Fifth Vital [EN]: Chapter 199

199. Whistle Surgery

“And this, in my opinion, is scientific.”

“What is it?”

“Fanta.”

“Ah, Fanta.”

“Fanta… what’s that?”

Unlike the senior nurse who understood the meaning of ‘Fanta,’ the youngest nurse tilted her head, puzzled.

“It means that when certain ‘Fantas’ [referring to people who seem to attract bad luck] are on duty, accidents are 100% likely to happen.”

‘Fanta’ was a slang term referring to medical personnel who, when on duty, seemed to attract more patients or cause existing patients to become more critical.

“Oh, so that’s what you call it. I thought you were talking about some kind of soda.”

“Well, Fanta does fit. But do we have a Fanta among us?”

As the senior nurse looked around, Lee Chan-hee quietly raised a finger and pointed.

“Don’t tell me, it’s me?”

“Yes.”

“Come on, what are you talking about? I’ve never heard the word ‘Fanta’ while working at the hospital. How can you say such a disappointing thing?”

“Of course, I didn’t mean to offend you. But I’ve been thinking about my shifts for the past few months. And strangely, whenever I work with you, we get so many patients with cardiac arrest or multiple traumas.”

“Hey! I thought it was something important. Chan-hee? That’s a bit much.”

The senior nurse shook her head, waving her hand as if she couldn’t agree with Lee Chan-hee’s words.

“It’s natural for critical patients to come in when you work at a hospital. You’re just making things up.”

“Look, remember the multiple trauma patient the day before yesterday? The car crash victim.”

“Yes, of course.”

“And remember the patient who attempted suicide during your night shift last time?”

“Oh… yes, I remember.”

“See! 80% of the critical patients who came through the emergency room in the last few months came during your night shift. Isn’t that a Fanta?”

“Oh my gosh. Now that I think about it, it seems true.”

The nurse, who had been quietly thinking, admitted to the undeniable truth.

“See? This is science. We must avoid Fantas at all costs.”

“But what does that have to do with you not looking good?”

The youngest nurse, who had been listening to their conversation with interest, asked.

“Well, I have a good intuition. This calmness and leisure, so different from our usually chaotic emergency room, feels like the calm before the storm.”

“Lee, are you writing a novel?”

“What I mean is, I think a critical patient is about to come.”

“What!?”

“……!”

As soon as they heard those words, both nurses reacted as if they had heard something they shouldn’t have.

“Lee, I think you just jinxed us with that statement.”

“The youngest is right. How can you say such a bad thing?”

“My intuition is right. And it’s all because of the Fanta among us.”

“Ugh! Why are you being so unlucky, Lee?”

Just as Lee Chan-hee’s continued Fanta talk made the senior nurse speak sharply, the youngest nurse pointed to the transparent glass door of the emergency room entrance.

“Oh! I don’t think Lee’s intuition is right. Look over there. It looks like a patient is coming.”

Beyond the transparent glass door that the youngest nurse pointed to, an adult man was walking in.

“Phew! Thankfully, he’s walking in, so it doesn’t seem like a critical patient, right? Let’s hope Chan-hee’s intuition is wrong this time.”

“I guess so.”

Lee Chan-hee, scratching her head in embarrassment, approached the shabby-looking man in his 50s who entered the emergency room.

“I came to see a doctor.”

“Where are you…!”

Lee Chan-hee, who was smiling and responding to the man’s words, suddenly stopped speaking, inhaled, and slightly turned her head before responding again.

“Where are you uncomfortable? First, please use the blood pressure machine here to check your blood pressure.”

“You can take your hand out. Where are you uncomfortable?”

“Well, it’s not that I have a clear pain anywhere, but I came because I’m vomiting blood.”

“Blood?”

“Yes.”

“Did it come out in your stool too, by any chance?”

“It came out in my stool too.”

“How long have you been seeing blood?”

“Not long. Today… it seems like it started around 1 PM, since lunchtime.”

“Why were you vomiting?”

“Well, I drank a lot of alcohol during the day.”

The patient very confidently told the story of drinking alcohol since the afternoon.

“And when I vomited, I saw a handful of blood coming out.”

“Do you have any abdominal pain?”

“No.”

“Diarrhea?”

“No diarrhea either.”

“Do you have any underlying diseases?”

“Underlying diseases?”

