Chapter 167
When I arrived at the scene, it was utter chaos.
“Look at that. They’re hauling a guy out.”
“Did he get caught stealing something?”
Even the citizens out for a walk and the older gentlemen who’d been night fishing had gathered to watch the spectacle, murmuring among themselves.
I rose onto my tiptoes and peered over the crowd.
There was no smell of blood.
It didn’t look like he’d cracked his head open in a traffic accident or a fall.
Instead, what caught my eye was a shiny black suit.
‘A wetsuit?’
The man sitting on the ground was wearing a full-body diving suit from head to toe.
And beside him, the coast guard officers were surrounding him and arguing.
“Sir, I’m asking why you were fishing illegally. There’s a reason you’re not supposed to do it.”
The police officer tapped his notepad in frustration.
“The things you collected just now are all evidence. First, come to the station and write a statement….”
“No! Forget the statement and all that! I’m telling you, I can’t feel my legs!”
The man in the wetsuit shouted.
“Patient, please calm down.”
The paramedic standing nearby tried to soothe him with an awkward expression.
“You say you can’t feel your legs right now, but from what we’ve checked there’s no external trauma, and even when we palpate your spine there’s no pain. Your vitals are just showing a bit of high blood pressure from being excited. So please, just listen to the police for now….”
From the paramedic’s point of view, it was a difficult situation too.
When someone claims paralysis even though they don’t appear injured, more often than not it’s a Hollywood act to dodge criminal charges.
Especially 119 paramedics saw their share of chronic fakers.
“N-no! I’m telling you, I really feel like there’s nothing below my waist! It feels like my legs aren’t even mine!”
“Sir, please don’t hurt yourself! We just need one form confirming the illegal fishing! Why were you under the water at this hour anyway? We’re trying to crack down on this….”
“I’ll explain that later, just take me to the hospital first! Do you want to watch me die?!”
Situation assessed.
I caught Baek Eun-seo’s eye.
‘Let’s go.’
Baek Eun-seo and I pushed through the onlookers and forced our way inward.
“Excuse us. We need to get through.”
“Please don’t shove!”
“Just a moment. It’s urgent.”
As we pushed through the people and approached the police line, a policeman holding a flashing baton stepped in front of us.
“Hey! You can’t come in here! Step back!”
“I’m a doctor.”
I reached into my pocket confidently to look for my ID badge.
‘Huh?’
Only then did I remember I’d stuffed it deep in my bag when I changed into the hoodie earlier.
“….”
The police officer looked suspiciously back and forth between my empty hands and my hoodie.
That was when it happened.
Baek Eun-seo took her ID badge out from her chest pocket.
“This person and I are doctors. I’m from the university hospital behind us, and we came because it looks like there’s a problem with that patient over there.”
Smart backup, as expected.
“Huh? You’re doctors?”
The young-looking police officer finally changed his expression.
“He’s been saying all along that his legs feel weird even though he looks fine…. We called an ambulance, but we can’t tell whether this is genuine or not. We’re really at a loss too.”
“Yes, yes. I understand the situation. Let us take a look first.”
I approached the patient.
“Eun-seo, go ask the paramedic a few things. Check the vitals, chief complaint, and the scene report.”
“Ah, yes!”
Baek Eun-seo immediately ran toward the ambulance.
I crouched down and met the patient’s eyes.
A rather veteran-looking policeman kept questioning him from the side.
“You need to cooperate quickly so we can get him to the hospital….”
“Officer?”
I cut him off.
The veteran officer froze and looked at me.
“Are you perhaps….”
“I’m a doctor. Emergency medicine.”
I pointed at the patient’s legs.
“May I take a quick look? He doesn’t look in good shape.”
“Ah… sure, go ahead. Though he does seem like he’s faking it.”
Once the veteran officer saw that I’d been allowed past the cordon, he stepped back.
I placed my hand on the patient’s thigh.
“Can you hear me?”
“Yes! Yes! Are you the doctor? Please save me! My legs are strange!”
The patient grabbed my arm.
