#43 The ICU Marine (3)
The sheets were stained with blood.
What on earth happened last night?
Just then, someone tapped me on the back.
I was startled.
“Yoonsung, what happened?”
My intern colleague, Yoonsung, had tissues stuffed in his nose.
Did he have a nosebleed?
Not only that, but his eyes were sunken, and he looked like he had been through something.
Why does he look like that?
I asked in surprise.
“What’s wrong?”
“Man, you wouldn’t believe it. A patient went crazy trying to pull out his lines in the middle of the night…”
Yoonsung whined, on the verge of tears.
From what I gathered, the patient’s delirium had worsened during the night.
He suddenly started shouting and thrashing around, trying to pull out the tubes connected to his body.
Actually, trying to pull out lines is a common occurrence during delirium.
“Suddenly, he was saying he needed to get a gun and ripped out his chest tube.”
“He pulled out his chest tube?”
“Yeah. Blood was dripping from the tube, and blood was flowing from his chest. It was the worst moment of my intern life so far.”
“Ah, so that’s what the bloodstains are from…”
I was finally able to grasp the situation.
So that’s what the bloodstains scattered all over the sheets were!
He must have caused quite a commotion, pulling out a tube stuck in his chest.
Moreover, Yoonsung’s story didn’t end there.
“Suddenly, he started saying he had to charge into the mountains and asked me to cover him… holding the chest tube like a gun in one hand! I thought I was going crazy.”
“So what did you do?”
“All the lines were pulled out, so there was nowhere to inject. I gave him an intramuscular injection of haloperidol [an antipsychotic medication], and he calmed down a bit. Even that, the nurse barely managed to inject it while I was holding the old man down.”
Yoonsung shuddered.
The patient’s symptoms seemed to have gotten much worse overnight.
He certainly wasn’t this bad yesterday…
It made me realize how scary delirium can be once it starts.
“But what’s wrong with your nose?”
“I got hit.”
“You got hit by the patient?”
“Yeah, I was trying to hold him still, and I got punched in the face. The old man is surprisingly strong.”
Oh, dear.
I clicked my tongue.
Delirious patients do sometimes assault nurses or caregivers.
Later, they might say, ‘I thought the nurses were trying to kill me,’ to justify their actions.
That’s how severe the hallucinations and delusions become.
“Be careful when you’re on duty. He’s a war veteran, so his punches are pretty fierce.”
With that, my colleague disappeared, looking utterly fed up.
Looking around, the nurses who had worked the night shift also looked exhausted.
I approached the bed and examined the patient’s condition.
Wheeze— Wheeze—
The old man was sleeping soundly.
Of course, he didn’t look healthy, having only had lung cancer surgery two days ago.
But it was hard to believe that he was the same person who had been raging like a madman last night.
‘He’s a really unique patient.’
I suddenly became curious.
Does the hospital look like a battlefield in the old man’s mind?
If so, is there a way to alleviate this delirium?
‘I’m feeling motivated for the first time in a while.’
I was already wearing a challenging smile.
Attacking Grandpa was a new stimulus for me, who had been spending listless days in the ICU [Intensive Care Unit].
As a doctor, I wanted to know more about this patient.
And, if possible, I wanted to help.
Maybe there’s something I can do this time.
* * *
Soon, visiting hours would begin.
At each bed, family members were holding their patients’ hands and talking.
But no one came to visit Attacking Grandpa.
I asked Nurse Cha Yoori, who was sitting at the station.
“Does Attacking Grandpa not have any visitors?”
“I guess not. No one’s here.”
Nurse Cha Yoori’s answer felt familiar.
Was it because it reminded me of Grandma Kim Hyejung?
I felt sorry for the grandmothers lying alone in the ICU, and it was the same this time.
“But yesterday, a veteran’s association member visited.”
“Ah, that’s right, you said he was a Marine?”
“Yes. I think the lung cancer is probably due to the aftereffects of his participation in the war.”
War aftereffects, huh…
I opened his chart.
It briefly stated his participation in the Vietnam War.
But it was difficult to really know the patient with just a line or two of information.
It would be nice if I could find out a little more information…
‘Wait. Maybe I can find information that’s not on the chart online?’
I turned on my smartphone and opened a search engine, typing in a few keywords.
‘Vietnam War, Marine Corps, Attacking’
Soon, I was able to find a video.
It was a video interviewing people who had suffered from Agent Orange exposure after participating in the Vietnam War.
