Fifth Vital [EN]: Chapter 167

Fifth Vital Sign – Episode 167

167. Even Hippocrates Would Fail

A doctor is someone who is closer to the hospital and has a better understanding of diseases than anyone else.

Lee Dong-hoon was also like that. But he didn’t know it at this time. He never even imagined that his positive mindset, which had never wavered in his life, would collapse.

“Well, the fasting time is up. And the guardian? Shouldn’t we contact family?”

“Family? Ah, it’s okay.”

“Still, wouldn’t it be better to let your wife know?”

“No. If I tell her that I collapsed and came to the hospital this early in the morning, my wife will only be surprised. I’ll tell her in the morning.”

“Okay. Then just a moment. Please move patient Lee Dong-hoon to bed number 20.”

“Yes, Doctor.”

“Admit him and contact the ward in advance. And send a cardiac marker [a blood test used to detect heart damage] to the lab as usual.”

“Doctor, I’ve taken an electrocardiogram.”

Tae-kyung received the electrocardiogram results that had been taken in the meantime and checked them immediately.

“The electrocardiogram is good. But I’ll still send the cardiac marker. And please also send amylase and lipase [tests related to pancreatic inflammation].”

“Okay.”

Lee Dong-hoon underwent the tests quickly according to Tae-kyung’s orders.

“Thank you for your hard work with the tests.”

A little later, Tae-kyung went to Lee Dong-hoon, who had finished all the tests and returned.

“Was it difficult?”

“What’s so difficult about tests?”

Every patient who visits our hospital is special and important to Tae-kyung, but this time it was even more so. Because the other person is Lee Dong-hoon.

He was always with me while performing numerous surgeries at Shinhwa University Hospital, and he always supported and encouraged me when things didn’t go well.

‘Dr. Kim will definitely do well. Just you wait and see. In the end, the one who laughs will be our Dr. Kim Tae-kyung.’

Lee Dong-hoon used to say that every time he was passed over for a professorship. I couldn’t express it directly, but I got quite a bit of strength from those words.

Lee Dong-hoon was that grateful to Tae-kyung. That’s why this time, I wanted to return that gratitude.

“The staff were all so kind. I feel like I’ve become a VIP. But coming here and seeing you, Dr. Kim, you’re really amazing.”

“Me?”

“Yeah. Leading a hospital is not an easy task, but you seem to be doing well. You look like a director who is in charge of a hospital.”

“Doctor, are you praising me because I might have to operate on you?”

Tae-kyung joked back, embarrassed by the compliment.

“Of course. You’re an important person holding my life, so I have to make a good impression. Isn’t that right?”

“Is that so? By the way! How are the professors doing?”

“Well, superficially, they’re doing fine.”

“Superficially?”

“I told you before, didn’t I? That parachute [someone unqualified who gets a position through connections] who came as your replacement. That person is not doing his job properly.”

“The professors must be worried.”

“What can I say? Because of Kwon, the professors have more surgeries, and it feels like we’re walking a tightrope, wondering if something will happen.”

Once the story of Shinhwa University Hospital came up, Lee Dong-hoon seemed to have a lot to say.

“Looking back now, Dr. Kim, you did the right thing rejecting Director Go’s offer a hundred times over. Anyway, Dr. Kim, you’re doing well now.”

“Thank you.”

“Excuse me, Doctor?”

While exchanging stories with Lee Dong-hoon for a while, Nurse Lim Jeong-sook called Tae-kyung softly.

“Doctor, just a moment. Please rest for a while.”

“Don’t worry about me. Go do your work.”

Tae-kyung knew why Nurse Lim Jeong-sook had called him.

“The results are out, right?”

“Yes, Doctor.”

“I’ll take a look right now.”

“You seem more nervous than patient Lee Dong-hoon, Doctor.”

“I guess so.”

Nurse Lim Jeong-sook was right.

Tae-kyung’s expression heading to the station was more serious than Lee Dong-hoon’s, who was waiting for the test results with a comfortable face on the bed.

Tae-kyung sat in front of the monitor and seriously checked the CT results.

The liver and stomach appeared on the monitor, followed by the abdominal aorta, kidneys, large intestine, and small intestine in order.

