Chapter 59

Episode 59 The 1-Star Rating Amusement Park (2)

Even though my arrival for the Night Shift felt as vivid as a moment ago, the children's cries, the parents' anxious sighs, and the warning sounds from the monitors ringing without rest meant that the clock was already ticking toward 11:00 PM. Merely four hours had flowed by, yet I felt as if my soul had aged forty years.

The Pediatric Emergency Room was a literal miniature version of hell.

There were children suffering from febrile seizures, children wheezing for breath, and children with gastroenteritis vomiting like fountains and emptying their bowels. And right alongside them were the parents, weeping as they bore the full brunt of their children's pain.

Just then, a nurse at the station spoke up.

"Bed C-5 has been admitted for hospitalization, so one bed just cleared up."

At that exact moment, Head of Doctor's Office Lee Minjae sprang up from behind my back and roared.

"Finally...! Finally, a bed is free!!"

I stared blankly at Lee Minjae with hollow eyes.

"Uh, is that really that much of a good thing?"

"Is it a good thing? Hyunjae, you've lost your mind!"

Lee Minjae gripped my shoulder tightly and pointed toward the hallway.

"Did you forget that we had to lay kids down on temporary stretchers in that hallway earlier? You see that mess and you still think a free bed isn't a good thing? This is heaven! Now only nine beds are full! We went from 100% down to 90%! This is a miracle for the Pediatric Emergency Room!!"

At his loud shout, the guardians nearby started looking at us with anxious expressions.

"Uh, Teacher, maybe lower your voice a little..."

"Oops!"

Only then did Lee Minjae seem to notice his surroundings. Clearing his throat, he corrected his posture.

"Ahem. Han Hyeonjae. Thanks to the pediatric patient who was just admitted, a ray of light has shone upon the Emergency Room. Shouldn't we commemorate this miracle? The kids have stabilized a bit, so the Chief will specially buy canned coffee. Follow me."

"Oh, thank you, Teacher."

In front of the main entrance of the Emergency Room, the cold night air tickled my cheeks. For the first time in several hours, I pulled off my mask and inhaled the fresh air to my heart's content.

Lee Minjae stood in front of the vending machine and dropped in some coins. Two cans of coffee dropped with a heavy thud.

Ah. This is exactly the reason to keep living.

It was at that very moment.

Hmm, what is that...?

On the road across from the hospital, the pedestrian light at the crosswalk was surely red. However, two people were ignoring that red light entirely and sprinting across the road. Held tightly in their arms was something small wrapped in a blanket.

"Uh... Uh-oh? Teacher, look over there..."

My voice trembled.

"Uh... looks like a child?"

All the joy disappeared from Lee Minjae's face. The two people ran toward the Emergency Medical Center, shouting at the top of their lungs.

"Please save our son!"

The can of coffee in my hand fell to the floor.

"Cyanosis..." Lee Minjae muttered softly.

He was right. The skin around the child's lips and nose possessed a deep blue tint, looking almost as if it had been painted with watercolor.

We moved at the same time.

"I'll take him!"

I dashed toward the man and took the child from his arms. The child's body was limp, and his skin was cold. Why had this tiny body become so cold? Holding the child close, I ran into the Emergency Room alongside Lee Minjae, who was following right behind me.

"How old is the baby! When did this start?!" Lee Minjae ran with them, practically shouting at the parents.

"He's two years old! He was fine just a moment ago, but suddenly his breathing turned strange, and he started turning blue...!"

"Set up a bed in the pediatric Resusc room, quickly! Quickly! Let's get a call out to the Pediatrics on-duty doctor!"

Nurses moved busily to prepare the Resusc room, and someone came running while pushing a pediatric Emergency Cart. Holding the child, I sprinted toward the Resusc room. The weight of the tiny life in my arms felt like a thousand pounds.

With that heavy weight, I carefully laid the child down on the Resusc bed.

"Connect the monitor and hook up an IV line, quickly!"

Nurses attached EKG electrodes to the child's small chest and wrapped a Blood Pressure Cuff around him. Another nurse struggled to find a blood vessel in the child's foot.

"The child can't breathe! Airway first!"

Lee Minjae took his position at the head of the bed and secured the airway.

"Ambu bag! Where is the Ambu bag!"

Cyanosis. A sign that the body is severely lacking oxygen.

"Saturation! What is the oxygen saturation?!" Lee Minjae yelled.

A nurse clipped a Pulse oximeter probe onto the child's small toe. Everyone's eyes locked onto the monitor.

I swallowed hard. 80%? No, it might be in the 70s. In the worst-case scenario, it could even be in the 60s.

The monitor screen blinked. The number indicating the heart rate jumped up to 150. And finally, the oxygen saturation number appeared on the screen.

[ SpO2 : 85% ]

...

A heavy silence fell over the room. I doubted my own eyes.

"......What is this?" Lee Minjae muttered blankly.

