Fifth Vital [EN]: Chapter 31

“The red container has seasoned dried squid, and the white kimchi is on the table, so remember to put it in the fridge after today.”

“Wow! I wanted to eat white kimchi anyway. Thanks, Mom. Thanks for bringing it, sis.”

Euijin was on the phone with her older sister in the examination room.

– “By the way, you were on duty and you’re working again? Doesn’t your hospital ever let you rest?”

“Sis, do you think this is some university hospital? We work according to what we can handle. And don’t worry, I’m resting well enough.”

– “Oh, right, Euijin, would you like me to set you up on a blind date? My brother-in-law…”

“No, thanks.”

– “You won’t even listen. He’s a really good guy.”

“Sis, I’m getting another call.”

– “Jeong Euijin, are you lying again?”

“I’m not lying. I’ll call you later.”

Euijin deliberately hung up the phone and shook her head. Just then, she heard a knock on the examination room door.

Knock, knock-

“Yes.”

“Doctor, there’s a patient in the emergency room.”

“Do I need to anesthetize them?”

“No, it’s not that. The patient is pregnant.”

“Is that so? Then please do a blood test and urine test and guide them to the examination room.”

“Understood.”

* * *

The pregnant woman, having completed the basic tests, entered Euijin’s examination room with her husband.

“I’ve had a stuffy feeling in my solar plexus [the area in the upper middle abdomen] and a slight pain in my stomach since last night.”

The husband had rushed her to the hospital.

“At first, I thought it was just Braxton Hicks contractions [false labor pains], but then I thought maybe it was indigestion from dinner.”

The wife continued, biting her lower lip, as if the pain in her lower right abdomen was considerable.

“But since a while ago, my lower right abdomen has been hurting unbearably.”

“Doctor, the results are in.”

“Thank you.”

Euijin received the test results from the nurse and examined them carefully.

“Doctor, is there something wrong with our baby…?”

“No. There’s nothing wrong with the baby.”

Hearing that there was nothing wrong with the baby, the wife showed a relieved expression even in the midst of her pain.

“Then why is my wife in so much pain?”

“The ultrasound shows that the baby is fine, and the urine test is also normal, but the blood test shows a high level of inflammation.”

“Inflammation?”

“Yes.”

The pregnant woman’s blood test results showed an inflammation level of 18,000, far exceeding the average.

“Why is the inflammation level so high?”

“We need to confirm with an abdominal ultrasound, but I suspect appendicitis.”

“Appendicitis? What is that?”

“It’s commonly known as appendicitis [inflammation of the appendix]. Let’s proceed with an abdominal ultrasound first.”

Hearing the word appendicitis, the wife could only look at her stomach with worried eyes.

* * *

“Hello.”

Taekyung, who had come down after finishing rounds in the ward, greeted Team Leader Choi.

“Good morning, Doctor.”

“Seeing you come to work so early every day, I think you’re very diligent, Team Leader.”

“You flatter me. I just want to set a good example for the staff.”

“That’s a very admirable attitude.”

“By the way, you must not have slept well because of your night duty.”

“Not at all.”

It was his first night duty, but it wasn’t as busy as he had expected.

Fortunately, there were no critical patients, so he was able to get a few hours of good sleep.

“That’s a relief. Oh, by the way, did you know that the staff have come up with a nickname for you these days?”

“A nickname?”

“Yes.”

“I don’t think I’m that distinctive of a person.”

“They call you ‘In-the-yeol-dak,’ Doctor.”

“In-the-yeol-dak? What’s that?”

“It’s short for ‘a more passionate doctor than an intern.’ Look at you now.”

Team Leader Choi pointed to the small notebook and pen that Taekyung was holding.

“Even when there are no patients, you take every opportunity to do rounds and always carry a notebook and pen.”

“Ah, this?”

Taekyung shook the notebook in his hand.

“Interns carry these around a lot.”

That was true. Usually, interns always carry a notebook and write down what the attending doctors order.

However, Taekyung’s purpose for using the notebook was different.

He was recording the patients’ fifth vital sign. The smell also changed depending on the disease and treatment, so detailed recording was essential.

“But, Doctor. What are you writing in that notebook?”

“It’s nothing special, just for recording patients’ information.”

“I thought there would be something amazing written in it.”

“Of course not.”

Taekyung suddenly thought that he should never lose the notebook.

“Then I’ll go prepare for my work now.”

Watching Team Leader Choi head to the office, Taekyung mulled over his nickname.

“In-the-yeol-dak, huh? I like it.”

“Doctor?”

He heard a nurse calling from behind him as he was feeling pleased.

“I think you should go to the examination room now.”

“What’s wrong?”

“A pregnant patient has arrived, and I think you should see her.”

“If it’s a pregnant patient, I think the OBGYN doctor should see her too.”

“She said she’s going to the examination room.”

“Okay.”

Hearing that it was a pregnant patient, Taekyung quickly headed to the examination room.

* * *

Clang-

“Senior?”

Euijin greeted Taekyung as he opened the examination room door.

“You weren’t in the emergency room either, where were you?”

“I was just making rounds in the ward. Do you need something?”

“Yes.”

“Dr. Jeong, I’m sorry, but can we do it later if it’s not urgent?”

“It’s urgent for me too. Are you going into surgery?”

“No, the OBGYN said she’s coming. But do we even have an OBGYN in our hospital?”

“We do. She’s right in front of you, Senior.”

Euijin pointed to herself with her index finger.

“What!? What do you mean… Never mind. The patient comes first, so brief me.”

“It’s a 25-week pregnant woman who’s been to the ER a few times. The abdominal pain she’s been feeling since last night has gotten worse, so we did an abdominal ultrasound and it’s appendicitis.”

