Fifth Vital [EN]: Chapter 227

Fifth Vital Sign – Episode 227 (227/502)

227. Strapped with Grenades

“My unit’s soldier is sick and came here, but there’s been no explanation until now…”

Just as Choi Tae-shik, misunderstanding the lack of attention, was about to protest, he heard,

“Guardian, that patient could die tonight.”

The utterly unexpected response instantly shut his mouth.

“……!”

“W-What do you mean by that…”

“Exactly what I said. He could die.”

Tae-kyung spoke to Choi Tae-shik in a low voice, pronouncing each word precisely.

He conveyed the seriousness of the situation without any emotion. He strongly implied that courtesy or emotional expenditure were not important right now.

He didn’t raise his voice or curse, but Choi Tae-shik immediately recognized it in that brief moment of less than a second.

After all, he was a military officer.

He was a soldier whose job involved adopting appropriate attitudes and actions once he grasped a situation.

Therefore, he could tell that the doctor’s words, like a bolt from the blue, were not a lie.

“Ah, yes… Should I explain this to his parents, his family?”

Choi Tae-shik’s tone, which had been sharp, became polite as if flipping a coin, now that he had fully grasped the situation.

“Yes, if you can reach them or if they come, please put them on the phone with me.”

“…Understood.”

While the atmosphere between Tae-kyung and Choi Tae-shik grew heavier, Choi Mona, having been contacted by Lee Chan-hee, hurriedly entered the emergency room after finishing her work at the ward.

Due to the serious atmosphere between the two, Choi Mona was assessing the situation from a slight distance.

“Hey! Choi, did you see that?”

Lee Chan-hee, having seen another patient, approached Choi Mona and spoke to her.

“That guy had a strong presence, but he was eventually subdued by the teacher’s aura. Our director is the best after all.”

“…….”

“But, you know… I’m sorry to ask this in the middle of all this, but can I ask you just one thing?”

“What is it?”

“Well, that…”

Lee Chan-hee carefully asked in a very small voice, getting close to Choi Mona’s ear.

“Is that lanky guy your boyfriend?”

“……!”

“No, I’m just curious. It’s not like I’m interested in you or anything…”

“He’s family. Are you satisfied now?”

“F-Family! That lanky guy is your brother? Or younger brother?”

Choi Mona, with her trademark chic expression, left a word and moved towards Tae-kyung and Choi Tae-shik.

“Please contact the intensive care unit and tell them a patient is coming.”

Leaving Choi Tae-shik, who was standing blankly with a dumbfounded expression, behind, Tae-kyung was rapidly issuing orders.

“Yes, understood.”

“Don’t forget to check the additional orders I gave.”

“Yes, Director. Excuse me, are we using restricted antibiotics?”

“That’s right.”

Restricted antibiotics cover a very wide range of bacteria, and if overused, they can lead to resistance, leaving no alternative drugs.

Therefore, it is correct to perform a culture test and use them after seeing the results. But that only matters when the patient is alive; otherwise, it’s useless.

Tae-kyung’s mind was now flooded with numerous thoughts and medical knowledge on how to save Kim Sung-hwan.

His mind was complex because he had to extract the most correct and important things from that overflowing medical knowledge to save the patient.

“And a culture test will also be done. Also, do an arterial blood gas test and full monitoring of blood pressure, EKG [electrocardiogram], etc., in real-time. If the blood pressure drops—no, what was the patient’s blood pressure when he arrived?”

“Systolic was 85.”

There was no point in asking about the body temperature. It was definitely high.

“The body temperature is 39.3 [degrees Celsius].”

As Tae-kyung expected.

“Excuse me, Doctor, what should I tell the family about the diagnosis?”

Choi Tae-shik, who seemed to be pondering for a moment, cautiously approached Tae-kyung and asked.

“Sepsis.”

“Sepsis?”

“Yes, in the patient’s case, it’s a severe systemic condition.”

