Dr. Shin Seonhan: The Doctor Who Sees The Future [EN]: Chapter 150

#150 Happy Birthday (9)

.

Doctor Song Yu-ju had clearly stated that.

She probably just stated the fact calmly, but the shock felt like a hammer blow.

“Could you… tell me a little more in detail?”

At my request, Doctor Song Yu-ju glanced at the time on her cell phone and said,

“I have to go into surgery now, so I don’t have time. I’m on call today, so if you want to know more, come to the on-call room.”

“Yes, thank you.”

“Okay.”

*Vibration*—

Doctor Song Yu-ju immediately left the obstetrics and gynecology department.

As always, she moved on to the next task with a busy pace and no emotion.

On the other hand, it was hard for me to remain calm.

“……”

I sat at the nurse’s station.

No-eul’s chart was displayed alone on the monitor screen.

‘Eisenmenger syndrome… But the mortality rate during pregnancy is 50%?’

Congenital heart disease.

This area, spanning pediatrics and thoracic surgery, is the most difficult for medical students to grasp during their six years of study.

There were countless complex heart malformations, and I remember it wasn’t easy to understand the disease itself.

It was difficult to understand the disease, but the various surgical treatments were even more complicated.

So much so that some friends boldly skipped the congenital heart defect section during exams and focused on other areas.

Even in the national medical examination, only a few of the simplest congenital heart defects are tested.

Because it is such a difficult field that no one can answer correctly if you start digging deeply.

But.

From the moment I learned that No-eul had this disease…

Now, Eisenmenger syndrome has become a disease that I must understand thoroughly.

Each letter written on the chart weighed down on my heart.

‘Pregnancy at the risk of her life…….’

Hearing it in Doctor Song Yu-ju’s cold tone made it feel even more stark.

“Intern, there’s a patient Lim Yu-jin in room 3 who needs an epidural.”

“Ah, yes.”

I shook my head at the nurse’s words.

‘Let’s get a hold of myself.’

I am a doctor.

I must not neglect my duties because of personal matters.

Because there are many other patients waiting for me.

‘Let’s do what I have to do first. And the first thing is to accurately understand the disease.’

My head was clearer than ever.

* * *

Evening fell on the ward.

With a calmer heart, I headed to the Department of Thoracic Surgery.

“Uh?”

*Ding*—

When I got off the elevator, a familiar face appeared as the opposite door opened.

“Oh, Doctor Seon-han! Long time no see. What’s up?”

It’s Doctor Ahn Gyeong-sik, who wears thick glasses.

Come to think of it, I met him when I first visited the thoracic surgery on-call room.

I bowed my head slightly.

“Hello.”

“You’re not in the Department of Thoracic Surgery this month, are you? You didn’t come up here because you’re curious about something again, did you?”

“Doctor Song Yu-ju is on call today, so I wanted to learn something for a while.”

“Today too? Haha, you have a lot of passion. Why didn’t I work as hard as Doctor Seon-han when I was an intern?”

Doctor Ahn Gyeong-sik adjusted his glasses and smiled, then headed to the on-call room with me.

“But how old are you, Doctor Seon-han?”

“I’m twenty-seven in international age.”

“Oh? International age? Then in Korean age…….”

Suddenly, Doctor Ahn Gyeong-sik looked embarrassed.

I smiled slightly.

“I took the college entrance exam three times.”

“Oh…… You looked young, but you’re older than me…… I’m sorry for speaking informally because you’re an intern.”

“No, it’s okay. You can speak comfortably.”

“Oh, sh-should I……?”

Resident year 1, Doctor Ahn Gyeong-sik, was stammering with a red face.

“Come on in……?”

Doctor Ahn Gyeong-sik opened the door with an awkward tone.

*Creak*—

It’s my second visit.

I entered the thoracic surgery on-call room and placed the plastic bag I was holding on the table.

“I didn’t know what you would like, so I brought everything I could find.”

*Rustle*—

Doctor Song Yu-ju, who was buried in the sofa in the on-call room, got up.

Then, she rummages through the snacks I picked up at the convenience store and takes out a candy.

“You said you were curious about that patient earlier?”

“Yes. I’m sorry for bothering you when you’re busy.”

“Wait, let me get some sugar first.”

Crunch, crunch.

Doctor Song Yu-ju rummaged through the bag for a while and crushed the candy I bought in her mouth.

Then, as if she woke up, she reached out to the side.

“Ahn Gyeong-sik, bring me a piece of paper.”

“Yes!”

I moved instinctively as soon as I saw Doctor Ahn Gyeong-sik’s quick action.

“And a pen.”

“Here it is.”

*Chaak!*

Doctor Ahn Gyeong-sik quickly hands over the paper, and I quickly hand over the pen.

“But senior, what are you going to explain today?”

“Adult PDA [Patent Ductus Arteriosus, a congenital heart defect], Eisenmenger syndrome caused by it. Do you want to explain it instead of me?”

“Ah, I’m not confident…….”

“Tsk.”

Doctor Song Yu-ju picked up a pen with several colors as if she didn’t expect it, and began to draw something without hesitation.

*Swish, swish*—

Soon, a cross-section of the heart was completed on the paper.

「Right atrium / Left atrium

Right ventricle / Left ventricle」

Then, this time, she fills the left and right sides with red and blue diagonal lines, respectively.

“You know what these colors mean, right?”

“Yes.”

I nodded.

—Red = arterial blood, oxygenated blood (left)

—Blue = venous blood, deoxygenated blood (right)

The blood that circulates through our body first enters the heart. Then, it receives oxygen from the lungs and exits through the heart again.

