Chapter 84: Future Plans of a General Hospital (1) (1/2)
Emergency Center General Clinic, 6:50 a.m.
”Yejun, say ah~.”
Dowook shone a pen light through the open mouth of a four-year-old boy. After examining whether there was any wound on the surface of the esophagus or whether the larynx was swollen, he turned to the guardian standing next to him.
”He swallowed it straight down. His breathing looks good.”
The father, who seemed relieved, asked.
”Then what about the coin he swallowed?”
”If it went down his esophagus then it'll come out of his stool. The location of the coin is…….”
Dowook looked at the X-ray he just took. The location of the coin was the upper esophagus. In this case, it was better to push it down with an esophageal dilator and wait for it to emerge on its own.
He was going to tell the father about this, but he heard the nurse's voice.
”Dr. Dowook. The doctor on duty is here.”
When he turned his head, he saw an emergency medical resident approaching. It was Noh Myeong-deok, who firmly endured his first year of residency while being directly or indirectly educated by Seong Chang Soo.
”Thank you for your hard work, doctor. I'll take over this patient.”
As a resident who had reached his second year, he was now a bit mature.
”Do you want to? It’s a pediatric case with a foreign object in the esophagus. The breathing is okay, but the patient finds it difficult to swallow.”
”Phew, kid. You should eat something delicious.”
Noh Myeong-deok patted the head of the boy sitting, with tears in his eyes and checked the X-ray.
”Sir, if you push the coin into the esophagus with the expander, you just need to check the stool for about four days.”
Noh Myeong-deok's response was the same as his, so he thought he was liberated from the 12-hour long training session.
Dowook, who was slightly bowing and backing away, suddenly stopped walking in front of the child’s X-ray. The ratio was subtly different to call it a coin. Something that wasn’t the same size as a 100 or 500 won coin. Was it foreign currency?
Ji Hwi-gwan’s sense seemed to be exerting a strong warning, so Dowook immediately asked the child.
”Yejun, what you swallowed, was it a coin?”
”A round one.”
The child didn’t seem to be able to distinguish it well, so he took out his cell phone and searched for a picture of a 100 won coin and showed it to the child.
”Like this?”
The child shook his head. A 500 won coin got the same reaction.
Dowook turned to the child’s father and asked.
”What was Yejun doing before swallowing the coin?””
”He was playing with toys.”
Dowook searched for a picture of a button battery on his cell phone and showed it to the child.
”This one?”
He glanced and soon nodded. Dowook turned serious and immediately shouted at the nurse.
”Please prepare a catheter kit. The patient swallowed a button battery.”
At this, Noh Myeong-deok was also surprised and turned back towards the X-ray picture.
Dowook spoke quickly to the child’s father while preparing for the procedure.
”When a child swallows something that is not food, they often don't know what it is. If it’s a coin waiting for it to come out is fine but this is a battery. It's safer to take it out as soon as possible. If you agree, I'll try to remove the foreign matter right away.”
Both the child's father and mother nodded in surprise.
”Yejun, can you lie on your side?”
He stood next to Noh Myeong-deok who quickly assisted Dowook.
The mouth opener hung on the child's mouth, and the airway was secured. A helping catheter was lifted to gauge the length of the esophagus.
”Do you want to do it?”
”I've never done an endoscopy on a pediatric patient…”
Dowook didn’t have any experience in responding to emergency pediatric patients either, but his hands naturally knew what to do since he had Chief Ji’s sense.
”I'll do it then.”
Spray anesthetics were sprayed on the child's neck.
Dowook slowly inserted the catheter into the child's mouth after checking the balloon attached to it.
”Count up to 10 in your head, Yejun. Then everything will be over.”
Dowook felt that he had reached the place where the foreign substance was located because of the feeling at the end of the catheter. 3 ml of saline was inserted into the catheter.
As soon as the catheter was pulled out, the battery appeared through the child's throat.
He used forceps to grab it, and put it on the cart's plate.
Clatter.
”Phew.”
As expected, it was a battery.
”It ended well, sir.”
When the child burst into tears, his father quickly ran to hug him.
”Yeah, okay, okay. Our Yejun. You were really brave.”
Dowook smiled as he looked at the child who was crying loudly enough to wake everyone in the emergency room.
Noh Myeong-deok approached Dowook, who took off his sterile gloves after finishing his work.
”As expected of Dr. Park. If I had diagnosed it, I would have handled it as a coin. How did you know what it was by just looking at the X-ray?”
”That's….”
Dowook couldn’t just say that he had a feeling so he was trying to think of an excuse when someone suddenly approached.
”Myeong-deok. As an emergency surgeon, don’t you do X-ray analysis training?”
It was Chief Ji Hwi-gwan who was on duty today.
Chief Ji touched the monitor on which the X-ray of Yoon Yejun was shown.
”Here. This circumference. It's different from coins. Dr. Park figured it out at once. If you want to make the right clinical decision, make that effort.”
”I'm sorry, chief.”
”Go to the DB, analyze and write a report about 100 charts of patients who’ve swallowed foreign substances. And, did you leave the procedure to a doctor from another department because you lacked endoscopic experience?”
”I'm sorry about that, too.”
”There are numerous patients receiving gastroscopy at the general examination center, go apply for it and come back after performing it 100 times.”
It was a brutal follow-up.
Dowook had no choice but to cheer for Noh Myeong-deok, who was dealing with Chief Ji.
It had been 2 years since he first started. However, the responsibility as a doctor required of a second year was not light. Dowook hoped this year Myeong-deok could continue to endure.
Chief Ji turned to Dowook, who was about to leave the emergency surgery clinic.
”Dr. Park Dowook.”
”Yes, chief.”
”I think I see you often when I'm on duty these days.”
”I applied on purpose because I wanted to observe your emergency response method.”
Dowook quickly thought of an excuse although it was also the truth.
”By any chance, are you…”
Chief Ji's eyes became intense as if looking at Dowook’s inner thoughts. Dowook became nervous under the intense gaze.
‘Professor Choi's style is so different.’
To put it in movie terms, Commander Ji was a righteous hero, and Last Choi was more of an egocentric hero.
Even if they were both heroes, Chief Ji was the type who you couldn’t talk to and would only proceed his own way.
”…Are you planning to apply for the position of a professor once the regional trauma center is decided?”
”What?”
”I don't think it's a bad idea because there will be an opening for a professor in neurosurgery. Same goes for Seodaemun Fire Station. Seeing this silent enthusiasm, I like how you’re taking the initiative and helping us at the emergency center. I look forward to your kind cooperation.”
Misunderstandings were intertwined and unexpected words came out.
He said good-bye to Chief Ji, and tilted his head while walking in the hallway of the emergency room.