"85%? He's this blue, but it only dropped to 85%? We're squeezing oxygen in with the Ambu bag, so why isn't the number going up? Is the machine broken? Switch the probe to the other foot! Quickly!"

The nurse hurriedly pulled the probe off and clipped it onto a different toe. The numbers on the monitor vanished for a moment, then popped up again.

[ SpO2 : 86% ]

Everyone in the Resusc room froze.

The child's lips were undeniably blue. The child was undeniably unable to breathe properly. The child's body was completely limp. Everything pointed to the typical, severe signs of hypoxia that occur when the body lacks oxygen.

Yet, the machine was merely hovering around that ambiguous number of 85%. Even though we were forcing high-concentration oxygen into his lungs.

I looked at Lee Minjae with confused eyes. Lee Minjae was also staring at the monitor with a dazed expression.

"A heart issue? Congenital heart defect? Or severe pneumonia? Sepsis?"

The most horrible words that flood a doctor's mind when facing a pediatric emergency patient poured out of Lee Minjae's mouth.

"No, this makes no sense." Lee Minjae shook his head. "For now, the probe! A new one! Bring a new one!"

At his shout, a nurse hurriedly dashed out of the Resusc room.

"Mother! Father! Pull yourselves together and listen to me! Right before the child became like this, what did he do? Did he eat something, bump into something, anything at all! Even the smallest detail!"

"Ba... Baby food..." the child's mother answered with a trembling voice. "For dinner, I ground up carrots and spinach to make him rice, and while he was eating, he suddenly started coughing and choking..."

"Baby food? He was coughing?" Lee Minjae's eyes flashed. A new possibility. "Is it aspiration?"

Muttering to himself, Lee Minjae rushed back to the head of the bed. He immediately picked up a small laryngoscope and carefully examined the inside of the child's mouth. He was checking to see if any food residue was caught at the entrance of the airway.

However, the child's throat was clean. He inserted a suction tip to draw out anything deep inside, but nothing came out except clear saliva.

"It's not aspiration either... Then what the hell is it!" Lee Minjae ruffled his hair aggressively.

Just then, the nurse came running back with a new oxygen saturation probe. Lee Minjae practically snatched the probe from her and clipped it onto the child's toe.

Everyone's eyes pierced the monitor once again.

[ SpO2 : 85% ]

Nothing had changed.

Before long, Lee Minjae pulled out his phone.

"...Is this Pediatrics on-duty? Yes, this is Lee Minjae, 4th year in Emergency Medicine. We have a 24-month-old patient in the pediatric Resusc room who came in with cyanosis... but his saturation is completely fixed at 85. Even though we're continuously giving him oxygen. Yes, you heard that right."

With the newly measured saturation coming out like shit yet again, there was no longer any reason for my mind to hesitate.

'I can't find the answer to this on my own.'

Pretending to listen to the child's breath sounds by placing a stethoscope on his chest, I pulled up the blue interface.

Title: Guys, pediatric emergency, super urgent, atypical

Author: Korean Slave 1 (Male)

A 2-year-old baby has cyanosis, but SpO2 is showing 85%. It's not a machine error, and it's not aspiration. We are continuously giving oxygen.

While anxiously waiting for a reply, a new comment popped up.

Hematoma is Hell: Suspect Methemoglobinemia. Did you do a history taking?

Methem... what?

Latte is Mine: That's it. It's a disease where the hemoglobin in the blood changes into a form that can't bind with oxygen. The blood is circulating throughout the body, but it can't deliver a single bit of oxygen. So the kid turns blue from lack of oxygen, but...

Cardiology Ghost: Did the kid's mom feed him well water or spinach by any chance?

Ah!

Cyanosis, a bizarrely fixed oxygen saturation, and baby food made of spinach and carrots. Every single piece of evidence was screaming toward one diagnosis: Methemoglobinemia.

I lifted my head. Lee Minjae had just ended his meaningless call with the Pediatrics on-duty doctor and was about to slide his phone back into his pocket.

I carefully opened my mouth toward Lee Minjae.

"Teacher."

"What."

"Could it perhaps be that?"

"What."

"Methemoglobinemia."

At that exact moment, Lee Minjae's body froze completely.

"Uh... um... right... Methemoglobin... uh... what?" Lee Minjae muttered.

Inside Lee Minjae's head, the faint memories of a hematology lecture from his medical school days were likely coming back to life. The discrepancy between cyanosis and oxygen saturation measurements. Nitrates. Baby food.

The look in Lee Minjae's eyes shifted from initial suspicion—what kind of bullshit is this guy talking about?—to absolute shock in the very next second.

"Huh? Huh?! Fuck, that's it!"

A curse of belated realization burst from Lee Minjae's mouth. Lee Minjae looked back and forth between me and the child on the bed with an expression of disbelief.

"Hey, Han Hyeonjae! How did you know this...!"