Chapter 103
In a flash.
Before my butt even touched the chair, my fingers were already snatching the mouse.
‘Okay, let’s sort this out. Sort this out.’
The thoracic surgery call was over.
All that was left was to wait for the patient to return safely from the CT, and in the meantime set up the medication in case anything happened.
I refreshed the EMR screen.
…
As I scrolled down, my eyes stopped on one line.
[Labetalol HCl (Labesin) 20mg IV push (Dr. Baek Eunseo)]
“Oh….”
An exclamation slipped out before I realized it.
While I had been wrestling with thoracic surgery and looking at ultrasound with the professor, Eunseo had already entered the order.
‘Eunseo. You’re starting to look like a real doctor now.’
The first thing to do when aortic dissection is suspected is lower the blood pressure and heart rate.
You have to reduce the pressure hammering the vessel wall and slow the speed of the tear.
That’s why beta-blockers are the first priority.
“20 mg. Good.”
Just as I was nodding in relief,
“...”
I felt a chill behind me.
When I turned around, Professor Cheon Eunjeong was glaring at the monitor with her arms crossed.
Her fingers were drumming on her forearm faster and faster.
“No, when is the CT coming up...?”
Professor Cheon’s eyes kept darting to the clock at the lower right of the monitor, then to the PACS screen, then back to the clock.
“It’s been over five minutes since they went down. Is the elevator broken? Or did something happen while they were setting up the line? Why isn’t it up yet?”
“Professor.”
I called out to Professor Cheon cautiously.
I thought she might punch through the monitor at this rate.
“What?”
“He probably just entered the CT room a moment ago? By now they’d have waited for the elevator, moved the patient bed down, positioned him, connected the contrast line...”
I tried to calm Professor Cheon by laying out the most reasonable timeline possible.
“The patient’s aorta is tearing apart and you’re worrying about the elevator? Forget the report—just send the images already. Seriously. Please.”
Professor Cheon turned back to the monitor and let out a groan.
All we needed was the image.
If we could spot the torn intima with our own eyes before the radiologist’s official report came in, we could send him straight to the operating room.
Every second, every minute mattered.
“Let’s wait a little longer for now.”
I forced myself to stay calm and changed the subject.
“Has the beta-blocker gone in?”
Professor Cheon asked as if the thought had just occurred to her.
“The blood pressure can’t spike. He’s already tearing apart; if the heart starts pounding, it’ll tear even more. It was 110 earlier.”
“Yes. It’s been given.”
I pointed at the monitor screen.
“Eunseo must have ordered it. Probably right before taking the elevator down to CT.”
There was even a procedure timestamp logged.
“How much?”
You can’t just put in a rough dose.
If it’s too little, it won’t work, and if it’s too much and he becomes hypotensive, coronary perfusion will drop and the already precarious right ventricle could come to a complete stop.
“You can see it. Labesin 20 mg IV. That’s an appropriate initial dose. As far as I know, that’s right, but...”
Professor Cheon bent down and leaned her face close to the monitor.
Then she straightened and gave a very short nod.
“Ah, right.”
Only then did Professor Cheon’s stiff shoulders loosen a little.
“That first-year is pretty sharp. Knows to handle things like this without being told. Better than you, huh?”
“...Is that so.”
Well, a good job is a good job.
“I’m joking.”
And so we once again stared endlessly at the blinking cursor and the empty image list.
Please.
Please just don’t let him burst while they’re being scanned.
That was the only thought in my head.
“By the way, Hyeonjae, what are you doing?”
Professor Cheon, tired of staring holes through the monitor, snapped at me.
I was repeatedly pressing the buttons on the station phone with the receiver pressed to my ear.
“Ah, the thing you asked me to do earlier. I’m contacting the guardian. It’s supposedly the son’s number...”
Beep. Beep. Beep...
The line was going through, but no one picked up.
This was the third time already.
“But when I call from the ER number starting with 051, they think it’s spam and don’t pick up. Guess the world is getting pretty ugly.”
At my serious analysis, Professor Cheon let out a deep sigh and held her forehead.
“Good grief, Hyeonjae... Did you try calling from your phone? If you call from a 010 number, they answer. Are you stupid?”
“…Ah!”
I took my phone out of my pocket.
Why hadn’t I thought of that?
“How does someone like this get called a genius...”
Ahem.
Ignoring Professor Cheon’s complaint, I dialed the guardian’s number on my phone.
Ring ring ring—
Before the second ring even finished, the other side answered.
As expected, that’s the power of 010.
[Yes, hello?]
It was a young man’s voice, as if he’d answered in his sleep.
“Hello. Sorry for calling so late. This is the emergency room at Busan Chungsin University Hospital.”
[What? The ER?]
The sleepiness vanished from the other man’s voice in an instant.
“Are you Mr. Son Jeongsin’s son, by any chance?”
[Yes, yes, that’s right. What’s going on?]
“Your father has just been rushed to the emergency room. I’m sorry, but we need you to come here as quickly as possible.”
[What? My father?]
“Yes. The patient came in with chest pain and shortness of breath, and based on the test results, a critical, life-threatening emergency called aortic dissection is strongly suspected.”
There was no point beating around the bush anyway.
I had to explain how urgent it was as quickly as possible.
“We may have to go straight into emergency surgery as soon as the CT results are confirmed. We also need surgical consent, and the situation is extremely serious. Please come to the emergency room as fast as you can.”
On the other end of the line, I could hear clattering and frantic movement.
[Yes! Understood! I’ll leave right now!]
