Chapter 21

Episode 21 Today, Too, the Peaceful Emergency Room (2)

30 minutes later.

Leaving behind an unprecedented diagnosis, Dried Seaweed Man disappeared into the Endoscopy Room, led by the hand of the Gastroenterology Fellow. Looking at the now empty Area A, I mused over the one word Sung-hoon Yoo had thrown out a moment ago.

"Because it’s a scene you’ll never again see in your life."

Would it really be though?

In this hell-like Emergency Room, all sorts of crazy, unimaginable things happened every single day. From a guy carried in after downing a whole bottle of Viagra to brag about his stamina, to a gentleman who drank industrial alcohol in his drunkenness and came in complaining he couldn't see. Dried Seaweed Man had merely added his name to that legendary list. Who knew what kind of crazy bastard would show up next to test the limits of my imagination?

Thinking that way, it was the exact moment I returned to the Station and was about to sit on the chair.

"Aaaaaaaaargh!"

Some man came screaming and charging into the Emergency Room.

What is this, a bomb terrorist?

No, rather than saying he ran in, it was more accurate to describe it as him practically rolling in. The man completely ignored the nurse’s shout telling him to follow the procedures at the triage desk, clutching his stomach as he crawled straight across the floor.

"S-Save me!"

Today's second villain had taken the stage.

"Patient, please calm down for now... Where does it hurt so much?"

"My... my stomach."

The man barely managed to answer amidst his pain. His face was slicked with cold sweat, and his lips were stark white. It surely didn't look like malingering; he was clearly suffering from truly excruciating pain.

I squatted down next to the man and asked again, "Your stomach? How exactly does it..."

"My anus... and stomach... they hurt..."

Anus? I narrowed my brow.

"It feels like my entire stomach is just on fire! Like it's being stabbed with a knife! Aaaargh!"

Acute appendicitis? Diverticulitis? Or maybe a bowel perforation? All sorts of horrible differential diagnoses flashed through my head.

"...Did you happen to eat something?"

Even in the depths of pain, the man replied with incredibly clear pronunciation.

"...Nuclear Fire Chicken Noodles with extra capsaicin."

"..."

Without realizing it, I slapped my forehead with my palm. Fire Chicken Noodles? And with extra capsaicin on top? Why at all do people pay their own money to commit chemical terrorism on their own bodies? The devil inside me roared.

"Patient, let’s get you lying on a bed for now. It must be very tough for you." I gestured to the surrounding nurses. "Move him to a bed and grab an IV line quickly! Mix Tagamet and Metoclopramide into 1 liter of normal saline and run it as fast as possible, and let's have him take a gastric protective gel right away!"

The nurses moved in perfect unison, transferring the man to a bed. Standing beside him as he continued to clutch his stomach and groan, I said, "Patient, you'll feel a bit better once you get the injection and take the medicine. And just in case, I’ll let you know the location of the restroom in advance."

I pointed toward the very end of the hallway.

"It's on the left at the end of that hallway. It'd be best to know beforehand. The signal will probably come soon."

Looking at my arm, I rolled up my sleeves. "I'll catch the IV line."

The nurses looked busy, so the least I could do was handle the line myself. Confidently, I tied the tourniquet and wiped the skin with an alcohol swab. The blood vessel was great. Thick and elastic, it looked remarkably comfortable. With a vein like this, I could catch it with my eyes closed.

Holding the catheter, I took one deep breath.

Poke.

...Uh?

I surely felt the sensation of penetrating the blood vessel, but there was no flashback of blood. A failure. The man's arm flinched.

"Sorry, patient. The blood vessel moved a bit..."

Making a pathetic excuse, I adjusted the angle once more. This time, for sure.

Poke.

...Ah.

This time it went too deep. It had punctured straight through the blood vessel. The moment I pulled the needle out, a dark blue bruise puffed up in an instant. It was a failure on the second try.

I quietly laid down the catheter. A 'knew that would happen' look flashed across the face of the veteran nurse watching me from the side.

Hmm. Let's just leave it to the Nurse!

Acting as if I were magnanimously stepping aside, I pretended nothing was wrong. The nurse took the tourniquet and catheter from my hands, and without a single moment of hesitation, succeeded on the very first try.

While trying my best to look unbothered, I wept on the inside. When on earth will my hands get skillful, when?

The clock pointed to 6:50 PM.

10 minutes. If I could just endure for 10 more minutes, this hell-like shift would finally be over. I sat on the Station chair, blankly staring at the clock hands ticking away. Please, let nothing happen just like this.

However, the God of the ER was always cruel.

"Ex... Excuse me!"

At the Emergency Room entrance, a man walked in with an awkward posture, holding the side of his mouth.

