Dr. Shin Seonhan: The Doctor Who Sees The Future [EN]: Chapter 137

Squeak—

Cheon Sa-yeon pulls out a chair and sits at the station.

Then, she opens the chart I looked at earlier and asks a question.

“What do you think is the most important thing to be careful about when a patient who has undergone PCI [Percutaneous Coronary Intervention, a procedure to open blocked arteries] receives surgery?”

This tone……?

It’s like giving a test question.

I quickly realize her intention.

‘She’s trying to reflect it in the intern evaluation.’

.

Every month, the residents’ intern evaluations consist of various items.

Appearance, attire.

Interpersonal skills.

Work attitude.

Enthusiasm to acquire knowledge.

And most importantly, clinical skills including rounds, prescriptions, and medical records, etc…….

In total, there are more than ten.

In other words, this kind of question can also be an evaluation criterion.

“Tell me as much as you know.”

Flash!

Cheon Sa-yeon widens her eyes and smiles.

It’s amazing every time I see it.

How can a person’s eyes open so wide?

Thinking that, I slowly open my mouth.

“Since the patient had a stent inserted into the coronary artery, I know that there is a high possibility of acute MI (acute myocardial infarction) [heart attack] or revascularization (procedure to reopen a blocked stent) after surgery.”

Cheon Sa-yeon’s eyes narrow at my calm answer.

Stent.

A small tube inserted into a blood vessel in the body.

When a foreign object is artificially inserted into a blood vessel like this, it is easier for blood clots to form in our body.

Therefore, the patient was usually taking medication to thin the blood and suppress blood clot formation.

The problem is that this medication must be temporarily stopped before surgery.

“Since the patient stopped taking the medication before surgery, it seems difficult to suppress the formation of thrombus (blood clot).”

My answer is over.

What kind of reaction will come back?

I wonder if she will pick a fight because she doesn’t like it…….

“That’s right. You know the basics.”

Cheon Sa-yeon nods.

The expression is half and half.

Half seems dissatisfied because she couldn’t find fault.

And the other half seems satisfied with my answer.

“Then how…….”

“There’s no choice.”

“Yes?”

“Although the risk is high, we have no choice but to take the risk. Right now, the most important thing is to get rid of the cancer. We also consulted with the cardiology department.”

.

That was Cheon Sa-yeon’s answer.

Of course, if you stop taking the medicine even for a short time, the risk of blood clots increases.

After the surgery, we decided to start taking the medicine again, and we are doing surgery while stopping the medicine as if walking a tightrope.

What if a blood clot forms in those few days?

Literally, there’s no choice.

We have no choice but to pray that they survive the precarious tightrope walk.

“Anyway, it’s not something an intern should worry about. Do you think the professor wouldn’t have thought about it? It’s already been discussed.”

Cheon Sa-yeon is right.

There is no way that the professors and residents would not have thought about what I am worried about.

They have taken all possibilities into consideration and made the best decision for the patient’s health.

“The intern just needs to do what they are told in the operating room. Just do what you are told. Okay?”

“Yes.”

“……Well, it’s better than interns who come into the operating room without even looking at the chart.”

Tok, tok.

Cheon Sa-yeon left such a compliment that wasn’t a compliment and disappeared.

Then, Nurse Misun, who had been holding her breath next to me, cautiously said.

“Can I breathe now?”

“Yes.”

“Seriously, is she a professor or what? She’s only a third-year resident, but she’s really putting on airs, that Patzzi [a Korean term for a jealous and mean-spirited person].”

Nurse Misun grumbled in a small voice.

I chuckled.

And on the other hand, I thought about what I had heard from Cheon Sa-yeon just now.

.

Of course, that may be true.

After all, what I do in the operating room is limited to simple things like .

‘But just in case, I should check the related content well in advance.’

That’s what I thought.

The results can be different depending on your mindset, even if you do the same work.

You can become a useless person, or you can become a smart puppy at a village school.

* * *

The next day.

Jeong Sun-rye’s ovarian cancer surgery was performed.

Thud, thud—

After preparing the operating room, I headed to the patient waiting room.

The patient was sitting in a wheelchair with the operating room number <15> written on it, quietly looking at something.

“Hello, patient.”

“Hello. Are you the young doctor from yesterday……?”

Even though I was wearing a mask, she recognized me by my voice.

I asked cheerfully to encourage the patient.

“Mother, what were you looking at?”

“I was just bored waiting, so I was just looking at the screen that was coming out.”

I followed the patient’s gaze.

A wall-mounted TV hanging on one side of the waiting room.

A program showing the beautiful natural environment of various countries around the world was playing silently.

A beautiful lake park was being shown, and the words were written in the lower right corner.

“The scenery is so beautiful. Where is that?”

“It’s Plitvice in Croatia, Eastern Europe.”

“Ah…….”

Plitvice, a national park in Croatia.

As it was the background motif for the movie Avatar, it was a beautiful forest as if a fairy would pop out.

“There are so many wonderful places in the world. Right?”

Patient Jeong Sun-rye kept admiring the TV screen, hesitated, and then said.

“Actually, my daughter and son said they would send me on a trip abroad this winter.”

“Where were you planning to go?”

“Oh, I don’t know, somewhere in Europe. I told them it was okay, but…… they’re busy taking care of themselves, so what’s with sending their mother on a trip?”

Patient Jeong Sun-rye smiled shyly.