“Calm down. When did this start? Right after you got out of the water? Or after that?”
“After I got out, my legs suddenly started tingling like they’d cramped up, then the strength went out of them and I collapsed. After that, it felt like they weren’t even my own legs.”
I pinched the patient’s shin hard with my fingers.
Hard enough to make the flesh twist.
“Can you feel this?”
“Mm….”
The patient only stared blankly at my hand.
“You can’t feel it? At all?”
“I can tell just by looking at it. I can’t feel anything at all.”
This time I grabbed his ankle.
“Try moving your toes. Wiggle your big toe.”
The patient bit his lip and strained.
Even so, his toes didn’t move.
‘This doesn’t seem like an act.’
Did he blow out a spinal nerve?
“When I do this, does it react….”
I tapped just below the kneecap with the side of my hand to check the knee reflex.
The leg that should’ve jerked instead hung limp without any reaction.
“…Nothing.”
The diagnosis was clear.
Paralysis from the waist down.
And considering this patient’s clothing and situation, there was only one cause.
Decompression sickness.
The bubbles from decompression sickness had formed in the spinal nerves and cut them off.
That was when I lifted my head.
“Doctor!”
Baek Eun-seo ran over after checking the paramedic’s chart.
“BP is 140 over 90, pulse 100, saturation 98%. Breath sounds are normal too. He does have mild hypothermia, but considering he’s been in the sea a long time, it doesn’t seem like anything major.”
Baek Eun-seo panted as she continued her report.
“The sensory level was T12(* the 12th thoracic vertebra), below the navel, with Anesthesia(* numbness), then he said his toes were tingling, and now he says it’s numb again. So the police said it looked like malingering and kept him waiting.”
“I see.”
Malingering?
The flip-flopping was the dangerous part.
“It’s spinal nerve paralysis. If we don’t move now, he’ll never walk again.”
“Nerve paralysis? But there wasn’t any impact and there’s no blood. How does paralysis happen?”
The police officer asked back in disbelief.
“Did this person come up quickly? While diving?”
I asked, looking down at the patient.
The patient nodded.
“He probably came up rapidly to avoid being caught by the crackdown. When you suddenly shoot up from deep water, the nitrogen dissolved in your blood turns into bubbles. Those bubbles block the blood vessels around the spinal nerves.”
“Ah….”
“If we delay, he’ll be left with permanent disability, so let’s move him quickly.”
Then the police officer hurriedly stepped aside.
“Ah… y-yes, yes. Clear the way! Clear the way!”
The police blew their whistles and split the onlookers apart.
With a path opened, Eun-seo and I raced to the ambulance, pushing the stretcher.
“One, two, three!”
Thud.
The patient was loaded into the ambulance.
‘Now I need to get in too….’
I scanned the inside of the ambulance.
Narrow.
‘The seating’s awkward.’
But this isn’t a giant fire station in the middle of Seoul.
In most regional ambulance calls, the number of personnel is obvious.
I glanced at the seat beside the driver’s seat.
‘Bingo.’
One paramedic in front, one emergency technician in back.
“Paramedic.”
“Yes?”
The paramedic looked at me.
“We’ll handle the back.”
“Huh? Ah, yes!”
The paramedic then went to the passenger seat, befuddled.
“We’re departing!”
…
Just two minutes by vehicle.
‘Come to think of it, it really is close.’
We arrived at the hospital after only starting an IV and checking his vitals.
Screeeech.
With a sudden stop, the rear doors opened.
Clatter.
As the stretcher passed through the ER’s automatic doors, the clatter of the wheels rang out loudly.
“Huh?”
The nurse sitting at triage jumped up in shock.
“Onset(* time of onset) about 15 minutes ago, lower-limb paralysis after diving. Suspected decompression sickness, so send him to Area A first!”
I headed straight for the critical care area, giving orders as naturally as breathing.
The specialists stationed there came darting out at the commotion.
“What’s going on?”
The night-shift professor was a face I’d never seen before.
‘Professor Kim Su-rim from Emergency Medicine?’
