Chapter 161
“Then... is there anything in trauma that you’ve been especially interested in lately, Dr. Han?”
The director asked casually, taking a sip of tea.
‘Damn, not really.’
If anything, it was more like how to take fewer night shifts, or how to have fewer patients?
Papers?
Latest findings?
Stuff like that is for professors to discuss at conferences over good food. My job is just to keep people alive.
But if I said, “Not really? I just want to go home,” I had a feeling I wouldn't leave this room alive.
I put on the most humble expression I could.
“I'm still focused on my role as an emergency medicine resident, which is to handle initial treatment and just keep the patient alive, so I haven't had much time to deeply study the latest trends or surgical techniques. I can only apologize for my shortcomings.”
That answer should be fine.
‘I'm just a resident, so please don't ask me anything difficult.’
That was the message hidden in my answer.
“No, no, why are you apologizing? Haha. Just speak comfortably. This isn't an interview room.”
But the director didn't seem inclined to back down.
That expression...
‘You really have something you want to say, don't you? Your inner genius is stirring. Come on, let's have an academic discussion.’
That's the kind of face he was making.
‘This is insane.’
This guy was crazy about scholarship too.
If I kept my mouth shut here, he looked ready to interrogate me until he let me go.
Better to bring up a topic myself, let him talk his head off, nod along, and then slip out.
‘To hell with it.’
Since the subject came up, I might as well ask about that.
“Could we discuss the specific protocol or method for partial REBOA?”
“Huh? Oh, sure? Yeah, what about it?”
The director leaned forward.
“First, things like catheters or the necessary tools... I only know the concept, but I don't actually know much about the equipment setup. So what kind of equipment do we use at our hospital, and do you happen to have plans to introduce it...?”
“Then I'll have to tell you about it. I just brought in a few of the latest kits for the trauma center this time. They're imported from overseas...”
The director started talking excitedly.
Good, now's my chance.
Pretending to listen, I nodded and quickly brought up the floating window.
My cover.
Please don't get exposed.
[Dead Doctor Gallery]
==================
@God of the Scalpel and any other gallery guys, come out for a sec
Author: Hell-Joseon Slave 1
Anything you're curious about lately—procedures, trends, guidelines, whatever?
I'm talking with the director.
I’ll ask for you instead.
==================
[Comments]
Back in My Day: Why are you asking that? What are you trying to screw up again?
ㄴ Hell-Joseon Slave 1: The director keeps acting like he wants me to say something impressive. If I want to keep up the genius act, I figure I should ask one professional question.
ㄴ Hell-Joseon Slave 1: Feels like I can't let the act slip.
Cardiology Ghost: Oh! Then TAVR (* transcatheter aortic valve replacement)
They're used a lot these days. BEV
(* balloon-expandable)
and SEV
(* self-expanding)
and I'd like to ask working doctors what they think about where BEV and SEV stand now, and how they compare.
ㄴ Hell-Joseon Slave 1: The hospital director is CS.
ㄴ Cardiology Ghost: Oops, sorry. If you ask a knife-slinger about procedures, you’ll get cut.
Let's Spin the Dialyzer: Then what's the latest thinking on alkalinization therapy with sodium bicarbonate...!
ㄴ Hell-Joseon Slave 1: I said CS, you asshole. Bring up the heart or lungs, not kidneys.
God of the Scalpel: Intermittent REBOA (* intermittent REBOA)
and Partial REBOA
(* partial REBOA)
I wanted to talk about those a bit.
ㄴ Hell-Joseon Slave 1: Yeah? What is it?
ㄴ God of the Scalpel: Copy exactly what I say and read it off. Let's do it one-on-one.
‘…?’
Okay.
From now on, I'm an avatar.
Director Lee Jae-yoon's passionate lecture on REBOA was nearly over too.
I took a deep breath and started reading the text that appeared in the gallery window verbatim.
“Director, then clinically, which do you think is more beneficial—the intermittent method, where the balloon is inflated and deflated, or the partial method, where pressure is finely adjusted to create continuous flow?”
