Dr. Shin Seonhan: The Doctor Who Sees The Future [EN]: Chapter 160

#160 Happy Birthday (19)

“Professor, the ECMO line here……!”

My heightened senses immediately picked up on it—the ECMO line.

Drrr―

The catheter inserted into the femoral blood vessel, connected to the machine, *was* the ECMO line.

That line was subtly vibrating.

A faint signal, easily missed.

But because I was so keenly alert, I noticed it before anyone else.

‘This kind of line vibration could indicate a problem with the patient……!’

Of course, I’m just an intern.

I’m not supposed to speak up during such a critical surgery.

But I can’t just ignore what I felt.

Right now, the patient’s life is at stake.

“The line? What about it?”

“It seems like the line is vibrating!”

Everyone’s attention immediately focused on the line.

Not only the cardiothoracic surgery team but also the anesthesiology professor leaned in to examine the ECMO line.

“……!”

Professor Jo Jae-yong and Dr. Yoo Jung-nam, who were intensely focused on the surgical field, also paused.

Professor Heo Jun-im, touching the ECMO machine, confirmed without delay, “It’s true, there’s chattering [vibration] of the ECMO line.”

“Ah, is that so?”

“It doesn’t seem to be a problem with the circuit [the ECMO machine and catheter], and the ECMO flow [blood circulation through ECMO] is also decreasing little by little, so it seems like there’s a lack of volume.”

Volume, meaning a lack of blood.

My hunch was correct.

No-eul was experiencing a shortage of blood in her body due to bleeding, and the ECMO line was indicating this.

The anesthesiology team immediately responded, “Understood. We’ll look at the ABGA [Arterial Blood Gas Analysis] results and do an additional RBC [Red Blood Cell] transfusion.”

Transfusion.

They were going to replenish the amount of blood lost from the patient’s body.

It was fortunate that a decision could be made so quickly.

‘Studying in advance wasn’t in vain.’

Who knew that learning as much as possible about ECMO before the surgery would be so helpful?

But…….

In any case, the current situation is like pouring water into a bottomless pit.

While replenishing blood is important, stopping the leak is even more urgent.

The fundamental problem is still ongoing.

“The bleeding isn’t easily stopping, is it, Dr. Jo Jae-yong? We can only administer oxytocin [a uterotonic agent to contract the uterus and stop bleeding] slowly in this situation…….”

Oxytocin was needed for hemostasis [stopping blood flow], but they couldn’t inject it quickly due to No-eul’s hemodynamic instability [unstable blood pressure and heart rate].

Professor Jo Jae-yong, sweating, replied to the anesthesiology team’s cautious words, “That’s right…… I was worried when we decided to use ECMO, but I didn’t know it would be this bad.”

The operating room is sometimes called a theater, but there is no set script here.

A place where unexpected things happen at any time.

That’s why doctors have no choice but to respond skillfully to various situations to the best of their ability.

He said to me and Dr. Yoo Jung-nam, “Leave the vitals to the anesthesiology and cardiothoracic surgery teams, and let’s focus on hemostasis. Jung-nam, grab this suture. Intern, suction here.”

“Yes, Professor.”

“Yes!”

We refocused on the surgical field where the bleeding wasn’t stopping.

“……By the way, the intern has a good sense. Good catch. Noticing the ECMO line vibrating right away.”

Professor Heo Jun-im’s quiet voice came from behind.

Of course, there was no time to say thank you.

As a member of the obstetrics and gynecology department, I focused on bleeding control for patient Jung No-eul.

Obstetrics and gynecology, anesthesiology, and cardiothoracic surgery.

Everyone was doing their best in their respective positions for the survival of patient Jung No-eul.

* * *

How much time had passed?

Finally, the hemostasis and suturing process was completed.

With drainage tubes inserted into her abdomen and uterus, No-eul was able to leave the operating room.

Drrr―

I proceeded, pushing the cart.

The bed No-eul was lying on slid out of the operating room and moved towards the hallway.

Five hours.

That was the time it took for No-eul’s surgery.

By the time the surgery that started in the morning was over, the clock was already pointing to the afternoon.

‘We’ve gotten through the critical moment for now.’

Surgical outcome?

It’s hard to say.

How great would it be if I could say it clearly…….

It’s not yet possible to clearly divide it into good or bad.

As Dr. Song Yoo-joo said, the post-operative process is more important now anyway.

I recalled the conversation between the professors a little while ago.

Opinion of the obstetrics and gynecology department.

For now, the bleeding has been somewhat controlled.

So, the rest is about trusting the patient’s own coagulation mechanism.

Opinion of the anesthesiology department.

In short, they’re worried.

It looks okay with the help of medication right now, but the heart is not yet in a reassuring state.

The opinions of the cardiothoracic surgery and cardiology departments followed.

After the surgery was completed with everyone’s agreement.

No-eul was transferred to the cardiothoracic surgery ICU to monitor her progress.

‘It was a surgery like a war…… I don’t even know how the five hours flew by.’

Drrr―

Pushing the bed.

It’s something I always do, but the sensation reaching my hands feels unusually heavy.

Well, it might be natural because the ECMO machine is on the ICU bed.

But it’s not just for that reason.

My heart is heavy.

