Fifth Vital [EN]: Chapter 131

Fifth Vital- Episode 131

Episode 131. B-But, there are so many worms…

“Sister, would you like to sit here? You’re familiar with CT scans, right?”

“After being abroad for so long, my memory is fading. The mountain village I was in didn’t have such equipment. The facilities were very poor.”

“I’ll explain it to you. You’ll remember when you see it. This here is the stomach. If you follow it down, it connects to the duodenum [the first part of the small intestine] and then the small intestine. If you follow that path, this is the end of the small intestine, close to the large intestine. Do you see something filling the inside of the small intestine here?”

Sister Kim Ye-eun’s gaze, which had been following the monitor with Tae-kyung’s detailed explanation, arrived at the end of the small intestine in question.

“Yes. There’s a lot. What is this? It looks like noodles, is it the *jajangmyeon* [Korean-Chinese noodle dish with black bean sauce] I ate earlier?”

“This is the end of the small intestine, so it’s nearly impossible for food to go down undigested. And if you look at the blood test results here, the white blood cell count is normal, so there’s no inflammation, but the eosinophil count is very high.”

“Then what on earth is this?”

“That’s parasites.”

“……!”

Sister Kim Ye-eun was momentarily speechless at the word ‘parasites.’

“As a nurse, you know that most of these parasites are transmitted through fecal-oral infection, from the anus to the mouth. When you were in Southeast Asia, the culture doesn’t always use toilet paper, and since you weren’t originally from there, your resistance to parasites is weak, which seems to be the biggest cause.”

“I understand the theory, but still, how can there be so many? Ah! So, is that why I don’t have any energy and don’t gain weight no matter how much I eat?”

“That’s likely to be related.”

“Oh… Then what should I do? Can I just take deworming medicine?”

“There are too many parasites right now, so if you take medicine, the dead carcasses can cause inflammation.”

“Then?”

“We’ll have to operate to remove them all first.”

“Surgery?”

“Yes. I know you’re surprised by the sudden surgery, but it’s a simple procedure to cut out a part of the small intestine and remove the parasites inside.”

“Is it dangerous?”

Sister Kim Ye-eun looked worried at the word ‘surgery.’

“Of course, all surgeries have risks, but this isn’t a major surgery compared to others.”

“Still, surgery so suddenly is scary.”

“Of course. It’s natural to feel that way. But don’t worry too much. Leaving it as it is could become dangerous.”

“…I understand. I’ll have the surgery. I’m scared, but after seeing it with my own eyes, I don’t think I can avoid it.”

She might not have known if she hadn’t seen the CT scan, but after seeing the parasites swarming in her small intestine, she felt the need for surgery.

“Dr. Lee Chan-hee will explain the surgical consent form and other details. We’ll proceed with the surgery in 4 hours due to the fasting time before surgery.”

“Yes, please take good care of me, doctor. Please remove every single one.”

“Of course. Then I’ll see you later.”

“Hello, patient. I’ll explain the pre-operative instructions.”

Lee Chan-hee took Sister Kim Ye-eun to continue explaining the surgical consent form and the remaining details.

Tae-kyung’s gaze returned to the CT scan.

“It’s really incredible.”

He had experienced countless patients, but this was a first. In fact, Tae-kyung, who hadn’t shown any reaction in front of the patient and other medical staff, was also surprised inside.

“It’s a miracle that nothing has happened until now.”

“Is that Kim Ye-eun’s patient’s CT?”

Eui-jin, who had come down to evaluate the patient regarding anesthesia before the surgery, approached and asked while looking at the monitor.

“You’ve never seen anything like this either, have you, Doctor Jung?”

“No. These guys look like roundworms. Right?”

Contrary to what he had expected, Eui-jin’s reaction was calm, and he immediately recognized the roundworms.

“Have you seen them before?”

“Of course. I may not know anything else, but I’ve seen more of these than you, senior.”

“How?”

“When I was abroad.”

“Ah, right!”

Tae-kyung had momentarily forgotten that Eui-jin had worked with Doctors Without Borders.

