Chapter 184

Episode 184 Person (1)

"Well, I should get going now. Let's iron out the concrete details regarding Dr. Han's situation soon. Thank you for your hard work, everyone."

As soon as Lee Jaeyoon brought the meeting to a close, the air in the room grew noticeably lighter. The professors stood up from their seats, gathering their respective manila folders.

"Yes, Director. Thank you for your hard work."

"Yes, Director! We will be on our way."

"Goodbye, Director~."

The professors poured out of the room in a swarm. I tried to blend into the crowd and make a perfectly natural exit myself. But just as I was about to stand up, the director, who was organizing his paperwork, raised a hand to stop me.

"Dr. Han, please stay."

"Uh? Yes, sir."

Reflexively, I plopped right back down onto my chair. The door clicked shut, leaving only the two of us in the massive executive office.

What is he trying to say to me?

As my mind raced with nervous anticipation, the director broke the silence with a chuckle.

"Well, to be honest, it doesn't actually mean much," Lee Jaeyoon threw out nonchalantly.

"Pardon? I'm sorry, I didn't quite catch that."

It doesn't mean much? What doesn't? The Acute Care Center? Wasn't he just talking grandly about it a moment ago, calling it the future of South Korean medicine and a massive one-and-a-half-year project?

"The Acute Care Center, I mean," the director clarified with absolute indifference.

"I'm not sure I understand, sir. What do you mean it doesn't mean much?"

"Well, you know that Acute Care Surgery department over at Seoul Asung Hospital? We just benchmarked that. We just changed the name a bit."

"Is that so?"

I blinked my eyes. Asung Hospital was one of the top-tier institutions in the country. They were already doing this over there?

"Now, think about it. Where do trauma patients with broken limbs and ruptured abdomens from car accidents go?"

"They are treated at the Regional Trauma Center."

Lee Jaeyoon held up a single finger.

"Exactly. That place already runs twenty-four hours a day, so there's no need to mess with it. Aside from that, acute abdominal patients with ruptured appendixes or twisted intestines are covered by the General Surgery residents on duty."

Lee Jaeyoon held up a second finger.

"As you know, our current on-call system is incredibly inefficient. That's why I wanted to overhaul the duty system and have specialists stationed in the hospital. But while they are looking at the abdomen, wouldn't it be nice if they could look at the chest as well?"

"I... suppose so?"

"Then, while they are looking at the chest anyway, wouldn't it be even better if they could look at the head too?"

"...? Pardon? Well, I suppose... that could be possible."

The logic was starting to expand in a very bizarre direction.

"So, well, that's how it was decided."

Lee Jaeyoon folded all his fingers back down and leaned his body comfortably against the back of his chair.

"It will be relatively easy to secure medical staff for General Surgery. For Thoracic Surgery, we will practically be sharing staff with the Aorta Hospital. And down the line, this center is scheduled to share facilities with the Cardiovascular and Aorta Hospital anyway."

"Which means...?"

"Trauma will be handled by the Trauma Center just like it always has been. We're just converting a portion of the on-call duty systems into an in-hospital residency system. And since we're restructuring it anyway, I figured it would be clean and efficient to shove them all right next to the Emergency Room! That was the idea."

"...Is that what this is?"

As it turned out, the plan was closer to a consolidated duty room and a remodeling project. Lee Jaeyoon pointed out the window.

"See that new Aorta Hospital building under construction over there? That tiny two-story thing sandwiched between the main building and the Emergency Room."

"Yes. I saw the construction."

"The blank space in that blueprint will likely go to the Acute Care Department. The first floor will connect to an expanded Emergency Room, and the second floor will be used for operating rooms and duty rooms. The spatial efficiency is perfect."

Just a moment ago in front of the professors, he had spoken as if he were building a holy sanctuary that would shift the paradigm of South Korean healthcare. But the reality was that the main objective was simply utilizing leftover space in a building and consolidating the duty system. Well, I suppose it counts as a radical reform in its own way, but...

"If that's the case, there shouldn't be a need to create an entirely new department with a grandiose title like the Acute Care Center or the Acute Care Department. Couldn't you just merge the physical spaces?"

