Fifth Vital [EN]: Chapter 11

Episode 11. Bullshit

“This is driving me crazy. He’s never late…”

Nurse Lim Jeong-suk, standing by the road in front of the hospital, was pacing anxiously while waiting for Euijin.

“Should I call again?”

Just as she was about to touch the phone she was clutching in her hand, a motorcycle sped up and stopped in front of her.

“Thank you, driver. Keep the change.”

“Dr. Jung!”

Nurse Lim Jeong-suk shouted as she saw Euijin getting off the motorcycle in her pajamas.

“Did you come here on a joyride? What’s with the motorcycle?”

“Don’t even ask. My car broke down on the bridge, so I called for a quick service. Is everything ready?”

“Yes, we’re just waiting for you, Doctor.”

“So, the doctor who’s in the operating room now is the one the Director was so eager to bring in?”

“Yes, that’s right. She seems to have a good personality and is very proactive about patient care.”

“That’s good. Oh! Please tell me about the emergency patient’s information.”

Euijin asked about the patient’s condition and rushed into the hospital with Nurse Lim.

* * *

“Dr. Lee, not yet?”

Tae-kyung asked Lee Chan-hee in a low voice about the absence of the anesthesiologist.

“He should be here any minute… I’ll contact him again.”

“Anesthesia is here.”

Just then, Euijin, who had changed into surgical scrubs, hurriedly entered the operating room. After carefully observing Tae-kyung for a moment, she continued speaking as if nothing had happened.

“My car gave me trouble, so it took a little longer. I’ll greet you properly after the surgery.”

“Alright. Since this is an emergency patient, let’s all focus on the surgery.”

“Yes, I heard the patient has cholecystitis [inflammation of the gallbladder], is that correct?”

“That’s right.”

“That must be incredibly painful. You must have suffered quite a bit.”

Tae-kyung felt relieved as he watched Euijin, who was expertly checking and preparing the anesthesia equipment. He could tell at a glance that she was a veteran anesthesiologist.

Having an experienced anesthesiologist for an emergency surgery late at night is reassuring, regardless of the intensity of the surgery.

“Doctor, just a moment!”

Euijin, who had finished preparing for anesthesia, urgently called Tae-kyung.

“So, it’s just the three of us, you, me, and Dr. Lee, performing this surgery?”

“Yes, the three of us.”

“Are you sure you’ll be okay with the lack of staff?”

Euijin asked about the insufficient number of people in the operating room.

Usually, there is a circulating nurse in the operating room. Because direct contact with supplies is not possible due to the risk of bacterial infection during surgery, the help of a circulating nurse is necessary.

“That’s why I prepared plenty of supplies before starting the surgery.”

In fact, Tae-kyung was aware of the staff shortage even before entering the operating room.

Nurse Lim Jeong-suk could have filled that role, but she had to take care of the hospitalized patients, so they decided to proceed as is.

“Doctor. The patient has arrived.”

Nurse Lim Jeong-suk handed over the patient lying on the bed to the operating room and then left.

“We’ll start the anesthesia now. Don’t worry about anything and just think of it as taking a nap.”

“Yes, please take good care of me, doctors.”

“Okay! Take a deep breath and count to ten.”

“One, two, three…”

Under Euijin’s skillful touch, patient Jo Mal-rye’s eyes slowly closed.

“Proceeding with endotracheal intubation [inserting a tube into the trachea to assist breathing].”

Careful Euijin checked to make sure the patient’s upper teeth were not loose before performing endotracheal intubation.

Afterward, she placed the stethoscope on the patient’s epigastric area [upper central region of the abdomen] to listen for gurgling sounds. If the tube entered the esophagus, the sound could be heard there.

Finally, she auscultated [listened to] the lungs each time artificial respiration was performed to confirm that the endotracheal intubation was perfect.

“Okay! You can start now.”

Euijin, having completed the perfect anesthesia, gave the okay sign.

“Povidone [antiseptic solution].”

“…….”

Lee Chan-hee, who was assisting Tae-kyung, remained still.

“Dr. Lee! What are you doing? I asked for povidone.”

