Chapter 91 – Future plans of a general hospital (8)

Dowook picked up the phone and called the internal medicine department. The call went through, and a slightly annoyed voice answered.

-This is Gu Sang-Do from integrated internal medicine.

“This is the emergency center. It’s because of a patient who visited the hospital due to breathing difficulties.”

-Who is it this time? You’re so persistent.

“Oh, I’m Park Dowook. I belong to the Neurosurgery Department. I’m on emergency duty support.”

-Neurosurgery? So annoying.

A scoffing voice was heard from over the phone.

“Can I make a notification?”

-Oh, yes. Please tell us.

“This is a 43-year-old female patient who first visited the hospital with hyperventilation symptoms and stabilized by controlling the respiratory rate and administering anti-anxiety drugs.”

Gu Sang-Do immediately cut Dowook off.

-If it’s stable, what’s the problem?

“Her blood sugar level is a little weird. If this is diabetic ketoacidosis, we need to urgently identify the underlying disease that caused it.”

-Blood sugar? Then…….

“It’s obvious that this is an internal medicine patient. Do you want to come down or should we just have a checkup here and take action? If the underlying disease turns out to be myocardial infarction or infection. I will record it on the computer. Symptoms are internal medicine, but emergency surgery and neurosurgery departments have treated it.”

After saying this, Dowook hung up the phone. Seong Chang Soo’s eyes, which were listening from the side, grew bigger.

“Hey, we’re going to take care of it? If she is going to have a myocardial infarction, she needs a specialist. If we take care of it, it’s our asses on the line.”

“Wait.”

Dowook leaned against the reception desk. Naturally, Gu Sang-Do ran down to the emergency room in about a minute.

“Integrated internal medicine! Where’s the patient?”

Dowook pointed to Treatment Room No. 2 in the general area. Seong Chang Soo tilted his head as he looked at Gu Sang-Do, who ran over.

“What? He could have just come. Why is he running that fast?”

“It’s the integrated medical evaluation period. I stimulated their trauma a little.”

“Did they also get hit by Last Choi?”

“Technically, I’m the one who hit them. Now, there’s also the blessing of Judgment Shim.”

“Who is that?”

Dowook’s gaze turned toward Shim Pan, who was talking to the head nurse in a friendly manner.

“That guy.”

“The bearded grandfather? The one who looks like the KFC grandpa?”

“Be polite. He’s a very old senior.”

In the meantime, the doctor from integrated medicine came over to Dowook with an expression of absurdity.

“What is this? That patient has stress-induced simple ketoacidosis. She has a history of diabetes but it is not serious enough to take insulin.”

Dowook pretended to know nothing.

“So? Are you saying that my notification is wrong? Where are you going?”

“It’s not wrong, but the information is kind of…”

After identifying the patient’s problem, he deliberately changed it to a more serious symptom that had needed urgent care, but the other doctor didn’t need to know that.

Gu Sang-Do sighed and continued to talk.

“It’s not bad enough for her to be hospitalized. Just prescribe fluids and discharge her.”

“A prescription for infusion? I see. Good job.”

“Oh. So tired.”

Gu Sang-Do grumbled and disappeared from the emergency room. Yeom Jinsoo approached
Dowook with a bright face.

“Thank you, senior. Thanks to you, we managed to solve a tricky situation.”

“Go and connect her to a line. They say that’s enough.”

“Okay!”

Seong Chang Soo looked at his junior who bowed and returned to the treatment room No. 2 and smiled in vain.

“Our Jinsoo is not the kind of person who greets others politely like that. Did she change her attitude after you helped her?”

“Why are you jealous of this?”

“What’s with that cheeky attitude? The internal medicine doctor was great. How could emergency and neurosurgery officially treat internal medicine patients? Then you’ll get cursed at.”

“It’s just like saying nonsense. I won’t cross the line, so don’t worry and go home.”

“It sounds like you’re going to do more.”

“I need to do a little more to make working at night easier. It’s annoying if my training is disturbed because of general treatment.”

Dowook approached the receptionist nurse who was classifying the number of secondary care workers. He re-accepted Shim Pan’s sense and looked through the patients in front of the waiting room.

Warm lights that stayed at major symptom points and disappeared.

The medical sense sent by the diagnostic fairy was very easy to utilize.

Dowook picked up his cell phone and recorded all kinds of diagnoses one by one.

In about 30 minutes.

Dowook picked up the phone.

“I’m Park Dowook in the emergency room. There’s a male patient with chest pain. He’s 70 years old. But doesn’t have a habit of smoking, high blood pressure, and diabetes.”

-If it’s such a medical history…….

“Do you think it’s reflux esophagitis?”

-Ah. That’s right.

“However, there is no significant change in EGC. Hang on. I think he’s traveled abroad. Pulmonary thromboembolism caused by not being able to move on a small plane would be a big problem. If you’re not going to come down, I’ll just…….”

-I’m coming!

Gu Sang-Do, who came running, quickly checked the patient. Panting, he looked at the patient and turned his head away.

