Fifth Vital [EN]: Chapter 138

Fifth Vital Sign – Episode 138 (138/502)

138. The Only Way

Beep- Beep-

The sound came from the machine for general anesthesia. More precisely, it was the sound of Do Seung-won’s oxygen saturation dropping.

“Huh!”

Everyone was taken aback for a moment.

‘The scent is getting stronger.’

Tae-kyung felt the fifth vital sign’s scent intensifying.

“Why is the oxygen saturation dropping?”

“Was the intubation not done properly?”

Ui-jin quickly checked the sounds of Do Seung-won’s epigastrium [upper central region of the abdomen] and chest with a stethoscope. There was nothing wrong with the anesthesia process just now.

“No. The intubation went in well.”

Tae-kyung was also taken aback by the sudden situation. This had never happened before while operating on a patient.

‘What’s the problem?’

No, in fact, it doesn’t make sense.

For people who can’t breathe, that is, patients who are approaching death due to breathing problems for any reason, the last method used is intubation.

That’s how absolutely helpful intubation is for breathing. But it didn’t make sense that the oxygen saturation was dropping and the patient couldn’t breathe even after intubation.

“Dr. Jung, could it be?”

Just as Tae-kyung was about to say something to Ui-jin when something came to mind,

“Quickly run and ask the guardian if the patient has asthma.”

Ui-jin, who had already come to the same conclusion, shouted to the anesthesia nurse.

“Yes, Doctor.”

“And bring dexamethasone (a strong anti-inflammatory drug also used to treat asthma) and the bronchodilators that are currently available on your way back. No, bring the medicine first.”

“Yes, I understand.”

* * *

“Guardian?”

The nurse who brought the medicine came out again and ran to Lee Seung-hee.

“Does the patient have asthma?”

“Yes, he didn’t have it originally, but he suddenly developed a cough last year, and when he was examined, they said it was asthma.”

“Then he’s taking medication too?”

“Yes. He’s taking medication.”

After hearing the explanation from Lee Seung-hee, the nurse headed back to the operating room.

Beep-

“Dr. Jung. The patient has asthma and is taking pills, but I don’t know exactly what kind of medicine it is.”

“The patient is having an asthma attack. Some people with asthma experience sudden bronchial constriction when intubated. In this case, the oxygen saturation drops like this.”

Tae-kyung also thought about this possibility earlier. There was nothing wrong with the surgery preparation process or the process of explaining to the patient.

As he was thinking that, Do Seung-won’s negative attitude toward the surgery came to mind.

After hearing Ui-jin’s explanation just now, he realized that Do Seung-won had lied when signing the surgical consent form.

When asked about his past history, family history, underlying diseases, and medications he was taking, Do Seung-won said he had none.

He was in despair, not wanting to have surgery and wanting to die, so he didn’t tell the truth in order to really die.

‘Ha! Why did you do that, patient?’

Tae-kyung looked at Do Seung-won lying down with a frustrated expression.

Meanwhile, Ui-jin, who had administered the medication, quickly drew arterial blood from Do Seung-won’s right arm.

“Go run it and give me the results.”

“Yes, Doctor.”

“I’ll increase the oxygen ratio to 100%.”

“Yes, I understand.”

Everyone in the operating room focused on the patient, and Ui-jin quietly watched the monitor.

“It’s going up.”

After that, the oxygen saturation gradually increased, and soon the machine sound stopped. The oxygen saturation had returned to normal.

“Go get more medicine ready and have it ready to give at any time.”

“Yes, Doctor.”

“Doctor, about the patient.”

Ui-jin looked at Tae-kyung and continued.

“How about spinal anesthesia?”

Ui-jin began to discuss Do Seung-won’s anesthesia with Tae-kyung.

“Spinal anesthesia? Actually, it doesn’t matter for the amputation. But I’m a little worried that the patient might interfere with the surgery.”

The leg amputation that Do Seung-won was undergoing could be performed with spinal anesthesia. The reason for using general anesthesia was that the patient might experience mental stress during the surgery and for the smooth progress of the surgery.

However, it was uncertain whether a patient who had not honestly disclosed the medications he was taking and who had no desire for surgery would cooperate well with spinal anesthesia.

‘It doesn’t seem easy…….’

Honestly, it didn’t seem like cooperation would be easy right now.

“It seems that if there is a lot of bleeding during the surgery, it will have a big impact, so I think the asthma attack will come again.”

“It could be more dangerous than now then.”

“Yes, so I think spinal anesthesia is currently safer for the patient.”

“Then we’ll do spinal anesthesia for Do Seung-won. Dr. Jung, let’s wake up the patient.”

“Yes, Doctor. I’ll give the patient a reverse (medication to reverse the effects of anesthesia).”

Do Seung-won briefly tensed his arms and legs, and his face turned red. Then, Ui-jin removed the intubation device.

“Patient, try to come to your senses. Patient!”

“Cough. Cough!”

Do Seung-won coughed quite a bit for a moment and then continued.

“Is the surgery over?”

“No. It hasn’t even started.”

“What!?”

Do Seung-won frowned as if he hadn’t fully regained consciousness.

“Why?”

“You didn’t tell me you had asthma, did you?”

“……!”

“You have asthma. Some people with asthma have difficulty with general anesthesia. So, I’m thinking of doing spinal anesthesia.”

“That’s good.”

Do Seung-won seemed to have fully regained his senses now and recognized that this was an operating room. And he continued to speak stiffly with an emotionless expression.

“Actually, I deliberately hid my underlying disease.”

“What did you say?”

“Doctor, don’t waste your energy on me. I’m sorry, but… I’m not going to have surgery.”

“What!?”

