Could It Be a Cold? (3)

I hung up with Park Woo-young and immediately looked up the on-call thoracic surgery resident's number and called. My heart was pounding even harder than before.

“Yes, this is Kim Dojin, a third-year cardiothoracic surgery resident.”

“Hello, doctor. This is Han Hyeonjae, first-year emergency medicine resident. I'm calling about a patient.”

I reported much more tersely than before.

Surgeons hate long explanations.

“A 54-year-old male patient, currently maintaining blood pressure at 90 over 60 with a right ventricular infarction accompanied by an inferior wall infarction. Cardiology is planning an intervention, but the patient is extremely unstable, so there's a very high chance of cardiogenic shock or cardiac arrest during the procedure. I'm calling ahead about standby VA ECMO before the procedure.”

The third-year thoracic surgeon on the other end fell silent for a moment.

Just as the fear that I might have gone too far began to creep up on me.

“…Wait a second. First-year EM? Not internal medicine, emergency medicine?”

“Yes, that's right. I'm calling on behalf of the cardiology team.”

“…Ah, right. Nothing much. Of all the first-year calls I've heard so far, that was the cleanest. No fluff. Keep holding on. I'm heading down.”

The call ended.

I stared blankly at my phone.

Huh? Suddenly? I got praised?

How?

No, wait, he didn't even ask anything else?

How?

No, but why in the first place?

Why?

I closed my eyes for a moment. My head spun wildly as the memory of that night a few days ago, when my sacred day off had been stolen outright, and the memory of that hellish tutoring session flashed by like a panorama.

***

In my officetel, a blue gallery window floated in the air before me as I lay like a corpse on a cheap sofa.

Back in My Day : Idiot! You think myocardial infarction always comes with chest pain? That's textbook bullshit! Old people with diabetes just come in saying they're weak, and some people come in saying their stomach feels off! Their jaw hurts, their neck hurts, their back hurts! You have to suspect all of it! The moment you take the patient's words at face value, you're not a doctor—you're just a receptionist!

I answered half-asleep and utterly soulless.

ㄴ HellJoseonSlave1 : Oh yes, yes, got it. So if your whole body hurts, that's myocardial infarction too, huh.

The screen changed, and dozens of ECG waveforms flashed past my eyes.

CardiologyGhost : Now, inferior-wall infarction. What do we look at first? V4R! Right ventricle! Why? Because the treatment changes! If you give nitro, the patient dies! What's this? Anterior wall infarction! And this? Posterior wall infarction! Then where do you put the leads? V7 through V9! Burn it into your brain, you bastard! If you can't memorize it, I'll jam electrodes straight into your heart and make you memorize it!

I writhed in pain.

And then, at the end of that night, just before my consciousness was about to cut out entirely, someone had carelessly thrown out a comment.

ㅇㅇ(223.39) : But you guys are talking awfully calmly. RV

(*right ventricle)

MI extending all the way to the RV

(*myocardial infarction)

means arrests come on like crazy while you're trying to open it up. Shock too. At our hospital, whenever a case like that comes in, we always call CS

(*Cardiothoracic Surgery, thoracic surgery)

and have the ECMO team on standby before starting. Not preparing for that is basically saying you want the patient dead, isn't it?

***

Back then, I'd just brushed it off...

As expected, experience isn't something you get for free.

But I didn't have time to get sentimental about it.

Because just then, I started hearing the sound of someone running in from far away.

The automatic doors at the ER entrance slid open, and a man with a sweat-soaked face rushed in.

It was Park Woo-young from cardiology, the same guy I had just been on the phone with.

Of course, I hadn't seen his name tag or known his face before. But in this quiet ER, who else would come barreling in like that if not the on-call cardiology doctor?

“Infarction…! Where…!”

“Yes, doctor! Right here!”

I pointed to bed B-28.

Park Woo-young, who had rushed over, first checked the patient's level of consciousness, then snatched the EKG printout from my hand and finished scanning it in just two seconds.

“It's completely blown. Still in the 90s?”

“Yes, we gave 500 cc, and he's barely holding at 90 over 60. Heart rate dropped to 50.”

“Even with fluids, it's still like this? What... looks like the right ventricle has completely given out. It's a total occlusion.”

Park Woo-young muttered to himself as he turned on the portable ultrasound.

And then he spread gel on the patient's chest and brought the probe down.

The image of the heart beating laboriously appeared on the monitor.

“Look at the wall motion. The inferior wall and RV... hardly moving at all. The diagnosis is certain.”

