Fifth Vital [EN]: Chapter 306

307. Not a Drizzle, but a Torrent

Just as I was about to ask why, the phone in my gown pocket rang insistently.

“Just a moment. Yes, this is Lee Chan-hee.”

– Dr. Lee, it’s about that ascites [fluid buildup in the abdomen] patient from earlier.

“What about that patient?”

The call from the emergency room nurse concerned patient Go Myung-hwan, who had undergone a paracentesis [a procedure to drain fluid from the abdomen] 20 minutes prior.

– His ascites is acting strangely.

“What do you mean, strange?”

– About 1L of ascites drained, and then it just stopped?

“What? That can’t be right. He was so full…”

Just by looking at him, Go Myung-hwan’s abdomen was distended with ascites, so Lee Chan-hee was puzzled.

– Exactly! I think you need to come and take a look.

“Maybe the patient shifted. Okay, I’ll head down now.”

This wasn’t uncommon. Often, the ascites flow would cease if the patient moved or the catheter dislodged slightly.

In those instances, repositioning the catheter usually restored the flow. That was the typical course of action.

“Emergency room call?”

“Yes. I’ll ask you later.”

“Okay, go quickly.”

Lee Chan-hee decided to postpone his question for Euijin and went to the emergency room first.

“Huh. That’s odd.”

Upon arriving at the emergency room, Lee Chan-hee immediately began manipulating the catheter in Go Myung-hwan’s abdomen.

“It was draining well, and then it suddenly stopped.”

“Excuse me…?”

Go Myung-hwan, who had been silently observing, spoke to Lee Chan-hee.

“Doctor?”

“Yes, patient.”

Lee Chan-hee replied while continuing to adjust the catheter.

“I think you might need to reinsert it.”

“Ah, yes. I understand. Then I’ll try another puncture nearby.”

Go Myung-hwan spoke casually about a potential complication, so Lee Chan-hee quickly prepared for another puncture.

Gathering new instruments and materials, he attempted the procedure again. When the thick needle pierced Go Myung-hwan’s abdomen, he flinched.

‘Oh! That’s strange…’

Something felt wrong. Unlike before, no ascites flowed out.

“Patient, just a moment. I’ll try a few more times.”

“Yes.”

Lee Chan-hee carefully withdrew the needle and then pierced the area beside it. Then he removed the needle and pierced below it.

“…!”

Each time, Go Myung-hwan flinched, his expression growing increasingly pained.

“Ugh!”

Go Myung-hwan glared at Lee Chan-hee as if ready to grab his collar. Piercing the abdominal wall was quite painful. It was no joke; it really hurt.

Repeatedly stabbing raw flesh without anesthesia was enough to turn even the closest friends into enemies.

Lee Chan-hee, as a medical professional, understood the pain, so he, too, grew increasingly anxious—no, more accurately, embarrassed.

‘Why is this happening?’

His embarrassment stemmed from the fact that this procedure was usually straightforward, and he had never encountered a situation where it failed after performing it on so many patients.

He had followed the correct procedure as always, yet this situation was baffling. And, more than anything, it was strange that the ascites had initially drained well before abruptly stopping.

‘Just one more time. Let’s try one more time.’

Lee Chan-hee started to become overconfident.

He had performed the procedure successfully thus far, so he decided to try again, assuming it would naturally work out.

“Patient, I’ll try piercing here one last time.”

The last place he attempted to pierce was higher than his usual puncture site. It was also a location he would typically avoid.

Thump-

“Ugh!”

As soon as he pierced, a scream erupted.

“Oh my! Doctor, stop now. It hurts too much!”

Go Myung-hwan complained in a whiny voice, but Lee Chan-hee, engrossed in the procedure, didn’t register it.

Because rather than simply being focused, an even more alarming situation was unfolding.

Blood was flowing out of the catheter.

“…!”

The most dreaded side effect of ascites puncture is this.

Because the organs in the abdominal cavity float due to the ascites, the probability of piercing them is quite low, but the risk always exists.

So, although it wasn’t a difficult procedure, it was a dangerous one.

If an organ is punctured, blood may continuously flow into the abdominal cavity, and if the intestines are pierced, the contents of the intestines may leak out, necessitating emergency surgery.

Therefore, when performing ascites puncture, two things must be carefully monitored.

First, whether blood is coming out of the catheter, and second, whether gas is escaping.

But instead of yellow ascites, bright red blood was flowing out, even dripping.

To anyone, it was dripping, but to Lee Chan-hee, who was witnessing blood for the first time during ascites puncture, it seemed like a torrent, not a drizzle.

‘I’m screwed!’

“Ah! Doctor, it hurts so much,” Go Myung-hwan said, wincing in pain.

“Did I fail again?”

“That’s… just a moment.”

Clearly, Lee Chan-hee should have stopped there. But in his flustered state, he pulled out the catheter and immediately pierced the area next to it again.

In an instant, he was overwhelmed by the desire to completely drain the patient’s ascites and the patient’s irritated complaints, causing him to act irrationally.

He should have reported to Tae-kyung as soon as he saw the blood.

“Argh! Stop stabbing me!”

This time, no ascites came out either. Lee Chan-hee’s panicked mind cleared, and he regained his senses and tried to withdraw the catheter.

He now realized that he needed to report to Tae-kyung quickly, manage the situation, and then face the consequences.

But then he heard a sound.

Whoosh-

It was faint, but he distinctly heard the sound.

“…”

It was the sound of gas escaping, which he had feared the most. Gas escaping meant that he had punctured the intestines.

Because there was no other source of gas in the abdomen besides intestinal gas.

‘Ha! Let’s get a grip.’

