Fifth Vital [EN]: Chapter 453

Fifth Vital- Episode 454

454. Button

“Self-harm, I see.”

“That’s right. It is self-harm.”

Among all the patients Tae-kyung had seen, the most frequent ones were not cancer patients or traffic accident victims, but those who harmed themselves.

Back when he was working in the emergency room at his previous hospital, not the current one, he saw a lot of self-harm patients.

Because the hospital was so large, there were correspondingly many self-harm patients.

It might sound strange to say, but self-harm patients are by far the number one regulars in the emergency room.

So, having seen countless self-harm patients, he had also seen numerous wounds they inflicted on themselves.

He encountered various cases, from general self-harm patients to those with mental illnesses.

Therefore, Tae-kyung was very familiar with self-harm-related trauma.

Self-harm patients are largely divided into two categories: those who admit they harmed themselves and those who don’t.

When facing patients who don’t admit it, communication can be difficult, causing a lot of trouble.

Especially when a patient with a mental illness self-harms, it can be more challenging than with general self-harm patients.

Tae-kyung once recorded and observed the wounds of these self-harm patients to better understand them, conducting his own research.

Then one day, the son of a patient who had undergone surgery and was there as a guardian happened to be a forensic scientist.

The father was hospitalized for quite a long time after the surgery, and the filial son visited the hospital frequently despite his busy schedule.

The guardian kindly shared various points of interest with Tae-kyung, whom he saw often. After that, Tae-kyung purchased recommended books and studied the trauma of people who inflict wounds on themselves.

The knowledge he gained then has been very helpful in seeing patients ever since.

That’s how Tae-kyung knew that the self-inflicted wound on Seol-rae’s arm had a different direction of force and that one of them was a self-harm wound.

“……Me?”

“…….”

“Choi Mona?”

Tae-kyung repeatedly called out to Choi Mona, who was staring at the wound on the phone screen with a dumbfounded expression.

“Yes, Doctor.”

“Are you okay? You look very surprised.”

As Tae-kyung said, Choi Mona was quite surprised. She couldn’t understand why Seol-rae would harm herself.

“Why would she do that?”

“What? Self-harm?”

“Yes. She must have been having a hard time being bullied at school, but I don’t understand why she would torment herself again.”

“Well, we can’t jump to conclusions and say this or that, can we? We don’t know why she self-harmed unless she tells us honestly, but there’s one thing we can be sure of.”

“What is it?”

“That student is hurting just as much in her heart as she is in her wounded places. That much is certain.”

“Ah!”

“That’s right! I almost forgot something important.”

“……?”

“That child’s self-harm is NSSI (Non-Suicidal Self-Injury).”

“Does that mean it’s not self-harm intended to commit suicide?”

“That’s right.”

NSSI (Non-Suicidal Self-Injury) is an abbreviation for non-suicidal self-injury, meaning self-harm that is not intended to cause death but to injure one’s own body.

“Choi, you’ve seen patients who self-harmed to commit suicide, right?”

“Yes. I’ve seen many.”

“At least that student doesn’t have hesitation marks on her wrist.”

Hesitation marks refer to wounds caused by self-harm.

They are mainly found on the wrists, abdomen, chest, and neck, with the most common location being the wrists.

“If you think about it now, you can tell that the wounds are different from those of self-harm patients.”

Tae-kyung was right.

A characteristic of self-harm patients is that wounds frequently occur on the wrists. However, both of Seol-rae’s wrists were clean, and her neck was clean as well. And he had looked at her abdomen earlier, but it was clean.

While treating the child’s wounds at the hospital, he had never seen any wounds on her wrists.

Of course, he hadn’t checked her chest, but considering Seol-rae’s treatment pattern so far, if there had been wounds elsewhere, she would have received treatment without hesitation.

“Choi?”

As the two were having a serious conversation, nurse Lim Jeong-sook called out to Choi Mona.

“Lee Seol-rae’s test results are in.”

“Yes, thank you.”

Upon hearing nurse Lim Jeong-sook’s words, Tae-kyung immediately checked the test results on the monitor in front of him.

The blood test results were normal with no abnormalities.

“She said she hasn’t had a bowel movement for several days, right?”

“That’s right.”

“Looking at this, her abdomen is full of stool. At this point, she needs medication to help her have a bowel movement. Just a moment……!”

Tae-kyung, who was looking at Seol-rae’s X-ray screen on the monitor, narrowed his brows and leaned closer to the monitor.

And Choi Mona, who was next to him, also stared at the monitor with a puzzled expression.

Inside the X-ray screen, there was something round with four small holes in it, near the stool.

Tae-kyung had never seen anything like that inside a person’s large intestine before.

“What is this?”

The unknown object intensely aroused the curiosity of the two.

“Choi, have you ever seen anything like this?”

“No. This is my first time seeing it. What could it be?”

One thing was certain: it wasn’t something to eat.

“It’s not something to eat, so did she swallow it without knowing? Choi?”

Tae-kyung, who was enlarging the unknown object as much as possible and staring intently at it, raised his head.

“This thing, it looks like that, doesn’t it?”

“Like what?”

“Doesn’t it look like a button? This looks like a button.”

“A but……ton?”

Upon hearing Tae-kyung’s words and thinking of a button, something suddenly flashed through Choi Mona’s mind.

“……!”

The small, transparent acrylic box that Seol-rae had been holding in her hand several times while sitting in the waiting room and before starting the examination on the bed.

She had definitely seen buttons and several pieces inside that box.

As the memories in her head surfaced, she became convinced that the unidentified object in the X-ray was a button.

