Another Peaceful Day in the ER ER ER (2)

Thirty minutes later.

After leaving behind a diagnosis unlike anything anyone had ever seen, Seaweed Man disappeared into the endoscopy room, led away by the gastroenterology fellow.

I stared at the empty Area A and mulled over what Yoo Seonghun had just said.

'Because it'll be a sight you never get to see again in your life.'

Would it really?

In this hellish ER, every imaginable kind of stupid shit happened every single day.

The guy who bragged about his virility by downing an entire bottle of Viagra and getting hauled in, the gentleman who drank industrial alcohol while drunk and came in saying he couldn't see—the dried seaweed guy had just added his name to that legendary list. What kind of lunatic would show up next and test the limits of my imagination?

Just as I was thinking that and heading back to the station to sit down, it happened.

Aaaaargh!

Some man screamed and rushed into the ER.

What, was he a bomber or something?

No, 'rushed in' was the wrong way to put it—he had practically rolled in. Ignoring the nurse shouting for him to follow the triage desk procedure, the man clutched his stomach and crawled right across the floor.

P-please… save me!

The second villain of the day had appeared.

Sir, please calm down first… where does it hurt that badly?

My… my stomach.

The man barely managed to answer through the pain.

His face was slick with cold sweat, and his lips had gone ghost-white. This didn't look like malingering; he was clearly in genuine, severe pain.

I crouched beside him and asked again.

Your stomach? What's wrong with your stomach…

My anus… and my stomach… hurt…

His anus? I frowned.

My whole stomach feels like it's just burning! Like it's being stabbed with a knife! Aaaagh!

Acute appendicitis? Diverticulitis? Or maybe even bowel perforation? Every horrific differential diagnosis flashed through my head.

…Did you eat anything?

Even in pain, the man answered with crystal-clear pronunciation.

…nuclear buldak with extra capsaicin.

….

Before I knew it, I slapped a hand to my forehead.

Nuclear buldak?

And with extra capsaicin?

Why the hell would you pay money to carry out a chemical terrorist attack on your own body?

My inner demon roared.

Sir, please lie down on the bed for now. You must be in a lot of pain.

I waved to the nurses nearby.

Move him to a bed and get an IV line in fast! In one liter of normal saline, mix Tagamet

(*Tagamet, acid secretion inhibitor)

and Macperan

(*Metoclopramide, antiemetic)

and give it as quickly as possible! We'll also have him take some gastric-protective gel right away!

The nurses moved in perfect unison and transferred the man to the bed.

Standing beside the bed, I said to the man, who was still clutching his stomach and groaning,

Sir, you'll feel better once you get the injection and take the medicine. And just in case, I'll tell you where the restroom is in advance.

I pointed to the far end of the hallway.

It's left at the end of that hallway. Better remember it now. You'll probably get the urge soon.

I looked at my arm and rolled up my sleeve.

I'll start the IV myself.

The nurses look busy, so at least I should get the line.

I confidently applied the tourniquet

(*Tourniquet, compression band)

and wiped the skin with an alcohol swab. The vein looked great—thick and springy, almost too easy to hit. At this rate, I could hit it with my eyes closed.

Catheter in hand, I took one deep breath.

Poke.

…Huh?

I definitely felt the needle go through the vein, but no blood flashed back.

Fail.

The man flinched.

I'm sorry, sir. The vein moved a bit….

I made a pathetic excuse and adjusted the angle once more.

This time for sure.

Poke.

…Ah.

This time I went in too deep. I had gone straight through the vein. The moment I pulled the needle out, a dark blue bruise swelled up in an instant.

Second try: fail.

I quietly set the catheter down. The veteran nurse watching me from the side had a 'I knew it' expression flicker across her face.

'Hmm. Let's just leave it to the nurse!'

I put on a generous act and stepped aside. The nurse took the tourniquet and catheter from my hands and got it done on the first try without even a moment's hesitation.

I pretended to be calm, but I was crying inside.

When will my hand ever get faster? My hand.

The clock read 6:50 p.m.

Ten minutes. If I could just hold out ten more minutes, this hellish shift would be over.

I sat down in a station chair and stared blankly at the hands of the clock.

Please, let nothing happen now.

But the god of the ER was always cruel.

"Uh… excuse me!"

A man walked in from the ER entrance in a half-bent posture, clutching at the corner of his mouth.

Ah, why did you have to come now, sir?

I swallowed my tears and approached the man.

How did you get here?

The man began speaking hesitantly.

My tooth is dangling

Your tooth is dangling?

I repeated his words and looked at his face.

There was a dark bruise and a scraped abrasion on his left cheek and jaw.

How did this happen?

I missed a step on the stairs and fell face-first.

Did you hit your head when you fell, or lose consciousness even for a moment?

No, I don't think so. It's just my tooth… something's wrong with my tooth.

First, I ruled out brain injury from the trauma. I checked the patient's pupillary reflexes and performed a quick neurological exam.

There were no obvious abnormal findings, but with trauma patients, you always have to assume the worst.

Sir, let's get a head CT first to make sure there's no problem with your head.

After sending the patient off to radiology, I took a brief breath. The CT would handle the head issue. But what on earth was I supposed to do about that 'dangling tooth'?

I slumped in the corner of the chair and, out of habit, opened the gallery window.

