Dr. Shin Seonhan: The Doctor Who Sees The Future [EN]: Chapter 69

#69 You Call This Thoracic Surgery? (17)

We were baffled.

Even though the intubation was done correctly, the patient’s oxygen levels were dropping.

‘This is bad. At this rate, the patient’s life is in danger!’

Damn it.

I felt like cursing.

I desperately racked my brain.

Think, Shin-seon.

Otherwise, the patient might die!

* * *

Meanwhile, in the operating room.

Third-year resident Song Yu-ju was finishing her long and arduous battle with Professor Tal-gok.

“Everyone, you’ve done a great job.”

“Thank you for your hard work.”

Song Yu-ju’s body went limp.

A long surgery.

No matter how healthy a surgeon is, their stamina gets completely drained.

Maintaining extreme concentration for hours is not easy.

It’s not uncommon for medical staff to feel dizzy and collapse during surgery.

“It’s been a while since we had such a challenging patient.”

The professor was also exhausted.

However, he seemed to have regained some composure.

He had been irritable just a moment ago, but now he seemed to be in a better mood.

This was probably because the difficult surgery had ended relatively successfully.

“Can you finish up?”

“Yes.”

Beep―

The professor left the operating room.

Song Yu-ju switched places and stood where the professor had been.

Residents often handle the finishing touches, including sutures (stitches).

As she finished the surgery, Song Yu-ju asked the circulating nurse,

“So, what was going on outside earlier?”

“Pardon?”

The circulating nurse had already been replaced by another nurse.

“No, it’s just that I heard a call from an intern earlier. I was worried if something was happening outside.”

“Ah! When I came to work earlier, I heard a CPR [cardiopulmonary resuscitation] announcement looking for thoracic surgery personnel? It sounded like they were gathering people at the cancer hospital….”

An announcement?

Song Yu-ju felt uneasy.

The operating room doesn’t pick up CPR announcements from the wards or ICU [Intensive Care Unit].

If they were making an announcement, it must have been something serious….

She had a bad feeling.

“Could you call Dr. Ryu Myung-in on my pager, please?”

Beep, beep, beep―

The signal rang through the pager’s speaker.

However, Ryu Myung-in didn’t answer.

‘The intern isn’t answering the call?’

Song Yu-ju frowned.

Has he already let his guard down?

That’s unlikely.

Or maybe the ward is just that hectic and chaotic.

Song Yu-ju asked the nurse again.

“Do you happen to know what the CPR announcement was about earlier?”

“Well, I don’t know either. I changed clothes and came straight into the operating room.”

“…I need to go out there quickly.”

Song Yu-ju muttered to herself and hurried her suturing.

Swish, swish―

The needle holder held in her slender fingers moved busily.

A swift pace.

But even so, she didn’t lose her precise, measured movements.

Stab.

Pull.

Tie.

Following her delicate touch, the surgical site was gradually being closed.

The eyes of the nurse, who was standing as the second assistant across from her, widened.

‘Wow… is she a person or a machine?’

Song Yu-ju’s suturing skills were almost like acrobatics.

She was even faster than usual today.

Even in the midst of all this, she maintained her composure and didn’t even blink.

Precise―precise―reverse―precise.

After perfectly finishing the last suture, Song Yu-ju stepped away from the field.

Clang!

As soon as she put the surgical instruments down on the tray, she took off her surgical gown and shouted,

“Thank you for your hard work. Please take the patient for car-out (transferring the patient to the recovery room after surgery).”

Song Yu-ju left the operating room.

Tap, tap―

Her pace quickened.

Although she was exhausted from the surgery that lasted over 3 hours, she couldn’t delay even for a moment.

‘Interns. Don’t cause any accidents while I’m gone!’

After Song Yu-ju left.

The anesthesiology resident in the operating room grumbled.

“What… isn’t that doctor doing the sutures too carelessly? Even if she has something urgent.”

Then the operating room nurse chuckled and retorted.

“Doctor, is this your first time doing surgery with Dr. Song Yu-ju? If you’re curious, come over here and take a look. See if these are carelessly done sutures.”

What?

Why is she making such a fuss….

Thinking that, the anesthesiology resident craned his neck and peeked at the surgical site.

And he was speechless.

“No, how can she do this so quickly….”

“Do you think the professors praise Song Yu-ju for no reason?”

The incision made for the surgery was perfectly sutured, looking almost like a single line.

“Wow….”

The anesthesiology resident’s mouth dropped open.

It was the moment he confirmed Song Yu-ju’s reputation, which he had only heard about, with his own eyes.

* * *

Beep, beep, beep―

A warning sound echoed in the treatment room.

The patient’s oxygen saturation was rapidly decreasing.

‘Damn it! What’s the problem this time?’

I gritted my teeth.

Ryu Myung-in was flustered and didn’t know what to do.

If this continued, the patient could suffer brain damage.

The future I saw could unfold unchanged.

I had to find the problem right now.

“Ryu Myung-in, the intubation was done well, so what’s the problem?”

“I… I don’t know. Could it be that the lungs are already completely damaged…?”

What the hell is he saying?

He’s making ridiculous noises.

He seemed to be in a state where he couldn’t make rational judgments.

I shook my head.

“The X-ray taken this morning showed that the right lung was fine. If one lung is clearly healthy, but the oxygen saturation is dropping like this….”

As I looked at Ryu Myung-in, his face was pale.

His eyes were unfocused.

What’s wrong with him?

He muttered as if his mind had snapped.

