Chapter 137
Thus, the newly formed group chat [Park Seong-jeong Rehabilitation Project].
Baek Eun-seo, who had been part of the original group,
“Honestly, since we’re classmates, me monitoring him feels like going a bit too far, and I think Seong-jeong will feel uncomfortable. I’ll support him in spirit!”
Then she delivered that wonderfully social-savvy, max-level line and slipped away, and the empty seat was filled by two far more terrifying people.
One crazy specialist physician.
Right, Lee Minjae.
And Chief Choi Soo-min.
The chat room’s atmosphere turned heavy in an instant.
It had transformed into a razor-thin sheet of ice where survival mattered, not just a study group where classmates could snicker and make Seong-jeong study.
And in that chat room, one video was sitting there by itself, uploaded the previous night.
[EM 4th-year Choi Soo-min]
(Video: 2 min 43 sec)
I was half curious, half terrified as I played the video.
[Video plays]
Tap.
In the video, Choi Soo-min was massaging Park Seong-jeong’s shoulders with a kindly expression.
“Seong-jeong, how’s studying going? The homework your big sister gave you is a bit much, right?”
“Yes! Doctor! I, um... yes. I’ve almost finished going through it! It’s going well!”
Park Seong-jeong’s eyes were shaking violently, as if he’d seen something unseeable.
“Oh, really? Going well? What a relief. If you don’t want to kill a patient, you’d better work hard, hm? If we make a mistake, the patient ends up with a bad outcome. You know that, right?”
“Yes. I understand. I’ll keep it in mind.”
“Then when a patient with acute pancreatitis comes in, what criteria should we use for initial fluid resuscitation?”
“Um... first, I think we should consider Hartmann’s.”
“Why? Normal saline
(* normal saline)
is also an option. Why that one specifically?”
“Well, there’s research showing lactated solution is more effective at reducing the inflammatory response. In fact, I understand there isn’t a significant clinical difference from normal saline!”
“Okay. You studied some. Then let’s add a variable.”
Choi Soo-min’s eyes curved into crescents.
“What if the patient has pancreatitis accompanied by a bit of hypercalcemia? Would you still use Hartmann’s, which contains calcium?”
“Huh? That...”
Park Seong-jeong’s brain freeze came through the screen.
“Time’s up, you’re disqualified. Since it doesn’t have a clinically meaningful effect on serum calcium, there’s no problem using Hartmann’s. Study again. By tomorrow morning.”
“Yes! Sorry!”
[Video ends]
I clicked my tongue.
So that’s Choi Soo-min’s teaching method.
Actually, I hadn’t been directly called out much by that guy, so I didn’t know.
What can I say? It’s scarier than just openly chewing someone out, because he drives you so hard you can’t breathe, turns your mental state into powder, and then puts it back together.
“Still, you’re pretty quick on your feet. Your response time got faster.”
Below that, Jo Su-yeon’s chat messages continued.
[JoSIUUU-yeon]
(PDF file)
Doctor, I pulled this from a foreign case report. Wouldn’t it be worth looking at? - 13:17
[EM 4th-year Choi Soo-min]
This is good. It’s neatly organized. Good work, Su-yeon! - 13:21
[JoSIUUU-yeon]
No!! Thank you, Doctor!! (emoji) - 13:22
Su-yeon.
You were absolutely determined to score points, weren’t you?
And that was when the person in question stepped onto the stage.
[EM Lee Minjae]
What? So that’s how you do it? A chat room for posting videos of you chewing the kid out? Okay, okay, got it. - 13:25
[EM 4th-year Choi Soo-min]
Couldn’t you make up some questions instead of chewing the kid out? What if he breaks down and runs off? - 13:26
[EM Lee Minjae]
Got it... - 13:26
Hmm, roughly speaking, Choi Soo-min must have predicted what kind of trouble Lee Minjae would cause, so she shut it down in advance and turned him into a quiz mule.
A wise call.
Actually, Lee Minjae is good at chewing people out too.
In fact, when it comes to the severity of that chewing-out, he’s even spicier and more vicious than Choi Soo-min.
I remembered the time in my first year when I got caught after giving a narcotic painkiller incorrectly.
“Guhh.”
Just thinking about it makes my stomach ache.
It still hurts.
Even though it’s been more than a year, that trauma is carved into my bones.
Park Seong-jeong is probably going through that kind of phase right now.
***
Day 2 of the Rehabilitation Project.
Coincidentally, Park Seong-jeong and I were on the same shift that day.
For some reason, Park Seong-jeong was completely shrunk in on himself, and I had switched on monitoring mode.
Then, around lunchtime.
A school-uniformed male patient came limping in.
“Student, why on earth did this happen?”
I asked while touching his swollen ankle.
The area around the lateral malleolus was puffed up.
The triage note said... a fall?
It didn’t seem like a fall from that high up.
“Ah, well, yes... there’s a bit of a reason.”
“What reason? Did you maybe ride a bike or something...?”
“No, that’s not it. Today’s Wednesday, you know.”
“Right? It is Wednesday.”
I continued the simple physical exam.
When I pressed on the ligaments, the tenderness was severe.
I’d have to wait for the X-ray to know for sure, but based on the situation, it smelled like a fracture.
“But what does Wednesday have to do with your ankle? Unless, no, is there some reason you have to go somewhere early today? An exam? Then we’ll see how things go and, if possible, send you back to school quickly...”
“No. Our class is on the second floor, exactly. And Wednesday is Suda Day, you know. The day with no leftovers.”
“Suda Day?”
“Yes. It’s the day the cafeteria serves the good stuff. Today’s menu was pork cutlet and spaghetti.”
