Fifth Vital [EN]: Chapter 166

Fifth Vital Sign – Episode 166 (166/502)

166. Throbbing and Dull

Sitting on the fishing chair, Lee Dong-hoon suddenly looked around. The silence that had calmed his mind now felt frightening, perhaps because he had collapsed.

At this moment, he wasn’t a doctor but an ordinary patient gripped by the fear of illness.

Hoping the paramedics would arrive quickly, he stood up, but at that moment,

Thud- Rustle-

A sound suddenly came from behind.

-Wild Boar Area.

Instantly, the wild boar warning sign at the entrance of the village leading to the fishing site flashed through his mind.

‘What? Is it really coming out?’

Just as he wondered if it might really be a wild boar, a stray cat wandering around the fishing site passed by.

-Meow

“Ugh, damn it! You scared me. Hey, you almost gave me a heart attack.”

-Meow

“Sorry, but I didn’t catch any fish today, so I have nothing to give you.”

Tense from the cat’s presence, Lee Dong-hoon moved to his car, turned on the heater, and lay down with his legs up. Then, he turned on the headlights so the paramedics could see him easily.

And exactly five minutes later-

“Are you the one who called 119 [South Korea’s emergency telephone number]?”

The paramedics he had been waiting for so eagerly arrived.

“Yes, that’s me. I’m the one.”

Lee Dong-hoon’s expression was brighter than ever when he saw the paramedics.

“I called it in.”

He had seen paramedics countless times at the hospital, but this was the first time he was so glad to see them.

“Please, take me to the emergency room of a nearby university hospital quickly. Please.”

“First, can you walk?”

“Yes, I’m okay now……!”

Lee Dong-hoon got out of the car, stepped onto the ground, and collapsed again on the spot.

“Oh dear. This patient is not going to make it.”

The paramedics next to him were also surprised and quickly took care of him.

“Just lie here. We’ll carry you.”

“Yes, thank you.”

Fortunately, he didn’t lose consciousness this time. The paramedics quickly put the surprised Lee Dong-hoon on a stretcher and into the ambulance.

“Excuse me, can you check my blood pressure first?”

Startled by another abnormal signal from his body, Lee Dong-hoon quickly regained his senses and spoke.

“And can you tell me what kind of IV fluids you have here?”

“Sir, we’ll take care of it. Just relax.”

The paramedic, not knowing Lee Dong-hoon was a doctor, calmed him down.

“You wouldn’t know even if I told you about the IV fluids. Don’t worry……”

“Sorry to interrupt, but I’m a doctor. I’m a professor of anesthesiology at Shinhwa University Hospital. So, please check my blood pressure first, please.”

Normally, Lee Dong-hoon wouldn’t have even said “please.” But now, the paramedics were the most important people in the world to him, so he didn’t want to upset them.

“Ah… I see. Understood. We currently have normal saline [a common intravenous solution].”

“Then what about vasopressors [medications that raise blood pressure]? What kind of vasopressors do you have?”

“We currently have epinephrine (a type of vasopressor that is powerful in raising blood pressure).”

The paramedic spoke while preparing to measure his blood pressure.

“Sir, I’ll check your blood pressure for a moment.”

“What is it?”

As soon as the blood pressure measurement was finished, Lee Dong-hoon quickly asked again, as if he had been waiting for it.

“What is it?”

“It looks like 100/75.”

“Give me 1L of normal saline first. Open the regulator all the way and don’t adjust it.”

“Yes.”

“Take me to Shinhwa University Hospital.”

“Understood.”

“And I’m sorry, but please keep measuring my blood pressure every 15 minutes. I lost consciousness at the fishing site earlier. If I lose consciousness again during transport, you don’t have to go all the way to Shinhwa University Hospital.”

“Pardon?”

“Our hospital will be on the way. Just go there.”

For a moment, Lee Dong-hoon thought of Our Hospital, where Tae-kyung was.

“Our Hospital?”