“It’s just a cold. Don’t you know what a cold is?”

“Really?”

It was another difficult case, so Gu Sang-Do went up to the internal medicine department while trying not to show his anger.

After measuring the time, Dowook called again.

-Why!

“Oh, my. Dr. Gu. Your voice is so sharp.”

-What is it?

“A female patient with gastroenteritis symptoms. She’s 41 years old. With severe abdominal pain and general feebleness.….”

– Never mind. It seems to be a simple symptom of enteritis, so just hydrate her.

“Really? That’s weird. She has reactive arthritis. If it’s infected with Yersinia bacteria, it’ll be very dangerous. Okay. We’ll take measures after a thorough examination. Rest.”

-…….

Gu Sang-Do came running down and headed to where Dowook was pointing, looked at the patient and screamed.

“Spoiled milk一!”

The female patient, who visited the hospital due to a slight stomach ache after drinking the wrong milk, looked at him with puzzled eyes.

An hour passed like that.

Ring, ring.

“This is Park Dowook. Dr. Gu.”

A little silence followed.

And

-…Why are you doing this to me?

Gu Sang-Do, who’d ran down 13 times in the last hour, continued in a tearful voice.

Dowook thought this was enough, so he spoke in a serious tone.

“Dr. Gu. I know very well that the relationship between the internal medicine departments and the surgery departments at the hospital is not going so smoothly these days. However, is there a need for such things to come out when on duty like this? Isn’t being on duty tiring enough for everyone without it?”

-That’s…

“Please do me a favor. Please inform the other internal medicine colleagues or medical offices. Or, I have no choice but to have them experience how it feels to run down every three minutes during night duty. I’m also defending myself.”

Warning that there may be infinite emergency calls. Beyond the phone, he heard a sound of someone gulping in terror.

– I… Dr. Park Dowook.

“What?”

-I understand what you mean.

Now that they seemed to be on the same page, Dowook spoke lightly.

“There’s a patient who visited the hospital for abdominal distension.”

-What?

Dowook smiled at the astonishing voice.

“I’m just kidding. If you understand, I won’t have anything to do tonight, but you’ll accept others sincerely, right?”

-Of course. Please save me. I’ll keep that in mind.

Two people on emergency duty approached Dowook after the call.

Dowook informed Hong Chul-soon of the result.

“I don’t think there will be a problem with cooperation with integrated internal medicine anymore. Other internal medicine departments will soon hear the rumors, so they will respond similarly.”

“Wow. You were great against the Hansung Hospital during the fire fighting event, and you’re amazing today, too, Dr. Dowook.”

Yeom Jinsoo, who did not know about the story of volunteer work at the fire station, looked puzzled.

“Senior. What fire fighting event?”

“No way. It was no joke. Hansung Hospital dispatched professors specializing in trauma surgery to the event.….”

Hong Chul-soon began to tell her about that day’s events.

Dowook stepped back and turned to Shim Pan, who disappeared after checking the goods.

‘Thank you for today, senior. Thanks to you, it worked perfectly.’

Afterward, he reached out to Chief Ji, who was sitting in a chair in the severe treatment area.

Weewoo weewoo!

He heard an ambulance arriving outside. From now on, it was time for emergency training until the morning.

* * *

At 9 a.m., the office of the cancer surgery team.

The patient’s major medical history was listed one by one on the whiteboard.

29 years old, male

Two months ago, stage 4 liver cancer due to hepatitis B was confirmed. Confirmation of radiation resistance while performing radiation and chemotherapy at the same time.

Since then, cancer metastasis had progressed, and the medical staff at S Hospital had determined that it was not treatable. Transferred to the cancer center of the hospital.

Behind Min Bo-Hoon, who was filling out a chart with a board marker, there were a lot of faculty members from the Department of Pancreatic Surgery.

“This is the overview of the combined surgery. When performing surgery that inevitably causes severe bleeding on one side, the other team needs to keep up the pace. The risk of patients who have to open their abdomen and brain at the same time depends solely on this.”

Kim Byung-seop, the head of the hospital’s pancreatic surgery clinic, who was looking at the information on Min Bo-hoon presented, spoke up.

“Professor Min. Vital care is impossible in an unexpected situation where both sides have major bleeding. Why don’t you try step-by-step collaboration surgery to finish one side and operate the other side?”

“If you try to remove it separately, the patient must endure a state of greatly weakened immunity during the hiatus in between. Cancer cells are more likely to spread throughout the patient’s body.”

“This is stage 4 liver cancer. Isn’t it a life-long surgery at best? Does the patient have to risk his or her life simply to reduce the surgery to five hours?”

“We’re looking for a cure. The patient also agreed to take risks.”

“Completely cured? Can you do that?”

“Young age. Resistant tumor. Immunity. This patient is a very unusual case.”

“What did the oncologist say?”

Kim Byung-seop looked around the office and asked.

“Wait. Why are we the only ones discussing such a difficult surgery?”