“Could it be that the patient is… because of me? That can’t be… this shouldn’t be happening….”

This bastard.

What are you going to do if you panic now!

The situation isn’t over yet!

“Ryu Myung-in! Snap out of it!”

Slap―

I slapped him on the cheek.

Of course, I didn’t hit him hard enough to dislocate his jaw. Just enough to jolt him awake.

He looked at me with bewildered eyes.

“Ryu Myung-in, you’re this patient’s primary doctor.”

“….”

“Until the other doctors arrive, we have to take responsibility for this patient. Let’s think about what the problem is. You must have studied much better than me.”

At my calm words, Ryu Myung-in finally regained his composure.

“You didn’t have to hit me.”

“Shut up and think quickly.”

“Maybe the e-tube (endotracheal tube) went in too deep… it might have gone too deep into the left side, so there’s only ventilation in one lung.”

That’s a possibility.

Ryu Myung-in might have accidentally inserted the tube too deeply.

But I thought for a moment and shook my head.

“The auscultation [listening with a stethoscope] showed that the right side was also ventilating well. There’s a high probability that it’s well inserted….”

Wait a minute.

Something was bothering me.

What is it?

It was as frustrating as having an itchy back that you can’t reach.

I was definitely missing something….

‘Please, spin faster! My brain!’

Then, suddenly.

Something came to mind.

Like belatedly remembering the face of someone you accidentally passed on the street….

What I thought was strange when I auscultated earlier belatedly surfaced to the top of my consciousness.

“Come to think of it, the sound was a bit dirty when I auscultated the right side. But the X-ray this morning showed that the lung was clean.”

As if he had gotten a hint from my words, Ryu Myung-in’s eyes widened.

“It went over to the other side!”

“What?”

“When he was vomiting blood earlier, the blood clots might have gone from the left lung to the right lung?”

Ah!

Why didn’t I think of that?

You smart bastard!

At the possibility presented by Ryu Myung-in, our conversation gained momentum.

“Then how do we stop this? It’s going to get worse and worse.”

“We need to block the path coming from the left and protect the right lung. In that case….”

We shouted almost simultaneously.

“…Double lumen!”

Double lumen intubation.

The principle is simple.

The trachea (windpipe) in our body is shaped like an inverted Y, with each branch connected to each lung.

But the current situation is―

The blood coming from the damaged left lung is damaging the healthy right lung.

Therefore, it is necessary to block the passage leading to the damaged lung first.

A double lumen is a somewhat special device that allows ventilation to only one lung, making this procedure possible.

“Prepare a double lumen e-tube!”

Tap, tap―

The treatment room became busy again.

There was no double lumen e-tube available in our ward right now.

The nurses called other departments, and soon a transporter rushed in, panting, and handed over the instrument.

And the nurses are also preparing a bronchoscope [a thin, flexible tube with a camera].

This is because the trachea must be directly observed with a bronchoscope for double lumen intubation.

“Ryu Myung-in, have you ever done a bronchoscopy?”

“No. What about you, hyung?”

“I haven’t either.”

“Ha, what should we do?”

Ah, damn it….

I want to cry.

Do we have to headbutt it like we’re hitting the ground? [Try something without knowing how to do it].

Of course, I roughly know it theoretically, but even that is vague.

It’s almost like starting to drive on the highway after only learning how to drive from a book.

“Should we contact the emergency on-call doctor from anesthesiology? Shouldn’t we call anesthesiology for a double lumen?”

The experienced nurse, who was watching, said anxiously.

She had a look on her face that said she hoped someone would come.

Damn it!

I’m so powerless.

I know the method in my head, but I don’t have the experience.

It’s the first time I’ve felt so sad that I’m just a fledgling intern.

“Hey, move aside.”

At that moment, someone suddenly appeared in front of the treatment room door, and our eyes turned to that side.

A presence more reliable than a thousand troops.

The person we needed more than anyone else at this moment.

Song Yu-ju.

Panting, she had arrived in front of the treatment room door.

We shouted happily.

“Doctor!”

“What’s going on? Intubation? Why did you prepare a bronchoscope?”

Song Yu-ju quickly checked the patient’s vital signs and asked us as if scolding us.

She was still in her surgical gown, and she was sweating on her neck from running so much.

“The current situation is―”

We quickly briefed her.

A patient with pulmonary aspergilloma [a fungal ball in the lung] who was about to undergo surgery had severe hemoptysis [coughing up blood], and no one was answering the phone.

We had intubated him, and it seemed like blood was going over to the other lung, so we prepared a double lumen.

As soon as we finished speaking, Song Yu-ju auscultated both lungs.

“One person call the ICU and prepare a bed, and one person contact the anesthesiology emergency on-call. Nurse, you will start suctioning with me using the bronchoscope from now on.”

“Yes!”

As expected, Song Yu-ju.

She seemed to have finished assessing the entire situation in that short amount of time and began to skillfully direct the scene.

When the first mate took the helm, the ship that had been staggering in the storm regained its direction.

“Put jelly on the end here, and we’ll go in right away.”

Song Yu-ju immediately grabbed the black, long, snake-like bronchoscope.

Wriggle, wriggle.

Like a dragon crawling, she cleared the blood clots by digging into every corner of the patient’s trachea.

As her hand movements progressed, the oxygen saturation began to rise little by little.

“But how did you think of and prepare the double lumen?”

Song Yu-ju asked without taking her eyes off the screen showing the patient’s trachea.

How?

It’s too long to explain everything.

I answered simply.