Fifth Vital [EN]: Chapter 44

44. NPO Time

“Ugh, bleh… I can’t even look at it.”

Surprisingly, the trembling fingertip pointed to a dead snake amidst the shards of a broken liquor bottle behind the toilet.

“Oh, my! Goodness!”

Even Head Nurse Lim Jeong-suk, who had seen it all during her time as head nurse and was usually unflappable, was visibly surprised to see the snake.

“Ugh. Scary.”

In a way, it was understandable. No one expected to find a snake in a hospital bathroom.

“Choi Seon-hae, are you alright?”

Tae-kyung, however, wasn’t particularly surprised by the snake. Since it was already dead, the patient’s bleeding was the more pressing concern.

Before surprise could even register, his doctor instincts kicked in, and he began examining the patient.

‘No injuries.’

Fortunately, she didn’t appear to have hit anything vital during her fall. His gaze quickly moved to her lower body.

Choi Seon-hae’s patient gown pants were soaked with blood. As Tae-kyung removed her pants, blood trickled down from around her anus.

‘Damn it!’

Blood originating from the digestive system and anus is always a red flag. The amount of blood was definitely alarming.

“Let’s move the patient to the treatment room first.”

“Yes, Doctor.”

Tae-kyung and Nurse Lim Jeong-suk moved the patient to the nurse’s station’s treatment room, while the remaining nurse called Team Leader Choi.

“Team Leader, this is the 2nd-floor ward, room 209. The patient is experiencing bleeding in the bathroom.”

-Oh, really? I’ll contact the cleaning crew.

“Um, but I think you should come up, Team Leader. I don’t think the cleaning ladies are equipped to handle this.”

-They can’t handle cleaning it?

“Yes. There’s something else to clean up. I’m too scared to deal with it…”

The ward nurse glanced at the dead snake, shuddered, and spoke into the phone.

-What’s so scary in the bathroom? I’ll head up.

* * *

Tae-kyung, having moved the patient to the ward’s treatment room, immediately began issuing orders.

“Attach a patient monitor [a device that tracks vital signs in real-time] and prepare a blood transfusion. Two units of whole blood!”

“Yes, Doctor.”

“Let’s get the patient’s lab work done, stat!”

“Understood.”

“Gauze! Give me gauze. And hemostatic agents, too.”

“Here you go.”

Tae-kyung took the gauze soaked in hemostatic agent and carefully packed it around the patient’s anus. He then repositioned her on the bed while continuing treatment. Tae-kyung’s precise orders were executed swiftly.

“Vitals! What are the vitals?”

“Blood pressure is low, 88 over something. Heart rate is elevated, 120.”

“What about the lab results?”

“Hemoglobin [a measure of oxygen-carrying capacity in the blood] is 6.8.”

Too low. Significantly lower than normal.

“First, administer packed RBCs [red blood cell transfusion] and a 1L normal saline solution at 80cc/hour. And…”

Just as Tae-kyung was rattling off orders…

“Ugh… ugh…”

Choi Seon-hae, who had collapsed, began to regain consciousness.

“Choi Seon-hae, do you remember collapsing?”

“Yes. I’m sorry…”

“You don’t need to apologize. We’re here to treat you.”

“The doctor’s right. No need to apologize, Choi Seon-hae.”

“No. It’s not that…”

As Tae-kyung and Nurse Lim Jeong-suk reassured her, Choi Seon-hae hesitated before continuing.

“No. You told me to fast because I was going to have surgery. But I drank alcohol and ate food. So, I had diarrhea and stuff.”

Everyone was rendered speechless by Choi Seon-hae’s confession.

“No…”

“…!”

After witnessing the scene in the bathroom, suspicions had arisen, but the possibility still seemed unbelievable. There was no way someone scheduled for surgery would consume alcohol. He had dismissed the thought even while moving her to the treatment room.

“I’m sorry.”

Tae-kyung, hearing it directly from Choi Seon-hae, was dumbfounded. More than that, he simply couldn’t comprehend it.

It was fasting for her own good, yet she deliberately ate and drank. He couldn’t wrap his head around it.

“Then, you drank the snake wine that was in the broken bottle on the bathroom floor?”

It wasn’t an accusatory question, but rather an attempt to understand an incomprehensible situation.

“…Yes. A colleague I work with brought the alcohol and said it was good… No, actually, I have some circumstances…”

Choi Seon-hae was flustered, rambling about her situation.

“Actually… I drank it to die.”

Choi Seon-hae was overwhelmed by the thought of not receiving her back pay. The prospect of being unable to help her only daughter, who was about to get married, felt unbearable.

Then, the thought struck her that if she were to die, her family would receive a substantial insurance payout.

-I enjoy drinking alcohol. Is it okay to drink alcohol before an accident and surgery?

-Are you kidding me? You must fast before surgery, or you could die if something goes wrong. Follow the hospital’s instructions.

She had found a post online and drank the snake wine while watching the director’s behavior, convinced he had no intention of paying her.

“I’m sorry. Doctor.”

“Why did you drink that?!”

Tae-kyung shouted, his voice laced with frustration. It wasn’t anger directed at the patient, but a desperate attempt to get through to her.

“And you’re in a hospital!”