“Yes. So, if I lose consciousness, go to Our Hospital. If I’m conscious, go to Shinhwa University. And keep measuring my blood pressure, and if the systolic [top number] drops to 80, then administer epinephrine.”

“Excuse me?”

Another paramedic, who was checking something on his phone next to him, spoke.

“Shinhwa University Hospital is in the opposite direction from here, so it will take a while to get there. Is that okay?”

“Is that so? Just a moment. Can you get my phone out of my bag? Thank you.”

Lee Dong-hoon received the phone and quickly made a call.

“It’s Lee Dong-hoon from anesthesiology.”

-Yes, Professor.

“Who is the on-call surgery professor today?”

-It’s Professor Kwon Soo-hyun.

“What! Kwon Soo-hyun?”

Lee Dong-hoon’s voice, which had been calmly talking on the phone while lying on the ambulance bed, rose without him realizing it.

“If it’s Kwon…”

-You know, the one who came in as Kim Tae-kyung’s replacement. But is something wrong?

“Oh. No, it’s nothing. Thanks for your hard work.”

‘Kwon Soo-hyun? I almost made a big mistake.’

Kwon Soo-hyun, who came in as Tae-kyung’s replacement, had impressive connections but mediocre skills. She was a parachute appointment [someone who gets a job through connections rather than merit] who lacked real ability.

“Hello, is this Our Hospital?”

Lee Dong-hoon called again.

“Is Dr. Kim Tae-kyung seeing patients now? Yes. Thank you. Paramedic, please go to Our Hospital.”

After hanging up, Lee Dong-hoon asked the paramedic to take him to Our Hospital.

Even though Shinhwa University Hospital was his current workplace and a good hospital, he didn’t want to entrust his body to a doctor without skills. And he could trust Tae-kyung, so he could rest assured.

“Then we’ll depart.”

The ambulance, with its engine started, began to race through the darkness of dawn.

* * *

Our Hospital Emergency Room.

Shirr-

“Doctor! Is it broken?”

Tae-kyung, who was looking at the monitor at the emergency room station, opened the curtain, and the woman standing next to the bed reacted.

“No. Fortunately, the bone isn’t broken.”

“Really? Thank you.”

“It looks like there’s a crack in the right tibia [shinbone], so you’ll need a cast for about two weeks.”

“A cast? Mom, if I get a cast, do I not have to go to school?”

The elementary school student, who was watching videos on his phone with his older brother on the bed, asked with an innocent expression, and his mother quickly became stern.

“Why wouldn’t you go to school? And if you play games until dawn one more time, I’m selling the computer. Got it?”

“Ah, no way. I have to play the new game.”

The son, who had hurriedly turned off the computer he was trying to play without his parents knowing, seemed not to grasp the situation yet.

“Mom is just saying that. The computer is expensive, so she can never sell it.”

“Is that what you should be saying as the older brother? You should stop your brother from playing games, not join him?”

“I was just going to play the new game a little.”

“My brother is right.”

“Quiet. Anyway, when your dad comes back from his business trip, you’ll be in trouble.”

“You must be having a hard time,” Tae-kyung said to the mother.

“Oh, you have no idea. Besides these kids, there’s another big son at home. Raising three sons is a daily war.”

Tae-kyung knew to some extent the hardships of parents raising only boys, as he had treated many children in the emergency room.

“I just moved here recently, and I was worried about what to do if there wasn’t a hospital nearby, but I’m so glad you’re open late. Thank you.”

“It’s nothing. It’s not serious, and it will heal well if you wear a cast for two weeks. I’ll put on the cast for you. Here, please put on the cast.”

“Yes, Doctor.”

Shirr-

“Director?”

Just as he finished treating the child and was heading to the station, he heard Jang Deuk-chil’s shout along with the ambulance siren.

“An ambulance is coming in?”

“Did you receive any contact?”

He assumed it wasn’t an urgent patient since they usually contacted them before arriving if it was an emergency.

“No. Nothing.”

