Dr. Shin Seonhan: The Doctor Who Sees The Future [EN]: Chapter 5

#5 Fresh Intern Shin Sun-han (4)

Thud!

I dashed out into the hallway.

Other interns were also popping out like springs.

The Department of Internal Medicine is divided into nine sub-specialties, with 18 interns assigned. Half of them, nine, are on night duty.

Some are stationed in the main building, and some are in the Cancer Center dormitory here.

“Wait, let’s go together!”

I see Yeon-seo running from the women’s dormitory, hastily tying up her disheveled hair.

Wow…….

I thought it was a scene from a CF [commercial film, a Korean term for TV commercial].

Even in the midst of the chaos, the male interns are gawking at Yeon-seo with silly grins.

She can pull off that look even when she wakes up from sleep.

No, that’s not important right now.

Tap, tap, tap!

I asked as I ran.

“Yeon-seo, you said it was the 17th floor, West Ward, right?”

“That’s right.”

“You said the patients were stable earlier.”

“I don’t know who had the CPR [cardiopulmonary resuscitation]. The ward was as quiet as a mouse when I came back from dressing…….”

Yeon-seo’s face is pale.

Of course, it’s natural since CPR was initiated in the ward she’s in charge of.

“This will be the fastest.”

Tada-dak!

As soon as we arrived in front of the elevator, Geun-wook pressed all six elevator buttons.

As soon as we arrived on the 17th floor, a prickly voice was heard as if he had been waiting.

“Are the interns having it too easy these days?”

Damn it, an unpleasant face.

Kim Beom-soo, a third-year resident in Internal Medicine, commonly known as .

His particularly irritable personality is especially noticeable during night duty.

“The patient’s life is on the line, and you’re only arriving now? Are you already slacking off after only one month as interns?”

Viper Kim’s fierce voice continues.

Of course, it’s unfair for us who sprinted here.

From the intern dormitory in the Cancer Center building to this main building, it takes at least five minutes no matter how fast you are.

Unless you’re Usain Bolt, you can’t arrive any faster.

But excuses don’t work here.

“Sorry.”

We bowed our heads.

A university hospital.

A place where you can never let your guard down.

Here, interns are no different from privates [referring to the lowest rank in the military]. If they’re told to come, they come, and if they’re told to run, they run.

Of course, because the situation was urgent, Viper Kim’s nagging didn’t last long.

“One person switch out the ambu bag here, and the rest line up and do compressions.”

“Yes!”

Should I say it’s fortunate?

The interns who had already arrived were taking turns doing chest compressions.

A patient whose heart has stopped must continue chest compressions for at least 30 minutes unless ROSC (Return of Spontaneous Circulation) is achieved.

Usually, they take turns every two minutes, but when you actually press on the chest, it’s by no means a short time. After two minutes, most people are drenched in sweat.

I waited for my turn and checked the patient’s face.

‘Gasp!’

It was a familiar face.

Patient Kim Jeong-soo.

As expected, it was the patient I was worried about.

The content of my dream is really coming true.

How on earth is this happening?

“200 joules, charge!”

“Everyone step back! Shock!!”

“The rhythm has returned to normal!”

Fortunately, just before my turn, the electrocardiogram returned to a normal rhythm through defibrillation.

Emergency situation over!

I let out a sigh of relief.

But given Viper Kim’s personality, there was no way he would let us go quietly.

“Interns, listen carefully.”

“Yes.”

“If you’re late, the time to save the patient decreases. Do you understand what I’m saying?”

“Yes, I understand.”

“Now, in a CPR situation, how many seconds should you squeeze the ambu bag when intubation is done, according to the guidelines? Anyone want to answer?”

Viper Kim asks in a sharp voice.

Instantly, the back of my neck stiffens, and I become tense.

This is a test.

The intern colleagues have panicked expressions.

Of course, if you think calmly, it’s not difficult, but you’ll stammer at a surprise question.

“Can’t answer right away? Is this all the interns at Yeon-guk University Hospital are capable of?”

