Chapter 187

Episode 187 Today, An (Un)peaceful Emergency Room (1)

The automatic doors slid open, revealing a man propped up by someone else, both drenched in sweat. Behind them was a large group of teenagers who looked about the same age.

"Aaagh! Ugh, aaargh...!"

A blood-curdling scream echoed, completely shattering the peace of the Emergency Room lobby.

"Patient! Patient, stay with me! Look at me over here!"

The Nurse, who had just been chatting with me at the triage desk, instinctively bolted forward.

I also threw down the pulse oximeter I was holding and rushed toward the patient.

With screams like that, is it major trauma?

A femur fracture?

Or a stab wound?

At the very least, something was definitely broken or ruptured.

"What happened? Was there an accident right in front of the hospital?" I yelled urgently at the guardian, who appeared to be a friend helping the sweat-soaked patient.

To be in this much pain without arriving in an ambulance meant an accident must have happened somewhere nearby.

The friend looked pale as a ghost, trembling uncontrollably.

"No, well... uh... yes... I mean, no, it's not that...!"

"Please tell me. You have to tell me where he's hurt. I don't see any visible external trauma right now..."

"Uuugh, khhh..."

The situation was critical. If he was in that much agony, he could go into shock.

"Stretcher! Quickly!"

The emergency medical technician behind me dashed off. From inside, an Intern ran out and stood by, holding open the automatic doors leading deeper into the ER.

"Make way!"

While the intern cleared the path to the treatment room, I bent down to check the patient's condition.

There's no smell of blood. Where on earth is he ruptured?

"Guardian, where is the patient hurt?"

"He hurt his toenail! It's... it's a bit complicated to explain...!"

"...What?"

Had I misheard? A toenail, not an ankle amputation?

"Aagh... ugh... ah... my foot...!" The patient was still sobbing.

"His toenail? Did he, what, smash it in a door? Or did something heavy crush it?"

"No, uh... it got ripped off! His toenail was ripped off!"

The rushing EMT froze in his tracks. The expression on the intern holding the door turned into a giant question mark. I felt my own brain short-circuit for a moment.

Sure, having a raw toenail ripped off hurts. It hurts like hell. There's a reason pulling toenails is used as a torture technique. But this reaction was on par with having a leg chopped off.

"It was ripped off? Alright, I got it. Forget the stretcher, get a wheelchair! A wheelchair!"

"Yes!"

The EMT pivoted and wheeled a chair over. Together, we barely managed to get the groaning patient seated.

"Ah, it stings... shhh..."

"Calm down, patient. We'll look at it right away."

I looked down at his foot. His sock had been removed, and his right big toe was wrapped thick with toilet paper.

The blood hasn't bled through that much, though?

If it was a simple toenail avulsion, we just needed to disinfect it, suture if necessary, apply a dressing, and we'd be done. So why was he acting like he was on the brink of death?

"Did you do anything else after the toenail was ripped off? Like disinfecting it?"

"Uh... yes." The man who seemed to be the patient's friend spoke up, his voice dropping as he shrank back under my gaze.

"What happened? What did you disinfect it with? Hydrogen peroxide?"

Usually, pouring hydrogen peroxide causes it to foam up and sting terribly. However, the words that came out of the guardian's mouth defied all my expectations.

"Well... we poured Albochil on it. The stuff we had at home."

"...?"

The triage nurse, the EMT pushing the wheelchair, the intern holding the door, and me—everyone doubted their ears at the exact same time.

In all my years as an Emergency Medicine doctor, this was a first for a disinfectant.

Albochil? The Albochil I was thinking of? That legendary medicine that makes you breakdance from sheer agony when you dab it on a mouth ulcer with a cotton swab?

They poured that onto a raw, exposed nail bed where a toenail had just been ripped off? And they poured it?

They threw that stuff straight onto a throbbing, exposed nerve...

With that single phrase, I instantly understood why the patient was howling like a wounded animal.

While I examined the foot, the triage nurse turned to the pale guardian. "Guardian, what is your relationship to the patient?"

"Ah, yes! I'm his friend. A friend. We were just hanging out outside with some other guys... yeah..."

A friend. A friendship close enough to pour hydrochloric acid—no, Albochil—onto a buddy's raw flesh. Truly touching devotion.

"For now, go over to the administrative desk and register his name and information. Take a breath, guardian."

While the triage nurse skillfully guided the guardian outside the ER, I headed inward. The patient was still shivering and sobbing in the wheelchair.

With chemical burns, washing it out even a second faster is a matter of life and death.

"Let's get him into the treatment room first! Hurry!"

"Yes!"

The dazed intern grabbed the wheelchair handles and started running.

Clack-clack-clack—

"Bring me all the normal saline we have. The one-liter bags. We need to irrigate this!"

"Yes, sir! Got it!"

Undiluted Albochil is highly acidic. Since they poured it under a ripped-off toenail with exposed flesh, that toe was essentially undergoing a chemical burn right now.

Splash-splooosh!

Cold saline cascaded over the patient's big toe.

"Kuuuugh... ugh..."

"Hold still! If we don't wash this out, the nerves in your toe will die!"

We needed painkillers, fast. With this level of pain, he could go into shock.

