Dr. Shin Seonhan: The Doctor Who Sees The Future [EN]: Chapter 40

#40 ICU (7)

.

Do Not Resuscitate.

It refers to obtaining consent not to perform unnecessary cardiopulmonary resuscitation [CPR; a medical procedure to restore breathing and circulation] on patients with no chance of recovery.

“The guardians have already been informed over the phone.”

Beep—

Doctor Byun said, turning off the monitor’s alarm.

As the loud alarm sounds ceased all at once, a quiet stillness settled in the ICU as if by magic.

“……”

My head cools down.

Only then do I notice the surroundings.

In the ICU, no one but me is moving.

Even the nurses are avoiding my gaze.

‘So… I have to watch the patient die like this?’

Kim Hye-jung Grandma is slowly turning gray.

The heart rate slowly decreases, and a long time passes with a pulse in the 20s.

She is as good as dead already.

I wonder if Grandma’s soul is still nearby….

The heart is no longer functioning but merely twitching.

“Sun-han. Everyone dies. No one can defy that. For Kim Hye-jung Grandma, who has cancer spreading all over her body, CPR (cardiopulmonary resuscitation) will only cause the pain of broken ribs.”

Doctor Byun is right.

DNR is not just about giving up treatment.

It also means protecting the patient’s dignity and making their journey to heaven more comfortable.

‘But still, isn’t there something, some way…?’

I bit my lip.

But there is no way.

I couldn’t do anything for the grandma who was dying before my eyes.

“Sun-han, Doctor… we have to let Kim Hye-jung Grandma go now.”

Nurse Cha Yu-ri approaches and says.

Her voice is tinged with tears.

In the end, I had no choice but to get off the bed.

* * *

As time passed.

Shortly after, her son and two daughters, who were her guardians, arrived one after another.

Their eyes were red and bloodshot, as if they had been crying a lot on the way.

It seems they couldn’t visit often due to their livelihoods.

They drew the curtain and went inside, holding onto Grandma and crying for a long time.

“Mom!”

“I’m sorry… Mom, I’m sorry. Don’t be sick anymore!”

A wail close to sobbing echoes through the ICU.

Who wouldn’t cry like that in the face of their parents’ death….

People listening from outside look up at the ceiling with teary eyes.

Soon, Grandma’s heart stops moving, and the ECG [electrocardiogram; a test that records the electrical activity of the heart] on the monitor becomes a straight line with no waveforms.

“Patient Kim Hye-jung, I will declare the time of death as 3:20 AM.”

Doctor Byun Gyu-nam declared the death.

The guardians wail even louder.

The nurses also turn away and wipe away tears.

Having spent 70 days together in the ICU, they had grown attached like family.

“……”

I stood silently beside them.

Tears did not come out.

I was just frustrated.

To know the patient’s death in advance and not be able to do anything….

I feel so helpless for the first time.

And how much time has passed.

Nurse Cha Yu-ri approaches the guardians.

“Guardians… we will remove the various medical devices connected to the patient and allow you to see her again. Could you please step out for a moment and come back in?”

Nurse Cha Yu-ri’s words, delivered carefully in a gentle voice, show her skill.

And as the guardians temporarily leave, she says to me.

“Sun-han, Doctor, could you do the line removal here and suture [sewing up a wound or incision]?”

“Yes.”

“Sun-han, are you okay?”

“I’m fine.”

I answered calmly to Doctor Byun’s question.

Patient Kim Hye-jung has passed away.

Now I have to do what I have to do.

“Cut out the stitches, remove the C-line [central line; a catheter placed into a large vein] and CRRT line [continuous renal replacement therapy; a type of dialysis] that are in the patient. If a lot of blood flows from the hole after pulling it out, stitch it up….”

Doctor Byun Gyu-nam explains, then adds in a bright voice as if trying to comfort me.

“Sun-han. You don’t have to do it perfectly~ The patient has already expired, so just… roughly….”

“I will do my best.”

“……Okay.”

Doctor Byun stopped talking awkwardly.

I prepared the tools needed for the suture.

Suture.

Meaning stitching or suturing, it is the most basic surgical skill.

Any medical student aspiring to be a surgeon will practice suturing.

‘I never thought I would do my first suture like this….’

I had dreamed of becoming a surgeon since I was a child, while sewing.

I thought that one day I would use this skill to treat and save patients.

But I never thought I would do my first suture on a deceased person.

Moreover, that it would be Kim Hye-jung Grandma….

‘She was the patient I became closest to since coming to the ICU….’

I shook my head.

Let’s get a grip.

I am a doctor.

It’s not the time to indulge in sentimentality, but to do what I have to do as a doctor calmly.

I prepared an ivory suture and a small needle holder and approached the patient.

And I put on gloves and looked at the patient.

“……”

In a short period of time, Kim Hye-jung’s face was changing.

The body of a person without blood circulation was turning earthy so quickly.

I doubted whether she was the same Kim Hye-jung Grandma I had been talking to this morning.

I wondered if people return to earth like this.

‘Let’s clean up the lines first.’

The patient had thick lines connected to her neck and thighs, respectively.

Cutting the fixed thread and pulling out the connecting lines left large holes in the skin.

And black blood mixed with bodily fluids flowed out from there.

