Dr. Shin Seonhan: The Doctor Who Sees The Future [EN]: Chapter 47

#47 The ICU Marine (7)

Ma Dongseop.

He is a third-year resident in the Department of Thoracic Surgery.

Contrary to his appearance, which resembles a large wild bear, he has a surprisingly meticulous personality.

The reason he became a thoracic surgeon was simpler than one might think.

‘Should I say it’s a case of following my friends to Gangnam [a wealthy district in Seoul, implying following trends or popular choices]?’

Song Yoozoo and Yeo Bongcheol were his two closest friends at the time.

He followed Song Yoozoo in applying to the Department of Thoracic Surgery.

Of course, he knew it was an unpopular department, but he didn’t regret his choice.

Above all, there was a sense of reward in saving patients.

‘However, if there’s a problem…….’

The never-ending manpower shortage!

The Department of Thoracic Surgery was always short-handed.

Even when new residents came in, most of them were clueless.

Of course, there were some decent ones among them, but as soon as he decided to nurture them, they ran away in less than a year.

He couldn’t chase after them like hunting down slaves in the Joseon Dynasty [Korea’s last dynastic kingdom, implying a futile and unethical pursuit]…….

After experiencing that a few times, Ma Dongseop began to pray earnestly.

‘Please, please. Please send someone useful to the Department of Thoracic Surgery~ Someone who will stick around until the end!’

He felt like he wanted to set up a table with water and perform a ritual [a traditional Korean practice for making wishes or seeking blessings].

Then one day.

Could it be that the heavens had heard his wish?

Shin Seonhan, an intern he had been keeping an eye on, came to the thoracic surgery ward.

Ma Dongseop felt a surge of joy.

‘That’s right!’

‘Let’s try to win him over!’

So, he very kindly explained medical content to him, and in the process, he subtly tried to show off his coolness.

“The ambu bag [a manual resuscitator] is like this…….”

“Yes.”

Ma Dongseop handed the ambu bag to Shin Seonhan and thought.

Let’s show him how to successfully perform intubation here and appeal to him once more.

The cool image of a thoracic surgeon!

“Hey, friend. Have you ever done intubation?”

“No, not yet.”

“You’ll have to do it someday, so watch carefully.”

“Yes.”

Thus, Ma Dongseop began intubation in front of Shin Seonhan.

Of course, it’s a very basic skill, so there’s not much to brag about.

But isn’t it said that the basics are the most important?

In fact, it is very important to perform intubation quickly.

Even during the intubation, the patient’s oxygen saturation drops in real-time.

If too much time is wasted, the entire process must be stopped, and oxygen must be supplied again in many cases.

“This tube (E-tube) [endotracheal tube].”

Soon, the tube was in Ma Dongseop’s hand, and he tried to insert the tube into the patient’s trachea.

But…….

“Tsk.”

Ma Dongseop frowned and tilted his head slightly.

The inside of the patient’s throat is not clearly visible.

This is because there is more phlegm than he thought.

It seemed like suction (liquid aspiration) was needed before inserting the tube.

“Here, suc…….”

As Ma Dongseop was about to speak to the nurse, suction came into his field of vision.

It was an assist that came at a very opportune time.

Ma Dongseop grabbed the suction and said.

“As expected, our ward nurses are quick-witted. How did you know I needed suction just by looking at my eyes…….”

Ma Dongseop stopped talking and looked surprised.

It was none other than Shin Seonhan who had handed him the suction.

‘Oh?’

Ma Dongseop thought to himself.

‘This guy has a good sense. How did he know I was going to say I needed this……?’

Was he just holding it by chance?

Ma Dongseop soon cleared his mind and turned his head back into the patient’s mouth.

Swoosh—

After suctioning, Ma Dongseop held the tube in his right hand again and tried to insert it into the patient’s throat.

At that moment, Shin Seonhan’s hand came into Ma Dongseop’s view again.

Then, Shin Seonhan pressed down on the patient’s thyroid cartilage with his right hand.

“……!”

Ma Dongseop was surprised again.

As his vision improved, the vocal folds where the tube should enter became clearer.

With the improved view, intubation became much easier.

‘What is this guy? It’s not like he’s done this once or twice?’

Usually, interns are busy just handling the tasks that residents order.

But Shin Seonhan was different.

How could an intern who had just been here for three months be so quick-witted?

It even felt like working with a skilled resident.

Thus, Ma Dongseop smoothly completed the intubation in harmony with Shin Seonhan.

Fortunately, the patient’s oxygen saturation was normal.

“That BURP [Backward, Upward, Rightward Pressure] was good! Where did you learn that? Have you rotated through the surgery department before?”

Ma Dongseop said in admiration.

BURP refers to the act of the person assisting with intubation pressing the patient’s thyroid cartilage Backward, Upward, and Rightward.

This allows the practitioner to perform intubation much more easily.

“No, I only simulated what I learned as a student on my own, and this is the first time I’ve applied it to a patient.”

“First time?”

“Yes.”

Shin Seonhan nodded and replied.

“I was thinking about how I could make it easier for you anatomically…… I don’t know if my pressing helped.”

Ma Dongseok looked at Shin Seonhan with admiration.

His eyes were filled with favor.

It was like the eyes of Court Lady Han looking proudly at Jang Geum [a reference to a famous Korean historical drama, implying mentorship and pride].

He felt like he had finally found the talent he wanted in the Department of Thoracic Surgery.

