Dr. Shin Seonhan: The Doctor Who Sees The Future [EN]: Chapter 153

I pricked up my ears.

His following words were as rapid as a machine gun.

“If we use VA-ECMO [Veno-arterial ECMO], we will have to use heparin [an anticoagulant], and we will inevitably have a risk of bleeding. Eisenmenger patients [patients with a specific heart defect leading to pulmonary hypertension] have high hematocrit [the ratio of the volume of red blood cells to the total volume of blood], so thrombosis [blood clot formation] is likely to occur, so there is no guarantee that they will not suffer from thrombosis during the ECMO process. If we do it, we’ll have to do Fem-fem [femoral-femoral cannulation, a specific ECMO technique]…….”

Too fast!

Words as if he had a motor in his mouth continued for a while.

“…Considering these problems, we can’t necessarily say that putting in ECMO is always good.”

So, to sum it up, it’s another tug-of-war with the devil.

← : Thrombus [blood clot]

→ : Bleeding

If you ride the ECMO locomotive, it may lean excessively to the right, in the direction of bleeding.

If hemostasis [the process of stopping bleeding] fails after a cesarean section, it will strongly threaten the patient’s life.

Then, the professors who had expressed their delight also fell into 고민 [Korean word meaning ‘worry’ or ‘ 고민’].

“That’s right, looking at this patient’s hemoptysis [coughing up blood], it seems like blood clots form easily, but we can’t not use heparin (a drug that thins the blood)…….”

“Blood needs to clot well during surgery… To keep the ECMO running safely and prevent thrombosis, the blood shouldn’t clot well… It’s a dilemma.”

Soon, a heated debate ensued.

The perspectives from each department were slightly different.

For example, the pediatrics department, thinking about the health of the fetus, welcomed the use of ECMO.

However, the obstetrics and gynecology department and other departments that had to perform the surgery were worried that the mother’s condition might worsen in the event of an emergency.

‘It’s a crossroads.’

Tight tension, like pulling a rubber band, is felt on the skin.

All the medical staff gathered here are standing on a huge crossroads.

What is the right answer?

I don’t know.

Even the professors who had experienced the ups and downs of the medical field for decades could not easily come to a conclusion.

“Have we ever done a C-section (cesarean section) with ECMO on a mother in our hospital before……?”

At the cautiously thrown question, Professor Heo Jun-im shrugged his shoulders.

“As far as I know, we haven’t had one yet in our hospital.”

“Hmm.”

There is no precedent.

With that one word, everyone unanimously returned to a conservative attitude.

“Professor Heo Jun-im, how about a method of doing surgery with ECMO on standby?”

The anesthesiology professor threw out a second-best option.

The idea was to start without ECMO and prepare to use ECMO quickly if the condition worsened during surgery.

In a way, it was the most reasonable compromise.

“Well, there is such a method! Whether it’s better to prepare to insert ECMO at any time, or to proceed with delivery with ECMO from the beginning… This is difficult for me to say too.”

Professor Heo Jun-im ruffled his hair and smiled with a troubled expression.

A young and challenging personality.

However, that doesn’t mean you can recklessly take a chance on a patient’s life.

Unlike his unique optimistic tone, he was also approaching this issue carefully.

“Let’s think about it until tomorrow, and set the day after tomorrow as the delivery date for now.”

At the words of the obstetrics and gynecology professor, the cardiology professor nodded.

“Okay, I’ll take another look at the patient’s pulmonary artery resistance and pressure.”

Whether to deliver with ECMO or without ECMO.

It was a difficult problem with both advantages and disadvantages.

Everyone who participated in the meeting left the conference room with a troubled expression.

After the meeting.

I was in a complicated mood as I cleaned up the empty conference room.

It was a big step forward that the options were narrowed down after each department put their heads together and discussed them.

But no one could guarantee what kind of result awaited at the end.

“Seon-han, are you okay? I’m sure you’re worried a lot because the patient is an acquaintance…….”

My older sister, Mi-seon, who was cleaning up the conference room with me, asked with a worried expression.

I smiled bitterly as if to say I was okay and lifted the chair.

Suddenly, I was reminded of the old days.

* * *

“Seon-han. Isn’t it heavy? Are you okay?”

10 years ago.

I, who was a high school student, rolled up my sleeves and was carrying a large suitcase down the stairs.

A cool breeze was blowing, but I didn’t even know it was cold.

“I can move it.”

“No, you’re weak, noona [term of endearment used by a male to address an older sister or female friend].”

“Are you subtly making fun of me?”

No-eul noona smiled and glared at me.

I didn’t smile.

To be honest, I was a little sulky in my young heart.

I was sad and sorry to be separated from Noona, who I had been seeing in the neighborhood since I was a child.

‘Studying abroad, huh.’

In fact, it was something to celebrate.

Because I know how hard No-eul noona has worked to transfer to a foreign university.

It was a great opportunity for Noona, who aimed to become a translator.

Anyway, No-eul noona was steadily moving forward.

After loading the luggage into the taxi, No-eul noona said to me.

“I’m sorry. I can’t take responsibility until you take the college entrance exam.”

“It’s okay.”

I shook my head.

No-eul noona taught me to the best of her ability as promised.

What I learned during that time was not just studying.

How not to give up.

How to persevere.

Even how to take responsibility for what you have set as a goal and do your best.

No-eul noona smiled and shook my hand vigorously.

“Seon-han, fighting! Let’s achieve what we aimed for!”

“Yes, I will definitely become a doctor.”

“Yeah, I’ll believe in you.”

“And…….”

I hesitated.

Thinking about it now, it makes my hands and feet curl up, but I said it in a childish tone.

“If you get sick later, don’t go to another hospital and come to me. I’ll treat you all when I become a doctor.”

“Puhahaha!”

No-eul noona laughed, bending over.

It was the biggest laugh I had ever seen on her face.

My face turned red, and No-eul noona even wiped away tears from laughing.

“Seon-han, did you make my heart flutter a little?”

“Don’t tease me, I’m already embarrassed.”

“I don’t have to worry about being sick for the rest of my life? Because we have our reliable Seon-han.”

No-eul noona continued to laugh for a while, then patted my flushed cheeks.

“Take care.”

That was the last time I saw No-eul noona.

It was a promise I made when I was immature, but I still haven’t forgotten what I said.

So, even 10 years later, I think.

Let’s not give up.

Let’s persevere.

* * *

D-2 [Two days before the surgery].

The night before the surgery.

I was standing in the hallway for a while, talking to my family on the phone.

Seon-do noona was very surprised to hear my words.

Not only my second older sister, but all of our family members remembered No-eul noona’s existence.