A Surgeon Who Uses Martial Arts [EN]: Chapter 206

Chapter 39: Shock (1)

What could be the reason for the cardiac arrest after the sleep endoscopy? Jae-wook was still in the dark.

Of course, it wasn’t like there were no such cases.

Whether it was an overdose of anesthesia or the patient had an underlying heart condition.

There were generally two main reasons for cardiac arrest during an endoscopy.

In the case of this patient.

The first possibility could be easily ruled out.

The dosage of anesthesia was appropriate for the patient’s weight.

In other words, it wasn’t a case where additional anesthesia was administered because the patient wasn’t getting properly sedated.

Then.

It had to be assumed that the patient had a heart condition…….

However, the patient’s electrocardiogram showed normal findings.

“We might need to recommend an echocardiogram [a test that uses sound waves to create a moving picture of the heart]. What do you think?”

“I don’t think heart disease is very likely.”

“Then what’s the problem? Do you just think we were unlucky?”

Jae-wook jumped to conclusions about Jun-hoo’s opinion. Come to think of it, there was a third possibility.

Overwork, accumulated fatigue, stress.

If these factors combined, cardiac arrest could occur even in healthy individuals.

“I don’t think it’s that either.”

“You’re being uncharacteristically passive today? Is even the great Seo Jun-hoo stumped?”

“No. I suspect a different cause. I need to check when the patient comes.”

“Really? Hasn’t everything that could come up already come up?”

Jae-wook tilted his head.

He had no idea what other cause Jun-hoo was talking about.

About ten minutes passed.

Sung Gyu-tae, the younger brother of Professor Sung Gyu-shik from the Department of Hand Surgery, appeared.

Having finished his examination, he sat in the chair opposite Jae-wook.

With Jun-hoo by Jae-wook’s side, the three formed a triangular arrangement.

Gyu-tae was huge, like a bear.

His jaw was square, and his skin was reddish.

Jae-wook had a feeling.

This guy was definitely going to be aggressive and outspoken.

And the ominous premonition was correct.

“Hey. Why does this examination center conduct tests like that?”

“…….”

“I came here for an examination, not to die! What is going on here?”

Gyu-tae snapped aggressively.

Because he was so large and the younger brother of a professor at the main hospital, Jae-wook felt intimidated.

He bowed his head first.

“I apologize for the inconvenience. An unexpected incident occurred. We will ensure that this does not happen again.”

“It better not happen again. Because I’m never coming here again.”

Gyu-tae crossed his arms and continued speaking with a displeased expression.

“I trusted this place because it’s the hospital where my brother works and it’s one of the Big Five hospitals [the five largest and most prestigious hospitals in South Korea]. Seriously, what kind of farce is this?”

“I apologize once again. How are you feeling now?”

“I don’t have any major problems other than a tightness in my chest.”

“Do you have any underlying heart conditions?”

“No, I don’t. But, doctor.”

“Yes, please speak.”

“Isn’t that something you should already know? I clearly stated on the examination questionnaire that I don’t have any pre-existing conditions.”

Gyu-tae questioned in a prickly voice.

It was still unclear whether this was his usual personality or if he had become sensitive due to the cardiac arrest incident.

However, a few things were certain.

Gyu-tae was not an easy patient.

Persuading Gyu-tae would not be easy.

If things weren’t handled properly, Gyu-tae would complain to Professor Sung Gyu-shik.

And that story would reach the emergency medicine professor, making things difficult for him.

Jae-wook’s temples were already throbbing.

“The data hasn’t been transferred to our side yet.”

“Don’t you process things quickly with computers these days?”

“Examination center data, especially handwritten data, is slow to be computerized. We ask for your understanding.”

Jae-wook calmly began the interview.

The main focus of the interview was the patient’s family history and underlying conditions.

The goal was to analyze factors that could have caused the cardiac arrest.

But the result was a waste of time.

There were no patients with heart disease in the family.

Gyu-tae was healthy and did not suffer from chronic diseases such as high blood pressure or diabetes.

He also said that he didn’t usually visit the hospital and this was his first time getting a health checkup.

Since the results of the tests that had just come out were all normal.

Jae-wook felt internally frustrated.

He knew that if he couldn’t explain the reason for the cardiac arrest, he would be scolded by the patient.

-What? You’re a doctor and you don’t even know that? A person almost died! This guy is useless!

“Have you been overworked recently? Or have you been under a lot of stress?”

“Not at all. I even take red ginseng and I’m full of energy.”

Jae-wook could only laugh helplessly at Gyu-tae’s answer.

All escape routes were completely blocked. There was no way to explain the cardiac arrest to the patient.

“So why did I have a heart attack?”

Gyu-tae delivered the final blow, and Jae-wook hesitated. He had nothing to say, so words wouldn’t come out, making him frustrated.

But it was at that moment.

Jun-hoo, who had been silent until now, opened his mouth.

“Have you heard of anaphylactic shock [a severe, potentially life-threatening allergic reaction]? It’s a type of allergic shock where the condition suddenly worsens if you get stung by a bee or something.”

“I’ve heard of it. But what does that have to do with me?”

Gyu-tae scoffed as if it were absurd.

“Are you saying a bee came into the examination room, stung me, and ran away? Is that what you’re giving as a reason?”

“Jun-hoo, what are you doing? Weren’t you going to help me?”

Jae-wook whispered so the patient couldn’t hear.

Could it be that the thing he suspected earlier was anaphylaxis?

But linking the patient to anaphylaxis seemed extremely foolish.

Because there was no allergen that could cause an allergic reaction. The patient had also noticed this and was glaring with a fierce look.

“No, why is someone who isn’t even a doctor here in the first place?”

