Dr. Shin Seonhan: The Doctor Who Sees The Future [EN]: Chapter 57

#57. You Call This Thoracic Surgery? (5)

Click—

I closed the door and sat at my desk.

After moving my body for a while, my mind became clear again.

“Okay, shall we begin?”

Rustle—

I took out my notebook and opened it.

Even though it’s a digital age, analog paper and pen are still the best for organizing thoughts.

‘Reminds me of my days as a repeater [a student who retakes an exam to improve their score].’

Come to think of it, the desk at the boarding house felt exactly like this.

The days when I was just running towards my goal.

There was a memo on the desk that said .

The word I liked the most when studying English vocabulary for the college entrance exam.

I guess you could call it ‘grit’ in Korean.

I suddenly remembered those days when I studied so persistently.

Of course, even then, one corner of my heart was always anxious.

And so on…….

Doubts about myself.

And now, once again, I am doubting myself like I did back then.

That’s when you need grit.

I believe that if you stubbornly hold on to anything, you can somehow find a way out.

“Alright. Let’s do it!”

I rolled up my sleeves.

First, let’s start with the first clue.

Let’s recall what I heard in the dream.

Song Yu-ju definitely said this at the smoking area.

“Brain damage…….”

Rustle, rustle—

I flipped through the textbooks and started taking notes.

The weight of an adult brain is 1.2 to 1.4 kilograms.

A small organ that accounts for only about 2.5 percent of the total body weight.

However, more than 20 percent of the blood flow goes to the brain.

In other words, the brain uses more than 20 percent of the oxygen needed by our body.

‘You could say it’s an incredibly greedy fellow.’

What if the oxygen supply to such a brain is cut off?

It breaks down quickly.

In other words, if a patient doesn’t breathe for a certain amount of time, brain damage begins.

.

The time it takes for damage to begin when oxygen is not supplied to the brain.

And the damaged brain can never be recovered.

In just 4 minutes, it becomes an irreversible state.

Paralysis of the limbs, cognitive impairment, blindness, etc…….

They may become a vegetable, or even die.

‘First, let’s organize the cases where brain damage is possible due to hypoxia [oxygen deficiency].’

I continued to flip through the textbooks.

And after a while.

I nervously twirled the pen and almost threw the book away.

“Damn it. There are too many possible cases?”

The place where I will be working is the .

How many patients have lung problems?

Of course, there are countless cases where oxygen levels drop.

It’s like finding Kim Seo-bang [a common Korean surname, equivalent to finding a needle in a haystack] in Seoul.

But, wait a minute.

Hypoxia occurs in this hospital where oxygen can be supplied at any time?

To the point of causing brain damage?

Isn’t this a situation where CPR occurs and the heart stops, preventing oxygen from being supplied to the brain?

If not…….

‘Someone deliberately stopped the oxygen supply.’

I 짚었다 my forehead.

One thought leads to another.

Numerous possibilities branch out like tree branches.

My head became more and more complicated.

‘There is a limit to the first clue alone. But what if we include the second clue?’

Second clue.

If we recall what Ms. Song Yu-ju said, we can roughly estimate the time of the accident.

I rummaged through my memories.

Can such a situation occur?

Of course, it is possible.

Because it’s thoracic surgery!

I remembered what Yeon-seo said that the ward is sometimes empty because there is always a shortage of manpower.

They say the thoracic surgery ward sometimes becomes a medicine-free village.

It’s a funny yet sad story.

But it is a clear reality.

“Anyway, this is the conclusion so far.”

I closed the notebook.

Combining the two clues, it can be summarized in one sentence.

Of course, there is still a lack of information.

Because I don’t know which patient will develop hypoxia and how.

However, I felt relieved because I had a rough plan.

But…….

I’m still worried about Ryu Myung-in.

It is still unknown how he will act as a variable.

So, when that day comes, let’s not let our guard down even a little bit!

* * *

June 1st.

The day of thoracic surgery began.

Did you think the day would start by waking up early and doing rounds?

I thought so too.

However, the reality of thoracic surgery was not so easy.

“Sun-han, aren’t you sleeping?”

“How can I? My shift starts soon. I have to be fully prepared.”

“What? Already?”

Geun-wook looked at the clock while lying on the 2nd floor bed of the dormitory.

11:58 PM.

“Come on. Even so, will I get a call from midnight? Even if it’s thoracic surgery.”

When Geun-wook said that.

Ring, ring—

12 o’clock at night.

From the moment midnight passed, the pager started ringing non-stop.

Geun-wook looked at me as if he was dumbfounded.

I answered the phone with an expression as if to say, “I told you so.”

“Yes, this is intern Shin Sun-han.”

Soon, a nurse’s voice was heard from the other side of the phone.

Doo-geun, doo-geun.

Finally, the first call from thoracic surgery.

But…….

This was so different from the calls I had received in the past 3 months.