Hong Yoo-sun, who was standing quietly next to the door, answered this question instead.

“Tumor internal medicine is missing from the high-level cancer surgery team.”

“They’re leaving? Chief Hong, How does that make sense? How can you touch multiple cancers without a consultation? If you do this, aren’t you sending the ace of our department to a dead-end?”

“I just respected the ace’s opinion.”

Kim Byung-seop turned to Min Bo-hoon.

“What? How could you decide to do this?”

“We have no choice but to join hands with neurosurgery to operate on this patient properly. The oncologist said he would leave because he couldn’t tolerate that part.”

“You sold the future of the cancer surgery team for just one patient cooperation? Professor Min, are you crazy?”

“I don’t think it’s yet to be concluded whose future has been sold.”

“I’ll talk to Lee Ki-chul, so let’s leave this cooperation. This isn’t how we should do this. I heard that S hospital also gave up on this patient.”

Min Bo-hoon shook his head firmly.

“No. There’s not much time left until the surgery is viable.”

“Who did you hold your hands with? And. How come neurosurgery didn’t even show up at the preoperative meeting? Who’s the collaborator?”

“It’s Park Dowook, and I got a call that he would be late for about five minutes due to the surgery of a patient carried in at night.”

Rattle.

“Sorry!”

The office door opened and Dowook, dressed as if he had just run out of the operating room, entered. The blood splattered around his eyes told of the operating room’s struggle.

Kim Byung-seop’s sharp gaze was focused on Dowook who was catching his breath.

“I wondered who it was, and it was Choi Hoo’s kid, Park Dowook.”

“Hello, sir.”

“Okay. You’re the neurosurgery representative, right? Are you here alone?”

“Uh… Yes.”

“Oh, my.”

While Kim Byung-seop swallowed a sigh, Dowook stood next to the whiteboard. And he briefly apologized to Min Bo-hoon for being late.

“How far did you get?”

“I was talking about the outline of the surgery.”

“No. Professor Min was avoiding answering my question.”

Kim Byung-seop, who intervened in this conversation, asked Dowook.

“Dr. Park. This is an attempt to deal with both the abdomen and the brain at the same time. No matter how well the two parts work together, sudden bleeding always occurs. Professor Min didn’t mention the countermeasures. Are you going to do the same? Then, this would be very suicidal.”

Dowook had rushed from the operating room, but as soon as he came, continuous criticism flew in. Dowook was a little understanding of Dr. Gu’s pain, who he’s called down consecutively yesterday.

“I agree with your opinion that sudden bleeding cannot be prevented.”

“But you’re still going to do the surgery? I heard there will be two main surgeons, and it seems they’re both out of their minds.”

Dowook felt that not only Chief Kim Byung-seop but also the other professors’ eyes were not good so he looked at Min Bo-hoon and asked in a small voice.

“Did I miss anything? Everyone is not angry because of my tardiness, are they?”

“It may be because of the news that the oncology department refused to cooperate.”

“Oh, internal medicine. Is it the same here?”

Following outpatient clinics and emergency rooms, to the cancer center. The check seemed to be ongoing.

“Professor Min, hold on. The board marker.”

Dowook spoke while adding to the description of the surgical process on the whiteboard.

“I’m not saying I’m going to do this operation without any measures. We will cause artificial brain death to increase the response time at every bleeding moment.”

Kim Byung-seop’s eyes widened when he heard the words “artificial brain death.”

“What?”

Dowook wrote down the mechanisms such as inhibiting neurotransmitters that caused brain damage, protecting blood vessel barriers, and lowering brain pressure, and then tapped the whiteboard.

“Low body temperature therapy. Also called “coma therapy.”

Everyone was buzzing, but Hong Yoo-sun, head of the center, who was standing still, raised her hand and asked.

“Have you ever had cancer surgery that added this kind of therapy?”

“There are quite a lot of brain tumors alone. Professor Choi also did it twice in the past. However, the liver has no cases in Korea, once at Hansnipper Hospital in Germany, and twice at Mayo Clinic in the United States. Of course, considering resistant tumors, it will be the world’s first case.”

For the first time in the world.

The honor of setting a precedent for surgery that others would cite, which would emerge as the number one search word on the international medical portal.

The eyes of the hostile faculty turned into eyes of aspiration at once. Sensing the energy, Hong Yoo-sun slowly smiled.

Dowook returned the board marker to Min Bo-hoon and spoke quickly.

“It’s not an easy operation, but we also need support from two assistants in the excerpt part. Let’s decide quickly and continue the meeting. Who wants to participate?”

All the professors raised their hands.

Chief Kim Byung-seop, who read the outline of the surgery on the whiteboard again, coughed in vain. The findings of neurosurgery cooperation were flawless.

It was possible to cope with the bleeding situation, which was judged to be the most fatal.

Park Dowook, who made unconventional proposals casually, seemed to be unshakable.

Kim Byung-seop pretended to cover his coughing mouth with his hand and slowly lifted it up.