Back to Everyday Life (4)

Scurry-scurry-scurry-scurry.

The sound of those small, sturdy footsteps echoed across the ER floor.

I could see first-year resident Baek Eun-seo hustling around in a frenzy.

She had just finished her call with nephrology and immediately hung up the phone before running over to me.

"Doctor!"

"What is it?"

I answered without taking my eyes off the monitor.

"For now, the on-call doctor said they'd come down, review the lab results and the patient's condition personally, then take the patient through dialysis and up to the MICU"

"(* medical intensive care unit)"

"right away! They said the dialysis unit even has an open bed!"

"Ah... okay. Good. That's a relief."

Things were going more smoothly than I had expected.

Nephrology to react this quickly.

You could tell without even looking that Baek Eun-seo must've given them a terrifying(?) briefing over the phone.

"Then I'll go speak with the guardian for a bit! I still need to make sure exactly what the patient took earlier, and I have to confirm the medication history properly!"

"Sure. Go ahead."

Tap-tap-tap-tap.

The moment I answered, Baek Eun-seo shot back toward the family waiting room.

Where on earth does all that energy come from?

The day after a night shift, I don't even have the strength to walk and just drag my feet around like a zombie.

"Hmm. She's actually really exemplary."

She'd run off on her own to shake down the guardian for a medicine bag without being told.

A true resident, rare to see these days.

Of course, except for the fatal flaw that she asks way too many questions.

I smiled with satisfaction and started typing on the keyboard again.

I still had chart cleanup to finish.

***

It had been about six minutes or so, I guess?

I heard that scurry-scurry sound again.

"Doctor! Doctor!"

Baek Eun-seo came over to my side, panting.

There was a smartphone in her hand.

"First, I brought back the medicine photo and everything. I also finished asking the guardian about the history."

"Oh, really? That was fast. Let me take a look."

"Here! This photo right here."

On the smartphone screen she held out was a photo of a small gray munchkin cat.

"...Is that the medicine? Though excessive viewing might be bad for the heart."

Baek Eun-seo tilted her head at my words, then quickly checked the phone screen and scrolled down in a hurry.

"Ah, that's my cat at home! This... this is it."

The photo she showed me properly this time showed a crumpled pill box and white tablets inside it.

And on the outside of the box, though blurry, the English word 'aspirin' was visible.

So this was the high-dose aspirin used for fever and pain relief, not low-dose aspirin.

"Mm... yeah. Right."

I nodded while enlarging the photo.

"But where did they even get this? These days, if you go to a pharmacy and ask for headache medicine, they'll give you Tylenol or ibuprofen. I don't think they even sell 500 mg aspirin because of stomach problems."

"Exactly. When I asked, the guardian said the patient had a big bottle at home that he bought back when he was studying in the U.S. Looks like he took that because he had a headache."

"Huh... so it was study-abroad aspirin."

No wonder.

"I guess so...? Anyway, that should make the diagnosis certain, right?"

"Yeah. It's a dead giveaway. We have the ABGA findings and the drug evidence."

I patted Baek Eun-seo on the shoulder.

"Good job. Now go over to the chief and give him a quick report. You need to update the staff on the patient. And this case is a bit complicated and confusing, so I think we should get confirmation quickly."

"Yes! Understood!"

Baek Eun-seo hurried over to the attending's desk at the station.

I watched her with my chin propped in my hand.

A little while later.

The chief's hearty voice carried all the way over here.

"Good grief! How did a first-year get this right? I almost went down the wrong path thinking it was meningitis, but she identified it as aspirin DI just by looking at the ABGA?"

"Hmm......"

Chief, your voice is way too high.

Please get a grip, Chief.

"No, no! I was wrong, Chief. I thought it was meningitis and said we should do an LP, but Dr. Han Hyeonjae said it seemed more like drug intoxication..."

As Baek Eun-seo frantically waved her hands and tried to confess, the chief brushed it aside.

To be precise, he didn't seem to have any intention of listening.

"No, no, no! How far did you get already? And from someone who's been in the ER for almost a year now! In the process of suspecting meningitis and ruling it out, you found the drug, didn't you? That thought process itself is excellent!"

"Ah, yes. Thank you."

"So, anyway. Dr. Baek."

Chief Park Woong rummaged through his drawer and pulled out a thick stack of English journals, handing them to Baek Eun-seo.

"This is the latest toxicology review paper published in an international medical journal. It has some really good content on salicylate poisoning and dialysis efficiency, you know? It's perfect for this patient's case. Could you read it and give a brief summary presentation at next week's conference?"

"...Me?"

Ah, so that was the goal.

I immediately understood why the chief had praised Baek Eun-seo.

He wanted to turn Baek Eun-seo into Han Hyeonjae Mk.2.

"Dr. Baek, you can do very well. I'm looking forward to it!"

"Ah, yes. Understood..."

Baek Eun-seo returned to her seat, unexpectedly saddled with a toxicology assignment.

With a strange expression, it was impossible to tell whether she was happy about the praise or sad that her workload had increased.

I snickered to myself.

