Fifth Vital [EN]: Chapter 200

200. Dead Patients Don’t Come Back

“I don’t think so… Look at this.”

The nurse held up the IV needle that should have been in the patient’s arm.

“What’s going on here?”

“What do you think? Looks like he ran away.”

The nurse replied to Lee Chan-hee, who looked dumbfounded, as if it were nothing unusual.

“Ran away? Why?”

“Can’t you tell? That patient didn’t look like he had any money.”

It wasn’t just judging by appearances.

“That man is homeless.”

The nurse was right. The stubborn man in his 50s, who hadn’t listened to the doctor, was indeed homeless.

The reason Lee Chan-hee had unconsciously turned his head when he first saw him was because of the musty smell.

“Still, did he really run away because of money?”

“Of course, he ran away because of money.”

Choi Mona, who had returned from her rounds and was working at the nurse’s station, chimed in as if it were obvious.

“I’ve seen patients run away because of money at the hospital I used to work at.”

“Did you hear what Ms. Choi said? Dr. Chan-hee doesn’t know, but there are quite a few people who run away from the emergency room because of money.”

“I’m going to the restroom.”

Lee Chan-hee still had doubts, so he went to the restroom to check.

“Ha!”

“He’s not in the restroom, is he?”

“No, he’s not.”

Not only the restroom but also the lounge; he searched the hospital, but the man in question was nowhere to be seen.

“See? I told you he ran away.”

“No, why was he so stubborn if he was going to run away like this?”

“I don’t know. We won’t know until we catch him and ask him.”

“Seriously! This is ridiculous.”

“What’s with the ‘seriously’ again?”

Tae-kyung, who had finished surgery, sat next to Lee Chan-hee, who was still dumbfounded.

“Ah! Doctor. Did the surgery go well?”

“Yeah. It was a simple case, so it went well.”

“That’s a relief.”

“But what’s wrong?”

“Ah, you know. Earlier…”

Lee Chan-hee told Tae-kyung, who was curious, about the absurd story of the homeless patient who had run away.

“Seriously! If you don’t have money, you should at least be kind. I was really upset. Frankly, Korean people have a lot of compassion, so if he had just honestly said he didn’t have money, they would have helped him, but he ran away… You’re dumbfounded too, right?”

“…”

Lee Chan-hee turned his head towards Tae-kyung, who wasn’t answering, and saw Tae-kyung staring intently at the homeless man’s CT scan. But something was strange.

“Um, Doctor?”

Tae-kyung’s expression, who was carefully looking at the CT scan, gradually hardened, and his focused brow furrowed sharply.

‘No, why is his expression suddenly like that?’

Lee Chan-hee, feeling increasingly uneasy, called Tae-kyung again in a small voice.

“Doctor…?”

“Hey, Chan-hee?”

“Yes? Yes.”

Lee Chan-hee flinched at the serious call.

The fact that Tae-kyung called him by his name instead of ‘Dr. Lee’ meant something was wrong. But in the midst of the tension, an unexpected word came.

“Go catch him.”

“Yes!?”

“What do you mean ‘yes’?”

Tae-kyung’s voice was louder than before.

“I said, go catch him!”

“Um, Doctor, of course, it’s wrong for the patient to run away, but if you tell me to catch a patient who ran away tonight… And what method am I supposed to use to catch someone who ran away on purpose…?”

Lee Chan-hee’s voice gradually faded, but he said everything he had to say.

“Chan-hee, this is a big mistake on your part.”

“You think so too, right? It’s wrong to run away without paying, right?”

“No, it’s a big mistake to let the patient go like this.”

“Ah…”

Lee Chan-hee knew that too.

If it were someone else, no, if it were another doctor, he wouldn’t know, but Tae-kyung had a big heart for patients, so he probably felt sorry for the patient who ran away.

“But Doctor, I didn’t tell him to go, he ran away.”

“That’s not it… Ha!”

Tae-kyung sighed briefly.

“Actually, I should be angry with you right now, but it seems like you don’t understand, so I won’t get angry for now.”

“Yes? Did I do something wrong?”

“No. It’s not wrong, but rather ignorant.”

“Ignorant?”

“Yes. You said that patient had bloody stools, right?”

“Yes.”

“So you thought he needed an emergency endoscopy [a procedure where a camera is inserted into the body to view internal organs]?”

“Yes. It’s definitely bleeding inside the digestive system. The internal medicine department said so too.”

“Okay! The internal medicine department can say that. But we’re not the internal medicine department. You need to know.”

Tae-kyung, who would have already raised his voice, calmly continued his explanation.

“It’s highly likely that this is not internal bleeding.”

“Highly likely?”

“And it’s highly likely that this patient won’t make it through tonight.”

“Yes!? Won’t make it through tonight…”

Lee Chan-hee was startled by the terrifying sound and continued.

“But wouldn’t it be difficult to die overnight just because you have bloody stools?”

“If it’s bleeding inside the digestive system, it might be okay. But this patient’s bleeding is not inside the digestive system.”

“But the bloody stools…”

“That’s right. There is bleeding in the space inside the digestive system, that is, inside the stomach or intestines, so bloody stools come out. That’s very common sense and medically correct in most cases. But people who have had PPPD [Pancreaticoduodenectomy] or Whipple operations are exceptions.”

Lee Chan-hee didn’t easily understand what Tae-kyung was saying.

“I’m sorry. To be honest, I don’t understand what you’re saying right now.”

“Come here.”

“Yes, Doctor.”

Tae-kyung called Lee Chan-hee and quickly accessed the medical paper search site. And he entered two words in the search box.

[PPPD], [Pseudoaneurysm]

“Pseudoaneurysm?”

