A Surgeon Who Uses Martial Arts [EN]: Chapter 47

Surgical Doctor Who Uses Martial Arts – Chapter 47

Chapter 8: Emergency Medicine (9)

Jun-hoo approached the patient and listened carefully to the C.C. (Chief Complaint, main symptom).

The patient had been diagnosed with stage 2A lung cancer through a health checkup.

Two days ago, he underwent a lung resection [surgical removal of part of the lung] and was recovering smoothly.

However, he said that the chest pain had been particularly severe since lunch today.

He added that the pain did not subside even after taking painkillers.

‘See, what did I tell you?’

‘I told you there was nothing wrong, right?’

When Jun-hoo’s eyes met Seung-beom’s, Seung-beom’s eyes seemed to say that.

At first glance, Seung-beom’s opinion seemed correct.

The patient had undergone a general incision surgery, not an endoscopic surgery.

Since his chest had been opened left and right for several hours, it seemed natural for him to feel pain.

However, Jun-hoo’s opinion differed.

-My chest feels very tight. Especially when I take a deep breath.

Jun-hoo paid attention to this part of the patient’s complaint.

The mention of pain every time he breathed could not be taken lightly.

It was a pain with a unique characteristic.

“Could you lift up your gown for a moment? I’d like to listen to your chest.”

The patient lifted his gown, and Jun-hoo placed the stethoscope on the patient’s chest.

Below the patient’s collarbone.

Above and below the nipples.

He tried to listen to the heart and lung sounds near the scapula [shoulder blade].

However, he thought he heard something near the patient’s left nipple.

It was a dull sound like knocking on a wooden percussion instrument.

He strained his ears to capture the sound in detail, but the mysterious sound was no longer heard.

Was he hearing things?

Or was he hearing ambient noise?

Or was there really a problem in that area?

The sound was so small.

It disappeared so quickly that even Jun-hoo had difficulty making a proper judgment.

“He’s acting like a real doctor. What does he know from listening with a stethoscope?”

Seung-beom, who was watching Jun-hoo, sneered.

He looked down on Jun-hoo’s auscultation [listening to internal sounds of the body] and was displeased.

It wasn’t 100 percent wrong.

The interns had just started working at the hospital and had no experience auscultating in practice.

“Please be quiet while I’m examining the patient.”

Jun-hoo scolded Seung-beom.

He spoke as gently as possible because the patient was in front of him.

‘I want to properly diagnose the patient in pain.’

‘I want to get back at the lazy Seung-beom.’

With that thought in mind, Jun-hoo placed the stethoscope on the patient’s left nipple again.

The second attempt was somewhat different from the first.

It looked the same on the outside, but there was a big change inside.

This time, he had drawn on his internal energy to enhance his hearing.

Internal energy had endless uses, and it could also be used to amplify physical senses.

‘I knew my hunch was right!’

When he enhanced his hearing with internal energy, he clearly heard a dull lung sound near the stethoscope.

Thud. Thud. Thud.

A dull sound like someone hitting a wall with their fist.

There was a problem with the patient’s lungs.

Tests were needed to determine the exact cause.

“Jun-hoo, what are you doing here?”

Just then, Jun-shik, a first-year resident in thoracic surgery, entered the ward.

Jun-shik was from Shinwon University and knew Jun-hoo.

“Aren’t you an intern from another department? Why are you in thoracic surgery?”

“Seong-ho asked me to help out for a bit.”

“Is that so? Anyway, is there something wrong with the patient?”

“I just listened to his chest, and I heard a dull sound in his lungs.”

Jun-hoo notified Jun-shik based on the auscultation results and what he had heard from the patient.

He thought Jun-shik would understand him, but…

‘What?’

Jun-shik’s expression wasn’t very bright.

“It’s only been a short time since the surgery, so his chest pain must be severe. Aren’t you being too sensitive?”

Jun-shik sided with Seung-beom.

Then, an elated smile appeared on Seung-beom’s face.

Jun-hoo was uneasy because things seemed to be going wrong.

He didn’t want this kind of development.

“Then, could you listen to his chest yourself, senior?”

“Sure, why not.”

Jun-shik, who had switched places with Jun-hoo, listened to the patient’s chest and tilted his head.