“Yes. High blood pressure or diabetes, things like that.”

“I don’t have those, but I had surgery two months ago.”

“Surgery?”

“Yes, I had major surgery at a university hospital.”

“What kind of surgery?”

Lee Chan-hee asked carefully, writing the patient’s information on the monitor.

“What was it… that thing… something about the duodenum or pancreas, they said there was a lump there and they had to remove it.”

The man, who himself called it major surgery, didn’t know exactly what kind of surgery he had received.

“You don’t know what kind of surgery you had?”

“They removed it all.”

“Pardon?”

“The doctor there said it was major surgery. What did he call it? Some kind of whistle surgery? I’m not a doctor, so I don’t remember the name well. Haha!”

“Sir, how can you not know about your own body after having surgery like that?”

Usually, when people have surgery, they learn about it in detail, even if it’s a simple procedure.

To exaggerate a bit, Koreans, after getting sick and having surgery, know so much about their illness that they are almost semi-experts. But Lee Chan-hee was puzzled that this man, who had major surgery, was talking about it as if he were watching a fire across the river [being indifferent to something that concerns him].

Especially since he came to the hospital with an abnormal reaction in his body, it was absurd that he didn’t know about the surgery he had recently.

“What do I know? They just said I could die within six months if I didn’t have the surgery, so I had it.”

“Oh, so you had cancer?”

‘Stay calm! Lee Chan-hee, stay calm!’

Lee Chan-hee responded to the man as calmly as possible.

“At first, they suspected cancer. So I had it, and they did it for over 7 hours, but it wasn’t cancer. They said it was fortunate, but those damn doctors did that major surgery for nothing, as if it wasn’t their body. Anyway, I had major surgery.”

“Ah! Whistle surgery.”

As she listened to the patient’s story, Lee Chan-hee, who kept thinking about whistle surgery, remembered what kind of surgery he had received.

“Didn’t you have a Whipple’s operation (a surgery to remove the head of the pancreas, duodenum, gallbladder, and other anatomically close compartments when a specific area of an organ located in the epigastric region and fixed to the posterior abdominal wall needs to be removed due to cancer, etc., considered the largest and most difficult surgery in surgery)?”

“That’s right! That’s it! Oh, young doctor, you’re so smart. Whipple, that’s it.”

“I see. You thought you had cancer, but thankfully it was benign? You’ve been through a lot.”

“What do you mean, I get so angry just thinking about it that I wake up in the middle of the night.”

“So you didn’t have any complications after the surgery?”

“No, I was fine and came out. I was there for about ten days, and after that, for two months after the surgery, nothing happened.”

“You ate well too?”

“Of course. I digested well and had no problems.”

“Hmm! It seems like your current symptoms are bleeding in the digestive system.”

“Yes, actually, I went to a local internal medicine clinic earlier, and the doctor there told me to go to the emergency room, to a place where they can do an emergency endoscopy.”

“I think so too. First, you need to go to a place where emergency endoscopy is possible… I don’t know if we can do it right now.”

Lee Chan-hee turned her gaze to the senior nurse, who she had called a Fanta, and she approached, making an X with her hands.

“Lee, we can’t do an emergency endoscopy right now. The internal medicine doctor isn’t on duty today, and the director is in the operating room.”

“Oh, that’s right. Sir, I’m sorry, but we can’t do an emergency endoscopy right now, so you’ll have to go to a place that can.”

“Still, do it for me.”

“Pardon?”

Even though she clearly apologized and explained the reason, the answer that came back from the patient was too confident.

“I don’t want an endoscopy either.”

“Yes?”

“Just do that thing, the blood test.”

“Sir, we can do that if you want, but it’s not the best approach for you right now. If you go to another emergency room now, you may have to do it again, and what you need right now is to stop the bleeding through an endoscopy, so you’re just wasting time.”

“Oh, geez. It’s okay. It’s my body, so do the blood test first.”

Sometimes, when you meet patients who don’t listen to the doctor and insist on their own way, you feel frustrated. These patients don’t give in, no matter how good the doctor is, and insist that only their words are right.

In such cases, it was not easy for the medical staff dealing with the patient.

“Sir, of course, it’s your body, so we can’t force you, and we can’t refuse treatment if you want it.”

Lee Chan-hee tried to persuade him gently with a calm mind.