Ah, why must you come at this exact time, patient?

Swallowing my tears, I approached the man. "How can I help you?"

The man hesitated before starting to speak. "My tooth is dangling."

"Your tooth is dangling?" I repeated his words, examining his face. A dark blue bruise along with a scraped abrasion was visible on his left cheek and jaw.

"How did this happen?"

"I lost my footing on the stairs and fell face-first."

"Did you happen to hit your head while falling, or lose consciousness even for a brief moment?"

"No, I don't think so. It's just my tooth... my tooth feels weird."

For now, I first excluded any brain damage caused by trauma. I checked the patient's pupillary reflex and performed a simple neurological examination. There were no obvious abnormal findings, but for a trauma patient, one must always assume the worst.

"Patient, first, to check if there are any issues with your head, we will take a head CT."

After sending the patient to Radiology, I caught my breath for a moment. The CT would read the head issue. But what at all was I supposed to do about that 'dangling tooth'?

Crouching in the corner of a chair, out of habit, I opened the Gallery window.

Title: [URGENT] Trauma patient, tooth subluxation. What do I need to do for this in the ER?

Author: Korean Slave 1 (Male)

30s/M, tooth subluxation after a fall. Sent him for a CT to rule out brain damage. He says his tooth is shaking like crazy, what do I need to do for this in the emergency room? I know I have to call dental, but is there anything I can do before that?

ㅇㅇ (118.235): We are doctors, not dentists.

Latte is Mine: Tsk tsk. If you wanted to know that, you should have gone to dental school. I'll look at tongue cancer, but I don't look at teeth.

Mes of the God (Male): Teeth are not my domain.

Plastic Surgery Ghost: Isn't there a dental clinic where you got your wisdom teeth pulled? Ask them lol. Those people are the experts.

This was the first time these gentlemen were completely useless. With a hollow laugh, I closed the window.

A moment later, the CT results came back. Fortunately, it was normal.

"Patient, your head is fine. Now let’s look at the problem tooth. Open your mouth, please."

In any case, it wasn't like I graduated from dental school. I only knew the basics. Just the absolute basics.

The basics of dental trauma: if the tooth comes out completely, it's an avulsion, and it must be placed in a preservative solution and sent to the dentist as quickly as possible. But this wasn't out; it was just dangling. A subluxation.

Shining my penlight, I peered into the patient's mouth. One of his upper front teeth was noticeably out of position, and blood was oozing from the gums.

"I will check just once to see how much it's shaking."

With my hands in latex gloves, I carefully and lightly touched the front tooth. My only intention was to check which direction and by how much it moved.

"Alright, let's see how much it sha—huh?"

It was at that exact moment. A very small, unpleasant clicking sensation was felt at my fingertips.

And in my hand, the front tooth that had been attached inside the patient's mouth until a moment ago was now sitting there quietly. A perfectly shaped front tooth, completely intact down to the root.

...Fuck.

I had pulled out the patient's tooth.

A silence fell.

Both the patient and I stared at each other with wide eyes. Blood began to flow from the patient's mouth. I stared alternately at the tooth held in my hand and the patient's toothless gums. My brain was denying reality.

No, what did I even do? I just touched it.

"T-Teacher... my tooth..."

The patient's voice was trembling. At that voice, the string of my reason snapped.

"Uh... Uh-oh!! N-Nurse! The dental hospital here! Get a dental on-duty call, anyone, quickly!" I practically screamed.

Inside my panicked mind, all sorts of miscellaneous knowledge began to tangle together.

"And this! How do you save this tooth? Milk? It's milk, right? Go to the convenience store over there and buy a carton of milk quickly! Not low-fat! Regular milk!"

Right at that moment.

Thump.

Someone lightly tapped the back of my head.

"Sigh, you idiot."

Turning my head, I saw the 4th Year Lee Minjae looking down at me with a pathetic expression. It seemed he had witnessed the entire commotion from a moment ago.

"What are you doing right now? Why are you taking it out on an innocent nurse?"

As if Lee Minjae couldn't care less about my panic, he smoothly took the tooth from my trembling hand.

"What do you mean milk? We have plenty of stuff in the ER. Sterile normal saline."

He then skillfully directed another nurse right away.

"Nurse, please give me a 500cc saline bag and an empty container here to submerge the tooth. And Han Hyeonjae."

"Ye... Yes!"

"Find the dental contact number and call them right now. Tell them the patient has a complete tooth avulsion. Politely ask them to come as quickly as possible."

Thanks to the senior’s skillful tidying up, peace returned to the Emergency Room once again.

About 15 minutes passed. The Emergency Room automatic door slid open, and a man in a white gown walked in.