His expression showed that he couldn’t find any problems with the auscultation.

The dull sound in the lungs was so faint that he couldn’t catch it. Well, even Jun-hoo could barely confirm it with the help of internal energy.

“Did you hear a noise? I don’t hear anything.”

“Still, the patient is uncomfortable, so how about getting a chest X-ray?”

“Seo Jun-hoo, you’re crossing the line?”

Jun-shik frowned, showing displeasure at Jun-hoo’s suggestion.

“Not only are you meddling from another department, but are you saying that what I, a resident, am saying is wrong?”

“That’s not it. I’m just saying that we should do a proper examination because the patient is complaining of pain.”

“How good are you that you don’t listen even when your senior is treating you? You’re amazing.”

Seung-beom, who had been silent, sniped.

Jun-hoo was suddenly fighting a lonely battle against Jun-shik and Seung-beom.

However, he couldn’t back down like this.

Hadn’t he heard a clear dull sound in the patient’s lungs through his hearing amplified by internal energy?

If he ignored the patient’s condition.

He didn’t know what kind of tragedy would happen afterward. He might have to stop a disease with his palm that he could have stopped with his fingers.

Was that why?

Jun-hoo decided to be strong, even if he was hated.

“Senior, please order a chest X-ray. If there’s no problem, I’ll take responsibility.”

* * *

Thoracic Surgery On-Call Room.

Jun-shik was talking to Seung-beom.

The target of their gossip was, of course, Jun-hoo.

It was certainly commendable that Jun-hoo had come up to thoracic surgery to help.

However, it was extremely offensive that he had gone against Jun-shik’s diagnosis and demanded a chest X-ray.

‘How long has he been working at the hospital that he’s acting out of line without knowing his place?’

‘As an intern, that is.’

“I didn’t think Jun-hoo was like that… There’s a limit to how much you can look down on people.”

“You understand. He’s always been cocky since his days in medical school. He thinks he’s the best in the world.”

Seung-beom spoke informally to Jun-shik.

He was the same age as Jun-shik because he had retaken the entrance exam.

He had used his father’s position as the vice president of Shinwon University Hospital to become friends.

“I know. I need to get a tight grip on him this time. I’ve been too lenient with him.”

Jun-shik, who was sitting at his desk, pulled up the PACS (Picture Archiving and Communication System) image on the monitor.

He checked the chest X-ray image that Jun-hoo had taken the patient to get.

‘What a fuss.’

‘He doesn’t even know that you shouldn’t get too emotionally involved with patients.’

Jun-shik was about to scold Jun-hoo when he was startled.

There was a white shadow on the lower left side of the patient’s lung.

‘Wow… This can’t be happening?’

He rubbed his eyes and checked the image again, but the fact remained the same.

Jun-hoo’s diagnosis was indeed correct.

The shadow located on the lower left side of the patient’s lung.

It was evidence that the patient was suffering from pleural effusion [fluid buildup around the lungs].

Pleural effusion.

A disease in which blood components accumulate in the pleural space due to various causes.

If left untreated, it could lead to pneumonia and pulmonary embolism [blood clot in the lungs].

In this patient’s case, it seemed to have occurred due to decreased lung function after lung resection.

“What’s wrong? What happened? Tell me quickly.”

Seung-beom urged Jun-shik to answer.

“Jun-hoo is right. The patient has pleural effusion.”

Jun-shik scratched the back of his head and answered.

‘How embarrassing is this?’

The fact that a first-year resident in thoracic surgery couldn’t diagnose a patient better than a fledgling intern.

If there weren’t people around, Jun-shik would have torn his hair out in self-disgust.

“So, the patient didn’t have natural pain after surgery?”

“I guess so.”

“Then, the dull sound that Jun-hoo heard in his lungs with the stethoscope wasn’t a hallucination?”

“You have to say he heard it properly. But it’s strange? I definitely didn’t hear it. Is my ear blocked?”

Jun-shik only rubbed his innocent ear.

In any case, Jun-shik’s authority fell to the ground as a result of the chest image.

Because it turned out that Jun-shik was wrong and Jun-hoo was right.

‘How can I face Jun-hoo again in embarrassment?’

