Chapter 16

Episode 16 Lesson

As soon as the conference ended, I headed straight for the Emergency Room.

I spent my time managing various mild patients. There was a college student who fell down while drinking and scraped their knee, and a gentleman who came in for a tetanus shot after getting scratched by a cat. And then... today's first trouble maker made his appearance.

A decent-looking middle-aged man, with a thoroughly serious expression, claimed that his back had been hurting since last night. He said he searched Google, and all his symptoms perfectly matched terminal-stage pancreatic cancer.

"From what I know, isn’t the 5-year survival rate for pancreatic cancer less than 10 percent? Am I going to die now? Please take a CT, an MRI, and even that, what do you call it, P [something] CT. Run a tumor marker test for me, too."

I firmly pressed my temple.

‘Do you think this is a Health Check-up Center, mister?’

The devil inside me roared, but outwardly, I maintained a gentle smile.

"Patient, for now, let's start with a basic blood test and an X-ray before we discuss further. The most common cause of back pain is muscle pain."

"No, doctor! You don't believe my words? Do you know how much I searched the internet?!"

Ultimately, after a 30-minute struggle and only after showing him the normal findings of his blood test, the man reluctantly got up from his seat. Even as he walked out, I could clearly hear him muttering, "The doctors here have no skill. I should go to another hospital."

I wished good luck to the on-duty doctor at the other hospital's ER, whoever they might be.

Lunchtime.

Hunched over in a corner of the doctor's office, I poured hot water into my cup ramen. Kim Jihun sat down next to me and let out a deep sigh.

"Hey, that was the first time I've ever seen the Section Chief smile at you. Are you really going to Internal Medicine?"

"I said I'm not going."

"Stop lying!"

This crazy bastard wasn't listening to my words at all.

Colds, enteritis, headaches, dizziness. And the trouble makers sandwiched in between them.

Around the time it grew dark outside the window, I stared blankly at the EMR screen for a moment. The screen was still packed full with the names of countless patients.

Ha, I'm tired to death.

Where did my day off go? I was robbed of the entirety of yesterday. But in exchange, I survived today's conference. Is this really a profitable trade? I don't know.

The human Up-to-date. The new star of the Emergency Room. The crazy bastard preparing for a Double Board. All sorts of fucking modifiers were plastered in front of my name, but reality remained unchanged. I was still a low-ranking 2nd year.

"Aaaargh! Teacher! My back! I feel like my back is going to break!"

Bed 15 in Area B. A man who appeared to be in his mid-30s was rolling around on the bed, screaming.

"Patient, pull yourself together. Where does it hurt, and how?"

"I don't know! Just! I'm just saying it feels like my back is going to break! Aargh! I think the disc I injured before ruptured! Please, give me some strong painkiller..."

The man was practically crying, looking ready to grab me by the hem of my trousers. I pressed around the patient's back and legs to conduct a neurological examination. There were no clear findings like muscle weakness or sensory abnormalities. However, the man's expression was incredibly desperate.

"The one I used to get... that Pethidine or whatever, I felt a bit better after getting that. Could you please give me some of that? Yes? Please."

I firmly pressed my temple. In the end, I returned to the station and sat in front of the computer. I opened the patient's chart and brought up the order window.

[Pethidine 50mg IV]

My finger hesitated over the enter key. Really? Is it okay to just give it like this?

Something felt off. It didn't feel clean. Was this my instinct as a doctor, or my survival sense as a slave?

'Fuck, I don't know. Let's just ask.'

I brought up the blue interface in my pupils. I thought it would be a bit awkward to ask a senior about something like this, so the Gallery was perfect.

Title: 30/M severe lower back pain. Claims history of disc herniation. Demanding Pethidine. Just give it?

Author: Korean Slave 1 (Male)

The comment section was quiet. The Internal Medicine ghosts didn't seem to care about this kind of pain patient, and it was the same for the other surgery ghosts.

Ah, fuck it. Let's just give it.

Just at the moment I was about to bring my finger back to the enter key—

Mes of the God (Male): Did you check the DUR (Drug Utilization Review)?

DUR. Ah. Ah, fuck.

Chewing on curses, I hurriedly looked up the DUR. A new pop-up window filled the screen. And I doubted my own eyes.

[Prescribed Drug Name: Pethidine Inj. | Prescription Date: 3 days ago]

[Prescribed Drug Name: Fentanyl Patch | Prescription Date: 4 days ago]

[Prescribed Drug Name: Oxycodone CR Tab. | Prescription Date: 1 week ago]

[Prescribed Drug Name: Targin CR Tab. | Prescription Date: 8 days ago]

A list of narcotic analgesics filled the screen. For the past ten days, this bastard had been touring multiple hospitals, sweeping up narcotic analgesics. This was doctor shopping.

