Fifth Vital [EN]: Chapter 179

Fifth Vital Sign – Episode 179 (179/502)

179. Hemoglobin Level

“Yes, please draw blood from my leg.”

Usually, when drawing blood or inserting an IV line, the patient’s arm is used. However, if it’s impossible to use the arm, blood can be drawn or a line can be inserted in the leg.

Of course, it’s not a common occurrence.

“Is your arm uncomfortable? We can do it on your leg, but it might be more painful since we’re not as used to it.”

“I’ve had it done on my leg before, so it’s okay. And actually, I have a severe skin condition on my arm, so I can’t show it to people.”

Lee Min-hwi spoke while still clutching the end of his sleeve.

“This is a hospital, so it’s okay to show it.”

“I appreciate the thought, but I’m just too self-conscious about it.”

“Okay, I understand. Then we’ll draw blood from your leg.”

“Yes, thank you.”

The nurse drew blood from Lee Min-hwi’s leg as requested.

“And, Doctor, can I also get the IV for the endoscopy in my leg later?”

“Yes, but the doctor will decide after assessing your condition.”

“I know that. And the doctor already saw my condition earlier.”

“Okay, please wait a moment.”

The nurse left the bedside with the blood sample and headed to the 담당자 [person in charge].

A moment later-

“What is this? I need to tell them right away.”

Nurse Lim Jeong-sook took Lee Min-hwi’s test results and headed to Taekyung’s office.

Knock, knock-

“Yes.”

“Doctor, Lee Min-hwi’s lab results are in.”

“Oh? How did it co…!

Taekyung, who had taken the results and was checking them, was momentarily speechless.

“Are these really Lee Min-hwi’s results?”

“Yes, Doctor. I thought it was strange too, so I checked several times, but they’re correct.”

With Nurse Lim Jeong-sook’s answer, Taekyung’s gaze returned to the results.

Lee Min-hwi’s hemoglobin (the level related to oxygen transport in the blood) was 12. The result showed a normal level.

‘Normal?’

How could it be normal?

Lee Min-hwi had clearly said he vomited a large amount of blood and even showed a picture claiming it was his. If he had lost that much blood, it would be difficult for the levels to be in the normal range. Especially since he had bled like that not just once, but twice.

It was ironic.

His physical examination earlier was also strange. The skin under his eyes wasn’t pale, and his tongue wasn’t dry either.

If what Lee Min-hwi said was true, there should be corresponding symptoms, but nothing matched.

“This patient is strange. The levels shouldn’t be normal, but they are…”

“Something seemed off during the blood draw too.”

“Why?”

“He said he had a severe skin condition on his arm and asked to have it done on his leg instead, so we drew blood from his leg instead of his arm.”

“From his leg?”

“Yes, and he held onto his sleeve tightly with his hand until the blood draw was over. And he asked if he could get the IV in his leg for the endoscopy, and then he came to the station and asked whether we use midazolam, propofol, or ketamine for the sleep endoscopy.”

Midazolam, propofol, and ketamine were sleep anesthetics used in hospitals.

“He asked that? Why?”

“Well, I’m not sure, but he said our hospital uses propofol, so he said that was good because propofol works well for him, and he asked when he could get the endoscopy. What should we do, Doctor?”

As Taekyung listened to Nurse Lim Jeong-sook’s words, his brow furrowed and his expression became serious.

Normal hemoglobin level.

Complaints of heavy bleeding and pain.

Blood drawn from the leg.

A skin condition on the arm.

Endoscopy and sleep anesthetics.

He listed the words related to Lee Min-hwi in his head like putting together a puzzle.

‘He can’t get a shot in his arm because of a skin condition? How bad is it?’

Taekyung also found this part quite ironic.

Usually, no matter how severe the skin condition, patients show their condition and ask if an injection is possible.

They don’t take the initiative to refuse and ask to have blood drawn elsewhere like Lee Min-hwi.

‘Why hold the sleeve when drawing blood from the leg…!’