“No. Patient…….”

“What do you mean by that?”

Among the bewildered and surprised medical staff, Tae-kyung wore an expression that said he expected this.

“You’re saying you won’t have surgery?” Ui-jin asked with a surprised expression.

“Yes, I won’t get anesthesia either.”

“I understand your feelings. But if you don’t have surgery, the injured area won’t heal. If you leave it as it is, you could die, and the wound could rot.”

“It’s okay. That’s what I want. I’m sorry to the doctors here, but I really just want to die.”

Spinal anesthesia requires inserting a needle between the vertebrae to inject the drug. In other words, it is impossible without the patient’s cooperation.

Because Do Seung-won’s will is firm and unwavering, spinal anesthesia or sleep anesthesia is virtually impossible.

‘I have to make him have surgery…….’

Tae-kyung stared intently at the operating room wall without saying a word and pondered for a moment.

“Patient!”

Leaving Tae-kyung to ponder, Ui-jin, who was persuading Do Seung-won, was getting a little louder as if frustrated by the patient’s attitude.

“So, what you’re saying is to just leave it as it is…….”

“Dr. Jung Ui-jin?”

Tae-kyung placed a hand lightly on Ui-jin’s shoulder, who was raising her voice, and calmed her down.

He understood both Do Seung-won’s frustrated heart and Ui-jin’s heart.

“Nurse Lim. Just a moment.”

Tae-kyung called nurse Lim Jeong-sook and moved to a spot a little away from the bed where Do Seung-won was lying.

“Doctor. Do Seung-won needs to have surgery, what should we do?”

“He needs to have surgery. He will soon.”

“How?”

“Nurse, go out of the operating room right now and…….”

Tae-kyung explained to nurse Lim Jeong-sook with a serious expression how to get Do Seung-won to have surgery.

“Yes? No, Doctor. Still…….”

Nurse Lim Jeong-sook, who had heard the explanation, had a very surprised look on her face and couldn’t speak for a moment. She was wearing a mask, but her expression was still visible.

“Will it be okay?”

The method Tae-kyung came up with was quite shocking.

“This is the only way to get Do Seung-won to have surgery right now. Otherwise, the patient will continue to refuse surgery.”

“I understand. I’ll be right back.”

Nurse Lim Jeong-sook nodded with determined eyes and immediately left the operating room.

“Do Seung-won’s guardian?”

And she went straight to the guardian waiting room and called Lee Seung-hee.

“Yes, the surgery? Is my brother okay?”

It hadn’t been long since Do Seung-won had gone in to say that the surgery was over, so Lee Seung-hee felt something was wrong. In addition, she felt uneasy because the nurse had urgently asked about the medicine her boyfriend was taking.

“Well, we haven’t been able to start the surgery yet.”

“What!? What do you mean?”

“The patient didn’t say he had asthma, so he had a seizure during general anesthesia.”

“How’s my brother? Is he okay?”

“Yes, the anesthesiologist quickly performed emergency treatment, and the patient is currently awake.”

“Then the surgery?”

“We need to proceed with spinal anesthesia, but the patient keeps refusing.”

“Ha! What should I do?”

“So, I think the guardian needs to help with the surgery.”

“Me? I’ll help. What can I do?”

“Please stay with the patient.”

“With my brother?”

“Yes.”

Lee Seung-hee listened to Lim Jeong-sook’s explanation and followed her.

* * *

“Doctor. What should we do? I don’t think the patient will change his mind…….”

“He’ll have surgery soon.”

“Yes? What do you mean?”

Ui-jin, who was wondering about Tae-kyung’s answer, asked back. That’s when it happened.

Beep-

Five minutes ago, nurse Lim Jeong-sook, who had hurriedly left the operating room, was coming in with someone wearing surgical gowns and masks.

All the medical staff in the operating room were puzzled, and Do Seung-won continued to have a blank expression as if he had no interest.

“Oppa?” [Korean term for ‘older brother’ used by females; also used affectionately for boyfriends or close male friends]

Do Seung-won, who was startled by Lee Seung-hee’s voice that suddenly rang out, turned his head to the side. Then, he was surprised to find out that the person who had just come in and called him was his girlfriend.

“Seung, Seung-hee. Why are you here? You can’t come in here.”

“I know. But the doctor called me.”

“The doctor?”

“Yes. He told me to come in and cheer you on while you have surgery so that you can have surgery well. Are you really not going to have surgery, Oppa?”

“Ah, no. It’s not like that.”

As expected, Tae-kyung’s prediction was correct. Do Seung-won, who had not budged from his opinion, had become a docile sheep as if nothing had happened.

He didn’t want to show a bad side of himself in front of his girlfriend, Lee Seung-hee.

To get Do Seung-won to have surgery now, Lee Seung-hee had to be by his side.

“You remember me saying that I’ll always be by your side, right?”

“Of course, I remember.”

Do Seung-won never dreamed that Lee Seung-hee would come into the operating room.

“Let’s have surgery, Oppa. Let’s have surgery and work hard on rehabilitation. You can do it, Oppa.”

“Seung, Seung-hee…….”

“How cool and strong is the Do Seung-won I know. It doesn’t matter to me what you look like or what you do. I just like you for who you are. We decided to be together. So, cheer up and have surgery, Oppa. I’ll always be with you.”

Do Seung-won’s heart welled up at Lee Seung-hee’s words.

“Doctor? Just a moment.”

While Lee Seung-hee was calmly persuading Do Seung-won, Ui-jin approached Tae-kyung with a very serious expression.

The two moved to one side for a moment.

“Doctor. No, Senior?”

Ui-jin called Tae-kyung in a polite and heavy tone that she didn’t usually show.