Dr. Shin Seonhan: The Doctor Who Sees The Future [EN]: Chapter 177

#177 Where He’s Headed (8)

‘That person is…?’

It’s Teacher Ahn Gyeong-sik.

For some reason, he’s sitting on the floor, sobbing.

Tears are welling up behind his slightly slipped horn-rimmed glasses.

‘…Why is he crying so sadly?’

It’s a face I’ve never seen before.

A first-year resident in the Department of Thoracic Surgery.

He’s still early in his career, but he should be desensitized to most things by now.

For someone like that to be crying like that…

Suddenly, I remembered what Teacher Ma Dong-seop said when I was in the Department of Thoracic Surgery.

‘Have you ever known when it’s saddest to write discharge records for deceased patients?’

He paused for a moment, then scratched his nose with his thick fingers and continued.

‘It’s when pediatric heart patients expire (die). It’s really heartbreaking, unlike adults. I can’t forget each and every one of them…’

While telling this story in the hospital hallway, I felt his eyes, which resembled those of a wild animal, become moist.

So it was not easily forgotten, and now I could sense it.

Something bad is happening here in the Pediatric Cardiac Intensive Care Unit.

‘Let’s figure out the situation first!’

I quickly moved my feet.

Turning the corner, I could see people gathered around a bed.

A uniquely designed infant bed.

This bed, which can only be seen in the Pediatric Cardiac Intensive Care Unit, has a unique structure.

A square bed where a 3-7kg baby can lie is at chest height, and equipment to maintain the baby’s body temperature is installed above it.

And around it, there is space for various medicines and oxygen tanks.

Currently, there are 6-7 doctors gathered around the bed.

‘Oh, I can’t see well… what are they doing?’

There are too many people.

It’s hard to see what’s going on because it’s blocked by the doctors’ bodies.

I squeezed through them and leaned in.

Soon, my eyes widened.

‘Pediatric CPR (Cardiopulmonary Resuscitation)?’

Push- Push-

One person was wrapping the baby’s chest with both hands and repeatedly pressing down using both thumbs.

The principle is the same as CPR for adults, but the tension feels greater.

‘They do it like this for newborns. It’s my first time seeing it in person….’

The sternum on the baby’s chest is repeatedly compressed and released like rubber.

I wonder if it’s okay to press down so hard on such a small baby’s chest, which is only a handful.

But, there’s no choice.

First of all, it is urgent to squeeze the baby’s heart to supply blood flow to the whole body, including the brain.

In other words, the baby’s life is in critical condition right now.

They were somehow pulling up the baby’s life hanging on the edge of a cliff.

‘Epinephrine is going in, it’s been 26 minutes!’

‘POD (Post-Op Day) 5, right? Is the pediatric ECMO [Extracorporeal Membrane Oxygenation, a life support machine] ready?’

‘What’s the weight?’

‘3 months, 6kg!’

‘Should we book the operating room?’

Various conversations are going on in a chaotic manner.

A melting pot of chaos.

The medical staff are screaming and doing their best.

At the same time as chest compressions, thick needles are repeatedly going in and out of the thigh.

They’re trying to find a blood vessel, but it doesn’t seem easy.

‘If you’re doing CPR, it won’t be easy to find a blood vessel….’

At that time, a fellow teacher belatedly runs to the bed.

Seeing him in civilian clothes with sweat beading on his forehead, it seems he ran to the hospital from home in one breath.

‘What is it? The TGA [Transposition of the Great Arteries] patient who had surgery last week?’

‘Yes, that’s right!’

‘Did you contact Professor Hwang In-hak?’

‘Yes! He’s on his way.’

Haa… If it’s already been 26 minutes, it won’t be easy….

In the midst of the hectic conversation, the baby’s skin was gradually turning blue.

‘Wait, I need to see the baby’s name first!’

I suddenly came to my senses.

This dream might end.

I tried to check the baby’s name tag, but it was hard to see because it was blocked by people.

The moment I moved around to find out the child’s information.

Flash-

My vision flickered, and I returned to reality.

