Dr. Shin Seonhan: The Doctor Who Sees The Future [EN]: Chapter 27

#27 Gangnam Station (6)

What’s going on?

I turned my head.

The one asking for help was a female student in a school uniform.

I could clearly feel her hand trembling as she held onto me.

“What’s wrong with your friend? Is she hurt somewhere?”

The student nodded hastily in response to my question.

“Yes, I think my friend got hurt a little while ago… Her face looks really strange… She says she’s okay, but I don’t think she is. We just went to a karaoke room and were on our way home when something collapsed….”

The female student was sobbing, talking incoherently.

She seemed to be in a panic.

I managed to calm the student down and asked.

“Calm down and tell me. Where is your friend now?”

“She’s sitting over there, please come quickly!”

The female student stamped her feet and tugged at my sleeve.

Tap, tap.

I hurried my steps.

I quickly ran over and saw several students looking after someone.

In the middle of them, a bear-like male student was sitting down.

He was a gentle and kind-looking boy.

But now, his face was distorted with pain.

“Guys, I brought a doctor!”

“Doctor, please take a look at our friend!”

“Please!”

The friends said, sobbing.

Then, the male student, who was sitting down and panting, barely squeezed out a word.

“Guys, I’m okay… There are people bleeding over there who seem to need it more….”

“What do you mean you’re okay! You were hit directly by the falling railing earlier!”

“Where were you hit?”

At my question, the students all answered in unison.

“In the chest!”

“Chest?”

I felt a chill run down my spine.

If someone injured their chest in such a big accident, the probability of it being a serious injury is high.

I sat in front of the male student and examined his condition.

“Student, look at me.”

“It hurts a little here….”

The male student said, pointing to his chest, his complexion not looking good.

“Can I lift up your clothes a bit?”

Swish-

I lifted the male student’s top.

And I was very surprised.

His chest to the upper part of his abdomen was completely covered in red bruises.

There was no visible bleeding, but it was clear that he had suffered a major impact inside his body.

“Oh my, what should we do!”

“Doctor, is Jinwoo badly hurt?”

The students asked in surprise.

Stay calm.

Now is the time to calmly assess the situation.

I examined the patient’s body and checked Beck’s triad [a set of three medical signs associated with cardiac tamponade] one by one.

First item, hypotension [low blood pressure].

—The force of the pulse felt in the carotid artery and wrist is weak.

Second item, jugular vein.

—When I checked the jugular vein around the neck, it was swollen, as expected.

Third item, heart sound.

—Unfortunately, there is no way to know this on this noisy street without a stethoscope.

But I could be sure.

That this student is I was looking for!

Whew—

I took a breath.

‘Okay, I’ve identified the cardiac tamponade patient [compression of the heart caused by fluid collecting in the sac surrounding the heart]. What should I do next?’

Soon, one method came to my mind.

Pericardiocentesis [a procedure where a needle is inserted to remove fluid from around the heart].

It involves inserting a needle into the patient’s chest to drain the blood trapped in the pericardium [the sac around the heart].

It is a procedure that can only be done skillfully by at least a senior resident [a doctor in their final years of training].

In addition, ultrasound equipment is required for safe procedures.

‘I’ve never done it myself….’

Of course, I know the theory.

Because I saw a cardiologist perform the procedure a few days ago.

Of course, that doctor did it skillfully while looking at the ultrasound, and my job was simply to assist.

I was just handing over the medical devices they asked for and holding what they told me to hold.

No, if there was one more thing, I did the dressing and finishing work after it was over.

But I have to do that alone here now?

I looked around.

Of course, there are no suitable tools on site.

‘…Wait, what am I thinking? The best thing to do is to get him to the hospital as quickly as possible. Let’s not do anything reckless.’

I shook my head.

Thud, thud.

At that time, 119 paramedics arrived with a stretcher.

“Are you a doctor?”

A paramedic ran up to me and asked.

I nodded.

“Yes, I’m a doctor working at Yeonguk University Hospital.”

“I heard the general situation from the reporter. There is a patient with severe bleeding?”

“Yes. There is a patient with a lot of bleeding in his leg.”

I pointed to where Geun-uk was.

Then the paramedic nodded.

“Ah, I see! Then, we’ll prioritize that patient and the trauma patient bleeding from the head here….”

“No, this friend is the most urgent.”

“Yes?!”

The paramedic’s eyes widened in disbelief.

That’s understandable.

Because this male student’s condition looks like a simple bruise.

But it’s not.

Compared to what is visible on the outside, the patient whose life is most at risk is this male student!

Only I know this fact here right now.

“There’s no time to explain in detail. We need to get him to the hospital quickly to get pericardiocentesis….”

I tried to convey the situation to the paramedic as quickly as possible.

At that time.

Thud.

“Oh no! Jinwoo!”

“Jinwoo! Wake up!”

The male student slumped down on the street.

His face gradually turned yellow and was covered in cold sweat.

His friends hurriedly called out to wake him up, but he only repeated moans like “Ugh… Ugh….”

Damn it!

There is no time.

If this continues, the situation I saw in the future will be reproduced as it is!

I shouted loudly.

“Take it off!”

“Yes… Yes?”

“Take off your friend’s vest and shirt, quickly!”

At my words, the students hurriedly took off the male student’s top.

Seeing that his consciousness is fading, it seems that the blood around his heart is preventing his heart from beating, causing his blood pressure to drop.

When I touched his carotid artery, it was beating very fast, close to 120 beats per minute.