“If it’s sepsis, is it a lung disease?”

“No. It’s not that lung, but ‘sepsis’ as in putrefaction [the process of decay or rotting]. First of all, shouldn’t we tell the family the detailed situation when they arrive? I think that would be better…”

“Yes, but I also need to report to the unit. Please explain it to me first.”

“Then come this way for a moment.”

Tae-kyung decided to turn on the CT [computed tomography] screen he had been looking at earlier and explain it to Choi Tae-shik. The screen showed a black and white image of the inside of the abdomen.

“I don’t understand any of it, but something looks very messy.”

Choi Tae-shik whispered in a small voice after staring intently at the screen for a short time before hearing the explanation.

“Yes, you saw it accurately. The patient’s abdomen is full of pus right now. The beginning was right here, this part. It seems the initial cause was appendicitis, which is known as appendicitis to the general public.”

“Appendicitis… Isn’t appendicitis not that serious of a disease?”

“Usually, that’s right. But if it gets this severe and ruptures, it becomes peritonitis [inflammation of the peritoneum, the membrane lining the abdominal cavity] and can lead to a condition like the patient’s. It’s a common disease, but it can certainly lead to death, and some of the patients I’ve seen have died from it.”

“Then is the soldier’s condition serious right now?”

“Yes, it’s serious. Something big could happen at any moment. First, we’ll go to the intensive care unit and treat the patient, and I’ll give additional explanations when the guardians arrive.”

“I don’t know much, but if it’s this severe, shouldn’t we operate right away?”

Concern was growing more and more on Choi Tae-shik’s face.

“If surgery is needed, we will definitely do it. Of course, the patient needs it. But there are medical considerations. The appropriate time is not yet clear, so I’ll explain the details to the family.”

“Ah! Yes, I understand.”

In fact, Tae-kyung couldn’t be sure of that time right now either.

If the inflammation in the abdomen is this severe, it is generally better to alleviate the inflammation with strong antibiotics first and then perform surgery.

The surgery is also easier, and the prognosis can be better. But if it’s something that can never be controlled with antibiotics, then the story is different.

That cannot be determined with a CT scan either.

It is because it must be judged by looking at the patient’s condition afterward. And that responsibility was entirely Tae-kyung’s.

Kim Sung-hoon, who had arrived at our hospital contemplating suicide and desertion at the edge of a cliff, was facing an entirely unexpected situation and was being transferred to the intensive care unit.

“Oppa… [Older brother, as called by a female]?”

Choi Mona approached Choi Tae-shik, who had finished talking with Tae-kyung and was coming out of the emergency room with a serious face.

“Oh, Mona.”

“What happened?”

“He’s a new recruit, and he kept saying his stomach hurt, and he went to the medical unit, but I think the medical officer missed it.”

“Actually, that kind of thing sometimes happens in the military. Still, how did it end up like this…”

“I wanted to say that. But is there really no director here? That doctor from earlier seemed young? Is it okay? Why isn’t that director who changed your perception of patients here?”

As family, Choi Tae-shik knew Choi Mona’s personality well. Even at home, she was so blunt with patients that her parents often worried about whether she was okay living as a doctor.

Especially since his younger sister had frequently changed hospitals at one time, they were even more worried.

But one day, his sister, who had visited her parents’ house, told them that she had met someone who had changed her values as a doctor.

Choi Tae-shik was curious about what kind of person it was that had transformed the formidable Choi Mona.

“I heard that director is very skilled. I wish he would take a look at our soldier…”

“The director has been looking at him all along.”

“Where?”

“That person from earlier is our director?”

“What? That person? He’s so young?”

“What does being young have to do with being a director? Listen to me, Oppa. Consider it fortunate that you came to our teacher. That person is truly genuine in both character and skill. So don’t be so curt like you were earlier.”

“……!”

“What, why are you looking at me like that?”

“Seeing those words coming out of your mouth makes me think that person from earlier must be a real expert.”