‘The inside of the abdomen is still clean.’

And as the small intestine ended, there was a lot of fluid in the abdomen. Then Tae-kyung’s gaze moved to the side.

‘Ah! This is… The hemoglobin is too low.’

The lab results on the monitor next to it showed that hemoglobin (Hgb, the level of oxygen-carrying factors; the lower the level, the greater the possibility of bleeding) was too low at 6, which was half of the normal level.

After checking the results, Tae-kyung went straight to Lee Dong-hoon.

Clatter-

“Doctor?”

“Yeah. Dr. Kim. What’s wrong? You don’t look good?”

Lee Dong-hoon, who had worked with Tae-kyung for a long time, could tell Tae-kyung’s feelings with just a subtle expression.

“Right now, your hemoglobin is 6, and there’s a lot of blood pooled inside on the CT scan. I think we’ll have to open you up to find the exact cause.”

“Hmm… If it’s that serious, we’ll have to do an exploratory laparotomy [surgical opening of the abdomen], right?”

“Yes, we have to open you up and find it one by one.”

“The CT scan didn’t show the cause?”

“It’s not clear yet, but I see something strange.”

“Something strange? What is it?”

“There’s something in the small intestine.”

“Small intestine? What could be in the small intestine? Dr. Kim, I’m okay, so tell me without hesitating.”

“That’s why it’s not clear. As I said before, I think we’ll have to operate and see it directly.”

“Is that so? If Dr. Kim says so, then it must be so. Okay. I’m in your hands.”

“Yes. Then I’ll explain the surgery and get your consent.”

“Just have the director fill out everything. I trust our Director Kim Tae-kyung. It’s okay.”

Unlike Tae-kyung, who was worried, Lee Dong-hoon still had a face that was far from worried.

“Doctor? As you know, there is, of course, a possibility of death.”

“I know. Why wouldn’t I, a doctor, know that? But you know what? I know something that our Dr. Kim doesn’t know.”

“Yes? What are you talking about all of a sudden?”

“I’ve been watching Dr. Kim’s surgeries for a long time, so I know this well. If Kim Tae-kyung is going to die during surgery, then even Hippocrates [ancient Greek physician considered the father of medicine] would fail. Yeah, that’s right.”

“Ha! What are you saying?”

Tae-kyung couldn’t help but laugh at Lee Dong-hoon’s absurd words.

“Thank you for your words, but you’re being too flattering.”

“You think I’m exaggerating? But I’m not exaggerating.”

Lee Dong-hoon was serious. What he had just said was an exaggeration, but it wasn’t *just* an exaggeration.

After seeing Tae-kyung’s face after arriving at the hospital a little while ago, Lee Dong-hoon’s fearful and anxious mind disappeared.

That’s because of the deep trust that he can trust the doctor in front of him.

He had seen the surgeries of many doctors at Shinhwa University Hospital, so he knew better than anyone.

There is a difference in talent in the surgeries that doctors perform.

That difference is felt more prominently when the same doctors see it in the operating room.

No matter how theoretically brilliant a person is, there are cases where they can’t perform well in the field, and vice versa.

But there are also doctors who have both theoretical brains and surgical talent, and that was Tae-kyung.

To put it simply, it was the best example of what happens when a genius works hard.

In addition, there was one more thing that Lee Dong-hoon valued highly about Tae-kyung, and that was his humanity.

If a doctor is skilled, it is not easy to be kind. As patients flock to them after hearing their reputation and those around them praise them, they unknowingly put strength in their shoulders and stiffen their necks.

But Tae-kyung’s humanity was also genuine, so from the perspective of a fellow doctor, he couldn’t be a better doctor to entrust his life to and have surgery with.

That’s why detailed explanations of minor consent forms were not necessary.

“I trust our Dr. Kim.”

“Thank you. But it’s a formality, so I’ll get the consent form quickly and go up to the operating room right away.”

“Okay. See you in the operating room.”

Tae-kyung’s back as he left the bed looked bigger than ever. It was clearly a smaller hospital compared to Shinhwa University Hospital, but Lee Dong-hoon’s heart was even more reassured.

Clatter-

“Hello. Doctor.”