"Give him Ketorac right away! 10 milligrams!"

"Yes, yes! Ketorac, right?"

"Yes, that's right!"

Splash.

Only after pouring three whole bags of saline—to the point where the floor was completely drenched—did the bubbling foam finally disappear, revealing the raw, red flesh. White, necrotic tissue caused by the strong acid could be seen in patches.

"Sniff..."

"Patient, are you regaining consciousness a bit? Can you hear me?"

"Ah... yes... Doctor..."

Before I knew it, Lee Minjae had walked up behind me, crossing his arms as he looked up at the vitals monitor.

[HR 145]

"Geez... he's Usain Bolt. He's about to set a new 100-meter record," Minjae tsked.

"Are you here, Doctor?"

"Yeah. I thought a war had broken out. Did you say Albochil?"

"Yes. Right on top of an avulsed toenail, straight from the bottle..."

"Kids these days certainly have guts." Minjae examined the patient's foot intently. "Did you call OS? The bone might have been nicked when the nail came off, so we need an X-ray."

"Yes, I called them. But... the burn is the main issue rather than a fracture."

"True. Slather it with some mupirocin-based ointment, cover it with Vaseline gauze, and dress it. That should do."

"Right, will do."

"Make sure to use a burn dressing set for this. Don't use a regular one."

I chuckled as I picked up some gauze. "I'm not an intern, you know."

"Weren't you going to make the intern do it?" Minjae pointed to the intern who was cleaning up the empty saline bags next to us. The intern was just rolling his eyes with a 'I know nothing' expression.

"...Well, true. Watch and learn, kid."

"Yes, sir! Understood!"

Thud, thud.

With the sound of exhausted footsteps, the on-duty Orthopedic Clinic resident pulled back the treatment room curtain and walked in.

"Orthopedics..."

"Ah, Doctor. Thanks for coming down."

The orthopedic resident glanced at the patient's foot, then pulled up the X-ray picture on the monitor.

"The bone is fine. The nail bed damage isn't severe enough to need sutures either. Just wash it out well and keep up with the dressings; the skin should grow back fine." He let out a sigh of relief, clearly grateful that he didn't have to open up an operating room.

"Is that so? Thank you."

"Yeah. Just have him follow up at the outpatient clinic later. The wound is a bit deep, and since it's a chemical burn, we need to monitor the progress."

"It should be fine, right? I'm planning to write the prescription like this."

The orthopedic resident scanned the prescription chart and nodded. Since Emergency Medicine deals with burn care more frequently anyway, he didn't seem inclined to micromanage.

"Yes, yes... EM probably sees burns more often than we do. I'm sure you've handled it well. I'll head back up then."

"Alright, thank you for your hard work."

As the zombie-like orthopedic doctor departed, I finished the dressing and ripped the tape. Thanks to the painkillers—or perhaps sheer exhaustion—the patient had calmed down a bit.

Taking off my gloves, I finally asked the question that had been bugging me.

"Hey, kid."

"Yes... Doctor..." the patient replied in a whimpering voice.

"What on earth were you guys doing to end up pouring that on it? I'm just curious. If your toenail got ripped off, you should have come to the hospital or put on some antiseptic iodine. Why Albochil?"

It wasn't a medical question. I didn't think knowing this would help with treatment, either. The motivation behind this question was pure anthropological curiosity.

"Ah... well... that is..." The patient shrank back, making excuses in a tiny voice. "We're... high school seniors, you see?"

"You're seniors. So what?"

"It's that time of the year when everyone goes a little crazy. And we were curious..."

Minjae, standing next to me, burst out laughing.

"Because you're a senior, you poured Albochil on your toenail out of curiosity? Hmm... I don't think so. Of all the senior patients I've seen, you're the first one to use Albochil."

"No, my friend... he saw on the internet that if you put Albochil on it right when the toenail pops off, it might disinfect it completely... and that it would only hurt for a second, so I got curious too and just..."

"......"

Pouring an acidic solution onto raw flesh out of curiosity?

"Usually, high school seniors don't practice self-harm," I muttered, shaking my head.

"...Anyway! Since we saw it somewhere, we thought we'd disinfect it and wake ourselves up at the same time... and, uh... it turned into this. Sorry."

"...Alright, you can be discharged. Your take-home medicine includes antibiotics and painkillers. If this gets infected, you could lose the toe, so make absolutely sure to come to the outpatient clinic."

"Yes... thank you, Doctor. Goodbye..."

The patient limped out, propped up by the friend who had been waiting outside. The friend was avoiding the patient's gaze, looking incredibly guilty.

Watching them disappear through the emergency room entrance, Minjae crossed his arms and tilted his head.

"Fascinating, truly."

"What do you mean?"

"How is it that nine out of ten of these bizarre cases are male high schoolers? It's statistically significant, really."

"...Hah." I couldn't even deny it.

"But Doctor."

"Yeah?"

Seeing the male high schooler's reckless Albochil expedition suddenly reminded me of something I wanted to ask—specifically, Minjae's own reckless rumor-mongering.

"By any chance, did you go around talking to anyone about my dating life?"

"Huh? Me?"

"?"

"?"

Uh-oh. Then who was it?