“Is this the time for jokes?”

“It’s not like I can cry. My subordinate is sick and might die, so I have to pull myself together. I’m about to lose it right now.”

In fact, Choi Tae-shik’s mind was quite complicated right now.

It wasn’t just any matter, but a new recruit was sick and might die, so he couldn’t calm down easily.

“But is our soldier really in serious condition?”

“It’s serious. You heard the teacher’s explanation earlier.”

“I’m just saying that because ordinary people like me don’t understand those medical explanations well.”

“Think of that soldier as carrying a string of grenades all over his body that could explode at any moment. Do you understand now?”

“Ha! I’m going crazy.”

Choi Tae-shik, who immediately understood, took off his hat and let out a deep sigh.

“Damn it! To make matters worse, Private Lee’s first vacation is tomorrow. I don’t know how to tell his family about this.”

“You still have to tell them. That’s your job.”

“That’s right. I have to.”

“Tell them without startling them too much.”

Choi Mona patted Choi Tae-shik’s shoulder and entered the emergency room.

An hour later-

Tae-kyung was sitting in front of the computer in the examination room, barely eating the cold chicken pieces.

In fact, it was a late-night snack he had wanted to eat so much, but he couldn’t even touch it because of Kim Sung-hoon.

He was in serious thought right now, so he couldn’t even smell the savory oil.

Rather, it felt like the smell of Kim Sung-hoon’s fifth vital sign was lingering at the tip of his nose.

“Should I just open him up…”

Just as he was putting down the chicken he was holding and leaning his head back in the chair, the phone on the desk vibrated.

Rrrrrrrrr

“Yes. This is Kim Tae-kyung.”

-Director, it’s me. The patient with the perforated appendicitis. His consciousness is declining.

‘Damn it!’

Tae-kyung couldn’t help but curse inwardly as he listened to Nurse Lim Jeong-sook’s words.

He thought there was no other way now.

‘I’m opening him up no matter what.’

No, he must open him up. If he waited any longer, the patient could die.

“Contact the operating room right now and get the patient up immediately. Tell them to prepare about 4 units of blood because we’ll need to transfuse.”

-Right now? I thought we were going to use antibiotics first and see?

“There’s no time. Just get him up right away.”

-Yes, understood.

Hanging up the phone, Tae-kyung was heading straight to the operating room without delay.

Whirring-

As he entered the operating room, he couldn’t think of anything.

‘Frustrating.’

Kim Sung-hoon had a CT scan without using contrast dye earlier.

Because of that, the information that could be obtained from the non-contrast-enhanced CT was so limited that prediction was impossible.

There were no other findings besides appendicitis on the CT scan, but there could be other lesions since it was non-contrast.

Currently, it was exactly like jumping into enemy territory without any information.

“Director, are you doing it laparoscopically [using a small incision and a camera]?”

The nurse asked Tae-kyung, who was wearing surgical gown.

“Yes, I’ll try it first. But there’s a high possibility that I’ll have to do an open surgery.”

“Yes.”

“Dr. Jung, how’s the anesthesia?”

“Anesthesia is complete. You can start.”

The anesthesia had already been completed under Dr. Eui-jin’s lead.

“Alright! Let’s start the surgery.”

Just as Tae-kyung, who had announced the start of the surgery, was using tools to make a hole about 1cm in the abdomen to perform the laparoscopy,

“Ugh!”

“Ugh!”

The medical staff gathered in the operating room frowned and narrowed their eyes without exception.

“Whew! What a smell…”

It was a truly terrible stench.

It smelled like pus that had been stagnant and rotten. To be exact, it was the smell of rotten pus.

Only Tae-kyung was looking at the instrument that was making the hole with a calm expression in this stench.

‘Open surgery it is.’

Pus was coming out of the abdominal cavity through the instrument. It was sticky pus accompanied by a terrible smell.

“Laparoscopy won’t work. I’m opening the abdomen. Scalpel, please.”