Fifth Vital [EN]: Chapter 388

389. Bulging Abdomen and Thin Limbs

“Right after the director left. The paramedics said it’s a 55-year-old man complaining of upper abdominal pain. Bed number 3.”

Before Nurse Lim Jeong-suk finished speaking, Tae-kyung was already heading towards bed number 3.

-Swish

Opening the curtain and entering the bedside, the patient was lying down, unable to straighten his lower body, seemingly in too much pain. Seeing this, Tae-kyung could tell that the abdominal wall was being stimulated.

Judging from the patient’s severely pained expression, it was obvious that he wouldn’t allow anyone to touch his abdomen.

The patient, who looked to be in great pain, was the same man who had been lamenting his troubles to the taxi driver on the way.

“Hello, sir. How long has the pain been going on?”

“It’s been hurting since last night, but it wasn’t this bad. Suddenly, it started hurting like crazy just a while ago.”

“Can you cough for me, please?”

“Cou… cough?”

“Yes, please try.”

Cough-

“Ugh, I can’t. I can’t do it. Doctor, it hurts too much.”

At Tae-kyung’s words, the patient coughed and showed considerable pain due to the abdominal pain.

Usually, when a patient complains of abdominal pain, the first thing to do is to palpate [examine by touch] the abdomen. However, when the pain is quite severe, as with this patient, palpation is impossible, so coughing is used to stimulate the abdomen instead.

If the abdominal wall is stimulated, peritonitis [inflammation of the peritoneum, the membrane lining the abdominal cavity] or inflammation of an organ that irritates the peritoneum can be suspected.

As Tae-kyung approached to examine the patient more closely, he could smell a strong odor of alcohol coming from his mouth.

“Sir, you’ve been drinking a lot, haven’t you?”

“Yes, doctor. I’ve been drinking non-stop for the past month. My heart… my heart is so broken that I had to drink.”

Tae-kyung was used to hearing patients say they drank because they were upset. Most patients who come in drunk give that answer.

Koreans live in a world of competition and tension. But unfortunately, they don’t seem to know how to manage stress as well as foreigners.

Of course, this isn’t always the case, but at least in the emergency room, there were quite a few people who ran away from stress and ended up struggling in alcohol.

“Sir, have you had this before? And does it feel like a squeezing pain?”

“…Yes. But it wasn’t this painful back then. It feels like my stomach is being squeezed from around my belly button to my side, and it seems to hurt more when I lie down. It’s driving me crazy.”

After questioning him in more detail, Tae-kyung suspected AP (acute pancreatitis) [sudden inflammation of the pancreas] as a result of the patient’s excessive drinking, previous similar symptoms, squeezing pain, and other symptoms.

“Doctor, is it a serious illness?”

“Sir, first of all, don’t worry too much. I’m going to order a CT scan and some tests for diagnosis.”

“…Yes.”

Pancreatitis is, as the name suggests, an inflammation of the pancreas, and one of the most common causes is alcohol consumption.

When you drink excessively, the ducts in the pancreas temporarily contract, and the contents stagnate in the contracted pathways, causing inflammation. This damages the pancreatic cells, and the pancreatic enzymes within the cells circulate through the blood vessels.

Therefore, in pancreatitis, pancreatic enzymes naturally increase.

“Check the patient’s amylase [digestive enzyme secreted from the pancreas] and lipase levels. And take a contrast-enhanced CT scan.”

“Yes, Director.”

Swish-

After giving the orders and coming out of the bedside, Tae-kyung thought that the patient would be diagnosed with pancreatitis.

Since the treatment for pancreatitis is just IV fluids and fasting, it seemed like there wouldn’t be much treatment to do for this patient in the future.

However, he was curious as to what had happened that made him drink so much that it put a strain on his body.

It was clear that it was a problem that wouldn’t be easily solved, and that was why he ended up in the hospital so often due to frequent drinking.

Tae-kyung was worried about this patient’s future.

It was obvious that if he continued to drink, it would put a strain on his body again and repeat the bad situation.

In particular, once you start relying on alcohol, it’s hard to quit, and in many cases, you end up with even bigger illnesses later on.

There was something that doctors would say over and over again to patients who had problems caused by alcohol.

That was, ‘You have to quit drinking.’ But surprisingly, not many patients listened to the doctor.

Tae-kyung was going to strongly advise the patient to quit drinking when the results came out.

“Call the CT room and tell them to quickly take the CT of patient Jo Eung-gi, who is going down now.”

“Yes, Director.”

“And just prepare a narcotic painkiller.”

“The patient is in a lot of pain, should we administer it?”

“No. We shouldn’t administer it yet when the cause isn’t clear. Even if the patient is in a lot of pain, explain it well, and we’ll administer it when pancreatitis is confirmed.”

After explaining to the youngest nurse, Tae-kyung returned to the station.

After about 10 minutes, he confirmed that there were no kidney problems in Jo Eung-gi’s blood test. And the CT results, taken with contrast, came up in less than 30 minutes.

“Director, the CT results for patient Jo Eung-gi are out.”

“I’ll check right away.”

At the same time as his reply, Tae-kyung’s gaze turned to the monitor and stared intently.

