Fifth Vital [EN]: Chapter 119

Fifth Vital Sign – Episode 119 (119/502)

Episode 119. Less Than 1cm on the Right

“Something better?”

“This is it.”

Tae-kyung confidently answered, raising his hand in the air.

“Your finger?”

“Exactly. The best tool.”

Leaving the surprised Lee Chan-hee behind, Tae-kyung approached the patient.

“Are you still having abdominal pain?”

Fortunately, the patient was suffering from constipation rather than a disease, so the fifth vital sign [a method of quickly assessing a patient’s overall condition] was a mild level 2.

“Yes… Doctor. It hurts so much.”

The man lying on the bed looked genuinely in pain.

“Your large intestine is full of stool right now.”

“I’ve always been a bit constipated, but this time I haven’t been able to go for ten days. It’s never happened before.”

“That’s right. The constipation is preventing proper bowel movement, which is causing the pain.”

For a person, eating well and excreting well are important.

Especially excreting well is more important than one might think, and it cannot be emphasized enough.

Anyone who has ever suffered from constipation knows the pain and suffering well. Imagine not being able to defecate for nearly ten days, with all those toxins filling the large intestine. How difficult would that be?

This male patient must be in so much pain that it’s hard for him to go about his daily life.

“Doctor, what should I do then?”

“We need to remove the stool.”

“How?”

“Normally, an enema would be good, but the stool is so hard right now that the tube probably won’t even go in.”

The emergency room sees quite a few patients, both children and adults, who come in because they can’t pass stool due to constipation. Usually, an enema is administered to help them pass stool. However, when patients haven’t been able to defecate for a long time, like this patient, the hardened stool must be manually removed.

“If an enema won’t work, what do I do?”

“I’ll have to dig it out with my finger.”

“What? With your hand? I’m sorry, but… won’t it hurt if you dig it out?”

“If I just dig out the outer part, you’ll be able to pass a lot of stool. Then it won’t hurt. Don’t worry too much.”

“But will you do it here? Not in the bathroom?”

“Yes, we’ll do it here.”

Sometimes patients ask if they can do it in the bathroom out of embarrassment. Of course, I understand their feelings, but we can’t perform the procedure in the bathroom.

It’s a delicate procedure that requires careful consideration of the patient’s anus, and the doctor performing the procedure needs to be in a comfortable position.

The bathroom is not comfortable for either the patient or the doctor, which is why the procedure is performed on the bed.

“Ah… then please.”

“Please put a pad down here.”

“Yes, Doctor.”

Tae-kyung placed the large pad that Nurse Im Jeong-suk gave him under the patient’s buttocks. Then, he prepared a large container under the bed.

“You need to relax, okay? Try to ‘whoosh’.”

“Whoosh~!”

Then, he applied plenty of gel to the finger wearing a medical glove and inserted his index finger into the anus of the patient, who was lying in the fetal position.

“Ah! Doctor. Ugh!”

“Relax. If you tighten your anus, my finger won’t be able to move.”

The patient didn’t want to tense up, but he was involuntarily doing so.

“Don’t be alarmed and slowly relax.”

“Okay… okay.”

Tae-kyung bent the tip of his finger and carefully dug out the things that felt hard and even stiff.

Thud-

As he dug out the stool, lumps that felt hard rolled out of the anus.

“Oh, Doctor, just a moment.”

“It’s okay. We’re almost done.”

Tae-kyung soothed the patient and scraped out the remaining lumps one more time.

“Doctor!”

At that moment, the patient’s anus relaxed, and the contents that had been filling the large intestine were instantly discharged.

Thud- thud-

Tae-kyung, who had dealt with countless constipation patients, quickly and accurately got up from his spot. As a result, the unfortunate incident of stool splattering on his face and clothes did not occur.

Fortunately, the emergency room floor was also safe thanks to the large container that had been prepared in advance.

“I’m, I’m sorry…”

The embarrassed patient repeatedly apologized, not knowing what to do.

He had come to the hospital for treatment because of severe abdominal pain, but he never imagined that the doctor would manually remove the stool. As the pain disappeared, the patient felt not only sorry but also apologetic.

“I’m really sorry, doctors.”

“It’s okay. You’ve been through a lot. Please thank the cleaning staff when they come to clean up later.”

“Ah, yes. Of course. Of course. But my stomach hardly hurts anymore.”

Incredibly, the squeezing pain had disappeared, and the heavy, stuffy lower abdomen felt much lighter.

“Thank you so much, Doctor.”

“Get some IV fluids, and I’ll make an outpatient appointment for you. And when you go home today, your anus might feel hot, and you might have residual stool, so you might have to go again. Take a warm sitz bath [a shallow bath to cleanse the perineum] for less than 5 minutes and drink plenty of fluids.”

“Yes, thank you.”

“Here, give the patient IV fluids after the stool container is removed.”

“Yes, Doctor.”

“Ugh! What’s that smell?”

“What crazy person pooped in the emergency room?”

“Nurse. Where’s that poop smell coming from?”

The medical staff, as well as the patients receiving treatment, were startled by the tremendous smell that spread throughout the emergency room and made a comment each.

“Oh, I guess the constipation was severe.”

After that, the cleaning lady, as if familiar with the situation, quickly and efficiently cleaned the area with an indifferent expression.

“I’m sorry. It’s all because of me…”

“Oh, don’t be sorry for everything. It’s okay since it happened while you were getting treatment, so don’t worry about it.”

The cleaning lady, smiling at the man’s apology, quietly brought an air purifier, turned it on, and left the emergency room.

