Fifth Vital [EN]: Chapter 118

Fifth Vital Sign – Episode 118

Episode 118. A Finger?

“Lee Chan-hee?”

“Yes, Doctor.”

“I once performed a 15-hour LT [Liver Transplantation] surgery.”

“F-Fifteen-hour LT?”

Upon hearing that, Lee Chan-hee stuttered slightly without realizing it.

‘What is this? Why do I feel like I’m in trouble?’

He suddenly felt a chill, as if sweat would start flowing down his spine.

“I have a five-volume set of notes reviewing that surgery.”

A five-volume review for a 15-hour LT? Lee Chan-hee’s expression darkened as if he anticipated something unpleasant.

“Are you going to tell me the truth, or would you like to summarize those five volumes into two and submit them?”

“The upstairs bathroom drain burst, and water is leaking through my ceiling. The landlord wired me money for a motel and told me to sleep outside tonight.”

As soon as Tae-kyung finished speaking, Lee Chan-hee confessed everything without taking a breath.

A 15-hour LT surgery, and notes reviewed by Tae-kyung himself. Just hearing about it made him feel suffocated.

“That’s why I chose to be on call tonight. So, Choi and I will be here, and I thought you could get some rest.”

“Really? Then I’ll go rest for a bit. Call me if it gets busy.”

“Understood.”

After Tae-kyung left the emergency room with the earthworm doll, Lee Chan-hee and Choi Mona treated the emergency room patients.

A person with a cracked shin bone from a fall, someone with a severe cold, someone stung by a bee, patients arriving in 119 ambulances [Korean emergency services], etc. As always, various patients visit the emergency room for various reasons.

“Let me know when the test results for the patient in bed 3 come out.”

“Yes, Dr. Lee.”

“Dr. Choi, the images for patient 13 are up.”

“Yes, I’ll check them right away.”

The two of them focused on treating patients without exchanging a word for a while. Several hours passed like that.

“Um, excuse me…”

A middle-aged man, about 180cm tall, hurried in through the emergency room entrance connected to the outside, with his back bent over.

“My stomach…”

“Are you alright, sir?”

As the man complained of pain with a distorted face, the emergency room nurse immediately approached him.

“My stomach hurts so much.”

“Please sit here first so we can check your blood pressure. Sit here.”

“Yes…”

Even while putting his right arm into the automatic blood pressure monitor, the man clutched his stomach with his other hand and frowned.

“When did it start hurting?”

“Well, I’ve had stomachaches often. But today, it’s been hurting so much since morning. It became too hard to bear, so I came straight to the emergency room from work.”

“We’ll start with some basic blood tests.”

“No. Doctor.”

Lee Chan-hee, who was approaching from afar after finishing treating a patient, said with a determined expression.

“Let’s get a CT scan first.”

“Pardon me?!”

“The patient is in so much pain, so let’s do a CT scan along with the blood test.”

“Dr. Lee, wouldn’t it be better to look at the blood test results first?”

A nurse, who had quite a few years of experience, although not as much as Nurse Im Jeong-suk, spoke softly to persuade him.

“Yes, normally I would, but the patient is in a lot of pain, so I think it’s okay to take it right away.”

“Ah, yes… Understood, Doctor.”

Lee Chan-hee confidently returned to the station, as if satisfied with his order.

* * *

“Sir, thank you for your cooperation with the examination today. You can pay and leave. See you at the next checkup.”

“Then should I come back in six months?”

“Yes, sir. As the doctor explained earlier, he asked to see you again in six months, so we’ll check then. We’ll send you a text message so you don’t forget the checkup date.”

“Yes, thank you.”

“Thank you for your hard work.”

Nurse Im Jeong-suk, who had finished delivering the instructions to the outpatient, smiled as she entered the examination room.

“Doctor, do you know what that is supposed to be?”

Tae-kyung was holding the earthworm doll that Seyoung had given him and moving it around near the sunny window.

“I do, but I feel like I should put it in a sunny place. Seyoung gave it to me, so I want to keep it in a warmer place.”

“When you put it that way, I understand.”

“Are there any more scheduled patients?”

“No, there aren’t.”

“Then I’ll stop by the 2nd floor ward and then go to the emergency room.”

“You’re going to see patient Yoo Ji-cheon again, aren’t you?”

“Yes, I’m going to see her often.”

Tae-kyung stroked the doll Seyoung had given him and left the examination room.

“He’s really amazing. That’s why patients go out of their way to find him.”

Nurse Im Jeong-suk whispered to herself, watching Tae-kyung’s back as he headed to the 2nd floor ward.

* * *

As Tae-kyung stepped into the 2nd floor ward, the smell of formalin [a preservative] and sulfur filled the air.

It was no exaggeration to say that formalin and sulfur completely covered the smells coming from other rooms, as if they were the owners of this place.

‘It hasn’t gotten worse compared to this morning. That’s a relief…’

Formalin and sulfur.

The fourth stage of the fifth vital sign, meaning the stronger the sulfur smell, the worse the patient’s condition.

His footsteps followed the pungent smell to room 207. Tae-kyung looked at the name of the patient, Yoo Ji-cheon, hanging next to the ward with a heavy heart before entering.

“Ms. Yoo Ji-cheon?”

He called out the name of the patient Yoo Ji-cheon, who was closest to the ward door, in a deliberately bright voice.

“Yes…”

When her name was called, the patient replied weakly in a low voice and slightly parted the curtains.

“How are you feeling? I was wondering if your condition is better compared to this morning.”

“I’m okay. I feel better after taking a nap.”

She was so emaciated that she didn’t look like a 55-year-old woman.

Yoo Ji-cheon slowly raised herself, as if she had no strength in her voice and no energy.