All they needed to do was strengthen the consultation system. There was no reason to drag me into something like this.

"What do you mean there's no need? It's because of you."

"Me?"

"I know that you only pick up the scalpel in absolute worst-case scenarios. If you hadn't, I would have kicked you out of this hospital immediately."

"Haha..."

"You act as a bridgehead, Dr. Han. You are a doctor who grabs the scalpel only when it can be handled within the realm of Emergency Medicine. You walk that fine line beautifully."

"I suppose it could look that way."

"So I gave it some thought. What do I have to do to put a legal scalpel in this guy's hand?"

Lee Jaeyoon rubbed his jaw.

"At first, I contemplated throwing a tantrum at the Trauma Society, asking them to include an Emergency Medicine board certification in the subspecialty eligibility requirements for Trauma Surgery."

"Haha..."

He had to be joking, right?

"So, while reviewing various internal proposals, the opinion came up that it would be better to just create a ghost department within the hospital. That's how it started."

"A ghost department?"

"Yes. A department that exists on paper but is meaningless in reality. But then, if we were going to build such a department anyway, the suggestion came up to benchmark Asung Hospital—the best in the country—and build a proper Acute Care Surgery department instead. That's how it expanded."

The director smiled.

"Ultimately, a center that started out just to create a space where it wouldn't be illegal for you to hold a scalpel ended up merging with our original plan to reform the duty system. That is how the name 'Acute Care Department' came to be."

"Well, that's a relief."

I let out a sigh of relief.

"I was worried because I thought I would actually have to perform brain surgeries and heart surgeries all by myself..."

"Your role is to pave the way, Dr. Han. Though, of course, if the specialist can't make it or runs late, you'll have to do it."

Lee Jaeyoon smirked.

"You need a title to give you a justification for your actions. If Han Hyeonjae of the Acute Care Center opens up an abdomen rather than Han Hyeonjae of Emergency Medicine, doesn't it look like a specialized system?"

"I suppose that logic works too..."

"Furthermore, there was internal dissatisfaction. People were asking why we didn't have integrated internal medicine or hospital medicine departments when famous hospitals in Seoul do!"

Lee Jaeyoon snapped his fingers.

"So we thought, 'Hey, why don't we plus the role of a hospitalist here too?' Someone who can handle the ICU or ward management after operating on an acute patient."

An Emergency Medicine diagnosis of an acute patient, followed by surgical intervention, and then inpatient management. They had thrown all of this into a blender and wrapped it up in a nice, shiny packaging called the Acute Care Center.

"The ultimate reason this entire stage was set was to squeeze you into the hospital's organizational chart."

The director leaned forward.

"You seem a bit worried about surgical training, Dr. Han. I'm sure you feel a massive amount of pressure."

Uh. He hit the nail right on the head. Because of the possession system, I had been deeply worried that their plan was to make me run the center across every single medical field.

"I was a bit worried, yes."

"I'm not asking you to become a true, regular surgical team member. I've watched you operate and perform procedures very closely. Damage control in the ER, assisting with an emergency thoracotomy for a cardiac tamponade..."

I nodded my head.

"Your surgical skills were tremendous and your hands were fast, but those aren't the hand movements for a scheduled, regular surgery. Those are skills meant to keep someone alive, skills meant to buy time."

The director paused for a moment before speaking again.

"You have neither the intention nor the ability to lead a long, regular surgery, do you?"

"...That is correct, Director."

I wasn't a renowned physician who cured cancer. I was someone who grabbed dying people by the collar and dragged them back to the land of the living. In a way, I was the person who best fit the definition of primary acute care. Someone who couldn't lead a lengthy operation but could patch up the damage right at the start.

"So, I'm not trying to raise you to be a surgeon. I'm trying to raise a temporary surgeon."

"What do you mean by temporary?"

"Exactly what it sounds like. Sparing the blank space until the professor of the respective department arrives. Or filling the gap until the patient can be moved up to the operating room. A doctor who can bridge that void."

"In other words, while converting the on-call duty into an in-hospital residency system, you want to make sure I can legally pick up the scalpel in unavoidable situations?"