Lee Chan-hee greeted Lee Dong-hoon with the surgical consent form in his hand.

“I’ve come to explain the surgical consent form.”

“Oh my. What doctor are you?”

Lee Dong-hoon was somehow embarrassed by the title of ‘doctor’ called by another doctor who was not from Shinhwa University Hospital, where he worked, and who was not a close friend.

“Since I came as a patient, please treat me comfortably like a patient.”

“The director also calls you doctor, so I can’t do that. First, I’ll guide you through the surgery.”

After quickly guiding him through the surgery, Lee Chan-hee received a signature on the consent form.

“Then please sign here.”

“By the way, how is it working with our Director Kim? Is it difficult?”

“No. I’m learning a lot.”

“Well, Dr. Kim has a lot to learn from. But to be honest, since he’s not here, Dr. Kim is secretly picky, right?”

“No. He’s not secretly picky, he’s openly picky.”

Lee Chan-hee strongly agreed with what Lee Dong-hoon said.

“He’s so picky…”

“Haha! Is that so? He’s like that because he doesn’t just let anything go when it comes to patients and he’s uncompromising.”

“Yes, I know.”

“Are you going in as an assistant, Doctor?”

“Yes.”

“Please take care of me.”

Lee Dong-hoon, who was about to undergo surgery, had a pleasant short conversation with Lee Chan-hee before heading to the operating room.

* * *

“Dr. Kim Tae-kyung and all the doctors here, please take good care of me.”

Lee Dong-hoon, who arrived in the operating room, greeted the medical staff, including Tae-kyung, before anesthesia.

He had always been there as an anesthesiologist, but it felt strange to lie on the operating room bed to receive surgery.

“Of course. We’ll do our best. Just think of it as taking a good nap.”

Tae-kyung comforted him with warm words, knowing Lee Dong-hoon’s feelings.

“I will. I’ll just take a good nap and wake up.”

“Dr. Jung, please administer the anesthesia.”

“Yes. I’ll start the anesthesia.”

After that, anesthesia was performed quickly.

After the anesthesia was completed, sterilized sheets covered Lee Dong-hoon’s entire body, creating a surgical field.

“Then we’ll start patient Lee Dong-hoon’s surgery.”

With the words to start, Tae-kyung made a long incision of about 15cm below Lee Dong-hoon’s navel.

“Give me a toothed forcep [a 15cm forcep with a hook at the end that can be fixed] and a Bovie [a device that cuts skin or tissue with electricity and is effective for incision and hemostasis].”

Tae-kyung held one side of the incision with the forcep, and Lee Chan-hee held the other side with the forcep and pulled it to both sides. After that, Tae-kyung cut through the middle with the Bovie.

The tissues are cut simply by applying the Bovie, an electrosurgical unit. The bleeding parts in between are hemostated [stopped] with electricity using the Bovie.

As the smoke from the burning tissues rose inside the operating room, Lee Chan-hee quickly sucked in the smoke with a suction device.

If you continue to cut down the tissues, you will see a white membrane.

“Now it’s the fascia [a layer of tissue below the skin]. Put your hand in.”

“Yes, Doctor.”

At Tae-kyung’s words, Lee Chan-hee put his finger into the fascia hole to widen the distance between the abdominal wall and the intestine.

The reason for inserting the finger is to prevent the intestine from being damaged while cutting the abdominal wall with an electrosurgical unit.

When all the incisions were made, the blood pooled inside was visible. But as soon as he saw the blood, Lee Chan-hee had a quite surprised expression.

The amount of pooled blood was quite large.

“Wow! There’s a lot.”

“Yeah, there’s more than I thought.”

The blood was so full that the small intestine was floating.

“Put a cap [a device to prevent the small intestine from being sucked in during suction] on the suction.”

The vision was not clear due to the blood forming a river as much as the small intestine was floating.

‘I have to find it quickly.’

First of all, I had to find the cause of the bleeding, where the blood was coming from.

Shh-

As some of the blood in the abdomen was sucked in, it was visible that blood was flowing down from one side.

“I think it’s here.”

The blood was trickling between the mesentery [tissue that holds the small intestine] connected to the small intestine.