'Anyone could see he was just dumping the leftovers from his own studying because he couldn't be bothered... no, is that even the right expression?'

Anyway, it was the sight of a staff member tossing what they were studying to a first-year.

You know that stereotypical professor image you always hear about through the media.

Bullying graduate students.

It's a 100% match.

Poor kid.

This week is ruined.

Then, just then.

Bzzzz-

A sharp-looking man in a white coat entered through the ER entrance.

A name tag was pinned to his chest.

[Nephrology Jo Woo-hyeok]

Ah, he was here.

The savior who would wash our patient's blood clean.

The man who'd save the kidneys.

"Ah, doctor! You're here."

I stood up and greeted him.

"Yes. You're Dr. Han Hyeonjae from Emergency Medicine, right? I got your call and came."

Jo Woo-hyeok from Nephrology was scanning the patient's monitor and chart even while exchanging a proper greeting.

"This is the patient I gave you a heads-up about earlier. Salicylate poisoning."

"Uh... yes. Looking at the labs, the acid-base imbalance is really severe. Lactate is high too. Vitals are unstable, and I don't think fluids alone will keep up with the rate of elimination, so we should start dialysis right away. I'll take the guardian consent."

"Yes, got it."

Up to this point, it was a very peaceful consultation with a doctor from another department.

But then.

Jo Woo-hyeok muttered to himself while looking at the chart.

"Salicylates have a small molecular weight, but because they bind to protein, the flow rate should be a little..."

"Right? Qb"

"(* blood flow rate)"

"300 and Qd"

"(* dialysate flow rate)"

"500 or so, it'll pull it out cleanly, right?"

"..."

"..."

The moment I said that, a silence passed between us.

"Uh... yes?"

Jo Woo-hyeok snapped his head up and stared at me.

His eyes went wide.

"Huh?"

I asked back, startled too.

What did I just say?

Qb 300?

Qd 500?

Why do I know that?

How do I know that?

This is why you can't get too much detailed tutoring.

Who studies for the CSAT by taking a general biology lecture from a biology PhD?

You'd go to Daechi-dong and take Life Science 1 instead.

"Ah. No, no. Haha."

I hurriedly tried to clean up the mess, breaking into a cold sweat.

"I just heard it somewhere, haha. Don't mind it."

But Jo Woo-hyeok's gaze was anything but ordinary.

"Because you knew the dialysis settings..."

Jo Woo-hyeok muttered in disbelief.

"Among residents from other departments, you're the first person I've ever met who can rattle off hemodialysis settings so naturally without missing a beat. And not even from another internal medicine specialty, but from Emergency Medicine..."

"Ah, that's not it. I just guessed..."

"No, you're exactly right. Salicylate poisoning is all about maximizing the flow rate and washing it out because of protein binding."

Jo Woo-hyeok nodded in admiration.

I screamed internally.

These crazy ghosts.

It's because they taught me useless stuff too.

The harm of overeducation!

A moment ago, I couldn't even remember the name aspirin and spent ages trying to figure out what the medicine was in my head.

Yet they made dialysis machine settings that only a nephrologist would know come spilling out like a vending machine.

This uneven spread of knowledge.

This deformed stat distribution.

Anyway, that's how it is.

In contrast to mixing up the DI drug a moment ago, I could remember nonsense like this perfectly.

It felt like my brain was slowly becoming less and less mine.

"Hah... haha..."

I awkwardly laughed and backed away.

"There's apparently a resident in EM preparing for a double board—could that be you, doctor?"

Jo Woo-hyeok asked cautiously, his eyes sparkling.

"......"

What kind of nonsense is this now.

Double board, my ass.

Am I insane?

I'm barely managing Emergency Medicine as it is, and now you want me to do Nephrology too?

If internal medicine is three years and nephrology is two, how many years is that?

Five years.

You want me to train for another five years?

I'd rather die.

That double-board ghost story from early last year is still circulating around the hospital.

This is a disaster.

"No! Absolutely not! I'm Emergency Medicine to the bone! It's just... just random trivia!"

I waved my hands frantically and strongly denied the rumor.

"Aw, you're being too modest. I heard all the rumors. You do surgery, and now you're even dabbling in dialysis. You're a real talent, a talent."

Jo Woo-hyeok started jotting something down with a meaningful smile.

"Anyway, I'll get the patient to the dialysis unit right away. If you need a consult later, just send it over comfortably. I think we'll get along well."

He disappeared toward the elevator with the patient and the transport team.

I stood there in a daze, watching his back.

'...No way.'

This is why hospitals are scary.

Sometimes rumors spread even faster than at school, the refuge of my student days.

Before long, weird rumors would be floating around like, "Han Hyeonjae's even eyeing nephrology" and "There's an Emergency Medicine doctor who runs dialysis machines."

Then every time nephrology professors looked at me, they'd probably go, "By any chance, are you interested in kidneys?"

Just thinking about it was horrifying.

Whether those ghosts were helping me or just messing up my life.

I let out a deep sigh and clicked uselessly at the mouse.

All the while, I prayed with all my heart that this rumor would never reach the chief's ears.