* * *

The scenery in front of me slowly returns.

The noises from a moment ago disappear like a lie, and only a quiet silence lingers in the NICU [Neonatal Intensive Care Unit].

‘Damn it, I didn’t see the name!’

All the futures that have unfolded so far were events that happened to one of the patients in front of me.

I looked around.

Wait, but….

Which one is it?

The babies all look the same, and there are too many incubators.

‘Is one of these babies going to be in a CPR situation in the Pediatric Cardiac Intensive Care Unit?’

……Let’s calm down.

There’s still plenty of time.

Let’s calmly organize the information I got in the dream.

-Pediatric Cardiac Thoracic Surgery Intensive Care Unit.

-3 months, 6kg baby.

-CPR (Cardiopulmonary Resuscitation) 5 days after surgery.

‘And, I think they said T…… GA… Did I hear that right?’

I rummaged through my memories.

It’s a difficult concept, but I vaguely remembered it.

TGA (Transposition of Great Arteries).

It refers to a condition in which the positions of the aorta and pulmonary artery, which are important large blood vessels leaving the heart, are reversed from birth.

‘I heard that TGA patients often need emergency surgery as soon as they are born… but that child was said to be 3 months old?’

The moment I reached that thought, I felt overwhelmed.

It’s on a different level than ever before.

If the diseases I had seen before were mazes drawn on paper….

Now, I feel like I’ve suddenly been thrown into a dark labyrinth.

I felt dizzy from the congenital heart disease, which was incomparably more difficult than No-eul’s disease before.

‘……Let’s open the charts of the kids here first.’

I opened the charts of each of the patients in the NICU B cell (section) where I was.

The child I had just transported had no heart problems at all.

‘I don’t think it’s this child… Who is it, the child who will be admitted to the Thoracic Surgery Intensive Care Unit?’

As I opened the charts one by one, my finger stopped in front of one chart.

Lee Seul-gi

A baby who was transferred from another hospital with congenital heart malformation on the 10th day of hospitalization.

And the disease name is….

‘I found it, TGA!’

The diagnosis recorded on the chart included heart malformations of VSD (Ventricular Septal Defect) and PS (Pulmonary Stenosis) in addition to TGA (Transposition of Great Arteries).

‘A congenital heart defect complete set….’

The child I saw in the dream was 3 months old, but the baby in the chart I’m looking at now is only 3 weeks old.

Could it be that it showed me the future of this child 3 months later?

My worries grew deeper.

‘Intern, do you need anything? I don’t think there are any other intern jobs right now?’

The NICU nurse looked at me, who had been pondering in front of the monitor for a while, with a puzzled expression.

‘Ah… I was writing an intern record for a while. I’m trying to do it in advance.’

‘Yes, okay. If you need anything, feel free to ask.’

‘Thank you.’

I answered the nurse lightly and looked closely at the child’s chart.

It was recorded that she was born normally at 38 weeks and 4 kg, but her oxygen saturation was checked at 60-70% from birth.

She was transferred to the NICU of Yeon-guk University Hospital on the second day after birth, and the next day, she underwent a procedure to make a hole in the atrial septum of her heart.

The consultation record also contained a reply from the Department of Thoracic Surgery.

‘After performing balloon atrioseptostomy [a procedure to enlarge the opening between the atria], we will perform op. [operation] in 3-4 months.

Please share the f/u echo (echocardiogram) findings at the meeting.’

Based on this consultation record….

This child is likely to have surgery in 3-4 months and be in the Pediatric Cardiac Intensive Care Unit.

I made a conclusion and closed the chart.

‘Let’s go to the Pediatric Cardiac Intensive Care Unit first. There may be other TGA patients besides this child!’

Buzz-

The door to 03PH opens.

I was nervous even when the door opened.

Could there be a CPR situation going on right now?

With that tension, I walked to the bed in the Pediatric Cardiac Intensive Care Unit that I had seen in my dream.

‘Is the child currently hospitalized…?’

But it wasn’t.

There was a completely different child lying in the corner seat.

It was a child who had surgery for a simple ASD (Atrial Septal Defect) [a hole in the wall between the heart’s upper chambers].