Feeling the strength drain entirely from my body, I leaned my body against the back of the chair. Even these doctors, how could they just hand out narcotic analgesics without checking... No, it meant that piece of shit's acting was just that spectacular.

Meanwhile, new comments began to appear on my post.

Anesthesiology & Pain Medicine: Lmao caught red-handed, typical junkie method. Those bastards go around from hospital to hospital and even memorize the names of doctors who give them drugs easily. Once they think they've found a sucker, they become regulars.

Psychiatry Phantom: That goes beyond dependence; it has to be viewed as the addiction stage. He needs to come to psychiatry.

Truck Hit Guy: Wow, that bastard fakes an illness and gets Fentanyl prescribed. My entire body was literally crushed by a truck, and they gave me Tylenol. The world is truly fucked.

ㄴ ㅇㅇ(223.39): For real? You got Tylenol?

ㄴ Anesthesiology & Pain Medicine: That's got to be a lie, holy shit lmao.

Reading the ghosts' stories, I broke out in a cold sweat. What if I had pressed the enter key without checking the DUR? I would have almost added the name ‘Sucker Doctor Han Hyeonjae’ to that junkie's shopping list.

My mind snapped awake. I moved the mouse, closed the DUR window, and tried to delete the order.

"Phew..."

It happened at that exact moment. A giant shadow loomed behind my back.

"What are you doing?"

Lee Minjae (Male), a 4th-year Emergency Medicine Head of Doctor's Office, was looking down at me with his arms crossed, though I didn't know how long he had been standing there. His gaze was fixed on the computer screen where I had just been about to place the order.

I was ruined.

"You're going to give Pethidine?"

"This easily? Without checking the DUR, and without sufficient consideration of the patient's condition, how can you just give it out so easily just because they asked for it? This is why 2nd years shouldn't be given authority..."

I couldn't say anything.

‘No, that's why I checked. I asked the Gallery, checked the DUR, realized he was a junkie, and was just about to delete the order!’

The scream inside my heart couldn't make it past my throat. In the chief's eyes, I must have looked like a thoughtless, low-ranking 2nd year who got fooled by a junkie's acting and was about to prescribe narcotics, only to get caught right beforehand.

And that was half true. If it weren't for the Gallery, I really would have pressed the enter key.

The chief's scolding was long and harsh.

"The ER is not a marketplace. It’s not a vending machine that dispenses whatever drug a patient asks for. Aren't you going to pull yourself together?"

"Sorry."

"Every order you write must be accompanied by a reason, evidence, and responsibility. If you feel even slightly uneasy, check and check again, ask a senior, and if you still don't know, look it up in a textbook."

"..."

"Checking the DUR doesn't even take 30 seconds."

After a storm of nagging that lasted for a good while, the chief let out a deep sigh and turned away.

"Never repeat today's mistake again. Understood?"

"Yes. I will keep that in mind."

Even after the chief's back disappeared from view, I stood rooted to the spot for a long time. I felt humiliated and wronged.

But on one side of my mind, a thought began to surface. Until now, I had been using the Gallery like an all-powerful cheat key. If I hit a wall, I just posted a question. When an answer came, I chanted that answer like a parrot. In that process, I was skipping the most important step: thinking like a doctor.

The process of doubting, agonizing, finding evidence, and verifying.

"Ah. I shouldn't live without thinking."

In the empty station, I muttered quietly to myself.

After that day, a subtle change occurred in my ER life.

Of course, it was still just as fucked up and exhausting, but I decided no longer to depend on the Gallery for everything. I chose to trust my head, my hands, and my eyes first.

Of course, that process wasn't entirely smooth sailing.

A child sitting on an ER bed was crying. A laceration of about 2cm was gaping wide right on the child's forehead. Assuring the child's mother, I washed the wound and applied local anesthesia with lidocaine.

Then, under the watchful eye of a senior, I picked up the suture set. My heart trembled slightly.

‘It's okay. You practiced all night.’

Stitch by stitch, exactly as Mes of the God had taught me. Slowly, but carefully. The thread didn't get tangled, and my fingers didn't get tied up like before.

Granted, I was still clumsy. Sung-hoon Yoo (Male), a 4th year, watched my hands, clicked his tongue, and chimed in.

"Hey, you're tightening the knot too much. If you do that, it will leave a severe scar when you remove it later. Tie it just enough so the skin barely stays together."

"Ah, yes! Understood!"

I adjusted the tension as advised.

Like that, it took 15 minutes to finish the suturing on my own. Sung-hoon Yoo, the 4th year, tapped my shoulder as he passed by and said, "Still, it's passable."

At that nonchalant remark, a smile slipped out of me without my realizing it.