“Ah, yes. I’m sorry, Doctor.”

“This is the operating room. Focus on the patient.”

“I will focus.”

Holding the disinfectant povidone in his hand, Lee Chan-hee drew boundaries from the epigastrium to the inguinal area [groin] and then drew circles from the navel.

Single-port laparoscopy [minimally invasive surgery through one incision] requires more attention to disinfection because the instrument enters through the navel. The navel is recessed, so there may be more bacteria.

Therefore, he checked for foreign substances inside the navel and poured povidone once more, wiping every corner with a sterile cotton swab. After the disinfection process was completed, he pressed down with sterile gauze to make the skin visible.

Now it was Tae-kyung’s turn to step up.

‘The smell is getting stronger.’

There was a unique smell in the operating room, but Tae-kyung could only clearly smell the patient’s pain.

Even with a mask on, the smell of feces emanating from the patient remained.

“Let’s start the surgery. Doctor, please raise the table a bit.”

At Tae-kyung’s request, Euijin adjusted the height of the surgical bed.

“Yes, this is perfect.”

“I will install the laparoscope.”

While the bed height was being adjusted, Lee Chan-hee installed the laparoscope. He organized the many lines and light source lines so they wouldn’t get tangled and secured them with gauze.

“Is the Bovie (electrocautery) [surgical tool using heat to cut tissue] connected?”

“Yes, Doctor. It’s connected.”

Beeeep-

The unique high-pitched sound of the Bovie operating was heard.

Tae-kyung made a vertical incision about 2 cm above the navel with the Bovie so that the laparoscope could enter. The abdominal muscles appeared through the incision.

Lee Chan-hee pulled the muscles with forceps, and Tae-kyung also grabbed the forceps in his left hand and pulled in the opposite direction.

At the same time, he cauterized and cut the muscles with the Bovie in his right hand. Then, he inserted a single port with two flexible plastic rings.

He grabbed the end of the port and inserted it lengthwise into the incision, then folded the rings to support it from the inside of the abdominal cavity, with the other ring supporting it from the outside.

This prevented the instrument that secured the single-port laparoscopic passage from moving.

“……!”

Tae-kyung’s gaze turned to Lee Chan-hee after installing the port.

‘Why is he like that?’

There was something strange about him. He repeatedly narrowed his brow, slightly bent his back, and his shoulders trembled slightly.

“Dr, Doctor……?”

Just as Tae-kyung was about to ask what was wrong, Lee Chan-hee called him first.

“What’s wrong, Dr. Lee.”

“What should I do?”

“What do you mean, what?”

“I’m, I’m sorry, Doctor.”

Lee Chan-hee suddenly apologized and frowned deeply. His lips, hidden inside the mask, were also trembling.

“What do you mean suddenly apologizing?”

“I don’t think I can do it anymore. I don’t think I can hold on any longer.”

“Hold on? Dr. Lee, you’re in the middle of surgery. Speak clearly.”

“That’s…….”

Lee Chan-hee, who was answering Tae-kyung’s words, eventually couldn’t continue speaking and continued to look anxious.

“Doctor! I can’t do it anymore. I…… I think I need to go out.”

Tae-kyung doubted his ears for a moment.

To leave in the middle of surgery unless he was crazy. What kind of bullshit was this!

“I’m sorry. Doctor. I’m really sorry.”

“Dr. Lee? Lee Chan-hee!?”

Despite Tae-kyung’s shout, Lee Chan-hee left the operating room looking anxious.

“……!”

Lee Chan-hee left the operating room at the speed of light, and Tae-kyung was momentarily in a mental breakdown for a few seconds.

* * *

“Haa!”

Lee Chan-hee, who came out of the operating room as if he was being chased, took a deep breath.

He was still anxious as he hit his chest with his hand as if it was stuffy.

‘You moron.’

A familiar sound echoed in Lee Chan-hee’s ear like tinnitus as he walked toward the lounge.

‘You pathetic bastard. Why are you so weak as a man! Are you even a doctor like this!’

He thought he was okay. He thought he could get over it now, but that wasn’t the case.