"I’m the dental on-duty doctor who received the call. Where is the patient?"

"Oh, hello, Dental Teacher!"

I stole a glance at the name tag stamped on his chest. On his gown, it read: Department of Oral and Maxillofacial Surgery, Myung-chul Jin.

Oral... and maxillo... what?

Oral and Maxillofacial Surgery. It was long. What at all does this department even do? Was it not just dentistry? Did it mean a surgery department that looks at the mouth, jaw, and face? Do dentists perform face surgeries too?

Hmm, that place is a mysterious world as well.

Even through 6 years of medical school, 1 year of internship, and my resident life, I knew next to nothing about the world of dentistry.

As if he had no way of knowing my complicated inner thoughts, the dental teacher stepped straight toward the patient. He then received the container holding the front tooth I had pulled out—no, that had fallen out on its own—and examined it closely.

"Hmm, the periodontal ligament is still alive. The success rate for replantation is high at this level. Don't worry too much."

Comforting the patient, he skillfully examined inside the mouth.

"The alveolar bone is slightly fractured, but it's fine to this extent. We'll go straight up to our department and treat it simply."

Like that, Tooth Man went up to the dental hospital examination room side by side with the dentist. Only after their backs disappeared past the elevator did I let out a long sigh.

All the strength drained completely from my body. A terrible reality check filled the space where the adrenaline had exited.

What on earth did I even do during this whole day today? I gloated about saving a myocardial infarction patient, only to experience a reality check from Dried Seaweed Man, got humiliated because I couldn't catch Fire Chicken Man's blood vessel properly, and finally, right before leaving work, I even pulled out a patient's tooth.

Is this a doctor? No, just a troublemaker.

I trudged over and threw myself onto the sofa. Then, without any thought, I opened the Gallery, my only sanctuary. I had to vent about this incident somewhere.

Title: Hey, I just pulled out a patient's tooth.

Author: Korean Slave 1 (Male)

A trauma patient came in 10 minutes before off-duty. I touched a dangling tooth and it just popped right out. I didn't pull it. It fell out on its own. Anyway, it did. Sent him off after a dental call.

The moment I posted the text, just as I expected, the ghosts started laughing.

ㅇㅇ (210.94): LMAOOOOOOOOOOOOOOOOOOOOOOOOO

Operating Room Ghost 3 (Male): You crazy bastard lmfaoooooooo you're really doing all sorts of bullshit now lmaooo

Respiratory Ghost: lmfaooooo now you're even doing tooth extractions on top of everything else

I stared blankly at the ridicule.

Yeah, laugh, laugh it up, you bastards. You guys probably won't ever have to worry about getting a tooth pulled. Because yours must have all rotted away already.

After a long period of mockery, someone opened the floodgates for a serious discussion.

Hippocrates' Descendant: What kind of structure is a tooth made of that it falls out so easily? Is it different from bone?

With that single question, the atmosphere of the Gallery shifted rapidly. These ghosts were always starving for intellectual curiosity, even if the field wasn't their own specialty.

Bone Nerd 88 (Male): Since that's similar to my specialty, I'll explain. A tooth is also a type of bone. It's made of calcium and phosphorus. But it's a bit different from regular bone. The inside contains nerves and blood vessels, and the outside is covered by something incredibly hard.

Latte is Mine: Then what's the principle behind it being embedded in the gums? Is it just stuck on with glue?

Bone Nerd 88 (Male): It's connected to the jawbone by a ligament called the periodontal ligament. So it won't fall out from normal impacts.

ㅇㅇ (118.235): But that Hell Slave bastard pulled it out. Doesn't that mean that bastard's strength is insane?

Mes of the God (Male): It's not that he's strong, he's just stupid. The periodontal ligament was probably already mostly severed from the impact. It fell out because he touched it thoughtlessly.

The discussion began to flow in an increasingly profound yet idiotic direction.

Infectious Disease Ghost: Do teeth get infected too? Aside from cavities. For example, bacteria traveling through the blood and causing pus to fill the tooth.

Hematoma is Hell: Isn't that possible? Like pulpitis. Then what antibiotic should be used? Does the penicillin class work?

Nephrology Old Timer: I heard that tooth decay is bad for the kidneys too. Bacteria can travel through blood vessels and cause inflammation in the glomeruli.

And finally, they reached a stupid conclusion.

Hippocrates' Descendant: If so, then this is the conclusion. A tooth is a type of endocrine organ in the form of a bone, a hotbed of infection, and a very dangerous organ that can cause systemic diseases! Therefore, pulling them all out preventively will help extend the healthy lifespan of humans!

...That's enough.

I quietly closed the window.

Let's just... go home.