I turned to the paramedic and said.

“Do you have a syringe?!”

“A syringe?”

“Quickly! It’s cardiac tamponade. It’ll be too late if we take him to the hospital! We have to take action here!”

I held out my hand.

The paramedic was momentarily bewildered and flustered, but soon handed me a syringe.

Thud!

At that moment, someone grabbed my arm.

It’s Geun-uk.

“What… what are you trying to do?”

“Pericardiocentesis.”

“What? Pericardiocentesis?”

Geun-uk’s eyes widened.

He probably thinks I’m crazy.

Well, I think it’s crazy too.

“What basis do you have for doing that?”

“Chest contusion with hypotension and jugular vein distension. Look at the patient sweating, there’s no time!”

“So you’re going to do pericardiocentesis here without any professional equipment?”

“I have to.”

“You crazy bastard.”

Geun-uk whispered to me, his face pale.

“How are you going to take responsibility? Did you forget that we’re interns, you crazy bastard!”

“…….”

Instantly, my head cooled down.

Geun-uk is right.

I am an intern.

I barely passed and am barely clinging to Yeonguk University Hospital as an intern.

It is uncertain whether I will be able to stay in the same hospital next year.

“I know you were impressed by Professor Song Yu-ju. But you don’t have a sono [sonogram, ultrasound] attached to your finger. Don’t do anything reckless and let’s quickly move the patient to the ambulance….”

Geun-uk’s voice trembled.

At that moment, what Doctor Yeo Bong-cheol said to me came to mind.

—From now on, never do anything you can’t take responsibility for yourself. As an intern, don’t make judgments on your own without any fear. Got it?

That’s right.

What I’m trying to do is clearly beyond the capabilities of an intern.

But if I do nothing, this male student will surely die as I saw in the future.

“Doctor….”

“Please help Jinwoo….”

The young students are looking at me with desperate eyes.

I looked back and forth between Geun-uk and the students.

And, the deliberation was not long.

“Whew.”

I calmed myself and stared at the patient’s chest.

“From below the Xiphoid process [a small cartilaginous extension of the lower part of the sternum (breastbone)] to the left….”

“Hey, you really!”

Geun-uk’s voice is no longer audible to me.

As I held the syringe and moved my hand towards the patient’s skin, Geun-uk, the paramedics, and everyone around me stared with surprised eyes.

Thwack—

I stabbed the patient’s chest.

The needle begins to tear through the skin.

‘Concentrate.’

I tried to recall the procedures I had performed during my short internship.

So did ABGA (arterial blood gas sampling) [a test that measures the levels of oxygen and carbon dioxide in the blood], thoracentesis [a procedure to remove fluid from the space between the lungs and the chest wall], and bone marrow aspiration [a procedure to collect a sample of bone marrow].

The feeling of piercing the skin, the feeling of piercing the subcutaneous fat layer, and the feeling of piercing the blood vessels were all subtly different.

Of course, it’s a very subtle difference, but….

It was definitely felt in my hand, which was born with a more sensitive sense than others.

‘I’m trusting my hands.’

When I think about it, I’ve been unique since I was a child.

Growing up in a fish market, I guessed the weight of fish without a scale.

During my school days, when I flipped a coin, I guessed the front and back sides only with the sensation in my hand.

Every time that happened, I thought.

Why can’t other people feel this?

The sensations I feel have always been different from others.

The hand I was born with is such a hand.

So, I will be able to feel the pericardium too.

At this moment.

The only thing to trust is the feeling in my hand.

‘I can do it! I just need to pierce the pericardium that surrounds the heart without touching the heart.’

I focused all my attention on the sensation at my fingertips.

I push the syringe needle towards the patient’s heart.

In 1mm increments.

Little by little.

Piercing the skin layer….

Piercing the muscle and fat layer below it….

Very slowly towards the pericardium, which is the shell surrounding the heart….

I was staring intently at the end of the syringe, concentrating on the tactile sensation at the tip of the needle.

Meanwhile, the paramedic who was measuring blood pressure on my right arm shouted.

“Blood pressure is measured at 75 over 50!”

Damn it!

Even at this moment, blood pressure continues to drop on a second-by-second basis.

This is because the heart is not functioning properly.

But even at times like this, you shouldn’t rush.

If I make a mistake and pierce the heart, I will be crossing a river from which there is no return.

‘Stay calm.’

I maintained my composure.

The paramedic believed that I was a doctor and was waiting patiently next to me.

Trusting me, who had only obtained a medical license two months ago….

At that time.

Popping—

I felt like I was piercing something tough.

And, like when doing ABGA (arterial blood gas test), dark red blood began to rise slightly.

‘Yes, this is the feeling!’

I could tell instinctively.

That I just pierced the pericardium!

I fixed the needle with my left hand and began to pull the syringe cylinder with my right hand.

Squeeze—

Soon, red blood rises little by little into the syringe in time with the heart’s beat.

The blood had a dark red color that was ambiguous to call bright red.

After extracting about 20cc of blood, I pulled out the syringe and threw the blood on the floor.

Splash!

But the patient is still sweating and struggling.

‘One more time!’

I repeated the previous process once again.

Since the previous sensation remained, the second puncture was easier than the first.

The blood pressure, which was measured again after extracting 20cc of dark red blood three times, was 105/80.

The male student’s consciousness was also seen to be gradually clearing up compared to before, and I was able to confirm that his pulse rate had dropped to around 100.

“Ugh….”

At that time, a faint groan began to leak from the patient’s mouth.