Chapter 47

Episode 47 What on earth went inside? (完)

I tried my best to ignore Park Seongjeong (Male)’s bright red face and the deep despair (2) reflecting in his eyes.

Yes, Seongjeong.

This is how you grow strong.

I gave Park Seongjeong (Male)’s shoulder one last pat, returned to the station, and input a few additional orders.

“The patient is in a lot of pain, so for now, give one ampoule of the painkiller Ketorolac via intramuscular injection. And to pull that thing out, the muscles need to relax a bit, so try giving about 2mg of Midazolam slowly via IV injection. It’ll make the patient a bit drowsy and relieve the tension. Then it will be much easier.”

“Yes, teacher….”

Leaving that soulless response behind, I returned to my seat. Now, my role was truly finished. I had made the diagnosis, set the plan, and even assigned the personnel to execute it. Where else could you find a more perfect delegation of duties? I sipped my coffee again, feeling highly satisfied.

However, that peace (again) did not even last for five minutes.

“Aaaaaargh!!!!”

From deep within Area B, a horrific, desperate scream erupted—one that was hard to believe could come from a human being. Everyone at the station reflexively turned their heads toward that direction.

…It seemed Seongjeong had failed.

I pressed my hand against my forehead. With a scream of that magnitude, he didn’t just fail; he must have seriously messed something up. Sure enough, a nurse came running out.

“Dr. Han. Uh… the patient in Bed B-8… I think you need to go check on him. The intern was doing something, and suddenly the patient….”

Damn it, isn’t there anyone else?

I desperately scanned the surroundings. Another sacrificial lamb—no, no—another intern who could help me navigate this hell-like situation. Right, there was definitely one more. We had two interns on duty today.

Ah. Right.

My radar caught another pure soul diligently organizing EKG paper on the opposite side of the station.

“Minseong, let’s go!”

Choi Minseong. Right, we had him.

I snapped up from my seat and walked toward Choi Minseong like a man who had just met his savior. Then, I firmly grabbed his shoulders.

“Huh? Teacher? Where are we going?”

“There is a very rare and educational case. It’s a scene you might see only once in a doctor's life. A senior should personally take care of you and show you things like this. Follow me.”

Allowing no room for argument, I practically forced Choi Minseong forward by pushing his back and headed toward Area B.

Don’t worry.

There are plenty of interns.

Probably.

Pushing past the curtain, Bed B-8 was an absolute shambles. The patient was twisting his body on the bed, groaning in pain, while Park Seongjeong (Male) stood there with a pale face, completely at a loss. The latex gloves in his hand made it easy to guess the full story of the disaster that had just happened.

Looking at the wretched scene, I let out a deep sigh. Then, I put on the mask of a highly competent and calm senior doctor.

“Seongjeong, what’s going on? Explain calmly.”

“Te… teacher… I, well… gave the injection and thought the patient had relaxed… so I made him lie down on his side… and tried to pull it out… but the patient suddenly started screaming….”

I nodded and checked the patient's condition.

“Seongjeong, did you perhaps only tell the patient to relax his body without making him do abdominal breathing?”

“Huh? Abdominal breathing?”

“You should have guided him to take a deep breath in through his stomach and let out a long, deep sigh to release all the strength in his body. The sphincter naturally relaxes when you exhale, so you should have aimed for that timing.”

“Ah….”

“And the position. You just have the patient lying on his side right now. You should have adjusted his posture so that his knees are pulled up as close to his chest as possible. That way, you secure enough space for the foreign object to come out. In an awkward posture like this, it gets caught inside and won’t come out at all.”

I began to logically analyze the causes of the failure one by one. If there was one thing I studied truly hard during my intern days, it was this. Because I wanted to avoid seeing a horrific sight as much as possible…

“The most important thing is the direction. You were just trying to pull it straight out, weren’t you?”

Park Seongjeong (Male)’s eyes wavered. It seemed I had hit the bullseye.

“Our intestine has a curved structure that bends inward in an S-shape. Especially because of the sacral bone, there is a curve that bends backward once. If you ignore that and just pull, it won’t work.”

Following my perfect analysis, the looks in the two interns' eyes shifted slightly. Honestly, this was all thanks to me casually browsing through an informational post titled 'Removal of Rectal Foreign Body.txt' from the gallery while drinking coffee a moment ago.

“Both of you, come over here and take a good look. Failure is the mother of success. Based on Seongjeong’s noble failure, we are now moving forward to success!”

I snapped on latex gloves and made a solemn declaration.

“From now on, we begin the second attempt….”

And then, I snapped back to reality. Before my eyes, there was still a patient writhing in pain and shame, and in my hand were the clean latex gloves I had just put on. And in my mind, the cold, harsh truth echoed: 'You are someone with clumsy hands who can’t even catch a proper IV line.'

Me? Do this? Personally?