The video was over 10 years old, so the quality wasn’t very good, but it was still watchable.
I put on my earphones.
Skipping through the video, I was soon able to find the part I wanted.
The interviewer’s question.
Soon, Attacking Grandpa in the video answers.
He looks a little heavier than he does now, and a little healthier.
Soon, black-and-white archival footage is played on the screen.
Soldiers wearing helmets are moving in formation.
Should I call it a page of modern Korean history?
It feels strange to think that one of them is now hospitalized in front of me as a critically ill patient.
The old man suddenly stops talking, and after a while, he slowly begins to speak again.
I listened intently.
The war story told by someone who experienced it felt more vivid than reading it in a book.
Swish, swish.
The old man, who was continuing the interview, rubbed his eyes with the back of his hand.
It seemed that the memory of that day still brought tears to his eyes.
The dry eyes, like an old tree, were already moist.
The horrors of war.
It feels even more real when you hear it from someone who actually experienced it.
I was already immersed in the old man’s story.
That’s when.
“Surgical ICU visiting hours are over.”
The nurse’s voice is heard.
Soon, the nurses went to each patient’s family member to inform them that visiting hours were over.
And one of them came to me and said.
“Intern, after the family members leave, please insert an L-tube (nasogastric tube) [a tube inserted through the nose into the stomach] into bed number 7.”
“Okay, I understand.”
I stopped the video and got up from my seat.
I decided to take care of the immediate task first.
But for a while, the old man’s tears that I saw in the video did not leave my mind.
* * *
That night.
The feared thing started again.
As the sun set and it got dark, the patient’s delirium started again.
“We… we have to go find our platoon members!”
The old man shouts.
But there is no focus in his eyes.
It’s as if he’s staring intently at somewhere far away, not here.
“Grandpa, this isn’t a battlefield, it’s a hospital!”
“Let go of me, I have to go!”
Flail!
Suddenly, the old man pushes away the nurse who is trying to stop him and tries to get out of bed.
The nurses were horrified.
“Ah— someone call the attending physician quickly. Dr. Seonhan! Come here and try to stop him!!”
“Yes!”
Grab!
I ran to the patient.
Should I hold him down with force?
I’m worried about handling the old man’s skinny body roughly…
But after a while, I regretted my naive thoughts.
“Let go of me, you bastards!”
Thwack!
The old man’s fist grazes my face.
Ugh, that hurts!
I almost lost a tooth.
Where does he get that kind of strength?
Despite his skinny body, he looks as fierce as a tiger.
Is this the power of a war veteran?
“Senior, please help me!”
I shouted to Dr. Byun Gyunam, who happened to be passing by, while wrestling with the patient.
He glanced at me as if watching a fire across the river and said.
“Did you call thoracic surgery?”
“Yes!”
“Then prepare lorazepam [a sedative] and haldol [an antipsychotic] in advance and wait. It’s their patient, so they’ll take care of it.”
Ugh, that insincere man!
Soon, the nurses prepare sedatives.
Even in the midst of all this, the patient didn’t stay still for a moment.
“Grandpa, please stay still for a moment!”
But the more we did, the more the old man thrashed.
He kept struggling to pull out his chest tube and fighting with us.
A nurse, unable to watch any longer, shouts at Dr. Byun.
“Don’t just watch, Dr. Byun, please lend a hand!”
“Ugh, how annoying…”
Dr. Byun slowly approached and tried to press down on the opposite arm.
Then, he was kicked between the legs by the patient’s thrashing foot.
Thwack!
“Ugh…”
Dr. Byun swallowed.
Thud.
He collapsed, clutching his groin with a painful expression.
Meanwhile, the old man was wielding violence on everything he could reach.
This is a disaster!
If the chest tube is pulled out again today, it will definitely have a negative impact on the patient’s postoperative prognosis.
What should I do?
It would be nice if I could calm the patient down even for a moment…
Then, suddenly, an idea came to me.
Maybe this method will work?
I shouted solemnly.
“Platoon leader! Get a grip!”
…….
A moment of silence.
Dr. Byun and the nurses are looking at me with bewildered eyes.
Cha Yoori is also blinking.
They have eyes that seem to say, ‘What are you doing?’
I blushed with embarrassment.
What was I thinking? It’s not like we’re playing war in the hospital.
But…….
The old man suddenly looked lively and looked at me with a happy expression, saying.
“You’re… Private Kim?”