‘Huh? Intern Technician Leader! What brings you here?’

At that time, someone greeted me happily.

It’s Teacher Ahn Gyeong-sik, who was in the Pediatric Cardiac Intensive Care Unit.

The sight of him sitting sadly on the floor in my dream flickered before my eyes, and I wanted to treat him warmly for some reason.

‘Teacher, do you have any TGA patients in the ICU right now?’

‘Huh? TGA?’

Ahn Gyeong-sik’s eyes widened as if he had heard an unexpected word.

He adjusted his thick glasses and said.

‘TGA surgery is not frequent, so there are none in the intensive care unit right now… Is there anything you’re curious about?’

‘Ah, then there was a TGA baby among the NICU patients….’

‘Oh, that’s right. She’s had a hole made in her heart for now, and she’ll have total correction surgery later.’

‘You’re making a hole?’

‘Aha~ It’s probably a difficult concept for our intern!’

Teacher Ahn Gyeong-sik seemed excited to be able to talk about something he knew after a long time.

‘Okay, look. I’ll explain it simply.’

‘In the case of a normal person.’

‘Heart → Lungs → Heart → Whole Body → Heart → Lungs…….’

‘It is connected in one circulation loop, and the heart delivers oxygen received from the lungs to the whole body.’

‘However, in the case of TGA (Transposition of Great Arteries) patients, there are two circulation loops in the body.’

‘(1) Heart → Lungs → Heart → Lungs…….’

‘(2) Heart → Whole Body → Heart → Whole Body…….’

‘If these two circulation loops do not mix, our body will not be able to get oxygen.’

‘Seul-gi is still too small and young to have major surgery.’

‘So, the story was that they would make a hole in the heart so that the circulation loops could mix, and then perform major surgery after the child had grown a little more.’

‘……So, she’ll probably have surgery around the end of January.’

‘Ah, I see. Then what kind of treatment will the child receive for 3 months?’

‘Hmm… Just eat well and grow well. The pediatrics department will continue to observe. Until the child grows up enough to withstand the surgery!’

‘Ah, yes, thank you.’

January….

As I became close to the children while working in pediatrics, I couldn’t even imagine sending a child to heaven.

‘It’s the month I’m going to be rotating in TS (Thoracic Surgery). Let’s keep it in mind. Lee Seul-gi.’

There must be something I can do to change the future.

No, I have to.

* * *

‘Ina, it’s time to go home now.’

‘I don’t want to!’

‘You don’t want to go home after being discharged?’

‘I want to play with Gorilla Uncle more!’

Last week of October.

Ina was clinging to Geun-wook like a piece of gum.

Geun-wook played with Ina for 10 minutes as promised.

He gave her a piggyback ride and played Superman.

As if he had been doing strength training for this day, Geun-wook played the role of a human roller coaster for Ina.

‘Teacher, thank you so much for taking good care of our Ina all this time.’

‘Haha, it was nothing. I’m glad Ina has improved a lot.’

‘It’s thanks to you, teacher.’

‘Oh, no.’

Now it’s time to say goodbye.

Geun-wook also felt sad.

There’s no way to avoid parting with a beloved patient.

No matter how close they become like an uncle and niece, the relationship between a doctor and a patient is only within the hospital.

As there were other intern jobs tightly packed, there was no more time to spend.

‘Ina, you have to say goodbye to the teacher?’

Eventually, the guardian barely managed to pull her away, and Ina reluctantly backed away.

The pouting lips are sad.

But she doesn’t cry.

Is it the last bit of pride as a stubborn rascal?

Geun-wook couldn’t help but smile at the sulky look.

‘Goodbye, Ina. Eat well and listen to your mom! Be healthy! Bye-bye!’

Geun-wook smiled brightly and waved his hand.

But the aftertaste of turning around was bitter.

Is it because I’m so attached to her?

Ina will be remembered among the many patients I met during my internship.

‘Gorilla Uncle!’

At that time, Ina called out to Geun-wook from behind and ran towards him with quick steps.