Chapter 19

Episode 19 Not a Cold? (3)

I hung up the phone with Park Wooyoung and immediately looked up the contact information for the Thoracic Surgery on-duty doctor to make a call. My heart was pounding even harder than before.

"Yes, this is Kim Dojin, 3rd Year in Cardiothoracic Surgery."

"Hello, Teacher. This is Han Hyeonjae, 1st Year in Emergency Medicine. I am calling regarding a patient."

I reported much more concisely than before, because surgeons hate long explanations.

"A 54-year-old male patient with an Inferior Wall Myocardial Infarction accompanied by a Right Ventricular Infarction, currently maintaining a blood pressure of 90 over 60. A procedure is scheduled in Cardiology, but the patient's condition is highly unstable, so the possibility of cardiogenic shock or cardiac arrest during the procedure is judged to be very high. I am contacting you in advance regarding a VA ECMO backup before the procedure."

The 3rd Year in Thoracic Surgery on the other end of the handset was silent for a moment. Just as an anxiety that I might have gone too far started to creep in...

"...Wait a minute. You said you're a 1st Year in EM? Not Internal Medicine, but Emergency Medicine?"

"Yes, that's correct. I am calling on behalf of the Cardiology teacher."

"...Ah right, it's nothing major, but that's the cleanest call from a 1st Year I've ever heard. No fluff at all. Hold the fort well. I'm coming down."

The call disconnected. I stared blankly down at my cellphone.

Huh? Suddenly? I got a compliment? How? Without asking anything else? How? No, why in the first place? Why?

I closed my eyes for a moment. My mind spun dizzily, and like a panorama, the memory of that night a few days ago flashed through my mind—the day my sacred day off was completely stolen from me, that memory of tutoring that felt like hell.

In the void before my eyes, right above the cheap sofa in my officetel where I lay like a corpse, a blue gallery window was floating.

Latte is Mine: You idiot! Do you think a Myocardial Infarction always presents with chest pain? That's just bullshit that comes out of textbooks! Elderly people with diabetes just come in saying they have no energy, and someone else comes in saying their stomach feels upset! Pain in the jaw, pain in the neck, pain in the back! You have to suspect all of it! The moment you blindly believe the words a patient says, you're not a doctor, you're just a receptionist!

In a half-asleep state, I replied half-heartedly, without any soul.

ㄴ Korean Slave 1 (Male): Ah, yes, yes, I get it, master. If the whole body hurts, it's all a Myocardial Infarction, got it.

The screen shifted, and dozens of EKG waveforms zipped past before my eyes.

Cardiology Ghost: Now, this is an Inferior Wall infarction. Then, what did I say you have to look at first? V4R! Right Ventricle! Why? Because the treatment changes! If you give nitro, the patient dies! What's this? Anterior wall infarction! This? Posterior MI! Then where do you attach the leads? V7 to V9! Etch it into your brain, you bastard! If you can't memorize it, I'll drive electrodes directly into your heart to make you memorize it!

I writhed in pain. And at the very end of that night, right before my consciousness was about to cut out completely, a comment someone had carelessly thrown out appeared.

ㅇㅇ(223.39): But you guys are talking so peacefully. If it's an MI that has extended all the way to the RV (*Right Ventricle), cardiac arrest happens so easily while trying to open the vessel. Shock happens easily too. In our hospital, when a case like that came in, we always called CS (*Cardiothoracic Surgery) to have the ECMO team standby before we started. Not preparing for that is basically saying you're going to let the patient die, isn't it?

Back then, it was just something I brushed off... As expected, experience isn't gained for nothing.

However, there was no time to get lost in those sentiments. Why? Because right now, from a distance, the sound of running footsteps started to be heard.

The automatic door at the entrance of the Emergency Room opened, and a man with a sweat-drenched face ran inside. It was Park Wooyoung from Cardiology, whom I had been talking to on the phone just a moment ago. Of course, it wasn't that I recognized his face or saw his name tag. But who else would come running frantically into this quiet Emergency Room at this hour if not the on-duty doctor from Cardiology?

"Infarction...! Where...!"

"Yes, Teacher! Right here!"

I pointed to the B-28 bed.

Park Wooyoung, who had run over, checked the patient's state of consciousness first, then snatched the EKG printout sheet that was held in my hand and finished scanning it in just two seconds.

"It's completely blown. Is the blood pressure still in the 90s?"

"Yes, 500cc of IV fluid has gone in, but it's barely maintaining 90 over 60. The heart rate has dropped to 50 beats per minute."

"It's in this shape even though fluids are going in? What the... the right ventricle must be completely knocked out. Complete occlusion."

Park Wooyoung muttered to himself as he turned on the portable ultrasound. He then applied gel to the patient's chest and placed the probe against it. On the monitor screen, the image of the heart beating with great difficulty appeared.

