Dr. Shin Seonhan: The Doctor Who Sees the Future

Chapter 20
Triage (5)

『 Translator – Divinity 』

I grabbed Jo Jin-gi and asked urgently,

“Did you make any mistakes today?”

“Why are you suddenly picking on me?”

Jo Jin-gi replied, sounding annoyed.

“I’m just asking in case.”

“Hey, I was called an ace during my clinical rotations. I know what I’m doing, so mind your own business!”

His face crumpled.

Of course, his pride was hurt. It was his colleague, not a senior, questioning him.

But if there was even a slight suspicion, I couldn’t let it slide today.

“You didn’t have any problems with the thoracentesis?”

“No, I didn’t.”

“What about the post X-ray? You took one after the procedure, right?”

“I took it, but I haven’t checked it yet…”

“What?!”

“Damn it, you’re so serious.”

Jo Jin-gi frowned.

He continued with an irritated excuse,

“Hey, do you think you’re the only one working hard? I was busy too while you were dealing with the traffic accident patients! It’s not like I can’t postpone that for a bit, right?”

“…”

Sweat trickled down my back.

Checking the X-ray after draining pleural fluid was a basic procedure.

How could he neglect that, even if he was busy?

My suspicion grew.

‘Wait. If there was a problem with the patient, the nurses wouldn’t have missed it, right?’

I looked towards the station, but…

It was the nurses’ shift change time. They seemed busy with the handover.

Anxiety about a potential medical accident crept in.

“Quickly open it now.”

“What?”

“The X-ray!”

“Damn it, you’re so pushy. I’ll check it, alright?”

Jo Jin-gi grumbled and checked the X-ray on the monitor.

“Uh… the pleural effusion is still there? No wonder it wasn’t coming out easily when I poked him. Should I try again?”

[A pleural effusion is accumulation of excessive fluid in the pleural space, the potential space that surrounds each lung.]

Jo Jin-gi looked puzzled, staring only at the left lung.

But my eyes were focused on the right lung.

Holy shit, what is this?!

I barely managed to suppress a curse and said,

“Can’t you see this?”

“What?”

“There’s a pneumothorax this big on the opposite side, the one that’s supposed to be filled with fluid?”

[A pneumothorax occurs when air leaks into the space between your lung and chest wall.]

“Huh?”

Jo Jin-gi’s face turned pale.

He was an intern at Yeonguk University Hospital, after all. It was enough time for him to realize that something was wrong.

‘He caused a pneumothorax on the right side when he was supposed to be treating the left lung?’

A possibility flashed through my mind.

This guy, did he really…?

“Did you perhaps puncture the wrong lung?”

Jo Jin-gi froze, unable to answer my question.

There was a saying, “tunnel vision.”

It referred to the phenomenon of only being able to see what was directly in front of you, like when you were in a tunnel, with everything else shrouded in darkness.

It was a fatal mistake by Jo Jin-gi, who was performing the procedure after a long break.

“Where’s the patient?”

I asked urgently.

If Jo Jin-gi had punctured the wrong lung, it was a critical situation.

He had created a hole in the healthy lung, and we had to take immediate action.

“W-wait!”

Grab!

He suddenly clung to my sleeve.

And with a desperate expression, he pleaded,

“Seon-han, if this gets out, my internship evaluation this month is screwed.”

“What?”

“I’ve already been getting the cold shoulder because of the cast on my hand… Can’t we just let this slide?”

What?

What was he talking about?

As I stared at him in disbelief, Jo Jin-gi mumbled in a tiny voice,

“The pneumothorax is small, so it should be okay… even if we leave it alone…”

“You crazy bastard.”

My voice dropped.

I had never lost my composure like this since becoming a doctor.

“Don’t be ridiculous. It’s not about your intern evaluation, the patient could die because of you!”

Flinch—

He flinched and stepped back at my outburst.

“Where’s the patient? This X-ray was taken 30 minutes ago! Where is the patient?!”

“Zone A-8…”

Thump, thump!

I ran towards the patient.

Swoosh!

I opened the curtain, and an elderly man in his 60s was lying there alone, gasping for breath.

His supraclavicular fossa deepened with each breath, and his breathing was rapid. He was breathing so heavily that he could barely speak, expressing his distress with gestures and expressions. He had a nasal cannula supplying oxygen, but his oxygen saturation was only 53%.

This is more serious than I expected! The alarm is going off, but it seems like no one heard it in the chaotic ER.

‘This is it!’ The future I saw in my vision. The future where a medical lawsuit is filed due to an intern’s mistake is unfolding before my eyes.

I increased the oxygen flow and shouted, “Prepare a facial mask with oxygen!”

A nurse, startled by my loud voice, came running from afar. Jo Jin-gi, watching the situation, is frozen, unable to do anything. I urged him, “Don’t just stand there! Show the X-ray to Dr. Yeo Bong-cheol and contact TS (Thoracic Surgery)!”

“O-okay!” He finally seemed to grasp the gravity of the situation and ran off.

I turned my head and focused on the patient again. Let’s think! What can I do right now?

The patient is currently suffering from a pneumothorax. Pneumothorax means that air is present inside the chest cavity, where there shouldn’t be any. The solution is to drain the air quickly so the lungs can function properly again.

—Needle aspiration.

I quickly came to a conclusion and shouted, “Please bring me a 16G needle!”

“Yes!” The nurse moved swiftly, and soon a long, sharp needle was placed in my hand.

Pause—

I looked down at the needle and hesitated for a moment.

…Is it right for me to do this? Perhaps I should wait until someone more experienced arrives.

But there is no time. The patient is gasping for air as if he might stop breathing at any moment. He is an elderly man, and I can’t guarantee what will happen if this condition persists for much longer.