Viper Kim’s voice became fierce.

It’s not good to drag this out any longer. At this rate, I don’t know what kind of abusive language that human will spew out.

In the end, I stepped forward.

“When the airway is secured, you should breathe once every six seconds.”

“What is the diastolic pressure when doing compressions?”

“The intra-arterial blood pressure must be at least 20 mmHg during diastole.”

Viper Kim’s expression softened slightly.

He stared at my face and asked again.

“How much Amiodarone should you give when it’s a Shockable Rhythm?”

“Initially, 300mg bolus, then 150mg thereafter.”

“Correct.”

Viper Kim nodded.

“Still, it’s a relief that there’s at least one intern who’s paying attention.”

……Well, I’ve been thinking about it all day.

The scene I saw in my dream this morning was so vivid that I had been replaying the CPR situation in my head all day.

If that weren’t the case, I might not have been able to answer so quickly.

In any case, Viper Kim’s tone softened somewhat.

“The other interns should reflect. Especially those from Yeon-guk University.”

“Yes.”

“What are you doing? Why aren’t you all disappearing?”

The interns bowed and left the ward.

Before returning, I glanced at the clock on the wall.

02:40 AM―

The time was passing through dawn.

* * *

“What, it ended quickly without doing anything.”

“I know.”

“I was going to do some hard compressions since I’ve been working out lately, but it’s a shame. Hehe.”

On the way back to the dormitory, Geun-wook showed off his arm muscles and joked.

The interns’ tension was relieved by his joke.

“By the way, why did Viper Kim let us go early for once?”

“It’s all thanks to Sun-han. I don’t even want to imagine how much we would have been nagged if we hadn’t answered.”

“By the way, why is that human being such an asshole?”

“I’m never going to Internal Medicine because I don’t want to see Viper Kim.”

The interns’ chatter continued with gossip.

Complaining about the resident you hate is the only comforting thing in intern life.

But I couldn’t concentrate on the flow of the conversation at all.

What is this feeling?

It’s like I’m missing something important…….

.

.

The content of the dream has already been reproduced exactly.

If the dream is reproduced again…….

In about 40 minutes, will be reproduced.

I stopped walking abruptly.

The other interns looked back at me as if asking what was wrong.

“Wait a minute. There’s something I’m worried about.”

“What?”

“You guys go in first.”

“What? Hey, where are you going!”

Tap, tap, tap!

I turned back towards the West Ward.

Of course, I know it’s a useless delusion.

But…….

‘It doesn’t hurt to check.’

If I go back to the dormitory like this, I don’t think the uneasy feeling will go away.

As I was thinking that and running, I heard a voice from behind.

“Wait, let’s go together!”

When I turned around, Yeon-seo was already hurrying after me.

“Why are you following me?”

“Then where are you going, oppa [older brother or male friend, a Korean honorific]?”

“I’m going to see the patient again.”

“Why are you worried about Patient Kim Jeong-soo? He was originally my patient. If anyone should be concerned, it should be me.”

Is that so?

Come to think of it, that’s right.

“Then let’s go together.”

Anyway, two people are better than one.

With my confused mind right now, objective thinking seems impossible.

* * *

Patient Kim Jeong-soo was quietly asleep with a ventilator attached.

The attending physician, Viper Kim, was nowhere to be seen, perhaps he went to the restroom.

Yeon-seo and I examined the patient’s condition in front of him.

Beep, beep…….

The regular rhythm announcing the patient’s heartbeat echoes drily.

I nudged Yeon-seo with my elbow and asked.

“What do you think?”

“About what?”

“The patient’s condition.”

“Hey, can we tell just by looking? It’s only been a month since we became interns.”

“I guess so.”

Even as I said that, I couldn’t take my eyes off the patient.

Maybe even with our intern eyes, we can point something out.

“Do you know anything about this patient?”

“Well…… I passed by him in a wheelchair while he was moving to the Cath Room (catheterization room, a procedure room for PCI procedures)? But I smelled cigarette smoke.”