“The place I was in was also very poor, so there were quite a few. I was so surprised when I saw a parasite patient for the first time. I still remember it vividly.”

“That serious?”

“Yes, everyone in the operating room might be quite surprised later. I’ll go see the patient. See you in the operating room.”

“Okay, see you later.”

Tae-kyung’s gaze turned to the parasites in the monitor once again.

* * *

4 hours later-

Tae-kyung, who had finished preparing for the surgery, stood in front of Sister Kim Ye-eun.

“Anesthesia confirmed.”

Eui-jin, who had carefully checked the anesthesia status, said while checking the patient.

“Then, let’s begin the surgery. Scalpel, please.”

Tae-kyung, who received the scalpel, made an incision from above the navel, along one side of the navel, and then below again.

“The patient is so thin… Mosquito, please.”

Tae-kyung grabbed the fascia [a layer of connective tissue] with a mosquito clamp and gave it to Lee Chan-hee.

“Bovie, please.”

As he cut the fascia with the bovie [electrocautery device], thick smoke rose, and the unique smell of cutting skin filled the air.

Immediately after opening the abdomen about 15cm, Tae-kyung inserted his hand into the patient’s abdomen. Then, he took out a bundle of the small intestine.

“Wet gauze, please, and spread it on the patient’s lower abdomen.”

Tae-kyung placed the small intestine on the wet gauze and grabbed the bovie again.

“Bovie again, please.”

Tae-kyung held the small intestine and placed the bovie on one side of it, causing the people in the operating room to tense up and focus on the small intestine. And then, after making an incision of about 2cm, it happened.

“Ugh!”

“Oh!”

“Oh my goodness!”

The medical staff, without exception, let out short exclamations at the sight they were seeing for the first time.

Even Eui-jin, who had experience with similar patients, couldn’t get used to the sight.

“A bowl!”

Tae-kyung also shouted in a hurried voice, seemingly surprised.

“Give me something to catch them quickly.”

Thud- thud- thud- thud-

Worms with a circumference slightly smaller than a thumbnail and a length of about 20cm poured out of the cut surface of the small intestine.

“B-But, there are too many worms.”

Lee Chan-hee, who thought he had a strong stomach, was also flustered by the worms pouring out.

“Hold the bowl well.”

“Yes, doctor.”

From a distance, they looked like udon noodles, but they were clearly disgusting worms that moved and writhed on their own.

“Wow, how can there be so many?”

“I know. It feels so much more intense seeing it in person than on the CT scan.”

Eui-jin and nurse Lim Jeong-sook exchanged words while looking at the still wriggling worms. It was incomparable to seeing it on the CT scan.

Tae-kyung, who was looking directly at the parasites in front of him, was amazed that Sister Kim Ye-eun wasn’t in more pain than just abdominal pain. That’s how many there were.

“Doctor, there are worms left in the small intestine.”

Although worms poured out of the cut surface of the small intestine, the ones attached to the small intestine with their mouth suckers didn’t fall off.

“Kelly, please.”

Tae-kyung used the Kelly clamp to grab the bodies of the worms attached to the small intestine one by one and carefully tore them off.

Thud thud thud-

At first glance, a dozen or so worms wriggled and fell onto the steel container one after another. The way they wriggled even after falling was so grotesque.

“There are still more left.”

The problem was that these worms were filling the small intestine.

Even Tae-kyung, who had seen countless surgeries and disgusting sights, felt goosebumps all over his body.

“Lee Chan-hee. Grab one side of the small intestine and lift it up.”

“Yes, doctor.”

Tae-kyung inserted an instrument deep into the hole in the small intestine and tore out the worms.

Thud thud thud-

Then, more worms poured out again. From now on, it was a repetition of this task. He repeatedly inserted and removed the Kelly clamp.

In between, there was very slight bleeding from the small intestine due to the parasite suckers. However, it was insignificant bleeding and was stopped with compression alone.

“There are so many disgusting things.”

Before he knew it, the steel bucket was more than half full of worms.

“I’ll check one more time to make sure there aren’t any left.”

Tae-kyung also carefully examined the small intestine, touching it here and there.