Beep-

The air purifier turned on with a red light, indicating the highest level of pollution, and worked diligently.

Meanwhile, Tae-kyung washed his hands thoroughly and took a seat in front of the station monitor.

‘Compared to the smells I usually smell, this is nothing.’

Unlike others who were struggling with the smell, Tae-kyung, who was already accustomed to the smells he usually encountered, was not bothered by it.

“Doctor Choi?”

“Yes, Doctor.”

Tae-kyung called Choi Mona, who had settled in front of the station monitor.

“I was wondering if you’ve seen the records of the patient who was transferred recently.”

“I’ve checked the 207 cancer terminal patient.”

“Good job. Doctor Choi, you don’t have any urgent patients, do you?”

“No, I’m waiting for the patients’ test results.”

“Then, Lee and I will take care of things here, so go and get some rest.”

“It’s okay…”

“Don’t say it’s okay. Anyway, when you come back from your break, I’ll tell Doctor Lee to take a break too. If we’re short-handed in the emergency room, I’ll call you right away, so go and rest.”

“Yes, I understand. Um… Doctor?”

Choi Mona turned back to Tae-kyung as if she had something to say.

“Yeah? What is it?”

“Is Seyoung going to the Sunflower Center [a support center for victims of abuse and assault] after she’s discharged?”

The Sunflower Center was a place that helped people who had suffered from child abuse, domestic violence, sexual assault, etc., with treatment and psychological therapy.

“That’s right. Mental health professionals and psychotherapists there will help her recover well psychologically.”

“That’s good.”

“Why, are you going to miss Seyoung now that she’s leaving?”

“No, that’s… I’ll go and rest then.”

Choi Mona hurriedly greeted him and left the emergency room, as if her feelings had been discovered.

“Turtle number 2’s growth is remarkable.”

“Ugh, the smell. What turtle are you talking about?”

Lee Chan-hee, who had been seeing other patients after watching Tae-kyung’s constipation patient procedure, approached and said.

“Our turtle number 1 is doing well too.”

“Yes? You’re talking about turtles again. More than that, you’re amazing, Doctor.”

“The constipation patient just now?”

“Yes.”

“What’s so amazing about it? It’s something all doctors do.”

It was true that all doctors did it, but Lee Chan-hee, who had administered many enemas, had not yet done it manually like that.

As Tae-kyung said, the procedure itself was not amazing, and it was all done by hand. But somehow, directly removing that dirty stool seemed amazing. In reality, stool would often splatter on the face or body, and there were quite a few unspeakable difficulties.

“It’s nothing special, so don’t make a fuss.”

“Oh! Yoo Ji-cheon, the patient?”

Lee Chan-hee said, shifting his gaze to Tae-kyung’s monitor.

“Come to think of it, since you came, Doctor, quite a few patients like that patient have transferred to our hospital.”

“I know. I’m grateful that they’re transferring on purpose because of me.”

“But is that person undergoing chemotherapy after surgery?”

“Haven’t you checked the patient yet?”

Tae-kyung asked, shifting his gaze from the monitor to Lee Chan-hee.

“I’m sorry. I haven’t checked the other hospital’s records in detail yet.”

“Come here. Let’s look at it together. I know everything, but you need to know too.”

“Yes. I should have checked it earlier, I’m sorry.”

Click- click-

Tae-kyung clicked on Yoo Ji-cheon’s old file.

“But do you have some kind of connection with Yoo Ji-cheon?”

“Connection?”

“You seem to be paying particular attention to him and caring about him.”

In fact, Tae-kyung pays a lot of attention and care to all patients. Moreover, his rapport, which represents the trust, faith, and bond between doctor and patient, is very good.

That was something that not only Lee Chan-hee but all the employees of our hospital felt the same way. But sometimes, they wondered if he was being too meticulous with the patient, and this was one of those times.

He already made a lot of rounds, but he checked on Yoo Ji-cheon even more often and checked his condition.

Since Tae-kyung was paying so much attention, Lee Chan-hee couldn’t help but be curious.

“Are they perhaps an acquaintance?”

“No, not at all. Yoo Ji-cheon has a bit of a sad story.”

“A sad story?”

“Actually, he discovered cancer in its early stages during a health checkup. Look here. This is the record from that time.”

“Oh, you’re right.”

“I even discovered it with an ultrasound. If you look, it was a small tumor less than 1cm on the right breast…”

Tae-kyung clicked on Yoo Ji-cheon’s ultrasound image from that time.

“Here, if you look at the ultrasound at that time, the borders are irregular. And it’s longer parallel to the pectoralis major (the large muscle in the chest). So I suspected cancer and immediately did a biopsy (a method of diagnosing malignancy by taking a part of the tissue with a syringe, etc., and examining it under a microscope). And it was diagnosed as cancer, and after that, it would have been a simple matter of cleanly removing only the cancerous lesion. It would have been.”

It was just as Tae-kyung said. The ultrasound image at the time, as well as the result record, showed that it was completely early-stage cancer, even to Lee Chan-hee.

People who receive results after the cancer has progressed to some extent sometimes regret that it wasn’t discovered earlier.

That’s because the treatment method, the patient’s pain, and the survival rate are different in the early stages and when the disease has progressed. But Lee Chan-hee couldn’t understand how Yoo Ji-cheon had become such a severe terminal cancer patient after discovering the cancer in its early stages.

“But why did it turn out like that? What on earth happened to the patient…”

“Nothing.”

An unexpected answer came from Tae-kyung’s mouth.

“Really, nothing happened. That’s why it became a big problem.”

“What do you mean by nothing happened?”