Moreover, there was no vitality in her eyes.

“Oh…”

Yoo Ji-cheon, who was looking at Tae-kyung with a faint smile, found something.

“Are you looking for something?”

“My hat.”

“It’s okay. You don’t have to wear it if it’s uncomfortable.”

“I found it.”

Yoo Ji-cheon put her hand inside the blanket and fumbled around before taking out an anti-cancer hat.

“I always wear a hat when I meet someone after my hair became like this.”

Her hair was in such a state that it was hard to imagine it belonged to a woman in her 50s, with only a few strands left.

“This is your 12th round of chemotherapy at our hospital. You’ve done so well so far. It must have been very difficult.”

“It was so hard at first, but this time it was bearable, so it was okay. Last time, my legs hurt so much, like I was being cut with a knife, and I almost died.”

“Side effects related to chemotherapy have limitations in terms of medication. Please tell me immediately if it gets difficult or worse.”

“Yes, Doctor. I will. You’re always so meticulous, then and now.”

“No, is there anything else that’s uncomfortable?”

“No, I’m fine.”

“Then I’ll see you later. Get some rest.”

“Yes, thank you.”

Tae-kyung greeted the patient and left the ward.

Yoo Ji-cheon was a terminal cancer patient who had been urgently transferred to our hospital a few days ago. He had been momentarily speechless at her changed appearance when she was transferred.

That’s why Tae-kyung couldn’t help but pay more attention and be more concerned. When treating patients on the border between life and death, his heart was bound to be different from usual.

Especially since it was patient Yoo Ji-cheon, he was even more concerned.

“Hoo!”

Tae-kyung let out a short breath as if to shake off his stuffy heart and entered the emergency room.

Tak- Tak-

“Dr. Lee?”

Tae-kyung, who was looking at the patient’s results on the monitor at the station, called out to Lee Chan-hee.

“Yes, Doctor.”

“About this patient here. You took a CT scan right away without taking an X-ray. Why is that?”

The screen Tae-kyung was looking at was the chart of the male patient who had come in earlier with severe abdominal pain.

“The patient was in so much pain, so I took a CT scan right away to differentiate other diseases.”

“Okay, Dr. Lee. That method isn’t wrong, but we’re still doctors.”

“Yes…?”

“What I mean is, there has to be a basis. You can’t do these tests first without a physical exam. Taking a CT scan first will help you find the cause, but if you keep doing this like you are, you’ll become dependent on tests. You have to prioritize the physical exam before any tests. Don’t ignore the physical exam, which is the most powerful thing you can do when a patient comes in.”

“But Doctor, this patient was complaining of pain. In this case, isn’t there an advantage to getting the results quickly?”

“Are you going to burn down the whole house to catch one flea?”

“Pardon?”

Tae-kyung wasn’t getting angry or scolding him.

There were occasionally junior doctors like Lee Chan-hee who did things like that, thinking they were being more considerate of the patient.

In a way, it was overzealousness. But patients can’t be seen with just zeal, so he had to explain what was a priority and why.

“You don’t use a bomber to devastate a field to hunt one cow. This is a barrage of tests. Tests aren’t AK-47s, so why are you firing them like this?”

“Ah…”

“You have to examine them, do blood tests, and suspect what kind of disease it is before testing. Dr. Lee Chan-hee! Huh?”

“Yes, Doctor. I’m sorry.”

Lee Chan-hee immediately regretted his actions and apologized, as if he understood Tae-kyung’s intentions.

“And look at this patient. Did you look at the CT scan?”

“I was just about to look at the results when you called me, Doctor. Really.”

It wasn’t a hastily made-up excuse. He was really about to see the results when Tae-kyung called him.

“Okay, look here. What do you think is the cause?”

Lee Chan-hee stared intently at the monitor, as if he would pierce through it. He rolled his eyes around and looked at the places he had already looked at again.

“Don’t you know?”

“No matter how much I look…”

“Look here. What’s this?”

Something was completely filling the inside of the patient’s large intestine on the monitor.

“It’s stool.”

“Yes, that’s right. This patient is in pain because of constipation. When was the last time the patient had a bowel movement?”

“That… I didn’t ask.”

“Doctor, the patient said he had his last bowel movement 10 days ago.”

Nurse Im Jeong-suk, who had been watching the situation from the side, quickly asked the patient and answered.

“Yes, that’s it. Did you hear what Nurse Im said? If you just do tests without asking questions, this is what happens. Asking questions, physical exams, and blood tests are very powerful procedures. Never neglect them. Got it? Keep that in mind.”

“I thought it was basic, and I was mistaken. I’m sorry.”

“The basics are the most important thing. First, let’s quickly treat this patient. Bring the gloves.”

“Yes, I’ll prepare the enema.”

“Lee Chan-hee?”

Tae-kyung called out to Lee Chan-hee, who was about to prepare the enema as usual for a constipated patient.

“Yes?”

“Have you ever touched stool that’s 10 days old?”

“No.”

Come to think of it, Lee Chan-hee had seen many patients with constipation for a few days, but he had never seen a patient who hadn’t had a bowel movement for 10 days.

“I’ve never seen it before.”

“An enema? No way. It’s too hard to go in. If you put the enema medicine in when it’s so full, there’s a risk of bowel perforation, so you have to take out the hard stuff blocking the entrance first.”

“The hard stuff? Then what kind of instrument should I prepare?”

“What instrument? Instruments are dangerous too. There’s something better.”

“Something better?”

“This.”

Tae-kyung raised his hand into the air and confidently answered.

“A finger?”

“That’s right. It’s the best instrument.”

Leaving the surprised Lee Chan-hee behind, Tae-kyung approached the patient.