"Precisely. Strip away the fluff, and it's nothing grand. The building is shared, and we aren't actually hiring a massive influx of medical staff, though the TO will increase slightly."

Lee Jaeyoon lowered his voice and whispered.

"We get to claim the public image of having the country's first all-encompassing acute care system, and under the guise of expanding essential medical services, we can rip away some local government grants..."

"Pardon?"

"Oh, nothing. Ahem."

Lee Jaeyoon cleared his throat. I'm pretty sure he was about to say "rip away." As expected, the position of hospital director isn't just given to anyone.

Lee Jaeyoon flipped through his documents.

"The loading itself won't be too heavy. Like I said, we're just improving the duty structure, so the manpower won't be bad. As for you, Dr. Han, you can just keep working out of the ER under the title of the Acute Care Department."

"Is that allowed?"

"That's the plan. Ultimately, your opinion is what matters most."

"Thank you."

"Take some time to think it over, and let me know when you can. We'll fill in the concrete details slowly as we go."

Suddenly, a question popped into my head.

"Then, Director... what you said to the professors earlier..."

"Ah, you mean the part about the one-stop system?"

"Yes. If what you're telling me now is true, it feels like there is a contradiction between what you wrote on that paper and told the professors, and what you are telling me now."

"I didn't call it benchmarking at first, did I? If I recall correctly, I only laid out abstract, idealistic words."

"Yes."

"It's a persuasion technique."

"A persuasion technique?"

"If you start by proposing an impossible, extreme measure, give them time to think, and then present a new revision that looks like a realistic compromise, how do you think the professors will react?"

"...Ah!"

Only then did I finally grasp the full picture. The director never had any interest in an idealistic, one-stop utopia department where an Emergency Medicine resident did everything by himself. Even if he eventually gave a few privileges to a guy named Han Hyeonjae, he had intentionally pushed an extreme measure at first so that it would look like he was giving up a massive amount of ground later.

If he hadn't become a hospital director, he probably would have made a great con artist.

The director checked the clock.

"Shouldn't you be heading back down? The head of Emergency Medicine must be waiting anxiously."

"Yes, sir."

I stood up from my seat.

"Thank you, Director."

"Run along."

I gave him a polite bow and stepped out of the medical director's office.

Click—

The door closed, leaving me alone in the long hallway.

But even if it isn't a super all-board department, opening a brand-new medical department is still a highly burdensome project. Why is the director going this far? And why go through all this trouble just for me?

I quietly looked back at the door of the medical director's office.

I'll just ask him next time.

Ziiing—

The moment the automatic doors of the Emergency Medical Center slid open, a chaotic scene greeted my eyes.

"Oh, Dr. Han! You're back! Please look over here!"

"Patient, you shouldn't pull that out!"

"Hey! I said I got here first! Why hasn't a single doctor shown their face to me yet?!"

The absolute madhouse that was the emergency room.

"Sigh... Yeah, this is my real job."

...

"Patient, I've given you a painkiller, but it takes some time to kick in. Looking at your symptoms, it strongly resembles a migraine, but a definitive diagnosis has to come from Neurology..."

"Then can't I just be admitted? Can't I get hospitalized and get a full workup, like an MRI and everything?"

"If you really want, I can order a CT scan for you, but the emergency-exclusive CT room has a massive waitlist right now. It might take over an hour."

I added with a deliberately serious expression, "And as for hospitalization, we can't really issue an admission order for a suspected simple migraine when it isn't an acute brain disease like a cerebral hemorrhage or a cerebral infarction. We just don't have enough empty beds."

"Is that so..."

"You see that large secondary hospital across the street? They allow for same-day outpatient visits, so going to their neurology department would actually be much faster for you."

"Aigoo... Alright, then. I feel like I'd pass out just waiting around here."

"I'll have your medication ready for you, so please take care on your way out."

Though the patient grumbled, he accepted the explanation and stood up from his seat.

"Whew."

To think that less than a day after debating the macroeconomics of medical systems with the director, I was back to routing migraine patients to other hospitals.

Once the situation was somewhat sorted out, I dragged my exhausted body toward the station. In the center of the station, Fellow Lee Minjae and Department Chief Park Woong were looking at a monitor with serious expressions, sharing a conversation.

