brief, satisfied expression.

“Deok-soo, let’s go.”

“Hyungnim [older brother/term of respect], I’m sorry, but can we rest for a bit?”

“What nonsense. You’ve been sitting and resting on the porch this whole time, what more rest do you need?”

“I’m not feeling well.”

Kim Deok-soo, wiping the sweat from his forehead, said cautiously.

“You got a shot at the hospital earlier.”

“I think my stomach hasn’t been feeling good since that shot…”

“Bullshit. That’s because you ate three bowls of jjajangmyeon [black bean noodles] and got indigestion. So lose some weight.”

“No, hyungnim [older brother/term of respect].”

“Shut up and get up quickly. We have to go to Daejeon to catch the guy who skipped out on the interest.”

“Yes, I underst…”

Thud-

Kim Deok-soo, who was getting up from the porch amidst the barrage of nagging, collapsed as if he were lying.

“Hey! Deok-soo? Kim Deok-soo!”

Quite startled, Jang Deuk-chil called out his subordinate’s name and shouted to Tae-kyung.

“Dr. Kim? Come out here. Kim Tae-kyung! Deok-soo collapsed.”

Clang-

Tae-kyung, who was changing clothes in the house, rushed out in his undershirt at the sound of the shouting.

“Ugh! The smell.”

Instantly, Tae-kyung almost took a step back from the pungent odor.

The smell, which had initially been like strong ammonia, now smelled similar to the formalin he had smelled during cadaver practice.

‘Why does it smell like formalin? This is driving me crazy.’

The piercing smell irritated his eyes, and he felt like his nose was wrinkling involuntarily. But now was not the time to talk about the smell.

“Call 119 first [emergency services number].”

“Dr. Kim, what’s wrong with Deok-soo? Huh?”

“What are you doing! I told you to call first!”

“Oh, oh, okay. I got it. Hello, is this 119? This is 11xx, Choyeodong…”

While Jang Deuk-chil was reporting to 119, Tae-kyung began to examine Kim Deok-soo in earnest.

“Kim Deok-soo? Can you hear me?”

He called his name repeatedly, but Kim Deok-soo showed no response.

“This is…”

Then, the arm revealed below the rolled-up sleeve caught Tae-kyung’s attention.

“Hives!”

After rolling up the sleeves a little more to check, hives were clearly visible on both arms. Soon after, he checked Kim Deok-soo’s breathing.

“Hoo… haa!”

Kim Deok-soo was taking long, labored breaths in and relatively short breaths out.

‘He’s having trouble breathing.’

The inhalation was difficult, and the exhalation was relatively fast, but this also seemed very difficult.

Tae-kyung put his fingers on the artery in his neck and checked his pulse.

‘Tachycardia.’

Kim Deok-soo’s pulse was clearly different from a steady pulse with rhythm. This was tachycardia (beating more than 100 times per minute) without even needing to measure it.

“Jang Deuk-chil?”

“Yeah. I reported to 119.”

“Deok-soo said he wasn’t feeling well after getting a shot, right?”

Tae-kyung asked, remembering Kim Deok-soo’s words from outside the door a little while ago.

“That’s right. Deok-soo said he felt like he had a cold this morning and went to the hospital. But he said his stomach kept feeling bad after that.”
Hives, tachycardia, and the fact that he continued to feel unwell after getting a shot. After synthesizing Kim Deok-soo’s condition, he was able to know his symptoms.

‘Anaphylaxis.’

Anaphylaxis is an acute allergic reaction. Generally, skin or mucous membrane changes, respiratory failure, hypotension, and persistent gastrointestinal symptoms of hypoperfusion are seen within seconds to hours after exposure to an antigen. If not treated properly, it can lead to death.

“Hello. Patient? No, I’m just here, and the person next to me is looking at him.”

In the meantime, Jang Deuk-chil answered a call from 119 and explained the situation.

-It can be dangerous to just look at the patient without knowing the exact condition. In particular, you should not touch the head carelessly.

“Really? Hey… Dr. Kim, they said not to touch the patient carelessly? Dr. Kim?”

Jang Deuk-chil kept calling Tae-kyung, but he had no time to answer.

“This is bad.”

Tae-kyung’s brow furrowed.

‘Swelling is coming up.’

As the blood pressure dropped, the pulse weakened, and his hands and feet began to swell.

“Ha… ah…”

As feared, it was visible that breathing was becoming difficult due to edema of the larynx. The patient’s condition is not good.

“Oh, oh! Dr. Kim? No!”

Tae-kyung tilted Kim Deok-soo’s head back as far as possible. Jang Deuk-chil, who was watching this, raised his voice in anger.

“They said don’t touch his head carelessly.”

Jang Deuk-chil, who was out of his mind because his beloved younger brother had collapsed, momentarily forgot that Tae-kyung was a doctor.

“I’m a doctor!”

This time, Tae-kyung shouted. And he added in a confident tone.

“Don’t worry.”

“That’s right. Dr. Kim is a doctor. I was out of my mind. Hello. I’m with a doctor now, so please come quickly.”

Touching a collapsed person carelessly was not the right thing to do. But Kim Deok-soo’s collapse was not due to external injury, and it was not wrong for a professional medical person to examine him.

Tae-kyung quickly took out his cell phone and shined the light into his mouth. As expected, the epiglottis (the flap of cartilage at the back of the tongue that prevents food from entering the trachea) was not clearly visible.

‘This is dangerous.’

If this edema continues, Kim Deok-soo could die.

He decided that he had to secure the airway first, let alone epinephrine (adrenaline, the best drug to stimulate the sympathetic nervous system to suppress edema and raise blood pressure), which is the most important treatment.

But there was a problem.

‘Damn it. I don’t have any equipment.’

For endotracheal intubation, the necessary equipment is required. It was unlikely that there would be any equipment on the floor of the old rooftop, let alone a hospital.

Since he couldn’t perform endotracheal intubation now, he had to secure the airway with a tracheostomy (a surgical procedure to create an opening in the trachea to facilitate breathing).

He couldn’t let the patient die while waiting for 119 to arrive.

“Do you have a knife?”

Tae-kyung, having made a quick decision, asked if there was a knife.

“…Wh-what do you need it for?”

Jang Deuk-chil, who doubted his ears for a moment, asked in disbelief.

Time was of the essence. If there were no teeth, he would use his gums; he decided to use a knife instead of equipment.

“Jang Deuk-chil, do you have a knife?”