“Cigarettes?”

My eyes widened.

It’s a matter of course, but smoking is discouraged during hospitalization.

Especially for patients about to undergo heart procedures.

“I wondered if it was coming from the patient, but I went to do other work.”

“Hmm…….”

Of course, smoking right now may not be fatal.

But if he couldn’t resist smoking even before a heart procedure, how much did he smoke usually?

I checked the EMR (Electronic Medical Record) on the monitor next to the patient.

[Kim Jeong-soo]

63/M?

HTN/DM/Dyslipidemia (+/+/+)

Smoking Hx (+) 80 pack―year

Ejection fraction 35%

PCI d/t unstable angina

“This is severe.”

I frowned.

A history of smoking at least two packs a day for 40 years is found.

Not only that.

Hypertension, diabetes, hyperlipidemia…….

He has all the bad signs for blood vessels.

And the ejection fraction is only 35 percent. In other words, the heart’s pumping function is significantly low.

Yeon-seo also looked at the chart and had a shocked expression.

“Wow…… now that I see it, it wouldn’t be strange if problems arose after the PCI procedure.”

“You think so too, right?”

“Yes.”

Yeon-seo nodded in agreement with my words.

PCI.

Percutaneous Coronary Intervention.

It sounds difficult because it’s a medical term, but it’s not such a complicated concept.

In our body, there are blood vessels called ‘coronary arteries’ that supply blood to the heart.

However, if these coronary arteries narrow, the heart muscle is not sufficiently supplied with blood.

PCI is a procedure that artificially widens this passage.

A small metal tube called a stent is inserted into the blood vessel to create a strong passage.

However, since an artificial device is inserted into the body, problems can arise.

‘So how does this patient die? He definitely returned to normal earlier……?’

I tried to recall the medical textbooks I saw in the intern dormitory.

Damn it…….

I can’t remember even though I just saw it.

I never forget the names of the fish sold at Garak Market once I hear them, but I have to assume that I forget medical knowledge as soon as I hear it.

I have to repeat it several times to barely remember it.

That’s why they say studying medicine is like pouring water into a bottomless jar, right?

Even when I was a medical student, I was a jar with a huge hole. I was just the type to pour water in diligently.

Anyway, that’s not important, how does this patient die! Remember at least one thing!

At that time.

Suddenly, a word flashed through my mind.

“Refractory V―fib [Refractory Ventricular Fibrillation].”

I murmured quietly.

Refractory Ventricular Fibrillation (Refractory V―fib).

It refers to malignant, repetitive ventricular fibrillation that does not respond to several shocks and medications.

If that happens, the patient is very likely to die!

I stared intently at Patient Kim Jeong-soo’s electrocardiogram graph.

“Doesn’t it seem strange?”

“What?”

“Look at the ECG (electrocardiogram) rhythm there. Look at the APCs [Atrial premature complexes] and VPCs [Ventricular premature complexes] passing by.”

In fact, the graph was changing little by little from normal.

Strange waveforms are visible like noise between the regular rhythms.

“I don’t really know…… but now that I hear it, it seems like it.”

“I have to talk quickly now.”

“About what?”

“That the patient is in danger.”

“Are you serious?”

Yeon-seo asked back in surprise.

Of course, even as I say it, I’m dumbfounded myself.

An intern in their first month telling the attending physician their opinion?

It doesn’t make sense.

It’s no different from a newly hired probationary employee advising their superiors.

It’s especially hard to tolerate in a hierarchical society like Korea.

“Are you really going to talk? I don’t think Kim Beom-soo sunbae [senior, a Korean honorific] will listen kindly, given his personality…….”

Yeon-seo says worriedly.

……Actually, Yeon-seo is right.

Who am I to say anything?

Let’s pretend I don’t know and move on.

There’s nothing good that comes from stepping forward unnecessarily.

What if I get labeled as a cocky bastard from my first month as an intern?

My head is telling me that, but my feet are moving on their own.