“I am a doctor here. I’m working in neurosurgery. I came to get a checkup and found out that the patient was in cardiac arrest, so I performed CPR [cardiopulmonary resuscitation].”

“Oh, really? Hmm. Well, I appreciate that.”

“Shall we get back to the main point?”

Jun-hoo naturally took the lead and continued speaking.

As if he had been waiting for this situation since earlier.

Anyway, Jun-hoo was a fascinating guy the more you looked at him. You could say he was already like a sly old fox, even though he was only in his first year of residency.

‘I don’t know well, but I trust you.’

Jae-wook fervently cheered for Jun-hoo in his mind.

* * *

“The patient had cardiac arrest because of anaphylaxis.”

“You’re saying it like it’s a math problem, just stating the answer?”

“That’s because the answer is so clear.”

“Seriously, you’re making me repeat the same thing. Doesn’t it make sense? Was I stung by a bee? Or do I have pollen allergies?”

“The causes of allergies are endless. You just don’t know about them.”

Jun-hoo continued speaking calmly.

The patient was picky, but there was no reason why he couldn’t be persuaded.

Because he had discovered a crucial clue while performing CPR.

From the moment he realized the answer and the solution process, Jun-hoo was already one step ahead of the patient.

“There are even these unusual cases.”

“…….”

“You can eat peaches and exercise, but if you exercise immediately after eating peaches, you can get anaphylaxis.”

“That sounds ridiculous?”

“It sounds like a lie, but that’s the reality. Someone is actually suffering like that.”

“So you’re going to lump my condition together with anaphylaxis?”

“Would you believe it if I showed you?”

“Please show me. Then I’ll understand right away.”

“Sunbae [a Korean term for a senior colleague or mentor], please draw 1ml of propofol S.C (Subcutaneous inj) [an injection given just under the skin].”

“So you’re saying the patient had anaphylaxis because of propofol?”

Jae-wook asked with wide eyes. However, his voice was small enough for only Jun-hoo to hear.

“Yes. I’m sure. Just trust me.”

“Propofol anaphylaxis, I’ve never even heard of that.”

“Me neither.”

“Are you kidding? You’re going to figure out a disease you’ve never experienced with just your intuition?”

“There’s no reason why I can’t. As long as there’s solid evidence.”

“If you’re wrong, we’re both going to be in trouble. That person is the younger brother of the professor of hand surgery.”

“It doesn’t matter. Even if it’s the president, if they come to get treatment, they’re just a patient.”

Jun-hoo replied in an indifferent voice.

From the moment he dreamed of becoming a surgeon.

Jun-hoo had never ranked patients based on their social status.

Whoever it is, if they are a patient, he does his best.

That was Jun-hoo’s way of thinking.

“You have a good spirit. Okay, now that it’s come to this, let’s go all the way.”

Jae-wook, who had left his seat for a moment, returned with a 1CC syringe.

Jun-hoo received the syringe containing propofol from Jae-wook.

Then, he approached the patient and disinfected the patient’s hand with an alcohol swab.

“If you’re playing games, I won’t let it go. My brother is a professor here.”

“So what are you going to do?”

“……Huh?”

It was Gyu-tae who was flustered when Jun-hoo came on strong.

Gyu-tae blinked and stared at Jun-hoo with a blank expression.

“Don’t mistake the fact that I’m here because you’re the professor’s brother. The reason I’m here is…….”

“…….”

“It’s because of the sense of responsibility that I want to take care of the patient I performed CPR on until the end.”

“…….”

“For your information, I found out later that you were the professor’s brother. It’s not like the fact that you’re the professor’s brother is written on your face, is it?”

Jun-hoo subtly criticized Gyu-tae’s arrogant attitude.

Then Gyu-tae’s face turned red.

“It’ll sting a little.”

Jun-hoo lightly pricked Gyu-tae’s hand with the syringe needle.

He injected about 0.5CC of propofol.

“It’ll be boring, but please move to the bed and wait for about 10 minutes.”

“I will.”

Gyu-tae readily got up from his seat.

However, his gaze towards Jun-hoo was not kind, giving off an atmosphere that he would not let it go if the result was normal.

“Hoo. I feel like I can finally breathe. Why is the patient acting like he’s going to eat the doctor up?”

Jae-wook let out a sigh of relief as Gyu-tae left.

“I know, right? He’s the type that would be tiring to have as a superior.”

“But, you know. Was there any reason to conclude that the patient had propofol anaphylaxis?”

“Yes. There was.”

“What was it?”

“When I was doing chest compressions, the patient’s chest was swollen and red. There were also hives.”

Jun-hoo said, recalling the time when he was doing chest compressions.

As expected of the master of observation.

Jun-hoo thoroughly observed the patient’s body even while performing chest compressions.

As a result, he was able to confirm allergic reactions on the patient’s chest and both arms.

“You could see that while doing chest compressions? Are you sure you didn’t misunderstand?”

Jae-wook tilted his head and continued speaking.

“The red swelling on the chest was because of the chest compressions, and the hives were actually goosebumps, right?”

“Would I mistake that? Don’t you trust me too much?”

“I do trust you…… it’s just that I’ve never heard of propofol anaphylaxis.”

“I searched for papers on the way here and there was exactly one case. It wasn’t a cardiac arrest case, though.”

“I hope that one case saves us.”

The two people, who had been chatting, got up from their seats amicably.

They headed to the bed where Gyu-tae was.

Jae-wook still seemed nervous, but Jun-hoo was full of confidence.

All the information that Jun-hoo had experienced and synthesized clearly pointed to propofol anaphylaxis.

If so, the patient was definitely propofol anaphylaxis.

There was no reason to be afraid.

Jun-hoo approached Gyu-tae, who was sitting on the bed, and spoke to him.

“Can you show me your hand?”