As soon as the surgery ended, various emotions that had been pushed aside in one corner of my heart began to surface.

‘Will she be okay?’

I looked at No-eul with concern.

She looks completely different from when she entered the operating room.

Her hair is disheveled, and she’s wearing a surgical cap.

She has a ventilator inserted into her mouth, and the marks from the monitoring devices attached during the surgery are clear on her forehead.

Infusion pumps connected to IV lines coming out of various parts of her body are stacked seven layers high at one end of the bed.

……This is the first time I’ve seen infusion pumps stacked so high.

That means No-eul is currently receiving various medications.

‘I hope she can overcome this.’

Zhiing―

The operating room door opens.

The bed returns the same way it came and heads to the intensive care unit.

Professors and residents from obstetrics and gynecology, anesthesiology, and cardiothoracic surgery accompany the patient.

I was pushing the bed from the very back.

At that moment, a commotion is heard in front of the intensive care unit door.

“Oh my, is that our No-eul?”

“No-eul!”

It’s No-eul’s family.

While we were fighting desperately in the operating room, the family must have had a hard time too.

How long those five hours must have felt to them!

They must have been waiting for No-eul and the baby to come back alive.

They run to the side of the bed and sob.

“Is my wife okay, doctor? She doesn’t seem to be conscious right now…….”

The husband asks worriedly.

The professors must have already explained the surgery once, but it’s the family’s heart that wants to ask again.

“We’ll let you visit once the ICU is set up. Please wait a moment.”

While Dr. Yoo Jung-nam briefly explains to the family, No-eul’s bed enters the intensive care unit.

The intensive care unit was also fully prepared and waiting for the patient.

‘The care here in the intensive care unit will determine No-eul’s future!’

For six months after childbirth, the mother’s cardiac output and systemic vascular resistance (SVR) return to their pre-pregnancy state.

And most of that process takes place during the first two weeks after childbirth.

In other words, the first two weeks after childbirth are the most hemodynamically unstable period.

Soon, the handover between anesthesiology and cardiothoracic surgery continued.

It was the moment when the entity responsible for the patient’s life was transferred to cardiothoracic surgery.

Of course, obstetrics and gynecology and cardiology will also continue to participate in the treatment.

And, more than anything…….

From now on, the most important thing is the patient’s own vitality.

She has to overcome it. Somehow.

The mother’s war is not over yet.

* * *

Cardiothoracic surgery intensive care unit.

Various intensive care unit settings are being made for No-eul.

Shhh shhh―

No-eul is breathing with the help of a ventilator and is asleep with various medications.

Wiiiing―

Right next to her, the ECMO machine is running quietly.

‘The post-op course has to be problem-free…….’

As I was anxiously watching the setting process, I felt a presence behind me.

Someone tapped me on the shoulder.

It was Professor Heo Jun-im.

“Hello.”

“Wow~ we’ve met before, haven’t we?”

The professor’s eyes crinkle as he says that.

“Yes, during the disciplinary committee before…….”

“That’s right, the Gangnam Station incident! I thought you were cool back then too, and you were cool in the operating room today too! An intern would be too busy just doing their job, but you even noticed the abnormality in the ECMO!”

Professor Heo Jun-im.

He had returned to his usual talkative self.

It’s like a different person?

The appearance inside and outside the operating room is clearly different.

I answered humbly, “I didn’t think you would remember me.”

“Oh, what are you talking about? There’s no one in cardiothoracic surgery who doesn’t know your name these days. And actually, I heard about you from Poong, too.”

I was momentarily delighted to hear a name I hadn’t expected.

“You mean Dr. Poong?”

“Of course~ you’d be surprised if you knew how small the Republic of Korea’s cardiothoracic surgery field is! I’m close with Poong! Who do you think made this surgical cap?”

He smiled and pointed to his surgical cap.

A rabbit pattern.

Come to think of it, the signature in Dr. Poong’s artwork was a rabbit, wasn’t it?

Of course, there’s room for debate as to whether it’s something that can be called a work of art…….

Anyway, there seems to be such a backstory to Professor Heo Jun-im’s unique hat.

“Come to think of it, I remember when I first received this surgical cap. It must have been about ten years ago. I really didn’t like the design of this surgical cap that Poong made for me as a lucky gift. But! Strangely enough, from the first surgery I went into wearing this surgical cap…….”

Blah blah.

Too much talking continues for a while…….

……This person really talks fast.

I think I can understand what it means to have blood coming out of my ears.

Anyway, I could roughly guess that the two were very close.

A collaboration between a chatterbox and a braggart, perhaps?

Thinking about it, it was quite an interesting combination.

“But you have a grim look on your face. Are you worried about the patient?”

“Ah, yes.”

I said quickly.

I couldn’t erase my worries.

A lot more blood than expected was flowing out of the drainage tubes that were placed in the patient’s abdomen and uterus.

I could see that major bleeding had stopped, but minor bleeding was continuing from the surgical site.

Then Professor Heo Jun-im said, “Have you ever heard of the dilemma of being a ‘mot-ssol’ [a Korean slang term for someone who has never been in a relationship]?”

“Excuse me?”

Suddenly, out of the blue?

It’s not in the mood to tell a silly story, but rather a tone like asking a riddle.