Swish—

Rather than blood gushing out, it just flowed out.

I sewed up the hole with the thread I had prepared.

Perhaps because of her long hospital stay in the ICU, Kim Hye-jung Grandma’s skin was not thick.

Stab—

The needle easily pierced the skin and passed through the fat layer under the skin.

Soon, the tip of the needle that pierced the skin and rose vertically sparkled.

I grabbed the end with the needle holder and slowly pulled it out.

Then I started to tie.

Regular—regular—reverse—regular.

I tied it once in the opposite direction to prevent the thread from loosening and finished the suture.

After suturing her neck and thighs like that, I pressed the remaining blood vessel injection site with gauze to stop the bleeding.

In my own way, I saw Kim Hye-jung Grandma off on her final journey.

“You worked hard.”

Shortly after, Nurse Cha Yu-ri came into the curtain.

She wipes the blood off the patient and finishes the work.

I quietly watched Grandma’s figure being covered with a white cloth and opened my mouth.

“Cha Yu-ri, Nurse.”

“Yes?”

“Did I do my best?”

“……”

“She must have been lonely and scared while she was in the ICU, I should have talked to her more often.”

Then, Nurse Cha Yu-ri said as if comforting me.

“Sun-han, Doctor, you did well enough. Grandma would probably be grateful too.”

“I hope so.”

I said bitterly.

Suddenly, Kim Hye-jung Grandma’s smile flickers before my eyes.

It was a cute smile that brightened the ICU every morning, even in the midst of hardship and pain….

I struggled to suppress my heavy heart and tidied up the bed with Nurse Cha Yu-ri.

At that time, something fell off the bed.

“……!”

It was a board with paper clipped to it.

I bent down to pick up the scattered papers and stopped.

Grandma’s crooked handwriting written with a pen came into view.

< Thank You >

< I'm Okay >

A lump in my throat—

Suddenly, tears welled up.

That night, I cried at the hospital for the first time.

Kim Hye-jung Grandma left the ICU like that.

* * *

300,000 people a year.

The number of patients admitted to the ICU.

And more than 40,000 of them die in the hospital.

<13.8%>.

When expressed as a number, the mortality rate seems simple.

But actually seeing each of these deaths with your own eyes is another matter.

A few days after Kim Hye-jung Grandma’s incident.

My daily life has changed slightly.

“Sun-han, Doctor, can you issue an NS [normal saline; a solution of salt in water] prescription and an RI [regular insulin; a type of insulin used to treat diabetes] prescription?”

“Yes, I understand.”

I logged into the EMR [electronic medical record; a digital version of a patient’s chart] at the nurse’s request and entered the prescription written on the slip.

I was still doing my best in my work.

But one thing that has changed is that I have started to distance myself from patients a little.

To be honest, I’m scared.

Because I realized that the ICU is a place where the patients I am in charge of can die at any time.

I felt like I was finally understanding Doctor Byun’s words that I shouldn’t get too attached to patients.

“Are you leaving work?”

7 p.m.

I ran into Nurse Cha Yu-ri in front of the elevator.

As it became mid-May, the clothes of people walking around the hospital became thinner and more colorful.

Nurse Cha Yu-ri is also wearing different casual clothes than usual.

Unlike when she is on nursing duty, her hair is down, giving her a different atmosphere.

I answered in a deliberately bright voice.

“I’m going to work out after work!”

“Oh, you’re so diligent, Sun-han, Doctor!”

“What about you, Nurse Cha Yu-ri?”

“I’m going to binge-watch the dramas I’ve been missing! The one you told me about is so much fun!”

We became a little closer after that day.

Was it because we felt similar emotions while sending off Kim Hye-jung Grandma together?

In addition to that, we were able to get close quickly because we did various difficult tasks together.

Even though it’s just the two of us in the elevator, it’s not awkward anymore.

“That drama is fun, right?”

“Amazing. I watched up to episode 3 yesterday, and I’m going crazy wondering what happens next.”

“The twist in episode 10 is amazing….”

“No! Don’t spoil it!”

Cha Yu-ri is bright again today.

After experiencing the death of a patient several times, she should be depressed, but how can she be so consistently bright?

Is it just her natural personality?

As I was thinking that, Cha Yu-ri asks.

“But Sun-han, Doctor, you look a little sad these days.”

“Me?”

“Even when you’re smiling, your eyebrows are like this all day long.”

As she says that, she makes her eyebrows droop with her fingers.

Was I?

I guess my expression was unknowingly gloomy.

“That was your first time, right? Patient expire [death].”

“Ah… yes.”

“I thought you looked a little dark these days, so I thought it was because of Kim Hye-jung Grandma’s incident a few days ago.”

Cha Yu-ri said that with a gentle smile.

I suddenly asked.

“How are you always so bright? It can’t have been just once or twice that you’ve had these depressing things happen in the ICU.”

Nurse Cha Yu-ri has worked in the ICU much longer than I have.

She must have experienced these feelings several times, so she must have been stressed a lot….

But, an unexpected answer comes back.

“Wait a minute… you don’t necessarily have to work out right now, do you?”

What do you mean?

As I was momentarily confused, Cha Yu-ri says with a smile.

“Would you like to go outside with me for a while? I’ll tell you how to relieve stress.”