Before Nurse Im Jeong-sook could finish speaking, Tae-kyung went out to where the ambulance was parking.

“Patient condition…”!

“Dr. Kim?”

Tae-kyung, who was questioning the paramedics taking the mobile bed out of the ambulance, was so surprised that he was speechless.

First, Lee Dong-hoon’s unexpected face came into view, and second, the smell of formalin [a chemical used for preserving tissue] enveloped him.

‘What? Why does Professor Lee smell like Stage 4 [referring to the advanced pathology lab]?’

Focusing on the smell, Tae-kyung first examined Lee Dong-hoon.

“Professor, what brings you here?”

“Wow, the director himself is escorting me; the hospital service is great here. There’s a reason why it’s doing so well.”

The anxiety that had filled Lee Dong-hoon’s heart lessened, and he felt relieved when he saw Tae-kyung’s face.

“I couldn’t wait to see Dr. Kim, so I just came.”

Tae-kyung had already made plans to see Lee Dong-hoon next week.

He was going to see his face after a long time and ask if there were any good anesthesiologists around.

“You seem to be doing okay since you’re joking around.”

Unlike the fifth vital sign, which was serious at Stage 4, Lee Dong-hoon’s expression was not at all concerning.

“What are you talking about? Seeing Dr. Kim brings peace to my heart.”

“What are your symptoms?”

“I’ve had abdominal discomfort for 12 hours, and I haven’t eaten anything all day, but I’m not hungry at all.”

Tae-kyung focused as Lee Dong-hoon explained his symptoms while the paramedics pushed the bed.

“Then, two hours ago, I felt dizzy when I sat up, and I collapsed at the fishing site. When I woke up, an hour had passed. So, I quickly called 119.”

Tae-kyung’s eyes changed subtly as he touched Lee Dong-hoon’s abdomen while he continued to explain.

“Do you have any underlying conditions?”

“You know, I’m clean. I don’t have anything like that.”

“Then I’ll quickly take a lab and CT scan first. Your kidneys are good, right? I’ll use contrast right away.”

“No problem. Do whatever you want, Director. Please take good care of me.”

“Of course. Absolutely.”

Zhiing-

“53-year-old male patient.”

The emergency room automatic door opened, and Tae-kyung’s instructions began.

“Start full monitoring now and give Hartmann’s solution (a type of IV fluid containing electrolytes, etc.) as a 500 bolus [a large dose given rapidly], then give it at 100cc/hr [cubic centimeters per hour].”

“Yes, Doctor.”

“Do a lab right away and let’s go to CT. Call the CT room. And just in case, tell them to prepare the operating room in advance.”

“Understood.”

“Oh! Operating room? Dr. Kim, do I need surgery?”

“Of course, I’ll know once I see the CT, but touching your stomach just now, it seems like hemoperitoneum (blood pooling in the abdominal cavity due to bleeding).”

Earlier, when he palpated Lee Dong-hoon’s abdomen, it felt throbbing and had a dull sound, indicating that fluid was pooling. Moreover, his abdomen was slightly distended even though he hadn’t eaten anything, and his blood pressure was dropping and his heart rate was increasing, suggesting possible intra-abdominal bleeding.

“Hemoperitoneum! Me? Why?”

“I’ll need to run tests to find out the reason, but the good thing is that it doesn’t seem like peritonitis [inflammation of the peritoneum] yet.”

“Anyway, I’ll just trust our Dr. Kim.”

“How are you feeling now?”

“Is it because I heard the explanation? My stomach feels like it’s stabbing a little. And I’m a little cold.”

Lee Dong-hoon shrank slightly as if he were cold.

“Professor, when was the last time you ate?”

Since surgery might have to be performed immediately depending on the results, Tae-kyung asked about the fasting time.

“I’m okay with surgery right away. NPO time (fasting time required for surgery) is fully met.”

A doctor is someone who is closer to the hospital and has a higher understanding of diseases than anyone else.

Lee Dong-hoon was also like that. But he didn’t know it at this time.