This seems to be a mother’s unique boast about her children.

I smiled.

“You must be happy. Your children are filial sons and daughters.”

“Oh, it’s nothing.”

“If you have surgery and receive chemotherapy well, you will be able to go on a trip abroad.”

“I have to.”

The patient seemed a little less nervous after talking to me.

And she admired the screen again.

“It’s so pretty…… I wonder if heaven would look like that.”

At that time, a nurse walked out from inside the operating room.

“Doctor, please come into the operating room now.”

I proceeded with the patient’s car-in procedure [transferring the patient to the operating room].

When the patient lies on the bed, several confirmation procedures are carried out under the nurse’s lead.

“Patient, what is your name?”

“Jeong Sun-rye.”

“Do you know what surgery you are having today?”

“Ovarian cancer…….”

And the patient’s anesthesia began.

“…….”

Sae, sae—

Soon the patient fell asleep, and an endotracheal tube was inserted into her mouth.

Jieeng—

The person who opened the operating room door and came in was the first assistant, Teacher Cheon Sa-yeon.

“Hello.”

I greeted her as usual.

Cheon Sa-yeon glanced at me and asked.

“You know it’s a long surgery, right? You’ve been working for a few days now, so you can get a rough idea just by looking at the surgery name.”

“Yes.”

“Don’t even think about dozing off.”

Cheon Sa-yeon’s tone is sharp again today.

But perhaps because of yesterday’s conversation, it was less sharp than usual.

I answered without complaint.

“Yes. Please take good care of me.”

After a while.

I skillfully finished preparing for the surgery with Cheon Sa-yeon’s help and headed to the sink.

Shuaaaa—

I wash my hands.

For some reason, I feel a little more nervous today.

Of course, the success or failure of the surgery is more than 90 percent up to the professor.

But if there is even 1 percent that I can add, I will add it.

The main character has a role, and the supporting character has a role.

“Hello!”

“Oh, hello.”

The professor, who is the main character, soon enters the operating room.

He puts his cell phone on the desk and exchanges a few words with Cheon Sa-yeon while going to wash his hands.

“Sa-yeon, the paper I mentioned last time. Can you submit the abstract to this fall conference?”

“It took some time to fill in the missing parts of the data. I will send it to you by the day after tomorrow.”

“Okay. The submission deadline is approaching, so we need to hurry.”

“Yes, Professor.”

Soon, the professor, who came in after washing his hands, stood on the patient’s right side.

Paat—

The shadowless lamp turns on.

That’s how Patient Jeong Sun-rye’s surgery began.

* * *

.

It is the most fatal cancer among gynecological cancers.

It is also famous for being difficult to detect early because the symptoms are not unique.

Therefore, when it is discovered, it has often already metastasized to other places.

The stage of ovarian cancer is largely divided into four types as follows.

Stage 1—Fortunately, the cancer is still only in one ovary

Stage 2—The cancer is confined to the pelvis

Stage 3—The cancer has spread within the abdominal cavity

Stage 4—The cancer has spread far beyond the abdominal cavity to other organs

In addition to ovarian cancer, most cancers are divided into stages 1 to 4 like this.

Stage 4 refers to when the cancer has spread far beyond where it originally grew.

Therefore, these stage 4 cancer patients cannot undergo surgery and must undergo chemotherapy/radiation therapy.

What if you have cancer and can have surgery?

You should think of it as fortunate.

Patient Jeong Sun-rye, who is currently undergoing surgery, was expected to be in stage 3.

In other words, the cancer is confined to and spread within the abdominal cavity.

Ovarian cancer is unique in that the exact stage and prognosis can only be determined after surgery.

Therefore, the specific situation for Patient Jeong Sun-rye will only be accurately known after opening her abdomen.

“Scalpel.”

Ssuk—

The professor used a scalpel to begin the laparotomy [surgical incision into the abdomen].

A midline incision is made, dividing the center of the abdomen, and blood flows where the knife passes.

Soon, pink abdominal muscles begin to appear slightly below the fat layer.

Cheon Sa-yeon grabbed the abdominal muscles on the opposite side of the professor with forceps, and the professor began to cut between the muscles of the abdomen with a bovie (electric scalpel).

Shriek—

Smoke rises.

I held a suction and helped prevent the smoke from obstructing the professor’s view.

When the muscles were cut, the peritoneum, the innermost wall of the abdomen, was visible.

When this peritoneum was opened with a bovie, the inside of the patient’s abdominal cavity was finally revealed.

“Let’s see.”

The professor suctioned ascites [fluid buildup] from the opened abdominal cavity and began to carefully examine the inside of the abdominal cavity.

“Hmm…… there seems to be a little adhesion. It doesn’t seem like there are any tumors visible on the liver and diaphragm…….”

Adhesion.

When tissues that should be separated in our body are stickily attached, we say .

For surgery, these stickily attached tissues must be separated one by one.

This process must be carried out carefully because tissues/organs can be injured when dissecting adhesions.

Therefore, adhesion is a factor that makes surgery difficult and lengthy.

‘This surgery won’t be easy.’

Even I, as an intern, could sense that.

The professor immediately performed a test on the ascites in the abdominal cavity.

This is to test for possible cancer metastasis.

Then, he began to examine the other organs in the abdominal cavity in detail one by one.

“Okay, shall we start?”

Chiiiik—

With the smell of burning and smoke, the long surgery began in earnest.