‘Don’t even think about taking a step out of the operating room until you do it perfectly.’

Lee Chan-hee’s expression deteriorated rapidly at the sharp voice ringing in his head.

“Let’s not think about it. Let’s stop thinking about it.”

Lee Chan-hee felt like his head was spinning and quickly lay down on the floor of the hallway, feeling the prodromal symptoms of collapsing.

* * *

“Leaving in the middle of surgery? Is he crazy?”

The assistant, who plays the role of another hand in the operating room, left in the middle of the surgery. With a little exaggeration, it felt like one hand was gone.

“Doctor. Dr. Lee Chan-hee probably won’t come back. It’s absurd, but you have to proceed with the surgery.”

Euijin was right.

There was no time to ask why in the situation that was happening before his eyes. If there was no tooth, he had to use his gums [idiom for improvising]. The patient’s surgery was the priority right now.

‘Calm down! You can do it.’

Tae-kyung looked around and comforted himself inwardly. He was about to move, organizing his thoughts, when it happened.

“Doctor, I’ll go in and help you.”

Euijin said, getting up from her seat. Of course, the main job of an anesthesiologist was to check the monitor and monitor the patient’s condition.

But now, she decided that helping Tae-kyung was the priority. She thought the patient’s anesthesia was safe and she could assist.

“Don’t worry about the anesthesia, just assist me from the side…….”

“No!”

Tae-kyung shouted loudly as Euijin tried to move from her seat.

“If you help me, it will be difficult to deliver supplies.”

“Ah!”

Euijin immediately understood Tae-kyung’s words. If she assisted, she couldn’t act as a circulating nurse.

If she assisted, she would have to wear sterile gloves, but anesthesiologists don’t wear those gloves. However, if she wore sterile gloves, she couldn’t touch the supplies due to contamination issues.

“I’ll do it alone.”

It wasn’t bravado.

‘It’s not easy, but I can do it enough.’

As a result of drawing an image in his head for a moment, the conclusion was that it was possible.

“Are you sure you’re okay alone?”

“I’m okay.”

There was no other good way, but Euijin decided to trust Tae-kyung’s confident eyes revealed under the surgery gown.

“Then let’s continue.”

Tae-kyung’s voice changed subtly. In addition, a level of concentration that could not be compared to just before was emanating from his body.

‘First, let’s keep the table close.’

Tae-kyung decided to bring the table with the surgical instruments next to him in order to perform the surgery alone.

“……!”

But a small problem arose. The monitor installed so that the assistant Lee Chan-hee could see the laparoscope’s view was standing firmly on Tae-kyung’s right.

He tried to push the monitor next to him with his foot, but it only shook precariously once and didn’t budge.

‘Damn it!’

He quickly decided to give up because it would be a big deal if it fell on the patient.

‘Let’s not touch the monitor.’

Since he couldn’t bring the table next to him, he decided to pick up the necessary tools himself. Tae-kyung stretched his hand toward the space above the patient’s body with all his might, like an acrobat.

With a careful touch, he succeeded in picking up the electrocautery.

“That’s right!”

Euijin, who was quietly watching the scene, nodded and said.

One of the most important things to be aware of during surgery was contamination.

Tae-kyung tried to move behind the monitor to proceed because of the contamination, but he couldn’t pass because the suction line was blocking him.

“Doctor?”

Eventually, Tae-kyung decided to ask Euijin for help.

“Please watch carefully to see if anything gets contaminated when I pick up the tools.”

He asked Euijin to guide him so that he could grab the tools safely. When you concentrate, your field of vision narrows to the area you are focusing on.

Moreover, it is not easy to look at the whole situation now that there are restrictions on the movement path.

“Is it because of the field of vision? Don’t worry.”

On the other hand, Euijin had a wider field of vision than Tae-kyung and could see the whole thing. That’s why he asked him to guide him so that he could grab the tools safely.

“I’ll watch you carefully, so trust me.”

Tae-kyung was about to grab another tool when it happened.

‘Oh, the height is a little different.’

The height of the bed and the table with the surgical instruments, which he hadn’t been aware of earlier, was different.

“One, two, three…….”