Taekyung, recalling what Nurse Lim Jeong-sook had said a moment ago, suddenly had something flash through his mind.

‘Endoscopy and propofol, and the act of drawing blood from the leg instead of the arm and holding the sleeve, the words that come to mind fit perfectly.’

Thump-

“Ah! Oh my.”

Taekyung, who had been thinking deeply, suddenly jumped up from his chair, causing Nurse Lim Jeong-sook to react in surprise.

“Did this patient register at the emergency room?”

“No, he came through the front desk.”

“Why?”

“I have a suspicion. I’m sure of my hunch, but I don’t have enough evidence.”

“What do you mean?”

Leaving the curious Nurse Lim Jeong-sook behind, Taekyung headed to the reception desk.

“Who registered Lee Min-hwi earlier?”

“I did, Director. I did it.”

Kim Young-i, who had dealt with Lee Min-hwi, raised her hand in response to Taekyung’s question.

“Did you happen to see the patient’s arm or notice anything strange while registering him?”

“I didn’t see his arm. He sat down on the floor once while registering, saying he was tired.”

“Oh, really? Okay.”

“Um, Director!”

As Taekyung was about to leave the desk, not feeling anything particularly strange, the hesitant employee called out to him.

“Actually, there was something a little strange. I accidentally saw something in the patient’s bag, but I only caught a glimpse, so I’m not sure.”

“What did you see?”

“That was… a syringe.”

“……!”

As the word ‘syringe’ came out of the employee’s mouth, Nurse Lim Jeong-sook, who had been listening to the conversation, was speechless, and Taekyung became increasingly convinced of his conclusion.

“A syringe?”

“That patient also crashed his car in the parking lot, didn’t he?”

Behind Chief Choi’s words, who joined the serious atmosphere like a comic relief, Jang Deuk-chil, who had heard the story on his way back from the bathroom, also chimed in.

“He crashed his car?”

“Yes, he crashed the front bumper of an expensive foreign car into the wall, but he didn’t seem to care much. And…”

Jang Deuk-chil also said everything he thought was strange while looking at Lee Min-hwi. And Taekyung headed straight to the parking lot.

“That’s the car.”

“Wow! He came in a pretty expensive car.”

Unlike Chief Choi, who was surprised to see the expensive car, Taekyung’s mind was focused elsewhere.

“You said you heard a glass bottle sound?”

“Yes, Director. When I tried to pick it up and throw it in the trash, he refused with a firm reaction.”

-Click

“Chief Choi, Agent Jang. Everyone, shine your phone flashlights.”

Taekyung shone a medical flashlight on the driver’s side of the car, but it wasn’t easy to see.

“And don’t get too close to the car, in case there’s a sound.”

“Ah! It’s hard to see the bottom because of the chair.”

It was as Jang Deuk-chil had said.

The chair was blocking the view of the glass bottle in question. It seemed like something was reflecting the light, but it was impossible to know exactly what it was.

Feeling frustrated, Taekyung shone the flashlight on the back seat, just in case.

“……!”

And then he saw something.

“Everyone, shine your lights over here.”

“Oh! What is that?”

As Jang Deuk-chil and Chief Choi shone their flashlights on the back, a chilling sight began to appear clearly.

“It’s a glass bottle.”

In the back seat, dozens of small glass medicine bottles were piled up haphazardly. There were also used and discarded syringes.

“Director, that’s a medicine bottle, right?”

“Yes, it’s propofol.”

The identity of the medicine bottle was propofol, a type of intravenous anesthetic used for sleep anesthesia.

Lee Min-hwi was addicted to propofol, also known as milk injection.

You might think that it’s not a big deal to be addicted to a drug used for sleep anesthesia, but you’d be wrong.

Propofol, which has been designated as a psychotropic drug, a narcotic that causes hallucinations, arousal, and habitual addiction since 2011, should not be administered arbitrarily by individuals.

When you wake up after getting propofol, you feel a clear feeling as if you have woken up from a refreshing sleep. Also, unlike other sleep anesthetics, there is no hazy or dizzy feeling like you feel during a hangover.