'No, I can do it. I just need to follow the theory I explained a moment ago. Adjust the position, guide the breathing, match the angle and….'

A perfect simulation ran in my head. However, my body and my hands seemed to have absolutely no intention of following that simulation. My fingertips began to tremble slightly. The recent failure of intern Park Seongjeong (Male) and the patient's horrific scream brushed past my mind.

What if, what if I fail too?

What if I, who lined up that grand theory as if I were some amazing person and solemnly declared the second attempt, fail just the same?

The nickname 'Han Hyeonjae (Male), the mouth-fighter who is only good at theory' would start circulating among the interns. Besides, this isn't something that absolutely must be done right this second, nor is the patient's life in danger, right?

I suddenly stopped moving. Then, I put on a very serious and cautious look. The two interns held their breath, waiting for my next move.

“No.”

“Yes?”

“…This won't do.”

I pulled off the latex gloves I had worn for less than a minute and tossed them into the medical waste bin.

“Not right now.”

“What… do you mean by that won't do?” Park Seongjeong (Male) asked.

“Removing it by hand. We shouldn’t do it right now.”

I began to explain, pretending to make a highly serious medical judgment.

“Listen carefully, guys. Seongjeong made the first attempt earlier. Even though it failed, it was an attempt with very important diagnostic value.”

Question marks popped up on the faces of the two interns.

“Through that attempt, we learned one important fact. The patient's sphincter tone is high beyond expectation. And because of the pain and anxiety caused by the failure of the first attempt, the probability of success is extremely low even if we try a second time right now. In fact, if we rashly force it and end up scratching the rectal mucosa, it could lead to bigger complications like bleeding or perforation.”

Smoothing down my doctor's gown, I delivered a conclusion like a highly wise senior.

“In times like this, a true professional doesn't let pride dictate a reckless approach. Choosing the safest and most certain method is what it means to be a real pro. For the sake of the patient.”

I solemnly declared.

“Let’s call Gastroenterology!!!”

At my declaration, the two interns stood with dazed expressions for a moment, but soon nodded as if deeply impressed. This was entirely a decision for the patient. Yes, it was.

Leaving the two interns behind, I exited Bed B-8 with very natural, heavy-sounding footsteps. Sorting out the aftermath was the interns' job. Feeling as though a heavy burden had been lifted from my shoulders, I leisurely returned to the station.

I sat in front of the computer and logged into the EMR. I clicked the 'Consultation Request' tab and selected 'Gastroenterology.'

[Consultation Request Form]

Requesting Dept: Emergency Medicine

Well, right, since I am in Emergency Medicine for now.

Receiving Dept: Gastroenterology

Since they need to use an endoscopy, the receiving department is Gastroenterology.

Primary Diagnosis: R/O) Rectal Foreign Body

This part is obvious.

History: Patient visited the hospital today with a chief complaint of a Rectal Foreign Body. Following a failed first manual removal attempt, the patient's pain and sphincter spasms have worsened, leading to the judgment that further manual removal carries a high risk of rectal damage. It is considered that endoscopic removal is required, so we request a consultation. Currently, the patient's vitals are stable, and there are no findings suggesting perforation on the abdomen X-ray. We request a prompt reply.

The moment I hit the enter key, I was liberated from all responsibilities and obligations.

Hahaha. Now, this troublesome problem belongs to the Gastroenterology on-duty doctor. I leaned my body deep into the back of the chair.

About twenty minutes after submitting the consult, a man with a face drained by fatigue approached the emergency room station. It was the Gastroenterology on-duty doctor.

“Emergency Medicine Dr. Han Hyeonjae (Male)?”

“Ah, yes! I am Han Hyeonjae (Male).” I snapped up from my seat.

“Rectal foreign body… first removal attempt failed. So, how is it now?”

“We administered a sedative and painkiller to the patient and are monitoring his progress. Vitals are stable, and there are no signs of perforation.”

“Hm….”

Stroking his jaw, he stared intently at the X-ray picture. Even after seeing the clear silhouette in the picture, his expression didn't change much. Then again, a gentleman like him might be completely unfazed by this level of stuff.

He scrolled down to check my charting, tilted his head, and asked, “The chart only says foreign body. So, what exactly went inside?”

The moment of truth had come.

I scanned the surroundings for a moment. Nurses and other doctors were busily moving back and forth across the station. I lowered my voice as much as possible, stepped closer to him, and confessed in a tiny whisper.

“That….”

“Yes?”

“An adult… yes….”

“….”

The Gastroenterology on-duty doctor froze.

“Ah… right….”

He tried his best to maintain a calm face, but he couldn't hide his lips twitching willfully.

“Haha… haha….”

Without asking anything further, he headed toward Area B, saying, “Let’s go see the patient first.”

Following behind him, I thought to myself: it was the most awkward consult scene in the world.