"...So for now, I've transferred them to the ward."

"Hmm, right. That's not a bad call. If anything, moving them up to a general room to monitor them is... Oh? Hyeonjae, you're back?"

Park Woong looked up and spotted me.

"I'm back, Chief. I just came down."

"Right, right. I already heard from the secretariat office. Anyway, I've been briefed on the general gist of that plan."

Park Woong scanned me with a meaningful gaze.

So it already reached the chief's ears.

"Let's catch up and have a talk about it later, alright? If we're going to adjust your dispatch schedule, we'll need to rewrite the doctor's office schedule entirely."

"..Yes, understood."

"Take it easy. Don't burn yourself out the moment you get back."

Park Woong patted my shoulder and disappeared toward the chief's office. The moment he left, Lee Minjae, who was standing right next to me, lunged forward.

"Hey, Han Hyeonjae."

"Yes, Teacher."

"What plan? What are you up to? Did you cause trouble?"

He was exactly what you'd expect from the number-one news source in the doctor's office, a man notorious for his mind-boggling nosiness.

"Ah... there is something like that. It's just that nothing is finalized yet."

"What is it? A double board? Are you going to get your Emergency Medicine board and then try for another department? Or are you running away? Where to? Internal Medicine?"

"It's nothing like that..."

"Then don't tell me..."

Lee Minjae gasped dramatically, a look on his face as if he had just uncovered a tremendous secret.

"Don't tell me you are the one going to Johns Hopkins for training?!?! I heard a TO opened up this time!!"

Lee Minjae grabbed my shoulders and shook me violently back and forth. My head wobbled loosely.

"Johns Hopkins! A place even I haven't been to! A mere resident?!"

"No, it's not! You're wrong! It's not training!"

I shook my head frantically. Johns Hopkins? More like Geoje Hopkins.

"It's not? Tsk... What a shame. I really thought it would be you..."

Lee Minjae let go of my shoulders with a disappointed look.

"It's not. I'll tell you about it later."

"Really? Well, alright."

Lee Minjae clacked away at his keyboard before suddenly turning back to me as if a thought had crossed his mind.

"Oh, right. Take this."

Lee Minjae rummaged through his gown pocket and pulled out a crisp, elegant envelope, thrusting it toward me.

"What is this? A disciplinary write-up?"

"Stop being a jinx. It's a wedding invitation."

Pffffft!

I almost spat out water I wasn't even drinking. Well, I basically spat out air.

"Pardon? You're getting married?"

"Yeah. I'm getting married. Next month."

To think that this person, whom I thought was a permanent emergency room ghost, actually found a match. Could there be a crazier event in this world?

"Congratulations, sir."

"You know Shin Yeeun from Dermatology? I think she's a senior two years ahead of you."

"Ah, yes, Teacher. I think I've heard of her... She was a real beauty and a top student..."

"Yeah, exactly. She opened up her own clinic in Seomyeon recently. Anyway, with her."

A private dermatology clinic owner in Seomyeon and a university hospital emergency medicine fellow. How should I put it... it felt like the ultimate union of capitalism and humanitarianism. To be completely honest, I could bet my entire life savings that Lee Minjae must have saved the country in his past life.

"Wow, that's completely unexpected. With you, sir? Did you charm her, or did you kidnap her?"

"Hey, watch your mouth, you punk. It's love, love. Man."

His networking skills were truly incredible.

"Since we're on the topic."

Lee Minjae nudged my side with a sly grin.

"You're a 3rd-year resident now, and in another year and a half, you'll be a specialist. Summer is right around the corner, and your side must be feeling pretty chilly."

"Why would my side feel chilly in the summer..."

Is this guy seriously bullying a poor resident like me just because he's getting married? What a wicked man.

"Besides, I am kept perfectly warm by the fever of my patients."

"Cut the crap."

Lee Minjae whipped out his phone and scrolled through something.

"Listen up. One of Yeeun's friends is really great. Do you want me to set you up on a blind date?"

Creak.

My head turned toward him in slow motion.

"Pardon?"