Fifth Vital [EN]: Chapter 307

308. Hypothesis

Tae-kyung’s expression was unreadable as he examined Go Myung-hwan’s test results.

“That’s strange.”

He’d expected, based on Lee Chan-hee’s report of escaping gas and blood, a high probability of organ perforation. However, the numbers didn’t align with that at all.

Of course, the patient had liver failure, so the blood tests reflected that, but the indicators for organ damage were normal.

Moreover, the inflammation levels were also normal.

The CT scan didn’t show any air in the abdominal cavity, which is usually present when organs are damaged.

Lee Chan-hee, who was reviewing the results alongside him, felt a surge of relief mixed with confusion.

The CT scan showed no leaks from the organs, nor any blood in the abdominal cavity.

While CT scans aren’t 100% definitive, these results were certainly perplexing.

Go Myung-hwan’s CT scan showed the small intestine floating in the ascites [fluid buildup in the abdomen], and in some places, adhered to the abdominal wall.

“Chan-hee?”

“Yes, Doctor.”

“This is odd, isn’t it?”

“Yes… Looking at the CT scan, I’m starting to wonder if I misheard that sound earlier. But there were bloodstains, so I’m pretty sure I heard correctly…”

Lee Chan-hee tried to recall the moment, questioning his own perception.

“Did you notice anything unusual when you examined the patient’s abdomen?”

“The only thing that stood out was the surgery scar…”

“Exactly. And look at this CT scan. Doesn’t something seem off?”

“Ah, I’m not really seeing it…”

“This is just a hypothesis, but the patient has a surgical scar on his abdomen, right?”

“Yes.”

“And look at this CT scan. Normally, the small intestine should be floating freely in the ascites, but here, and here…”

Tae-kyung pointed precisely at the monitor. “Even with all that fluid, the small intestine is stuck to the abdominal wall, right?”

“Oh! Yes, that’s right.”

“Why would it be attached to the abdominal wall when there’s so much fluid?”

“Ah!”

As if struck by a sudden realization, Lee Chan-hee tapped his head. “Post-operative adhesion! It’s adhesions.”

“Right. Basic, isn’t it? The small intestine is adhering to the abdominal wall in places due to adhesions, creating compartments within the abdomen. So, when you drain the ascites, you only get the fluid from that specific compartment, not the rest.”

“Ah…”

“And here’s another hypothesis: it’s possible you did accidentally puncture the small intestine and a blood vessel.”

“But the patient’s condition is…”

“The wall of the small intestine is stuck to the abdominal wall, so even if it’s punctured, it might not leak into the abdominal cavity.”

“Is that even possible?”

“I’m reiterating, it’s just a hypothesis. How could someone with leaking organ contents sleep so soundly?”

Lee Chan-hee glanced at Go Myung-hwan as he listened to Tae-kyung’s explanation.

He was fast asleep while waiting for the test results, snoring softly.

“Seriously, this guy…”

“Alright! Shall we investigate then?”

“Yes?”

“We’ve formed a hypothesis, now we need to confirm it.”

“So, we operate and open up his abdomen?”

“You little…”

*Slap-*

Tae-kyung, unable to contain himself, playfully slapped Lee Chan-hee on the back.

“You’re just asking for it. You’ve been out of it all day. Focus!”

Lee Chan-hee stared blankly at Tae-kyung, a slightly embarrassed but brighter expression on his face.

“Just because you’re in surgery doesn’t mean you immediately jump to opening someone up!”

“I’m sorry.”

“That patient has liver failure, and look at the blood test. He’s already experiencing blood volume depletion due to the ascites and is in the early stages of kidney failure. Do you think he can handle general anesthesia and abdominal surgery right now?”

“No.”

“We always have to weigh the risks and benefits for the patient before performing any procedure or surgery. Putting him under general anesthesia in this condition could be fatal.”

“Ah! Then…”

“Then what could it be?”

“Sonography (ultrasound).”

“Right, ultrasound. Are you going to boil the emergency room ultrasound machine and eat it? This is exactly when you should use it. Go check it out!”

“Yes, Doctor.”

“Check it thoroughly.”

“Yes, I will check it thoroughly.”

Lee Chan-hee responded with renewed energy, feeling hopeful that Go Myung-hwan might be alright.

Above all, because Tae-kyung was the one suggesting it, his hope felt solid.

The worry that his mistake might lead to surgery for a patient in such a fragile state began to dissipate.

“Patient, we’re going to do an ultrasound now.”

“Ultrasound…?”

Go Myung-hwan, still groggy, replied in a daze.

“Yes, we need an ultrasound to accurately assess your condition.”

“Okay.”

Lee Chan-hee applied gel to the ultrasound probe and began a careful examination.

“How is it?”

After a few minutes, Tae-kyung came up behind Lee Chan-hee, looked at the screen, and asked.

“It’s just as you said, Doctor. There are no unusual findings in the abdominal cavity, and the small intestine is fixed to the abdominal wall in certain areas.”

“Look here.”

Tae-kyung tapped Go Myung-hwan’s abdominal wall, and the small intestine moved with it on the ultrasound screen, except in the places where it was fixed.

“Alright, then.”

After that, Tae-kyung immediately put on gloves and inserted a catheter and needle in a location completely different from where he usually performed ascites drainage.

“If you look at the ultrasound, you can see that there are no organs around here, there’s a lot of ascites, and it’s relatively compartmentalized, right?”

“Yes!”

“Then, we’ll drain the ascites from here, administer albumin [a protein that helps maintain fluid balance] depending on the amount drained, and since we’re still uncertain, we’ll admit him for observation overnight.”

“Yes, I understand.”

“Doctor?”