‘Yes, I have to do this.’

I stopped hesitating. Even as I hesitated, the patient was suffering from respiratory distress. As a doctor, standing by and watching wass no different from abandoning someone drowning and struggling in the water.

‘Even if they rush, it’ll take at least ten minutes for the thoracic surgery team to arrive. If I don’t do something now, it’ll be too late!’ I strengthened my resolve.

And more than anything…

Thump, thump—

My heart pounded.

A burning passion surged within me.

Just as I saw in the textbook, I inserted the sharp needle into the second intercostal space, just above the nipple, along the upper border of the rib.

Push!

The needle entered the patient’s chest.

The 60-year-old man’s body twitched and convulsed.

‘Not deep enough, deeper…’

I applied more force.

As the needle went all the way in, I heard the sound of air escaping from inside the patient’s body.

Whoosh—

The patient’s breathing gradually slowed down, and his oxygen saturation recovered to 83%.

And at that moment…

Gasp—

I heard the sound of the patient taking a deep breath through the facial mask.

‘I did it!’

I saved the patient.

The nurses, who were watching from the side, brought the emergency cart and prepared for intubation, just in case.

Then I heard Yeo Bong-cheol’s voice behind me as he ran in, talking on the phone.

“Dong-seop, it’s really urgent here. It looks like we’ll need to insert chest tubes on both sides…”

As soon as he arrived, his eyes widened.

“Shin Seon-han! What did you just do?”

Yeo Bong-cheol’s face turned pale.

It was understandable that he was shocked to see an intern like me performing an emergency procedure on my own.

“Are you crazy?! Who said you could…”

Just as he was about to unleash a torrent of scolding, Yeo Bong-cheol examined the procedure I performed and calmly assessed the situation.

“…Well, his SpO2 (arterial oxygen saturation) has gone up. Come out here, the thoracic surgery team will be down soon!”

Yeo Bong-cheol switched places with me and shouted to the nurse,

“Three-way and a 50cc syringe, please!”

“Here you go!”

“Shin Seon-han, help me out here.”

“Yes!”

Yeo Bong-cheol started drawing air out of the patient’s chest with the 50cc syringe.

Whoosh, whoosh—

With his thick arms pumping the syringe, he looked like he was operating a pump at a construction site.

Meanwhile, I assisted him by rotating the valves of the three-way connector 90 degrees each time.

It was a simple repetitive task, but even that was enough to see the patient’s condition rapidly improving.

“Sir, how are you feeling?”

Yeo Bong-cheol asked.

The patient, finally able to breathe comfortably, nodded and said in a hoarse voice,

“My wife stepped out for a moment, and I thought I was going to die because I couldn’t breathe… I couldn’t even make a sound…”

“You’ll be fine now.”

Yeo Bong-cheol reassured the patient.

Looking at the patient’s face, I felt a surge of sympathy and guilt.

He came to the hospital for treatment, but his breathing became even more difficult. How scared must he have been?

But instead of complaining, the elderly man smiled faintly and said,

“I thought I was going to die because I couldn’t breathe, but I feel much better now that the doctors are here… Thank you.”

“…”

We were speechless for a moment.

It was difficult to confess our mistake in front of a patient who trusted doctors completely.

As the atmosphere became heavy with silence, a large doctor from the thoracic surgery department arrived.

‘Who is this?’

I glanced at his chest and saw his name.

He had a strong presence.

If Yeo Bong-cheol was a mountain bandit, Ma Dong-seop was like a wild bear.

Standing side by side, their imposing figures doubled the pressure!

If they weren’t wearing white coats, their appearance would be intimidating enough to make anyone flinch.

“Bong-cheol.”

“Oh, Dong-seop, you’re here?”

“Good work! We’ll take it from here.”

“I’m sorry. I’ll leave it to you.”

Yeo Bong-cheol and Ma Dong-seop exchanged a brief conversation, patted each other’s shoulders, and the patient was transferred to the thoracic surgery department’s care.

While Ma Dong-seop disinfected the area and prepared for chest tube insertion, Yeo Bong-cheol turned to us and said,

“Interns, follow me.”

His eyes were sharp.

As expected, with Yeo Bong-cheol’s personality, he wasn’t going to let this slide.

It seemed like the ER was about to be flipped upside down.

***

Conference room.

An ominous silence filled the air.

Yeo Bong-cheol stood the four of us interns in a line and rubbed his forehead with a flushed face.

He looked like steam was about to rise from his head, unable to contain his anger.

I knew he had a fiery temper, but he seemed even angrier than usual today.

“This is the first time I’ve seen such a ridiculous mistake in our ER.”

“…”

“You call yourselves Yeonguk University Hospital interns, but you can’t even tell left from right on an X-ray!”

Yeo Bong-cheol roared.

I silently lowered my head.

It was clear that only Jo Jin-gi was at fault among the four of us.

But making excuses in this situation would only backfire, so it was better to stay silent.

“…”

“…”

So-dam and Joong-won hyung also remained silent, seeming to share the same thought.

Only Jo Jin-gi next to me was restlessly shifting his eyes.

“The patient’s left lung was already filled with fluid and barely functioning, and you caused a pneumothorax on the healthy side… And you didn’t even bother to check the X-ray properly?”

His voice grew louder.

And Jo Jin-gi shrank back further.

“Are you out of your mind? Do you want to kill the patient? Are you doctors or murderers?!”

Clank!

Just then, several residents opened the door and entered the conference room.

Their faces were also filled with annoyance.

“I heard someone punctured the wrong lung during the thoracentesis?”

“This is ridiculous. Who did it?!”

The situation was escalating.

Roll, roll.

Jo Jin-gi’s eyes seemed to be darting around faster and faster.