“Don’t blame yourself too much. I have a good idea.”

Seung-beom’s voice, turning the topic, was secretive and sweet.

* * *

At the same time.

Jun-hoo was laying the patient he was supporting on the hospital bed.

He was on his way back after taking an X-ray.

Although he couldn’t confirm the results, Jun-hoo was confident that his diagnosis was correct.

The dull sound of the lungs that couldn’t be heard if it was normal.

Because he heard it clearly.

“Doctor. Aren’t you getting scolded by your superiors because of me?”

“……”

“Everyone else is having a hard time, and I feel like I’m making a fuss.”

The patient said shyly and apologetically.

He thought that Jun-hoo had taken his side and was being targeted by his seniors.

“It’s not that the patient’s pain is natural just because other people are in pain. And you have to make a fuss when you’re in pain.”

“……”

“This world is such that you have to complain to be barely recognized.”

“Hahaha. I learned something from a young doctor.”

The patient laughed heartily.

While he was talking to the patient, Jun-shik and Seung-beom returned to the ward.

Even personally bringing a dressing cart.

The moment he checked the dressing cart.

Jun-hoo sensed that something was wrong with the patient.

“Ahem. Jun-hoo, you’re right. There’s something wrong with the patient. I confirmed pleural effusion with a chest X-ray.”

Jun-shik continued in a stiff tone.

“I’ll admit that I made a mistake earlier. But.”

“Yes.”

“Since you came up to thoracic surgery and even saw the patient, how about doing the treatment too?”

“Treatment as in…”

“Chest tube insertion. You have to remove the effusion in the pleura.”

Chest tube insertion was, as the name suggests, a procedure to insert a tube into the chest cavity.

Originally, it was a procedure that interns learned from the beginning, but it was rare for interns to actually do it.

This was because the difficulty of the procedure was considerable.

Usually, chest tube insertion was learned in the first year of residency.

Even residents often felt burdened by chest tube insertion.

Therefore, in the case of other departments, they often called thoracic surgery when chest tube insertion was needed.

‘But they’re entrusting that kind of treatment to me?’

Jun-hoo quickly realized Jun-shik’s impure intentions.

‘He must be thinking of correcting his authority, which had fallen due to misdiagnosis, with chest tube insertion.’

Jun-hoo didn’t know that Jun-shik’s heart would be so petty.

“Why? Does the great Seo Jun-hoo also get scared of chest tube insertion?”

Seung-beom, who was next to Jun-shik, provoked him.

He deliberately scratched Jun-hoo’s pride.

“I’ll do the treatment too. Instead, Senior Jun-shik, please just help me with the assist.”

Jun-hoo readily accepted the chest tube insertion.

Since he was in a position to help thoracic surgery for a while, he didn’t really need to do the treatment.

He could have just said he couldn’t do it and returned to the on-call room.

However, Jun-hoo wanted to win the battle of nerves.

He wanted to make Jun-shik and Seung-beom, who were trying to gloss over their misdiagnosis and suppress Jun-hoo, look foolish.

He also wanted to experience firsthand how difficult chest tube insertion was.

“Good. That’s how it should be.”

“I’ll go in right away. Patient, would you like to lie down comfortably?”

“I already took an X-ray, what else do I have to do?”

The patient looked at Jun-hoo with anxious eyes.

“Yes. I found the reason why you were uncomfortable.”

Jun-hoo explained pleural effusion to the patient and informed him that treatment was necessary.

Even though he heard that he was in pain, the patient’s expression was surprisingly bright.

He seemed relieved that he wasn’t being treated like a malingering patient.

‘Frustrating people.’

‘People who only know what’s convenient for them.’

‘If they had listened a little more to the patient’s words.’

‘Even if they couldn’t auscultate, they could have diagnosed pleural effusion with a chest X-ray…’

It was fortunate that Jun-hoo stepped in.

Otherwise, the patient would have suffered from sequelae [long-term consequences] of pleural effusion, such as pneumonia or pulmonary embolism.

Jun-hoo glared coldly at Jun-shik and Seung-beom and prepared for the treatment.

‘Watch closely, you trash.’

‘I’ll succeed in chest tube insertion in one try.’