“....”
This crazy cafeteria freak... no, no, could this patient seriously...?“
“Ah, right? It does serve tasty stuff. But why?”
“So I was planning to be the first one to eat the moment lunch bell rang. It was a perfect plan, really. But if I went down the stairs, everyone else would head that way too!”
Hmm... was that so?
“So I came up with an amazing idea. I was just going to go out the window and head straight to the cafeteria by climbing down the pipes, but the pipes were slippery, so...”
“...”
“...”
“Yes.”
I was at a loss for words.
You climbed down the pipes from the second floor just to eat pork cutlet?
Are you Spider-Man?
His single-minded devotion to food is personally admirable, but the price is far too harsh.
Ding-
“Ah, the X-ray’s up.”
A PACS notification popped up, and I hurriedly clicked it.
Ah.
It’s a classic fracture that happens when you fall from a height and land on your heels.
“Yes, student. When did you say your guardian would arrive?”
“They said they’d be here soon! I couldn’t exactly tell my mom I fell trying to get pork cutlet...”
“Yes. When your guardian gets here, tell them to come straight to me. I think you’ll need to be admitted.”
“What?! Admitted? And I still didn’t even get to eat the pork cutlet?!”
“Is pork cutlet the issue? Your leg is broken.”
Two kinds of regular orthopedic patients.
One: elderly patients.
Two: cafeteria brats who get injured while showing off.
The moment that theory sank in, I felt it deep in my bones.
After roughly explaining his current condition to the clueless high schooler and calling for an ortho consult, I hid behind the station monitor and kept sneaking glances at Park Seong-jeong.
He’s looking at a patient with abdominal pain.
Park Seong-jeong’s monitor had the chart for bed B-10 open.
A man in his thirties with right lower quadrant pain.
A textbook suspected appendicitis patient.
“No way he’s ordering a CT right away again, is he?”
My eyes narrowed like a hawk’s.
Because if he just skipped the lab check and a proper history and went, “Huh? Stomach hurts? CT, go!” I’d have to be ready to smack him on the back of the head.
What would be best?
The chart... no, better not, just in case.
EKG paper? Out.
Right, Tintinalli.
I’d whack him over the head with Tintinalli.
But Park Seong-jeong didn’t place the order right away.
He sat in front of the patient and wrote something diligently.
“Have you ever had surgery before, patient? Like appendicitis or a hernia?”
“No, I’ve never had surgery even once...”
“Then do you take anything for diabetes or blood pressure? Or have you ever been told your kidneys are no good?”
“No, everything was normal at my health checkup too.”
“Have you eaten anything recently that might have been off, or have you traveled abroad recently?”
Oh.
Thorough.
He was already spending ten minutes just on the history.
The nurse watching from the side was giving a look that said, “I still have to start this patient’s line—when will you be done?” but Park Seong-jeong kept right on asking.
A little slow, but better than missing something.
Of course, it’s a little maddening.
No, a lot maddening.
In the emergency screening area, the nurses finish the basic first-round triage and past-history check and leave notes.
If he can use that and just ask the essentials, it should be over in three minutes, so why is he asking everything again from one to ten?
“Right. I’ll chew him out about that later...”
Safety first.
Maybe because he messed up and got thoroughly scared, he’s checking things so carefully he looks like he’d tap every stone bridge before crossing it, then smash it to bits with a hammer.
Not a bad change.
A little while later, Park Seong-jeong came back to the station.
He didn’t sit down right away, but shuffled over to me hesitantly.
“Doctor.”
“What.”
I asked, pretending not to take my eyes off the monitor.
“I’ll report on patient B-10. There’s right lower abdominal pain, but the rebound tenderness isn’t clear. There’s definite tenderness when I press on McBurney’s point.”
Park Seong-jeong reported in clear order while looking at his notebook.
“The lab results show the white blood cell count is within normal range, but CRP is slightly elevated at 1.2. Considering the clinical symptoms and location, I can’t rule out acute appendicitis, so I’d like to get an abdominal CT. May I proceed?”
Oh.
Symptoms, physical exam findings, lab results, and his own judgment.
And most importantly.
“Not going off on his own and getting a senior’s sign-off.”
I turned my head to look at him.
“Did you check the renal numbers?”
My surprise question.
The number that had almost sent Park Seong-jeong to hell.
Park Seong-jeong answered immediately, as if he’d been waiting for it.
“Yes! Cr is 0.9, so it’s normal, and eGFR is over 60, so it’s rock solid! He said there’s no history of contrast allergy or any unusual constitution!”
His eyes were alive.
Confidence in the facts he’d checked.
“Okay.”
I curled the corners of my mouth slightly.
“Go ahead. Order the CT and go get it confirmed by the staff.”
“Yes, sir! Understood!”
Park Seong-jeong answered loudly and returned to his seat, starting to pound on the keyboard.
Though his solo prescribing privileges had been clipped(?) and even something as small as a CT now required approval, there was a strange sense of relief in Park Seong-jeong’s back.
That’s it.
Crossing the bridge only after tapping it first.
No, tapping it and, if it still seems suspicious, asking the person next to you, “Can I cross this?”
What a first-year needs right now isn’t genius-level diagnostic skill.
It’s the habit of putting safety checks in place so he doesn’t put patients in danger.
That has to become second nature if he’s not going to make mistakes even in a real emergency later on.
“You suffered a bit and finally came to your senses.”
Of course, his speed is still a little painfully slow, but the direction is right.
Speed will improve as he keeps at it.
I took a satisfied gulp of my now-cold Americano.
The Rehabilitation Project is working faster than I expected.
Maybe I should get pork cutlet for lunch today.