And Choi Mona intuitively knew that Seol-rae had swallowed it on purpose.

She had been wondering why Seol-rae was carrying that transparent box around, and now her curiosity was finally resolved.

“Doctor, that’s a button. I saw it.”

“You saw her eating a button?”

“No. She often carried a small box with buttons in it. Doctor, I think Seol-rae has pica.”

Pica is a type of eating disorder in which one eats non-food items, and it can occur not only in humans but also in animals.

Following self-harm, pica was truly a series of surprises.

“Self-harm and pica…… This friend definitely needs help right now. Right?”

“Yes, but why did you take pictures earlier?”

“I thought it might help that student later if I left a record of the wounds before treating them. It would be better to attach the photos when issuing a diagnosis.”

“Should we notify the police? Or should we call her guardian under the pretext of treatment and inform them?”

Choi Mona’s words became faster, and she seemed slightly agitated.

“No, don’t do either.”

“Yes!?”

Not doing either. An entirely unexpected answer came out.

That Tae-kyung, of all people, would say such a thing surprised Choi Mona.

“She’s in a situation where school violence is suspected, or rather, it’s almost certain, and you’re saying not to do either?”

“Yes. Both. Don’t do it.”

“I can’t understand what you’re saying right now.”

To say not to do anything when she should be helping right away was an instruction she couldn’t possibly accept.

“Choi Mona? You want to help Lee Seol-rae, don’t you?”

“Of course. I want to help.”

“Then you shouldn’t do it this way. It’s good to help, but the direction is wrong.”

“The di……rection?”

“Yes. Calling the police is good, and informing the guardian is good, but there’s something to do before that.”

“……?”

“Persuading the person who is being bullied at school is the first thing. If you start something without the person being prepared, will it really be helpful? No matter how much people around try to help, the person needs to change their will to escape the bullying. They need to have the desire to get away from the kids who are bullying them. In the process of resolving the issue, they will continue to face the perpetrators and argue about what’s right and wrong. Do you think the victim can be confident in front of the perpetrators without any preparation?”

“…….”

“The bullies might think that she’s still afraid of us, so there’s no need to apologize. Haven’t you seen the news? Kids these days are more cunning and smarter than you think.”

If she started something to help without Seol-rae’s mind being prepared, the situation could get worse.

“You don’t know what kind of situation Lee Seol-rae is in. If you want to help that friend, shouldn’t you at least talk to her and then help her?”

Choi Mona felt like she knew exactly what Tae-kyung was saying.

She seemed to have been too eager to help a child who was being bullied at school.

“And this is just my opinion, but Seol-rae seems a bit different from typical victims of school violence.”

Victims of school violence tend to become self-conscious and timid as they are bullied. But Lee Seol-rae didn’t show that.

Choi Mona, who was listening to Tae-kyung’s story, agreed with that story more than anyone else.

From the beginning, she had been fixated on the wounds and thought that Seol-rae was being bullied, but Seol-rae was actually a child who even seemed a bit bold.

“Doctor?”

“Why?”

“Could you persuade her while treating her?”

“Me? Why?”

“Well, because you’re good at persuading patients and understanding their feelings.”

Choi Mona’s desire to help was strong. But when she actually tried to do it, she wondered if she could do as well as Tae-kyung.

“I’m not someone who speaks warmly like you, and I don’t have the talent to move people’s hearts. I’m also worried that the child might misunderstand…….”

“You’re being weak, Choi Mona?”

“Yes. Doctor.”

“Answer me. Is Lee Seol-rae my patient?”

“She’s my patient.”

“That’s right. Lee Seol-rae is not my patient, she’s your patient. If she’s your patient, take responsibility to the end. What are you doing? The patient is waiting. Get up quickly. Quickly!”

At Tae-kyung’s firm words, Choi Mona jumped up from her seat and returned to the bed where Seol-rae was.

That’s right. Lee Seol-rae was my patient.

Charyeok- [adverb indicating a quick or sudden movement]

“Did you wait long?”

“No.”

Seol-rae, who was lying on the bed and looking at her phone, raised her head when Choi Mona came.

“Did you hear the director’s explanation earlier? This wound on your arm needs to be stitched, so we’ll anesthetize it and stitch it up.”

“Does anesthesia hurt a lot?”

“It stings, but it’s something even children can bear. Lie down comfortably.”

As Seol-rae settled in and lay down on the bed, Choi Mona first disinfected the wound area before stitching it.

“The test results show no major abnormalities, and your abdomen is a bit full of stool. That must have been why your stomach was uncomfortable. I’ll prescribe medication to help you have a bowel movement.”

“Will that make me have a bowel movement?”

“It will. But it will help more if you drink a lot of water.”

“What if I still can’t have a bowel movement?”

“Then we’ll have to insert medication into your anus, give you an enema, and if that doesn’t work, we’ll have to take it out directly.”

“Ew! I don’t even want to think about it.”

“So take your medicine and drink a lot of water. I’m going to anesthetize you. It’ll sting a bit.”

Seol-rae squeezed her eyes shut and opened them, but as expected, she handled the anesthesia shot well.

Choi Mona carefully stitched the open wound, using a small, hook-like needle with dissolving thread.

“Don’t move.”

“Yes, I won’t move.”

Choi Mona, who told her not to move, stitched each stitch carefully.

“Does it hurt?”

“It’s okay.”

Choi Mona, who stitched it up to minimize scarring, neatly tied the thread and finished. And she called Lee Seol-rae’s name, thinking about when to start talking.

“Seol-rae?”