“Oh?”
Lee Jae-yoon's eyes widened.
“In my limited view, intermittent REBOA can cause sudden blood pressure fluctuations and risk dislodging clots (* thrombi), but the technique is simple, while partial REBOA is hemodynamically stable but requires arterial pressure monitoring, making it difficult to use in the field.”
On and on.
They were my own words, but I didn't really understand what I was saying either.
The director nodded, unable to hide his admiration.
“Exactly. That's it. That's exactly the point we're struggling with. These days, they're even developing machines that automatically regulate pressure...”
And for a while, the director, I, and three invisible ghost doctors held a heated(?) discussion.
Of course, I was only playing the avatar.
“...Right. The problem is that the dedicated catheter is expensive, but its effectiveness has been proven for a while now. Dr. Han, you've really given this a lot of thought. Your scholarly drive is impressive.”
After talking at length, the director clicked his tongue regretfully.
“Unfortunately, it's been a while since I put down the scalpel, and I haven't personally performed trauma surgery in quite some time... So when it comes to deep discussions with a doctor who's still in the field like you, my knowledge is only what I've read in books, and that's a shame.”
He was being modest.
For a man who had climbed from department chief to center director and then hospital director, admitting his own gaps before a junior so far below him...
“Not at all. It helped a lot. I think I've got a direction now.”
I meant that sincerely.
Even though I was only playing the avatar, once I caught the flow of the conversation, I thought I had learned quite a bit too.
God of the Scalpel: Yeah, this isn't bad.
God of the Scalpel left a comment, seemingly satisfied.
I was just about to close the floating window.
But the text Cardiology Ghost had posted earlier lingered in my mind like an afterimage.
‘TAVR... BEV and SEV.’
The mood was good, and the director seemed receptive to my questions, so should I ask one more?
“Oh, and by any chance, what do you think about BEV and SEV...”
“Hm?”
The director's eyes widened.
“I mean, the transcatheter... valve replacement procedure...”
The director cleared his throat awkwardly, as if flustered.
“Ahem. I'd have to ask Chief Jung in cardiology about that to be precise, wouldn't I? I've done plenty of valve replacements, but I don't do transcatheter procedures much.”
The director gave an embarrassed laugh.
Oh, right.
Transcatheter aortic valve replacement is closer to the domain of cardiology.
And on top of that, a comparison of stent types.
It was way too specific a question to ask a director who'd already stepped away from the field.
“Oh, no, no, Director! I was just talking. I'm in emergency medicine—what business would I have handling stents? I just heard about it somewhere. I'll look into it separately. Haha.”
I hurriedly waved my hands to smooth things over.
“Would you? Heh heh, if you're curious, I could put you in touch.”
Put me in touch?
With whom?
The chief of cardiology?
No.
I'll pass.
“Ah, yes, Director... I was just worried that I might have needlessly stolen some of your precious time, as the head of our busy hospital and our idol...”
I pulled out all the flattery and flowery language I could, trying to set up my exit.
“Ah, it's fine, it's fine. I enjoyed it too.”
Lee Jae-yoon waved it off, but his lips were practically up to his ears.
Powerful people really are weak to praise.
“Thank you.”
I slightly lifted my hips and gauged the timing to stand.
He should let me go now.
“Then, well...”
Lee Jae-yoon's eyes lit up again.
“Is there nothing else you'd like to ask? Or anything else you'd like to talk about?”
“...”
‘Fuck.’
The professors in this hospital had to be out of their minds.
Why won't he let me go?
“I actually had the night shift yesterday... I'm really sorry, but could I head out now?”
I pleaded while trying to look as pitiful as possible.
If I stayed pinned down any longer, I'd be on the verge of dying from overwork.
“You did? Oh dear, I'm sorry again. I've been holding back someone on duty and droning on with boring stories.”
The director looked startled and checked the clock.
“Not at all. It was very valuable advice.”
“Right, right. Go get some rest. You've had a hard time as a young man.”
The director stood up and saw me out.
Just as I grabbed the doorknob, he tossed one last line at my back.