Red is the blood that takes oxygen and goes out to the whole body, and blue is the blood that returns after completing oxygen delivery.

Of course, these two should not be mixed arbitrarily.

“But what if there is a shunt [an abnormal connection between blood vessels] in here?”

*Tear*—

Doctor Song Yu-ju made a passage in the heart with a pen.

Then, an ominous path is created between red and blue.

“This is called PDA.”

PDA.

Abbreviation for Patent Ductus Arteriosus.

As the name suggests, it refers to a condition in which a shunt called the ductus arteriosus remains open.

“Senior! This ductus arteriosus is supposed to close naturally as soon as you are born, right?”

“That’s right.”

Song Yu-ju nodded as Ahn Gyeong-sik confidently intervened.

“It must be open before birth, and it must be closed immediately after birth.”

In fact, this ductus arteriosus is a blood vessel necessary for the fetus.

But it is no longer needed after coming out of the mother’s womb.

So it should naturally close…

Sometimes, it doesn’t close and remains open.

“What happens if you leave this shunt as it is?”

“Oxygenated blood and deoxygenated blood continue to mix.”

“That’s right. Deoxygenated blood will be delivered all over the body, right?”

Doctor Song Yu-ju’s explanation that followed was somewhat complex and proceeded quickly.

When I was a baby?

Pulmonary resistance is low.

So, the mixed blood from the shunt crossroads enters the lungs. With the strong force that the left ventricle squeezes!

Then, the lungs begin to scream.

The lungs begin to change.

In order to resist the strong force of the left ventricle, it begins to increase its strength by thickening the blood vessels.

Originally, the lungs should be quiet and weak like a weak person, but they unintentionally build muscle.

After a few years like that.

The lungs are already out of their mind.

Constantly exposed to the strong pressure of the left ventricle, the lungs are muscle monsters.

The heart is no longer able to send blood to this muscle monster.

The crossroads of the shunt.

The mixed blood that had been heading to the lungs now heads to the whole body. Without even going through the lungs.

Just as a traffic light design on a road is wrong, leading to a chain collision, a chain reaction of terror unfolds.

“Usually, these symptoms occur around the age of late teens to twenties.”

Teens and twenties.

That was the time when I was close to No-eul.

……Come to think of it, No-eul really hated exercising.

When crossing the crosswalk, even if half of the signal remained, she slowly waited for the next signal.

Whenever she had to run, she would get out of breath quickly.

Thinking about that time makes me feel sorry.

“It not only causes shortness of breath, but in severe cases, it can also cause sudden death.”

“I just thought she hated exercising…….”

“……?”

The faces of the two people have question marks at my mutterings.

Oh, right, I didn’t tell them about my relationship with the patient.

“Actually, I used to know the patient well, but I met her by chance in the hospital.”

“What?”

“Somehow…….”

“Wow, what is the percentage of meeting a patient you know in the hospital? Doctor Seon-han really experiences all the strange things alone.”

“Wait, that’s not important.”

Song Yu-ju cut off Ahn Gyeong-sik’s words and asked me.

“Tell me as you remember.”

*Click, click.*

Song Yu-ju picked up the pen again.

She is taking a kind of history taking through me.

She wrote down my words for a while, then tapped her lips with a pen and thought deeply.

“Cyanosis [bluish discoloration of the skin] was not severe until her early 20s…… The symptoms may have been mild when she was young.”

The timing of when the time bomb explodes varies from person to person.

For example, in the case of male patients, there are cases where they are fine even after going to the military and receiving all the training.

But that doesn’t mean there is no bomb.

“It’s a matter of when it will explode, but it can’t not explode forever. In that patient’s case, it has only now been revealed.”

If deoxygenated blood is mixed and goes to the whole body for a long time, there is no way the health can be fine.

Dyspnea [shortness of breath].

Cyanosis.

Increased red blood cell count.

And thrombosis [blood clot] accordingly.

Etc.

Various symptoms begin to appear clearly.

Besides, by this time, the lungs are already damaged, so no matter what medicine you use, you can’t reverse it.

The only way to solve it is to transplant another person’s lungs.

“This is Eisenmenger’s syndrome.”

Song Yu-ju’s explanation is over.

……I kept silent.

The more I think about it, the more unfortunate I feel. This is because most of them can be prevented with early diagnosis as a baby.

‘If only I had discovered it when I was young and blocked it with surgery…….’

I want to turn back time.

But I can’t do that unless I’m God.

The only thing I can do is to take the best measures, even belatedly.

“Doctor, is there any way to block this shunt even now?”

“It would be nice if it could be solved so easily.”

Song Yu-ju shook her head.

It is useless because the lungs are already damaged.

Conversely, if you block it now, it can 오히려 [rather] break the balance of the whole body that you have been holding on to.

“……If you touch it recklessly late, it can 오히려 [rather] get worse?”

“That’s right.”

*Whirly, whirly.*

Doctor Song Yu-ju spun the pen around.

It was a habit I had never seen before.

She is always a cold person, but she seemed quite complicated in this situation.

“Surgery is not always the best solution. In fact, the patient has been living a normal life for the past few years.”

“Yes.”

“But above all, the biggest problem right now is…….”

Song Yu-ju clicked her tongue and swept her hair up.

“……?”

Doctor Ahn Gyeong-sik and I raised our heads and looked at Doctor Song Yu-ju.

On that face, there was a complicated emotion that I had never seen before.

It was rare for Doctor Song Yu-ju to express her emotions like this.