Hospitals are places where lives are risked daily to pull people back from the brink of death. Yet, she had attempted to end her life in such a place.

“You’re saying you wanted to die… ha!”

There were countless things he wanted to say to Choi Seon-hae, but Tae-kyung bit back his words.

‘This isn’t the time.’

It was an emergency, and there was no room for anything else.

“I’m going to turn you on your side for a moment.”

Tae-kyung, regaining his composure, leaned down to check the gauze he had inserted earlier.

‘Damn it!’

The gauze was completely soaked with blood. Seeing the extent of the bleeding, Tae-kyung urgently called someone.

“Doctor Jung? It’s me.”

-Yes, Senior.

Tae-kyung quickly relayed the necessary information so Eui-jin could grasp the situation.

“So, I think we need to perform emergency surgery right now.”

-I understand it’s an emergency, but with such a low hemoglobin level and the patient’s NPO time [nothing by mouth] being insufficient, the patient could die.

It was a reasonable concern.

-So, I don’t think it’s a decision to be taken lightly.

He wasn’t wrong. During general anesthesia, endotracheal intubation [insertion of a breathing tube] is performed. However, if the fasting period is inadequate, food could enter the airway, leading to severe complications. And the hemoglobin level was dangerously low.

‘If general anesthesia isn’t an option…’

But it’s an emergency. Surgery is essential.

“Doctor Jung?”

-Yes, Senior.

“Then, spinal anesthesia is immediately feasible, correct?”

-Pardon? Spinal?

Eui-jin responded with surprise at Tae-kyung’s suggestion.

-But Senior, didn’t you mention cutting the rectum and creating an ostomy [surgical opening] externally? Performing that under spinal anesthesia…

“No, we’ll address that later. First, we’ll approach through the anus and suture the bleeding rectum. Of course, there’s a risk of infection if stool passes through, but stopping the current bleeding is the priority.”

-Ah, bleeding.

“Doctor Jung, is it possible?”

Tae-kyung posed the question, but his tone left no room for argument. It was a firm instruction. This approach was the most effective way to alleviate Eui-jin’s concerns as an anesthesiologist while simultaneously addressing the patient’s critical condition.

-Yes, Senior. I’ll prepare the operating room.

“I’ll be down immediately.”

* * *

“Oh my gosh, ugh! It’s disgusting.”

“I’ve only heard about it, but this is my first time seeing it.”

“Me too. Who would have thought I’d see snake wine in a hospital?”

Tae-kyung went down to the operating room with the patient, and room 209 was soon filled with curious patients and their families who had heard the commotion.

“Still, how can anyone think of making alcohol with snakes and drinking it?”

“I know. I wouldn’t eat it even if you gave me 100 million won [approximately $75,000 USD].”

“Hey. That’s because you ladies don’t understand.”

As some of the female patients expressed their disgust, the men chimed in.

“How precious that stuff is!”

“No, there are snakes all over the mountains in the countryside. What’s so precious about them?”

“That’s what we used to say when we were young. These days, with the air quality being so poor, it’s not like it used to be.”

“That’s right. And not all snakes are the same. I bet that was a very special snake.”

“Ugh, I don’t care what’s precious or not, why would you eat something like that?”

To the questioning voice, a middle-aged male patient summed it up succinctly in one word.

“Stamina!”

“Really?”

“Oh, what am I saying? My wife will be breaking chamber pots and preparing a 12-course meal from morning onwards.”

“Come on, don’t believe that. It’s all a lie.”

“Really?”

“I believed that and did it for my husband 10 years ago… I was so disappointed. Nothing happened.”

“No way. Did you use a small snake?”

“I even cashed out my kye [rotating credit association] and bought him a thick one worth 3 million won [approximately $2,250 USD].”

While the patients engaged in a lively debate about the snake in the bathroom, Team Leader Choi entered.

“Okay! Patients, please step aside for a moment. What’s so scary… Oh my!”

Team Leader Choi, who had confidently entered the bathroom with a composed expression, was startled by the sight of the snake.

“Oh my, I guess the team leader was surprised.”

“Didn’t the team leader say he was a Marine?”

“I know. A Marine who catches ghosts shouldn’t be afraid of a snake.”

Teasing voices followed him, but Team Leader Choi’s startled heart wouldn’t calm down.

‘Why is that here!’

Ghosts and snakes were clearly different. At least a ghost couldn’t bite you.

“Team Leader, you’re not afraid of snakes, are you?”

“There’s no way. He’s a Marine.”

It was true that there was no way. The only thing Team Leader Choi, who even caught ghosts, was afraid of was snakes.

“You must be really scared. Should I catch it for you instead?”

When a middle-aged male patient addressed him, Team Leader Choi finally moved.

“I’m not scared. Patients, please step back, it’s dangerous.”

“What’s so scary about a dead guy?”

“Still, be careful. I saw on the news that a 1-year-old snake in a liquor bottle bit someone and killed them.”

“It’s already dead. I’m not afraid of things like this.”

But despite his words, his hand trembled as he reached for the snake.

‘Eight-cornered camouflage man of the sea… I am a Marine. This snake is nothing. I’m not scared.’

Team Leader Choi sang the Marine Corps song and, after a 20-minute internal battle, managed to dispose of the snake.