Park Woo-young soon set the probe down and turned to me.

“Good job not using nitro, giving fluids first, and calling CS...”

Park Woo-young gave my shoulder a hard pat.

At that moment, another group rushed into the emergency room. It was the thoracic surgery team.

Behind the thoracic surgery team was even a hulking ECMO cart. The third-year thoracic surgery resident who had taken the call led the charge and stopped in front of Park Woo-young from cardiology.

“I'm Kim Dojin, a third-year cardiothoracic surgery resident. I came after getting your call. Where is the patient?”

Park Woo-young from cardiology immediately pointed to the patient as if he'd been waiting for it.

“Oh, thoracic surgery? Patient's here. He's still holding on, but the condition is really... We'll get him to the cath lab as fast as possible and try to open it up. If his blood pressure drops any further or he arrests during the procedure, I'll call you right away, so stay nearby and be on standby.”

“Yes, understood, doctor.”

The patient's bed began to move.

Countless IV poles and squeaking monitor equipment, and the medical staff surrounding them.

I blankly watched them go from the very back.

The patient was now out of my hands.

Whether he lived or died was now in the hands of God, cardiology, and thoracic surgery.

I turned my gaze back to the spot where the bed had been.

As the patient and the medical staff disappeared into the elevator, a deceptive stillness settled over the ER bay.

Only gauze on the floor, discarded syringe caps, and the now-ownerless bed remained.

Phew...

Once the tension eased, the gap left by adrenaline was filled with a dreadful fatigue.

A pitiful rumble echoed from my stomach.

Ah.

Right.

Lunch.

Only then did I remember I had been about to go eat.

What about Kim Jihoon—and my pork stir-fry?

I slowly lifted my head and looked up at the clock on the station wall.

Damn it.

My lunch break.

...It had all blown away, damn it.

I felt empty.

'Ah... my precious pork stir-fry.'

With that, I said farewell in my heart to the pork stir-fry on the cafeteria menu and trudged back to the station.

'Gallery.'

What the hell were those crazy ghost bastards talking about at a time like this?

Were they even debating my heroic exploits?

The moment the blue interface appeared, I snorted.

Title : [Goddamn breaking news] HellSlave1<<<< This bastard caught AMI from just a sore throat lol

Author : Operating Room Ghost 3

Title : Today's HellSlave performance summary.txt

Author : Psychiatry Ghost

And then, the featured post with the most upvotes and comments.

Title : HellSlave1 << this bastard's got a hell of an eye for detail, upvote lol

Author : ㅇㅇ (223.39)

I gave a dry laugh and clicked the post.

The comment section was already blazing.

ㅇㅇ (14.52) : Wow... he really caught it. Respect. How do you diagnose MI from a sore throat? If I were on EM duty, I'd have just given him cold medicine and sent him home.

Hippocrates' Descendant : Could the sense of the living truly surpass the knowledge of the dead.... How fascinating.

Operating Room Ghost 3 : That's insane, for real. That kind of instinct is just something you're born with.

Psychiatry Ghost : (a dumpling giving a thumbs-up emoji)

God of the Scalpel : He got lucky. But luck is skill too.

What a load of crap.

I was only saying that I hadn't forgotten the information you ghosts had shoved into my brain on my day off.

I kept scrolling. There was no sign of it ending.

ㅇㅇ(semi-anon) : So was that really a myocardial infarction?

ㅇㅇ (182.215) : When did you read the EKG? Can't you take a picture of the EKG and show it? Just give me the picture already. I'm getting dizzy.

Hematoma Is Hell : Hurry up and come write the follow-up, HellSlave, lol

Back-Gallery Lurker (1.234) : It wasn't even chest pain, and it was just a sore throat, lmao

BoneNerd88 : But wasn't saying to call CS in the comments a bit over the top, wasn't it? I feel like cardiology could've handled it.

ㄴ ㅇㅇ(118.235) : You're saying that because you don't know anything. Inferior-wall MI with right ventricular infarction is all about keeping the blood pressure up. There are tons of cases where they go down fast. Calling ECMO backup was a stroke of genius.

I stared at the screen full of praise, analysis, and mockery without feeling a thing.

To these ghosts, this incident was an interesting case, and I was a talented streamer.

These ghosts would never know that, as the price of this heroic act, I'd missed today's lunch special: pork stir-fry.

Sigh...

I quietly closed the gallery window, without even checking the points in the lower-right corner.