“But right now, you need an emergency endoscopy quickly, and if you waste time with other tests, it can actually harm you.”

“I know what the young doctor means, but just do as I say. It’s my body, not the doctor’s.”

“……!”

“What is it! You can tell if you take that CT scan.”

“Sir?”

“Ugh! Gee! Man. Why do you have so much to say when I’m paying for it with my own money? Huh?”

Lee Chan-hee was gradually reaching her limit with the patient’s continued unreasonable attitude. But she couldn’t get angry with the patient.

It’s not a joke, but sometimes when dealing with such patients, her respect for Tae-kyung welled up again.

Because no matter how unreasonable the patient was, he never lost his composure and eventually persuaded them to agree.

Lee Chan-hee also wanted to do as Tae-kyung did, of course, but she was at a loss with patients who insisted without looking back and forth like now.

“Sir? Okay. Come inside first.”

The senior nurse, thinking it wouldn’t work, hurriedly led the unreasonable patient inside.

“What’s wrong with that person!”

Lee Chan-hee spat out in a low voice with a frustrated tone.

“Chan-hee, calm down. There are people like that sometimes. Let’s just do the blood test and CT scan as they want and quickly transfer them to a hospital that can do an endoscopy.”

“Ha! It’s frustrating.”

“Who says it isn’t? Just ignore it. It’s no use persuading that patient. You know that.”

The nurse wanted to prevent unnecessary disputes with patients who didn’t listen, based on her past experience. She knew very well that such patients would not give in in the end.

“That’s right. What’s the point of fighting with someone like that? Let’s do that.”

Doctors are also human.

Sometimes, when things like this happen, they don’t feel good at all. Lee Chan-hee, feeling upset, deliberately didn’t approach the patient while he was in the emergency room.

She was just going to do the necessary tests quickly and send him away.

“Sir, first, we need to inject contrast dye to take a CT scan. There are side effects when injecting contrast dye…”

“That’s it! I’m not doing any of that.”

“Pardon?”

“I’m not injecting contrast dye. Just take it quickly.”

Lee Chan-hee, who was listening to the conversation between the nurse and the patient nearby, was angry, but as the nurse said earlier, she decided to do as the patient wanted and send him away.

“Nurse, get the consent form and do as the patient wants.”

“Yes.”

After that, as the patient requested, they had no choice but to proceed with the CT scan without injecting contrast dye.

Without contrast dye, it is impossible to identify blood vessels, so it is impossible to know whether there is bleeding in the digestive system. However, it was possible to know the structural changes, such as abnormalities in the area connected by surgery.

“Lee, the CT results are out.”

At the nurse’s words, Lee Chan-hee sat in front of the monitor and checked the results.

“The CT shows that he received a PPPD (pylorus preserving pancreaticoduodenectomy, a procedure similar to Whipple’s operation but preserving the gastric outflow area), and the connection sites are fine.”

“That stubborn guy said he had no problems for two months.”

“That’s right. Now, I’ll explain the CT and find a hospital that can do an endoscopy for transfer.”

“Yes, doctor.”

Lee Chan-hee approached the bed where the patient was to explain the results and opened the curtain.

Sharrrr-

“Sir?”

“Yes.”

“I just checked the results, and as I explained earlier, the CT doesn’t show the boundaries clearly because we didn’t inject contrast dye. But it doesn’t seem like there’s anything wrong with the surgical site. Of course, the surrounding blood vessels are not visible, so it’s not certain, but it seems like there’s bleeding inside the digestive system. As I said before, I’ll find a hospital that can do an endoscopy for transfer. And I’ll put the video on a CD for you.”

“Ah… I see.”

At the detailed explanation, the patient answered briefly as if it were someone else’s business.

After that, Lee Chan-hee started calling around to find a place nearby where emergency endoscopy was possible.

“Hello? Yes, he’s a 52-year-old male. Yes, there’s nothing special in his past history, but he has a surgical history. Yes. And…”

“Oh my! What is this?”

Lee Chan-hee, who was on the phone, turned her head at the sudden loud noise.

“Yes, please contact me after checking. Yes. Thank you.”

After quickly finishing the call, she approached the nurse who raised her voice.

“What’s going on?”

“Doctor, the patient is gone.”

“Who? That stubborn patient?”

“Yes.”