“Ah, a pregnant woman with appendicitis. It’s best to operate quickly.”

“But there’s a problem.”

“A problem?”

“Yes. You’re going to do an open surgery, right?”

The patient is currently pregnant, and her internal organs are pushed up.

The problem is that the appendix is pushed upwards because of this, and it may take time to find it. Therefore, it would be difficult to proceed with a laparoscopic surgery [surgery performed through small incisions using a camera], and an open surgery is necessary.

“At 25 weeks, the fetus is large, so laparoscopy is difficult. We have to do an open surgery anyway.”

“If it’s an open surgery, it’ll be general anesthesia.”

After the incision, it will be impossible to use spinal anesthesia as they search for the pushed-up appendix.

They have to perform general anesthesia on a pregnant woman.

“Dr. Jeong, is it because of the anesthesia?”

“Yes, because the anesthetic can affect the fetus.”

It had been a while since Euijin had performed surgery on a pregnant woman, so she couldn’t help but be more concerned than with other surgeries.

“I can’t help but think about possible side effects such as birth defects or miscarriage.”

“But the possibility is less than 1% according to the research papers, right?”

“Senior, you’ve even looked up the research papers?”

“Shinhwa University has had a few pregnant appendicitis patients. So I naturally looked up the related papers.”

Usually, in these cases, they would consult with the doctor in charge, but it is rare to look up the research papers themselves.

At times like this, Taekyung seems like he was born to be a doctor.

“Dr. Jeong, you know very well that all surgeries can have side effects.”

“I know. But it’s been a while since I’ve had a pregnant patient, and with the emergency surgery and the patient’s past medical history, I think I’ve gotten a little too deep into it.”

“Past medical history? What is it?”

“Asthma. Contraction is possible during intubation, and her bronchial tubes are sensitive.”

Taekyung’s brow furrowed. This is a more burdensome surgery than he thought.

“Do you know what she’s using to treat her asthma?”

“Because it’s a child she had after 10 years of repeated abortions, she refuses all medication since becoming pregnant.”

“Ah…”

A child she had after 10 years. The pregnant woman is probably only thinking about her child right now, more than her own pain.

“But if we leave the appendicitis as it is, even the mother could be in danger. We have to do emergency surgery.”

Taekyung continued after contemplating.

“And we need to clearly warn the mother and guardian about the possibility of abortion [termination of pregnancy].”

“I guess that’s the only way.”

There were concerns, but Taekyung’s words were the answer.

“Can I see the mother’s EMR [Electronic Medical Record] now?”

“Yes. I’ll open it for you.”

As Euijin opened the EMR on the PC, Taekyung approached the monitor.

“WBC is in the 18,000s, CRP is 7.53, there’s inflammation and tenderness. Where is the mother now? Guardian waiting room?”

“No. I told them to guide her to my examination room. Are you going to talk to her, Senior?”

“I have to tell her myself. I’m the surgeon.”

Now Taekyung has to explain everything about the surgery to the mother and tell her even the worst-case scenario.

He felt burdened to tell the mother an unbelievably scary and terrible story from her perspective.

“Are you going to be okay, Senior?”

Repeated miscarriages, a precious child she had after 10 years, and refusal of medication. It will definitely take a long time to persuade the mother.

Knowing that, Euijin asked with a heavy expression.

“It won’t be easy to persuade her.”

“I still have to do it. It’s the patient’s business.”

* * *

“Sob!”

“Seon, stop crying.”

“I’m sorry, Chukbok [Korean name meaning ‘blessing’]. Mommy’s sorry.”

The husband was comforting his crying wife in the waiting room.

“Honey? Could it be because of me?”

“What are you talking about, because of you?”

“No, I was wondering if it’s because I ate something wrong.”

“It’s definitely not that, so don’t even think about it. How’s your stomach? Does it hurt a lot?”

“I’m just worried that it’ll be bad for our Chukbok.”

Even in the midst of her pain, the wife was still only thinking about her baby.

For the two of them, who grew up as orphans, the existence of the child was bound to be special.

But at this moment, the husband’s mind was only filled with worry for his wife.

“Honey, our Chukbok will be okay, right?”

“Of course, he’ll be okay. Don’t think strange things and relax.”

The wife’s tearful gaze turned to her cell phone when-

Clang-

“Hello.”

Taekyung entered the examination room with Euijin. He could immediately smell the strong odor of stage 3 feces filling the examination room.

“This is the surgeon in charge at our hospital.”

As Euijin, who followed behind, introduced Taekyung, the couple’s gaze turned to Taekyung.

“Hello.”

“My name is Kim Taekyung.”

It was a truly lovely couple, the mother full of benevolence and the husband protecting her.

‘It’s quite strong, probably because of the inflammation.’

The concentration of the smell was quite strong, probably due to the mother’s high inflammation level.

“Have you heard anything about the patient’s condition?”

“Yes, Dr. Jeong Euijin next to me said it’s appendicitis.”

“Yes, it’s appendicitis, and the current inflammation level is also higher than normal.”

“Then what happens?”

“The mother needs to have surgery.”

“Yes!? Surgery?”

As soon as she heard Taekyung’s words, tears quickly welled up in the mother’s eyes.

The mother felt like her heart was breaking at the two words ‘surgery’.

“D-did you just say surgery?”

She took her hands out of her husband’s and unknowingly wrapped them around her bulging stomach. It was as if she was trying to protect the baby in her womb.

“Doctor, do I really need surgery?”

“Yes, the patient currently needs surgery.”

“Um, Doctor, I…”

The mother trembled her lower lip slightly and continued as if she had made up her mind.

“Can’t you treat me with antibiotics instead of surgery?”