Lee Chan-hee slowly removed the catheter. At the same time, cold sweat began to trickle down his spine.

“Patient, please wait a moment, and our director will come and see you. Please wait a moment.”

Go Myung-hwan frowned and turned his head away, saying nothing.

Clatter-

“Dr. Lee? How did…”

Lee Chan-hee couldn’t even hear the nurse’s question about the patient’s condition. He simply bolted out of the emergency room like a madman.

“Nurse Lim!”

He urgently called out to Nurse Lim Jeong-sook, who was working at the reception desk.

“D-Director! Where is the director right now?”

“He just finished seeing an outpatient and is in the examination room.”

Clunk-

“D-Director!”

Hearing those words, Lee Chan-hee burst into the examination room like a man possessed and stood before Tae-kyung.

“What is it? Is there a patient in the emergency room?”

“T-That’s, well, um…”

“Chan-hee?”

“Yes, Director.”

“You messed up, didn’t you?”

“Yes!?”

Tae-kyung hadn’t known Lee Chan-hee for just a day or two; they had spent considerable time together. Just by observing his tone, eyes, and subtle expressions, he could roughly discern what had happened.

“Yes…”

“Tell me everything from A to Z, without adding or omitting anything.”

“Yes. Earlier, a male patient in his 60s came to the emergency room. I performed a paracentesis (ascites puncture) on that patient, and…”

Lee Chan-hee recounted everything that had transpired accurately and without embellishment.

“Hey! You!”

Tae-kyung, who had been listening intently, raised his voice as soon as his junior finished speaking.

“Why are you acting like this when you know better!”

“I’m sorry.”

“Let’s go right now.”

“Yes.”

Tae-kyung scolded him briefly and then rose from his seat and left the examination room.

There was no point in berating Lee Chan-hee now; the patient’s well-being was the priority.

Tae-kyung’s pace quickened.

If the intestines were indeed punctured, emergency surgery might be necessary.

“Director, this way.”

Clatter-

“Hello, patient. I’m Kim Tae-kyung, the director of our hospital.”

Tae-kyung, making eye contact with Go Myung-hwan as he approached the bedside, greeted him in his characteristically gentle tone.

At the same time, he immediately sensed that the fifth vital emanating from him was at stage 4 [a measure of a person’s life force or energy].

Fortunately, the smell wasn’t as intense as it should have been for stage 4, not enough to permeate the entire emergency room.

As expected, a strong odor should have been wafting from before entering the emergency room, but it was a relatively weak stage 4.

“Ah, yes. You’re the director. Hello.”

Even without hearing the word ‘director,’ Go Myung-hwan could tell that Tae-kyung was someone important, based on his years of experience visiting hospitals.

“Okay! Our patient, I’m going to examine your abdomen for a moment.”

Tae-kyung palpated Go Myung-hwan’s abdomen, pressing, poking, and tapping it with percussion.

“Patient?”

“Yes.”

“You seem to be experiencing a lot of discomfort right now, and it appears that our medical staff may have inadvertently injured the inside while trying to remove the ascites.”

“W-What!?”

“So, we need to conduct blood tests and imaging tests now.”

“Ha! No. If you just remove the ascites properly again…”

“Since we made a mistake, all medical expenses will be free of charge.”

“…!”

Go Myung-hwan reacted slightly, flinching at Tae-kyung’s offer of free treatment.

“Then we’ll proceed, and since you may need hospitalization or surgery, we’ll start with a CT scan and blood test.”

“Excuse me, Director? Did you just say surgery?”

“Yes, if there is damage to internal organs, you may need surgery.”

“Damage… Then, will I get compensation for that?”

“If required by law, it will naturally be provided.”

“…!”

Lee Chan-hee, who had been listening to their conversation, was dumbfounded. This kind of exchange was usually unheard of. Afterward, Go Myung-hwan went to get the tests, guided by the emergency room nurse.

“Director, I’m sorry. I’m really sorry.”

Lee Chan-hee said, bowing his head with a dejected expression. It wasn’t a lie; he was genuinely remorseful to the point of being overwhelmed.

“If the patient really sues, then…”

“It’s okay. I’ll take responsibility.”

Tae-kyung said firmly, looking at his junior, who was at a loss for words.

Hearing those words, Lee Chan-hee was surprised and widened his eyes, lifting his head.

He knew that the words ‘take responsibility’ were not just comforting words but were said sincerely, which made him feel even more sorry.

“What you did is what I did, trusting you and entrusting the emergency room to you. And if there’s a legitimate basis for a lawsuit, we should naturally compensate. There’s no need to cover it up and withhold information from the patient because you’re afraid of that.”

“…”

“Just admit that you did wrong. It’s okay. Of course, only do that in our hospital. If you work somewhere else and something like this happens, then you decide on your own.”

Lee Chan-hee wanted to retort that he would never go to another hospital, but it wasn’t the appropriate time to say such a thing.

It seemed better to simply listen to Tae-kyung’s words now.

“Because other hospitals won’t provide compensation at the hospital level like our hospital does; they’ll tell you to handle it yourself.”

“Ah…”

“The hospital I used to be at was almost like that. I’m the director now. So, I can authorize all the hospital expenses within my discretion. In fact, all doctors would want to do it like me. But the money… and the hospital policy is like that, so they can’t do it even if they want to. Anyway, save your apologies for later, and let’s see the patient’s results first.”

“Yes, I understand.”

The somber conversation between the two ended, and time passed as they awaited the patient’s test results.

One hour later-

“But this is a bit…”

Tae-kyung’s expression was somewhat ambiguous as he reviewed Go Myung-hwan’s results.

“It’s strange.”