Go Myung-hwan, who hadn’t even realized he was being punctured because Tae-kyung performed the procedure so quickly, slowly turned his head and spoke softly.

“You’re doing it so skillfully, I don’t feel any pain.”

“It’s nothing.”

“Doctor, um, I…”

“Is there anything uncomfortable? Please don’t hesitate to tell me.”

“No. There’s nothing uncomfortable. I’m just relieved to hear that my organs weren’t punctured. It’s not that, it’s just that…”

Go Myung-hwan was hesitant, his voice trailing off, unsure of what he wanted to say.

The confident and stubborn demeanor he’d displayed before the examination had vanished.

“Patient, you have something you want to say, right?”

Go Myung-hwan nodded, his wandering gaze finally focusing on Tae-kyung.

“It’s okay, please tell me.”

“…I want to live.”

The words Go Myung-hwan uttered with such difficulty were the simple, fundamental desire to live.

The 60-year-old man spoke clearly, his eyes filled with the desperate plea of a child.

“I… I really want to live. Is there no way?”

“Patient, liver failure is a very serious disease. I’ll explain your current condition in detail.”

“No, Doctor. I was dozing off earlier and overheard everything you two were saying. And I wouldn’t understand even if I heard it. I’ve heard it countless times at the previous hospital and the hospital before that. I heard the people lying next to me saying that you’re a very famous doctor… Please save me. I really want to live.”

“…”

Lee Chan-hee, standing beside Tae-kyung, was speechless.

No matter how dire the situation, a doctor should never offer false hope. There was no known cure for liver failure.

Except for one thing.

‘How desperately does he want to live to say it like that? It’s heartbreaking…!’

Just as Lee Chan-hee was feeling sorry for Go Myung-hwan, Tae-kyung’s unexpected response surprised him.

“Yes, I’ll do my best.”

“Really!? Is that true?”

Not only Lee Chan-hee but also Go Myung-hwan himself reacted with surprise. It was a natural reaction, in a way.

“Then, receive treatment at our hospital. I’ll be with you until the end.”

“But, I don’t have the money… I don’t have that much money.”

Go Myung-hwan, who had been beaming at the words ‘do my best,’ quickly became dejected and embarrassed when he thought about the cost of treatment.

“The money is not a problem. Our hospital has strong connections with social work programs. And even if those don’t work out, it’s alright. Our hospital’s finances are quite stable.”

These were words that only someone with the full authority delegated by Chairman Kim Cheol-gi could say.

“Then, can I live?”

“There is only one way. Do you happen to know about it?”

“No.”

“Then, I’ll explain it to you gradually. First, don’t worry too much and get admitted. Go Myung-hwan, we’re on the same side now. Let’s fight this enemy called liver failure together, with me and our medical staff.”

“Th-thank you. Thank you so much.”

The stubborn man’s eyes welled up slightly at Tae-kyung’s sincere words.

Who wouldn’t want to live?

Living.

It was a fundamental desire that humans often take for granted. But that normalcy was denied to the patient because of his disease.

Initially, Go Myung-hwan, who seemed indifferent and only asked for ascites drainage, was actually someone who desperately wanted to live.

Moreover, he never imagined he would find hope at a hospital he’d visited on a whim, hoping to see his daughter’s face one last time.

“Then, I look forward to working with you.”

“I should be the one asking for your help. I’m the one who should be asking for your help.”

“Yes, then I’ll see you again.”

There was a warm atmosphere between Tae-kyung and Go Myung-hwan, but Lee Chan-hee was utterly bewildered.

“D-Doctor?”

Lee Chan-hee called out to Tae-kyung, who was leaving the emergency room after the conversation, and followed him.

“A little while ago, no, just now…”

“My words were confusing and very strange, right?”

“Yes.”

“I want to save Go Myung-hwan.”

“…!”

Lee Chan-hee’s eyes widened in surprise.

It was natural for a doctor to want to save a sick person. However, Go Myung-hwan’s case was particularly challenging, hence his surprise.

“Doctor, what you just said…”

“Let’s do LT.”

“…!”

Lee Chan-hee, already astonished, was even more shocked by Tae-kyung’s words.

LT was an abbreviation for liver transplantation.

“Consult with his family and see if there are any family members who can donate.”

“L-Liver transplantation? Really…?”

It was a first for him.

Liver transplantation was something Lee Chan-hee was encountering for the first time.

Organ transplantation is, without exaggeration, the pinnacle of all surgeries. Among them, liver transplantation is a particularly difficult and challenging field.

That was why Lee Chan-hee was so surprised and dazed just by hearing the words ‘liver transplantation.’

“Starting tomorrow, both you and Choi Mona will study liver transplantation and report to me! Study whenever you have time, and ask questions if you don’t understand anything. Do it properly. Got it?”

“Yes, Doctor. I will do it properly, really properly.”

Lee Chan-hee was still dazed as he watched Tae-kyung’s back as he left after saying those words.

“Liver transplantation…”

His heart was pounding, and he couldn’t calm down. Of course, they couldn’t perform surgery right away, and it would take quite a while until the surgery, but still, his surprised heart couldn’t calm down easily.

“Wait! How many children did Go Myung-hwan say he had earlier? Three? Four? Surely one of them will be a match.”

Usually, when parents undergo liver transplantation, the donor is often a child. Lee Chan-hee was sure that one of them would be a match for Go Myung-hwan’s liver.

“Ha! Liver transplantation…”

He was still making surprised expressions and muttering to himself as he was returning to the emergency room when-

*Clang-*

“Lee Chan-hee! Come with me!”

Suddenly, Tae-kyung came out of the examination room, strode up to Lee Chan-hee, grabbed him by the scruff of the neck, and dragged him into the examination room.