Once the things attached to the small intestine were completely removed, the ammonia smell that had been coming from Sister Kim Ye-eun also subsided significantly.

“I think everything’s cleared out? There’s nothing left.”

“Ugh! These things keep moving.”

Nurse Lim Jeong-sook shuddered.

“Now, let’s close the abdomen. Vicryl [absorbable suture], please.”

Tae-kyung sutures the two sides of the small intestine together with a needle, leaving a gap of about 5mm from the cut surface of the small intestine.

“Detach, please, several.”

Tae-kyung carefully sutured the fascia at 1cm intervals. And he tied each knot by hand, suturing again so that the layers matched.

“Dr. Lee Chan-hee, finish the rest of the skin, give the patient one albendazole [deworming medication], and send the lab out at 7 AM.”

“Yes, doctor.”

“And if there’s anemia, give a blood transfusion too.”

“Understood.”

“Doctor, you’re not going to show them, are you?”

Nurse Lim Jeong-sook asked, glancing at the still wriggling worms. Tae-kyung’s gaze also turned to the same place.

“Those things?”

“Yes.”

“Well…”

In the case of a patient who has undergone surgery, there are often cases where the guardian or the patient after surgery is shown the disease that was removed from the body. But this time, he didn’t even think about it.

“It’s better not to show them.”

He thought that showing the patient the wriggling worms might shock them unnecessarily.

In fact, anyone would be surprised if something like that came out of their body. Therefore, it was best not to show it for the patient’s sake.

“When did everyone take their deworming medicine? Ugh! They’re still wriggling.”

At the scrub nurse’s words, the gazes of the people, including Tae-kyung, turned back to the container with the worms.

“Because I saw that, I’m going to buy deworming medicine and have my whole family take it when I get home.”

“Come to think of it, I don’t even know when I took deworming medicine.”

“Me too. I took it once two years ago? But I didn’t take it last year or this year. What about you, Dr. Lee and doctor?”

“I don’t take deworming medicine separately.”

“Me neither.”

Tae-kyung agreed with Lee Chan-hee’s words. It is recommended to take deworming medicine once a year, but it was not mandatory.

In the past, the country told people to take deworming medicine from time to time to eradicate parasites. However, these days, parasites are no longer found in people’s bodies as often, so they don’t necessarily take deworming medicine like they used to.

Usually, people personally thought they should take deworming medicine and took it.

“Human psychology is so strange. I never even thought about taking deworming medicine until now. But because of that, I want to buy medicine too.”

“Me too.”

People nodded at Nurse Lim Jeong-sook’s words.

“Anyway, everyone must have been surprised by those worms today. Good job.”

“Good job.”

Tae-kyung came out of the operating room and went to see Sister Kim Ye-eun, who had woken up from anesthesia a little later and moved to the hospital room.

“Sister, are you okay?”

“Yes, I’m okay.”

“The surgery went very well.”

“Really? Thank you. Then there are no more parasites in my body?”

“We checked and removed everything in the small intestine.”

“Um, doctor?”

“Yes.”

“Did I really have that many parasites in my stomach?”

At Sister Kim Ye-eun’s words, which seemed genuinely curious, Tae-kyung recalled the parasites pouring out of the small intestine.

“There were enough to block the small intestine. You did well to have the surgery.”

“Really? I’m so grateful. I would have just ignored it again if it weren’t for you, doctor.”

“You’re welcome. Then get some rest.”

“Yes. Thank you for your hard work.”

Tae-kyung came out of the hospital room and walked down the hallway, quietly talking to himself.

“I need to wash my hands more thoroughly after using the restroom from now on.”

He already washed his hands well, but he thought he should wash them even more vigorously.

“Should I go home or not?”

Tae-kyung, looking at his cell phone clock and wondering whether to go home or not, went down to the first floor to check the emergency room situation.

Fortunately, the emergency room was not very crowded.

Tae-kyung, who was sitting at the emergency room station, checking the patient status on the monitor, raised his head and saw Choi Mona.

“What is it?”

But Choi Mona’s appearance was a little different.

“Something’s a little strange…”