“Yes. Pseudoaneurysm.”

“But what does this have to do with it?”

“Chan-hee, I want you to become a great doctor. But the most basic virtue of a great doctor is the ability to distinguish dying patients. For that, you need knowledge… I’ll give you exactly 3 minutes from now. Read any of the papers here quickly.”

“Yes?”

“2 minutes 59 seconds, 58 seconds. Time is running out.”

“I’m reading. I’m reading.”

At the sound of the countdown, Lee Chan-hee fixed his eyes on the monitor and began to read, and Tae-kyung listened to the nurse in charge of the homeless man about the situation and headed to the bed where the patient had been.

Charyuk-

“…!”

When he opened the curtain, as expected, the fifth vital smell remained faintly.

The patient was not in front of him, but the remaining smell was clearly a terrible fecal odor, high even among the 3 stages [a scale used to measure the intensity of fecal odor].

And in the meantime, Lee Chan-hee was quickly reading the paper.

“Patients undergoing Whipple or PPPD surgery may develop fistulas [abnormal connections between organs] due to digestive enzymes at the connection between the pancreas and the small intestine… Pseudoaneurysms [a collection of blood that forms outside of an artery or vein] can occur for various reasons like this.

Symptoms may include intra-abdominal bleeding, but may also appear as bloody stools, and there are often no symptoms such as pain…

The reason why it appears as bloody stools rather than intra-abdominal bleeding has not yet been revealed… There may be no symptoms for 2 months or even 3 months. If appropriate treatment for pseudoaneurysm is not performed, the patient may die due to massive bleeding.”

The patient may die. Death! Death…

Lee Chan-hee’s pupils shook violently as he repeatedly read the last sentence.

‘He may die from massive bleeding?’

Lee Chan-hee was ashamed and embarrassed and didn’t know what to do. He wanted to hide in a rat hole.

He had been repeatedly seeing only the unkind and stubborn side, and he didn’t know the patient’s urgent situation, who might die today.

Of course, bleeding inside the digestive system is also an emergency. But pseudoaneurysm can be a super emergency that can’t even be compared.

If an aneurysm [a bulge in a blood vessel], in which part of the artery wall collapses and gradually swells, bursts, a large amount of bleeding pours out into the abdominal space.

If that happens, dying within a few hours is perhaps natural.

“Lee Chan-hee?”

“Yes, Doctor.”

“You were surprised that I didn’t get angry like usual, right?”

“Yes, a lot.”

Lee Chan-hee nodded and replied. If it were Tae-kyung, he would have roared in this situation, but today it was strange that he was still maintaining his composure.

“Looking at it, I can see that you’re blaming yourself, so I don’t think I need to get angry.”

“I’m sorry. I was ignorant.”

It wasn’t wrong not to know, but a doctor shouldn’t be like that.

Lee Chan-hee thought it was his fault that he was ignorant because doctors shouldn’t not know this part of the patient.

“Don’t be discouraged. Hold your head up and look at me. Anyone can make mistakes. And don’t do it next time. But remember that if a patient dies due to our mistakes or ignorance, there is no next time for us.”

Tae-kyung continued softly, but the content was sharply embedded in Lee Chan-hee’s head.

“Dead patients don’t come back. Therefore, doctors should not make mistakes. No, at least that means you shouldn’t kill a patient because you don’t know. That’s why you have to keep studying. Do you understand what I’m saying?”

“Yes, Doctor.”

“Just as you and I and everyone here are precious, that patient is also a precious person. You shouldn’t dwell on the fact that patients are unkind. We just need to focus on preventing patients from losing their lives as doctors.”

“I will keep that in mind.”

“Chan-hee, you’re embarrassed and can’t forgive yourself right now, right?”

“…Yes.”

“Then I’ll give you a chance to make up for it. How about it?”

“Of course. What should I do?”

“Let’s go!”

Tae-kyung said, putting his hand on Lee Chan-hee’s shoulder.

“Huh? Go where…?”

“Where else! We have to go find that patient.”

“Fi, find the patient… Now?”

“What are you doing! There’s no time.”

“Ah, yes. I understand.”

Lee Chan-hee, feeling that Tae-kyung was serious, was taking off his gown.

“Call first.”

Choi Mona, who had been watching the whole situation, said.

“Unfortunately, the number that patient wrote down is a non-existent number.”

Nurse Lim Jeong-sook, who had grasped the whole situation, replied.

“What? Is Ms. Choi going too?”

Tae-kyung asked Choi Mona, who was quietly taking off her gown.

“I can run much faster than Dr. Lee. I’ll look for him too.”

“Okay. We’ll find him faster if there’s one more person.”

Tae-kyung didn’t stop Choi Mona because the homeless patient was so urgent. Fortunately, there were few patients in the emergency room today, and no new patients had come in yet.

Finding a patient who might have massive bleeding on the street was much more important now than staying still in the hospital.

“Ms. Lim, call Dr. Jung to the emergency room and contact me immediately if an emergency occurs.”

“Yes, I understand.”

Tae-kyung, who had instructed Nurse Lim Jeong-sook, came out with Lee Chan-hee, Choi Mona, and Jang Deuk-chil.

“Ms. Choi, check around the main gate of the hospital with Agent Jang.”

“Yes, I understand.”

“I’ll go to the convenience store with Dr. Lee through the parking lot. Call me immediately if you find him. Let’s go quickly!”

“Yes, Doctor.”

Tae-kyung, who gave the instructions, ran out the back door with Lee Chan-hee, and Jang Deuk-chil quickly went out the front door with Choi Mona.

Thus began a moonlit chase surpassing moonlit gymnastics to save a homeless man like a time bomb that could explode at any moment.