“Doctor, patient Hwang Jun-gyu has a fever, so I checked his temperature and it’s 37.9℃. What should I do?”

Uh…….

I was speechless for a moment.

They are asking me for judgment.

The intern calls I had received before were mainly command-oriented calls.

I just had to solve the problem if someone gave me a task.

Drawing blood, taking an ECG, doing dressing…….

In other words, there was little need for my judgment.

However, the calls I received as a chief resident were on a different level.

“Uh…….”

I couldn’t answer right away and trailed off.

Of course, I clearly know.

What differential diagnosis is needed for a patient with a fever.

So what kind of tests to do or how to treat them.

However, the differential diagnosis of fever in textbooks comes with dozens of diagnoses.

What should I do for this patient right now?

My head is spinning quickly, but something doesn’t come out of my mouth.

Then, the nurse’s voice is heard from the other side of the phone.

“It’s a patient who is 3 days POD [post-operative day] after RUL Lobectomy [right upper lobectomy]. We are using cefotetan as a basic antibiotic. He is also 51 years old, young, and has no other underlying diseases.”

As expected, nurses are familiar with these situations.

So they know how to talk to interns like me who are doing their first chief resident.

The nurse continues.

“Should we just watch and have him do lung care (respiratory management)? Should we recheck in 30 minutes? Or should we do a culture (blood culture test) and change the antibiotic?”

Have you ever seen such a kind nurse…….

They are giving me options.

I just have to choose.

In addition, they tell me all the basic information needed for the selection.

I answered by referring to the examples the nurse told me and the contents I saw in the handover.

“First of all, since it’s POD 3 days, I’ll check if he has a fever again in 30 minutes while doing lung care. If he still has a fever at that time, I’ll do a culture and decide whether to change the anti (antibiotic) to tazocin again.”

“Yes, I understand.”

I hung up the phone and sighed in relief.

I thought I had solved the first primary call without any problems.

But on the other hand, I woke up.

‘That’s why Yeon-seo said it wasn’t easy.’

After that, there was a notice that the fever persisted, and I eventually issued a culture order.

If it were the previous month, the chief resident would have issued the order and the 담당 [in charge] intern would have performed the culture.

But now?

Who will do it if I give the order?

Of course, I do it myself.

I realized once again that I am an intern chief resident who plays the drum and plays the janggu [a traditional Korean drum] all by myself.

‘The feeling is definitely different from the first day.’

Of course, that wasn’t the end of it.

That night, the phone rang several more times.

“Doctor. Patient Jeon Sang-wook’s BST [blood sugar test] came out to be 220, what should I do?”

“Doctor. Patient Lee Seung-chan’s saturation was checked at 91 while he was sleeping, what should I do?”

All of them were calls that made me worry.

They don’t give me time to look something up or ask someone after receiving a call.

The nurse is waiting without cutting off the phone until I give an answer.

‘Now it’s starting.’

Ma Dong-seop clearly said that intern life is just a tutorial.

But…….

Even the tutorial is not easy.

To put it in terms of a game, I’m still level 10, but I feel like I’ve started running a level 20 dungeon.

‘It’s better this way. The sooner I experience it, the faster I’ll level up!’

I thought positively.

Enthusiasm springs up.

That I judge and take responsibility entirely.

It felt like I had finally entered the first entrance to becoming an independent doctor.

* * *

Beep, beep—

Beep, beep—

The alarm rings.

5:30 AM.

I slowly opened my eyes.

The ceiling of the 2nd floor bed is now familiar.

“Koo-roo-roo-roo—”

Geun-wook is still sleeping on the 2nd floor.

The sound of snoring is as loud as a excavator.

I woke up several times in the middle to receive calls, so I met 5:30 AM in a hazy state where it was ambiguous whether I had slept or not.

“If you add it all up, did I sleep about 3-4 hours?”

I rubbed my sleepy eyes.

As expected, Yeon-seo was right.

I want to close my eyes for a few more minutes if I could.

But I shouldn’t.

“It’s the first day, so I have to show a sincere side.”

Young-cha! [a Korean expression of encouragement, like “Let’s go!”]

I got up vigorously.

The rounds with Ms. Song Yu-ju are at 6:30 AM.

Yeon-seo said that it would take 30 minutes to prepare for the rounds, but today is the first day, so I woke up an hour early.

I headed to the shower room.

I left the pager in the closet and pulled the lever of the shower.

The moment I started pouring water all over my body.

Ring, ring—

The pager rings.

It doesn’t leave me alone even while I’m taking a shower.

I dripped water and moved to the closet for a while and turned the bar of the pager to the right.

However, the phone did not recognize my touch because of my wet hands.

‘Oh, I have to wipe my hands.’

The moment I reached for the towel next to me.

Someone touched my phone and pressed the speakerphone button.

“Yes, this is intern Shin Sun-han.”

I answered and raised my face slightly.

The water falling from my head came into my eyes and blurred my vision, but a man’s face appeared in front of my blurry eyes.