‘This, this…… the more I look at him, the more I want him?’

Of course, Shin Seonhan didn’t show any great talent.

Especially compared to Song Yoozoo, who was a genius from his intern days, Shin Seonhan might be considered average in some ways.

But…….

His basic sense is good.

Just by instantly finding his role appropriately, Shin Seonhan is already surpassing the average intern’s level.

Moreover, he has innate diligence, so there is nothing more to ask for.

‘I can’t give this guy to another department!’

Thinking that, Ma Dongseop looked up and down at Seonhan and smiled.

Seonhan felt a chill at the somehow greedy (?) gaze.

At that moment, the thoracic surgery interns belatedly arrived in a hurry.

“Sorry, we’re late!”

“It’s already over. You guys.”

Ma Dongseop glared at the interns.

Then the interns flinched and became frightened.

Because of his unique menacing appearance, Ma Dongseop looked like a gangster even when he spoke normally.

On the other hand, Ma Dongseop gave Shin Seonhan a friendly expression that was 180 degrees different.

“Anyway, friend. It seems like there are no beds in our ICU, so we’ll have to go to the surgical ICU again. Can you help me transport the patient?”

“Yes, since he’ll be a patient I have to see when I go down anyway.”

“Okay. Thanks for the help~”

Ma Dongseop wrapped his arm around Shin Seonhan’s shoulder and spoke affectionately.

The other interns who were watching the scene could only look at each other awkwardly.

They seemed unable to adapt to Ma Dongseop’s suddenly softened tone.

* * *

A little later.

I went down to the surgical ICU with Dr. Ma Dongseop, carrying the patient.

It goes without saying, but the atmosphere was not welcoming.

“You brought this patient again??”

Byun Gyunam said with a frustrated expression.

The nurses also couldn’t hide their embarrassment.

I said awkwardly.

“They said there were no beds in that ICU.”

“You, you son of a…… be honest. Are you a spy sent by the Department of Thoracic Surgery? Why are you doing this to us?”

Dr. Byun grabbed my collar and said resentfully.

He didn’t seem to like it very much.

Perhaps it was only natural…….

How could they be happy when they had suffered so much because of the delirium when the patient was having an attack?

It was like a time bomb they had barely sent out rolling back in.

“Oh, aren’t you being too harsh? How can you bring that patient here again!”

“The thoracic surgery ICU beds are full, so we couldn’t help it. Please understand.”

Today, Dr. Byun and Ma Dongseop are having a war of nerves again.

I slipped in between them and asked.

“Um, doctors. I have a question…… just hypothetically.”

I started cautiously.

“What if the patient pulls out the ventilator on their own?”

“What?”

“Hey. Don’t say such terrible things!”

The two doctors exclaimed simultaneously.

They looked like they didn’t even want to imagine it.

Ma Dongseop stroked his chin and said.

“Pulling out the ventilator causes tremendous damage to the lungs and the entire body. It’s a catastrophe on a different level than pulling out the chest tube.”

“I thought so, right?”

“We have to hope that such a thing doesn’t happen.”

‘I’m going crazy.’

I felt anxious.

Because unlike other people, I know the future.

Clearly, if things continue like this, the patient having an attack will pull out the oxygen mask himself and fall into critical condition.

Conversely, if I can prevent that situation, wouldn’t the patient be able to recover?

‘The problem is, I don’t know when he’ll pull it out.’

The patient’s delirium occurs at any time.

It could be tonight, it could be tomorrow night…….

Or it could be weeks later.

‘Let’s think of a way.’

What if I ask Dr. Cha Yoori to watch him?

After thinking for a moment, I shook my head.

Even in the ICU, you can’t keep your eyes glued to a patient 24 hours a day.

Nurses basically work in 3 shifts: Day (D), Evening (E), and Night (N).

In other words, the maximum time a nurse can cover is 8 hours.

“Is there a way to apply restraints 24 hours a day?”

“Well, if the patient is moving a lot, restraints are the best way.”

Ma Dongseop said.

But Dr. Byun added.

“Still, patients who are going to pull it out will pull it out no matter what. I’ve even seen patients who were tied up in all their limbs twist their whole body to pull it out.”

“Is that so?”

“Hey, think about it. People can’t stand even slightly uncomfortable clothes, but a tube is stuck in their throat. Wouldn’t you want to take it out?”

Dr. Byun’s words made sense.

Ma Dongseop also nodded.

“Of course, a sane patient wouldn’t pull it out, but it’s definitely possible during delirium.”

In the end, unless the delirium is alleviated, the fundamental risk factor will not be removed.

If the disease is not resolved, the delirium will not improve…….

The delirium worsens the disease…….

It’s a continuous vicious cycle.

There must be an opportunity to break this link.

“Hey, why are you worrying so much? It’s not like that’s actually happened yet.”

Dr. Byun nudged me and said.

“Why do you have so many thoughts as an intern? Delirium has no solution anyway. All we can do is respond quickly.”

Delirium is a symptom that even neuroscientists have not accurately identified the cause of.

Therefore, it’s not like doctors have any special solutions.

The best they can do is to sedate them with medication whenever symptoms appear, or tie them to the bed and hope the symptoms disappear.

At that moment, Nurse Cha Yoori quietly came over and said.

“But…… it’s not like there’s no solution at all.”

A solution?

Dr. Byun and Ma Dongseop widened their eyes.

What kind of method is Cha Yoori talking about?

The three of us doctors listened to her words.