[But doctor, I’m over in the Gimhae area right now... even if I floor it, it looks like it’ll take at least 30 minutes to get there, so I might be late. If surgery is needed, I’ll consent to it first. I’ll give verbal consent over the phone.]
What a sensible guardian.
“Understood. We’ll proceed on the basis of your verbal consent. You can sign the paperwork later once you arrive. Please be careful and come as quickly as you can.”
[Yes! I’ll be there soon! Thank you!]
Click.
I hung up and nodded to Professor Cheon.
“I’ve contacted the guardian. He’s on the way, and we’ve gotten verbal consent for surgery.”
“Good job.”
Professor Cheon turned her gaze back to the monitor.
The PACS screen was still dead silent.
Just looking at that black screen made my blood run dry.
“Professor.”
“What?”
“But before we go to the OR, what about managing his blood pressure and heart rate...”
Even though we were using Labesin, I was worried about the details—what blood pressure target to set, and whether we should add esmolol if his pressure spiked during transport.
“Should I go to the CT room myself, maybe...”
Professor Cheon didn’t answer my question; instead, she shifted restlessly in her seat.
She seemed to be at the height of her anxiety.
She looked like she might bolt out the door at any moment.
“Eunseo, right? That kid’s sharp. They already took care of the Labesin earlier. They’ll do fine.”
“Still, they’re a first-year.”
“I had something similar blow up when I was a first-year too.”
“Are you and they the same? You’re a freak of nature.”
Professor Cheon grumbled, but still sat back down in her chair.
But her fingers kept drumming on the desk without stopping.
Tap.
Tap.
Tap.
That tapping sound was strangely syncing with my heartbeat.
Ding-ding~
The alert sound rang from the station computer.
At the same time, a new line appeared in the PACS screen list.
[ER187703 Son Jeongsin / M / 52 / CTA Aorta]
“It’s up.”
Professor Cheon shouted reflexively.
“Click it. Hurry, click it!”
“Ah, yes.”
You’re in a hurry, aren’t you.
I tightened my grip on the mouse and double-clicked that single line of text.
The loading bar spun.
One second. Two seconds.
And three seconds later, a high-resolution cross-sectional CT image filled the monitor.
“...”
Professor Cheon and I both held our breath at the same time.
There was no need to wait for the radiologist’s report.
The image there was so clear and horrifying that any emergency physician—or even a medical student—could tell what it was.
Ascending aorta.
The largest, strongest blood vessel in our body, carrying freshly pumped blood from the heart to the rest of the body.
The center of that round vessel had been split wide open.
That meant the thin flap created when the intima tore away had divided the vessel into two channels.
“Type A...”
Professor Cheon muttered.
“Right here...”
I pointed at the monitor with my finger.
Right at the opening where the right coronary artery branches off to supply blood to the heart muscle.
A flapping piece of dissected intima was barely blocking that opening.
Ding-dong-
Then the emergency room elevator doors opened, and a man in scrubs hurried over to the station.
There was no need to check who it was.
There was only one person who would be running around this urgently at this hour.
Still, for form’s sake, I decided to check the writing on the left side of his chest.
[Cardiovascular thor…]
So the thoracic surgeon is here.
There was no need to read any farther.
I sprang to my feet.
“Ah, thoracic surgeon!”
“Yes, yes—did the CT for that patient just come out?”
The thoracic surgeon, Kang Minseong, came gasping up to the monitor.
“It did, but... take a look.”
I wordlessly pointed at the monitor.
Kang Minseong’s gaze locked onto the screen.
“...Ah.”
A short sigh.
All the emotion was packed into that one exhale.
‘We’re screwed’ ‘Can we save him?’ ‘Tonight’s over’
“Should I call CT and ask them to send him straight to the OR?”
When I asked, Kang Minseong nodded vigorously.
“Please do that. I’ll contact the OR right away. The anesthesia team is already ready, so just send him up.”
He gave me a quick bow, then immediately pulled his phone from his pocket.
I picked up the intercom and dialed the CT room extension.
Beep-beep-beep-beep.
Truuu—
“CT room.”
“This is Han Hyeonjae from the ER. For patient 187703, please send him straight to the third-floor OR without bringing him back through the emergency room. Thoracic surgery has agreed.”
After hanging up and looking back, Kang Minseong was talking on the phone in some far corner of the hallway.
He was probably talking to the thoracic surgery professor.
As soon as he hung up, he waved at me once and then sprinted back toward the elevator.
“I’ll head up right away! Please take good care of the patient!”
The doors closed and he disappeared.
I stared blankly at the shut elevator doors.
“...Professor Cheon.”
I called Professor Cheon Eunjeong, who was standing beside me with her arms crossed, staring at the monitor.
“What?”
“We’re done with our part, right?”
“We are.”
Professor Cheon answered calmly.
Her gaze was still fixed on the image of the torn aorta.
“...Can he be saved?”
After a moment of silence, Professor Cheon shrugged.
“...I don’t know.”
Harsh, but that was the answer.
It was in God’s domain.
Professor Cheon took her eyes off the monitor and looked at me.
Then she patted my shoulder.
“Still, one thing’s certain: you raised that patient’s chances of survival by a huge amount.”
Professor Cheon gave a grin.
“Good job. Don’t get discouraged. Let’s work.”
That one line loosened the tightness in my chest a little.
Right.
I had done my part.
“...Yes.”
The night was still long, and there were still many patients to see.
I nodded and returned to my seat.
Silently praying for the miracle that would unfold in the OR upstairs.