“And Dr. Han.”
“Yes?”
“You said you wanted to encounter a wide variety of cases, didn't you? As an emergency medicine doctor, I mean.”
I nodded reflexively.
“Ah, yes, of course. That's what I want most as an emergency medicine doctor—seeing and learning from all kinds of patients. Haha.”
“Good, good. I like that passion. Anyway, there'll be some good news soon, so look forward to it. Get home safely.”
“Yes! Thank you!”
I fled the director's office.
Only after the elevator doors closed did my legs give out and I slumped down.
“Haa...”
…
On the way to my officetel after leaving the hospital by taxi,
I thought deeply while watching the scenery pass by outside the window.
‘Good news?’
Good news, as personally announced by the director.
Usually, good news from the higher-ups means money or honor.
‘A bonus? Special incentive pay?’
Would they generously reward us for handling the fire incident well?
Or send us abroad for training or something?
He did say he'd let me encounter a variety of cases, so maybe a tour of somewhere like Johns Hopkins in the U.S.?
“Heh heh heh.”
They say hardship comes before pleasure, and in the end, you have to know how to choose the right side and make a good impression on the higher-ups.
I fell asleep dreaming a very sweet dream.
…
***
And then.
I found out exactly what that “good news” was the moment I got to work two days later.
“...What is this?”
A single A4 sheet in my hand.
In response to my question, Fellow Lee Minjae flashed the most wicked, delighted smile in the world.
“What else? You're being sent to the branch hospital. Congratulations, Hyeonjae.”
With trembling eyes, I read the official notice again.
[Notice of Resident Dispatch and Rotational Assignments for the 1st Quarter Branch Hospital (Cheongjin University Geoje Hospital)]
What is this?
‘To promote exchange between the main hospital and its branch hospital and to foster residents' diverse clinical experience, rotational duty is hereby ordered as follows...’
I rubbed my eyes and looked over the paper again.
Regulatory basis: Paragraphs 3 and 4 of Article 24 (Dispatch and Rotation Training) of the Resident Training Rules
“Geoje... Geoje Island.”
Cheongjin University Geoje Hospital.
It was our hospital's branch on Geoje Island, where shipyards and heavy industry complexes were clustered.
The very hospital that opened this year.
“Fostering diverse clinical experience...”
The director's voice rang in my ears like tinnitus.
‘You said you wanted to encounter a variety of cases, didn't you, Dr. Han?’
‘Anyway, there'll be good news soon.’
This is the good news?
This?
I had to check the list.
Who was the colleague who'd die with me?
[Emergency Medicine] (Total: 4 / Period: 3rd week of April ~ 3rd week of June, 2 months)
(3rd-year and above)
Han Hyeonjae
(2nd-year and below)
Baek Eun-seo
(1st-year and below)
Yoon Tae-hyun
Kim Seoa
Four people.
“This isn't what I was hoping for...”
I muttered, looking at the empty air.
‘I wanted training in the U.S. or a bonus, not to be wrestling trauma patients in front of a shipyard...’
I thought carefully about what work in Geoje would be like.
First of all, Geoje is a city with a developed shipbuilding industry.
Which means there are a lot of workers, and therefore a lot of trauma patients.
And since the first university hospital established on Geoje was Cheongjin University Hospital...
The level of patient difficulty there was no less than at the main hospital—if anything, it was worse.
Just as tears were about to cloud my vision,
‘Ah, hold on.’
Wait, there was something important.
The official notice wasn't addressed to emergency medicine only.
[ To: Internal Medicine, Pediatrics and Adolescent Medicine, Emergency Medicine, General Surgery, Orthopedic Surgery ]
Then...
That meant there were others being dragged along from the other departments too.
I hurriedly snatched the paper and turned the page.
[Pediatrics and Adolescent Medicine] (3 people)
(3rd-year and above)
Son Jongun
…!
My eyes flew open.
“Yeeeeeesss!”
Before I knew it, I had clenched my fist and cheered.
‘So it's not just me who's screwed!’
As expected, God is fair.