As always, the white liver containing the contrast agent appeared, and as he moved the screen down with the mouse, the pancreas appeared.

‘That’s right. It’s right.’

As expected, the pancreas was full of small and messy inflammations, like dark clouds gathering around it.

Also, the blood test results showed that the levels of pancreatic enzymes and inflammation were skyrocketing.

As Tae-kyung thought, patient Jo Eung-gi was indeed suffering from AP (acute pancreatitis).

“How much did he drink to get like this? He should have had it in moderation… I’m talking about patient Jo Eung-gi.”

“Yes, Director.”

“First, administer the prepared narcotic painkiller, maintain fasting, and check the inpatient ward. And I’ll give you a detailed explanation later.”

“Yes, I understand.”

Since the patient’s condition was not in a state that required emergency surgery, Tae-kyung gave the necessary prescriptions and headed to see patient Jo Eung-gi after seeing other patients.

Swish-

“How are you feeling, sir?”

“It was really painful earlier, but the painkiller is strong, so the pain is a little better now.”

“I’m glad the pain has subsided. Your diagnosis is acute pancreatitis.”

“Pancre…atitis? Does that mean I need surgery?”

“No. There are cases like that due to complications, but usually not. But sir, you’ve been drinking a lot, haven’t you?”

“…Yes. I drank a lot.”

“Actually, in your case, the most important thing is to quit drinking. You must abstain from alcohol. If it’s difficult for you to quit drinking with your own will, would you like to receive psychiatric counseling related to alcohol? I’ll help you.”

“Ah, no. You don’t have to do that. I’m going to die from drinking. Actually, I was going to jump off the bridge earlier, but the taxi driver stopped me, and then I got a severe stomach ache and came to the hospital.”

“You were going to jump off the bridge?”

“Yes, doctor.”

“Why would you do that?”

Tae-kyung knew very well that this question itself was nosy. But since alcohol was the biggest cause, he had to ask.

“There’s no one in this world without a story, but I’ve had a really hard life. Since I had nothing, I worked so hard that people around me said I was foolish. I worked so hard to save money, and now I was finally able to live comfortably… But I lost all that money in stocks and coins.”

At the words stocks and coins, Tae-kyung’s face showed a mixture of pity and bitterness.

There were quite a few people who were frustrated by those two words and lost even the hope of life.

At some point, a craze for stocks and coins blew in, and when people gathered, nine out of ten people were constantly talking about it.

You always hear stories about who made a fortune in stocks or who hit the jackpot in coins.

Then, you naturally start to get involved in stocks and coins, thinking that you might get such a jackpot. But from then on, almost all your attention is focused on the phone screen and the monitor.

Furthermore, you imagine becoming a tycoon while looking at the rising graphs and red lines, but when you see the falling graphs and blue lines, your stomach churns and your mouth dries up.

Then, if you lose money due to continued losses, you pour alcohol into your aching stomach, and people who have lost their hearts and health end up visiting the hospital.

Tae-kyung had also seen several people who came to the hospital after losing money in stocks and coins.

There were people who were taken to the hospital after jumping into the river, people who were injured after drinking so much that they were drunk, and people who came to the hospital after trying to jump off the bridge like today.

Among them, quite a few people had health problems due to alcohol, like patient Jo Eung-gi.

He understood that they drank alcohol to forget their upset feelings even for a moment, but for the sake of their health, these people had to quit drinking.

That’s why Tae-kyung brought up the story of the Department of Mental Health earlier.

“I don’t see any hope of living anymore. What kind of money was that…”

“Well, what about your family? Do you have children?”

“I have a wife, a daughter, and a son, and they are both still students. But to be honest, I lost so much money this time that I couldn’t see the future at all. So I even thought about dying with my wife. If I die, my family will be left behind, so I thought it would be better to go together. But I couldn’t bring myself to tell my wife to die together, so I just tried to jump off by myself.”

Tae-kyung, who was listening to patient Jo Eung-gi’s words, flinched for a moment.

Not only stocks and coins, but also the economy has been so bad these days that the number of people who are having a hard time socially is increasing.

And among those difficult families, there are cases where they make the wrong choices.

The problem is that children lose their lives due to the wrong choices of adults.

Tae-kyung couldn’t help but be surprised that patient Jo Eung-gi had such thoughts, no matter how difficult it was.

The pain from acute pancreatitis is severe, but it is not a very serious illness. He was worried that this patient might have such terrible thoughts again after he recovered.

He thought he should change his mind first.

“Sir, you must be very heartbroken. How hard it must have been for you. First of all…”

“Hey! You son of a bitch!”

But before Tae-kyung could finish speaking, suddenly a loud voice came, and both hands came in from the side where the curtain was drawn.

“You son of a bitch!!!”

It was so sudden. The patient lying in the next bed suddenly grabbed Jo Eung-gi by the collar and shouted.

Tae-kyung, who was with Jo Eung-gi, as well as the people around him, were all surprised.

“Hey, what are you doing!”

When the surprised Jo Eung-gi shook off his hand, the man who had grabbed his collar fell weakly.

Looking closely, the man had a bulging abdomen and quite thin limbs.

Even his stomach had a needle inserted because he was having ascites [fluid buildup in the abdomen] drained.

“Oh no, sir!”