He had sharp features and looked pretty strict.
And thankfully, Professor Park Se-young, who’d still been hanging around and chatting during the day shift instead of going home, was there too.
“You’re here? I thought you’d already left.”
“I happened to bring him in.”
“What?”
“The patient. We found him by chance on the coast and brought him here with us.”
So this was the shift where the two of them were holding down the fort without the residents.
“Move him to a bed! Put him on the monitor!”
Professor Kim Su-rim said.
“What’s the history?”
“He rapidly surfaced while fishing illegally. He has lost sensation and motor function below T12. It looks like classic spinal decompression sickness.”
“You guys, on your first day at work, and already….”
Professor Kim Su-rim frowned and pressed the stethoscope to him.
“Breath sounds are fine. Run routine labs first, and since he came up so quickly, get an X-ray right away to check for pneumothorax. Give him one liter of fluids. Since he’s paralyzed, put in a Foley catheter right away.”
“Yes, understood.”
The nurses then coordinated and began treatment.
Fluids went in, oxygen was given, and monitoring started.
“Vitals are stable. BP is 130 over 80.”
Baek Eun-seo shouted while looking at the monitor.
…
“X-ray is here! Move!”
The radiology tech rolled the machine in.
It took just three minutes from the imaging to the picture appearing on the monitor.
“The lungs are clear. No pneumothorax either.”
Professor Park Se-young said, looking at the monitor.
“Then it’s definitely bubbles trapped in the spinal nerves. No brain symptoms either.”
The diagnosis was finished.
DCS Type 2.
Severe decompression sickness.
There was only one treatment.
Raising the pressure again to force the bubbles in the blood to dissolve.
Recompression therapy.
“….”
A silence fell at once.
Professors Kim Su-rim and Park Se-young looked at each other.
A memory flashed through my mind like lightning.
Just two hours ago, the hospital director’s orientation I’d listened to while dozing in the auditorium.
[…All facilities have been completed. In particular, the latest multi-person hyperbaric oxygen chamber and….]
[…And once the specialists for that department join us in May, we plan to officially open the hyperbaric oxygen treatment center and the aortic specialty center….]
It’s April right now.
‘Damn.’
The curse slipped out before I knew it.
Not every emergency medicine doctor can operate a chamber.
If you do it wrong, the patient’s eardrum can burst, their lungs can burst, or they can seize from oxygen toxicity.
So usually you need a subspecialist in hyperbaric medicine or a trained operator.
“Should we send up a helicopter?”
Professor Kim Su-rim muttered seriously.
“Where’s the nearest chamber? Tongyeong? Changwon? Or the main hospital?”
“Will there even be time? First of all, the branch hospital doesn’t have a doctor helicopter, so we’d have to take a fire department helicopter, and I doubt they’d hand one over right away. We’d have to check whether there’s even a fire helicopter base nearby first….”
Park Se-young answered in a drained voice.
“Samcheonpo or Sacheon? There is a Naval Medical Center in Changwon, but…. If we transport him overland first, wouldn’t it take more than an hour?”
One hour.
In that time, the spinal nerves would be crushed by nitrogen bubbles and die.
Permanent paralysis.
“Ha….”
I let out a deep sigh.
There was a way.
‘There has to be someone among the gallery freaks.’
The veteran lurkers of the defunct medical gallery.
Among them, the internal-medicine ghost nicknamed Back-in-My-Day Latte had once told a story about diving in Hawaii and ending up in a chamber.
He said that after entering as a patient, he became interested and even learned how to operate the chamber.
Back-in-My-Day Latte: There’s nothing special about a chamber. It’s just like a rice cooker.
Back then I thought it was nonsense, but now it was my only lifeline.
I glanced over at Professor Kim Su-rim.
We’d just met.
A strict professor I’d just met today.
First impressions matter, they say.
‘Professor Kim Su-rim will probably never forget my first impression.’
A lunatic or a genius.
I’d be stamped as one of the two.
Of course, the odds were higher for the former.
No choice.
The patient is right in front of me.