"Look at the movement. The inferior wall and the RV... the walls are barely moving. The diagnosis is certain."

Park Wooyoung soon put down the probe and turned to look at me.

"Not using nitro, giving fluids first, and calling CS—you did well..."

Park Wooyoung gave my shoulder a firm tap. At that moment, another group charged toward the Emergency Room. It was the Thoracic Surgery team.

Behind the Thoracic Surgery team, a heavy ECMO cart was following along. The 3rd Year from Thoracic Surgery who had answered the phone ran ahead at the front and stopped in front of Park Wooyoung from Cardiology.

"I am Kim Dojin, 3rd Year in Thoracic Surgery. I came after receiving the call. Where is the patient?"

Park Wooyoung from Cardiology immediately pointed to the patient as if he had been waiting.

"Ah, Thoracic Surgery? The patient is here. He's still holding on, but his condition is really... For now, we're going to move him to the intervention room as fast as possible to open it up, but if the blood pressure drops further or an arrest happens during the procedure, I'll call you right away, so please wait nearby."

"Yes, I understand, Teacher."

The patient's bed started to move. Numerous IV poles, creaking monitor equipment, and the medical staff surrounding them. I stood at the very back of that procession, blankly watching their backs.

The patient had now left my hands. Whether he lived or died was now up to God, Cardiology, and Thoracic Surgery.

I turned my gaze back to where the bed had been. Once the patient and the medical staff disappeared into the elevator, silence came over the Emergency Room bed like a lie. Only the gauze fallen on the floor, a discarded syringe cap, and an empty bed that had lost its owner remained.

Whew.

As the tension released, a terrible fatigue filled the space where the adrenaline had drained out. A growling sound echoed pitifully from inside my stomach.

Ah. Right. Lunch.

Only then did I recall the fact that I was just about to go eat. What happened to Kim Jihun, and what happened to my spicy stir-fried pork?

I blankly lifted my head and looked at the clock hanging on the station wall.

Oh, fuck. My lunch hour... it's completely gone, goddammit.

It felt futile.

'Ah... my precious spicy stir-fried pork.'

I said goodbye in my heart to the spicy stir-fried pork on the cafeteria menu that way, and trudged back to the station.

'Gallery.'

What would those crazy ghost bastards be chattering about at a time like this? Would they be holding a debate or something about my heroic performance?

As soon as the blue interface popped up, I let out a dry laugh.

Title: [Super Breaking News] Hell Slave 1 <<<< This bastard caught an AMI with just a sore throat lol

Author: Operating Room Ghost 3 (Male)

Title: Summary of Hell Slave's performance today.txt

Author: Psychiatry Ghost

And the concept post with the most recommendations and comments:

Title: Hell Slave 1 << Upvote if you think this bastard's observation skills are insane lol

Author: ㅇㅇ (223.39)

I gave a hollow chuckle and clicked on that post. The comment section was already burning hot.

ㅇㅇ (14.52): Wow... he actually caught this. I acknowledge it. How do you see an MI from a sore throat? If I were the EM on-duty, I would've just given cold medicine and sent him home.

Hippocrates' Descendant: Does the sense of the living indeed surpass the knowledge of the dead... This is deeply interesting.

Operating Room Ghost 3 (Male): That was insane, for real. That kind of sense is something you're born with, truly.

Psychiatry Ghost: (Icon of a dumpling giving a thumbs up)

Mes of the God (Male): He was lucky. But luck is a skill too.

Cut the bullshit. I just didn't forget the information you people crammed into my brain on my day off, that's all.

I kept scrolling down. There was no sign of it ending.

ㅇㅇ(Semi-fixed IP): So is that really a myocardial infarction?

ㅇㅇ (182.215): When did you read the EKG? Can't you take a picture of the EKG and show it? Give us the picture right away. I'm getting dizzy here.

Hematoma is Hell: Hurry up and come write a review, Hell Slave lol

Back Gallery-er (1.234): Not even chest pain, but a sore throat, what the fuck lmfaooooo

Bone Nerd 88 (Male): But wasn't calling CS in the comments a bit of an overkill? It seems like it could have been handled at the Cardiology level.

ㄴ ㅇㅇ(118.235): You don't know what you're talking about. For an inferior wall myocardial infarction accompanied by a right ventricular infarction, maintaining blood pressure is a matter of life and death. There are so many cases where they go down in an instant. Calling for an ECMO backup was a stroke of genius.

I stared at the screen full of compliments, analyses, and mockery without any emotion. To these ghost bastards, this incident was just an interesting case, and I was a competent streamer.

These ghost bastards wouldn't know. The fact that I missed the spicy stir-fried pork, which was today's lunch menu, as the price for playing this hero game.

Sigh...

I quietly closed the window of the gallery, without even checking the points in the bottom right.