For this reason, it creates the illusion of having recovered from fatigue, and many people are addicted to this aspect. However, side effects such as difficulty breathing, vomiting, and decreased blood pressure can also occur.

Therefore, it must not be abused by individuals, and experts must carefully monitor and administer it to prevent side effects.

Taekyung was initially questioned by the fact that he said he vomited a large amount of blood, but his physical examination and hemoglobin levels were normal.

Then, he was convinced that he was an addict from the blood draw from his leg and the excessive behavior to avoid showing his arm, and above all, the syringe that the receptionist saw.

The fact that he vomited blood and said that his stomach hurt and needed an endoscopy was a lie of an addict to get propofol.

If a person without authority illegally administers propofol, they can be sentenced to imprisonment for up to 5 years or a fine of up to 50 million won under the Narcotics Control Act.

“Chief Choi?”

“Yes, Director.”

“Report it to the police right away. Tell them that a patient who is illegally administering narcotics has come to our hospital.”

“Okay.”

In fact, even if someone like Lee Min-hwi comes to the hospital, not all medical staff may report it to the police and actively respond.

You can just pretend you don’t know and say no and send them out of the hospital.

But the reason why he does this is because he knows the dangers of propofol addiction better than anyone else, and he has seen people whose lives have been ruined by it.

Several years ago, Taekyung had to perform emergency surgery on a patient who jumped off a building due to depression caused by propofol addiction.

At that time, the patient barely survived after a long surgery that lasted more than 10 hours.

A few days later, Taekyung asked the patient, who had regained some consciousness, not to throw away his precious life.

Then the patient cried and said this.

‘I wanted to stop, but I didn’t know how to stop. There were only people selling me drugs, and no one told me not to.’

Among the people who sold drugs that the patient mentioned at the time, there must have been medical personnel. But at least he vowed not to become a doctor who would turn a blind eye when he saw such a patient later.

“Agent Jang, wait in front of my office, and be careful in case Lee Min-hwi tries to run away.”

“Yes, Director.”

“But Director. How do we buy time until the police arrive? Are you going to do an endoscopy?”

“We can’t give an addict more drugs, so we shouldn’t do an endoscopy.”

“Then what are you going to do?”

“We have to hold him back.”

“If we don’t do an endoscopy and just drag out the time, won’t he be suspicious? Those kinds of people are surprisingly perceptive.”

“I’m going to try to do the same thing this woman did.”

“The same thing?”

“Yes. We have to play along.”

Leaving Chief Choi and Jang Deuk-chil’s curious faces behind, Taekyung headed straight to the hospital with a confident look.

Taekyung, who had entered the hospital, called some of the staff to his office.

“Doctor Choi, see the patient as you did in the emergency room, and let Doctor Lee know the truth. Especially, tell Doctor Lee not to give him any attention.”

“Yes, Doctor.”

Lee Chan-hee usually had a lot of curiosity about patients, so he asked for caution because he could actively get involved in this matter.

“And Doctor Lim, you haven’t forgotten what I told you, have you?”

“Of course. I’ll go and give him a good wind [Korean idiom for ‘stir things up’].”

“And please bring a bottle of propofol to the office.”

“Yes, Doctor.”

After that, Taekyung went into the office, and Nurse Lim Jeong-sook and Choi Mona headed to the emergency room where Lee Min-hwi was.

At that time-

“Hasn’t it come out yet?”

Lee Min-hwi was waiting for the test results with an anxious heart.

‘What if I get rejected here too?’

Eventually, Lee Min-hwi, who was peeking around the bed curtain, happened to find Lee Chan-hee, who was seeing patients and coming from another bed.

“Excuse me, Doctor?”

“Yes, patient.”

“I had a test earlier, but hasn’t it come out yet?”

“What kind of test did you have?”

“The nurse took blood for a blood test. How long will it take? I’m in a hurry.”

Lee Chan-hee had not heard any information about Lee Min-hwi because he was seeing patients.

“What’s your name?”