Title: [Urgent] Trauma patient, tooth subluxation.

(*A tooth that hasn't come all the way out)

What do we do for this in the ER?

Author: HellJoseonSlave1

30s/M, tooth subluxation after a fall. Sent for CT to rule out brain injury. They say the tooth is fucking loose—what do I need to do in the ER? I know I should call dentistry, but is there anything I can do first?

ㅇㅇ (118.235) : We're doctors, not dentists.

Back in My Day : Tsk tsk. If you wanted to know that, you should've gone to dental school. We can look at tongue cancer, but we don't look at teeth.

God of the Scalpel : Teeth aren't my area.

Plastic Surgery Ghost : Don't you have a dentist who pulled your wisdom tooth? Ask them. Those people are the experts.

It's the first time I've seen these guys be this useless.

I let out a hollow laugh and closed the gallery window.

A little later, the CT results came out. Luckily, everything was normal.

Sir, your head is fine. Now let's take a look at the troublesome tooth. Please open your mouth.

Anyway, I didn't go to dental school. I only know the basics. Just the basics.

The basics of dental trauma. If a tooth is completely knocked out, that's avulsion, and it should be placed in a preservation solution and sent to dentistry as quickly as possible. But this one wasn't knocked out—it was loose. A subluxation.

I shone a penlight into the patient's mouth. One upper front tooth was clearly out of alignment, and blood was seeping from the gums.

Let me just check how loose it is.

With a latex-gloved hand, I gently touched the front tooth.

My only intention was to see how much it moved and in what direction.

Okay, lo— huh?

That was the moment.

I felt a tiny, unpleasant click at my fingertips.

And in my hand was a front tooth that had just been in the patient's mouth a second ago, sitting there obediently. A perfectly intact front tooth, root and all.

…Shit.

I yanked out the patient's tooth.

Silence fell.

The patient and I just stared at each other with our eyes wide. Blood dripped from his mouth.

I looked back and forth between the tooth in my hand and the patient's toothless gums. My brain was refusing to accept reality.

No, what did I even do? I only touched it.

D-doctor… my tooth…

The patient's voice was trembling. And with that voice, the last thread of my reason snapped.

Uh… y-yes!! Nurse! Dental hospital! Somebody call the dental on-call doctor, quick!

I shouted, almost screaming.

All sorts of random bits of knowledge started tangling together in my panic-stricken head.

And this! How do you save a tooth again? Milk? Milk, right? Somebody run to the convenience store and buy a bottle of milk fast! Not low-fat! Just regular milk!

At that exact moment.

Thump.

Someone lightly bonked me on the back of the head.

Jeez, you idiot.

When I turned my head, fourth-year Lee Minjae was looking down at me with a pitiful expression. He must've seen the whole commotion.

What are you doing? Why are you dragging the poor nurse into this?

As if my panic meant nothing to him, Lee Minjae gently took the tooth from my trembling hand.

What milk? We have something lying around in the ER already. Sterile normal saline.

Then he quickly gave orders to another nurse with practiced ease.

Nurse, please bring one 500 cc bag of saline and an empty container. We'll soak the tooth in it. And Han Hyeonjae.

Y-yes, sir!

Find the dental contact and call them right now. Say the patient's tooth has been completely avulsed. Politely ask them to come as quickly as possible.

Thanks to my senior's deft cleanup, the ER returned to peace once again.

About fifteen minutes passed.

The ER automatic doors slid open, and a man in a white coat came in.

I'm the dental on-call doctor who came after receiving your call. Where is the patient?

Oh, hello, doctor!

I stole a sidelong glance at the name tag pinned to his chest.

His coat read 'Oral and Maxillofacial Surgery, Jin Myeong-cheol.'

Ora… oral… what?

Oral and Maxillofacial Surgery.

That's a mouthful. What kind of department is that anyway? Wasn't it just dentistry? Does that mean it's a surgery department that treats the mouth, jaw, and face? Do dentists do facial surgery too?

Hmm, that's a mysterious world too.

Even after six years of med school, one year of internship, and residency, I still knew almost nothing about the world of dentistry.

The dental doctor walked straight up to the patient as if he had no way of knowing my complicated inner thoughts. Then he took the container with the front tooth I'd yanked out—no, the one that had come out on its own—and examined it closely.

Hmm, the periodontal ligament is still alive. At this rate, the reimplantation success rate is high. Don't worry too much.

He reassured the patient while expertly examining his mouth.

The alveolar bone is a little fractured, but that's fine. We'll take you up to our department right away and handle it with a simple procedure.

And so Tooth Man went side by side with the dentist up to the dental hospital treatment room.

Only after their backs disappeared beyond the elevator did I let out a long sigh.

All the strength drained out of my body. In the gap left by adrenaline, a vicious sense of emptiness rushed in.

I got cocky after saving a myocardial infarction patient, got a reality check from Seaweed Man, got embarrassed because I couldn't get the vein on Nuclear Buldak Man, and then finally pulled a patient's tooth right before clock-out.

Is this what a doctor is? I'm just a walking disaster.

I trudged over and flopped onto the sofa. Then, without thinking, I opened the gallery, my only refuge.

I had to vent about this somewhere.

Title : Hey, I just pulled out a patient's tooth.

Author : HellJoseonSlave1

A fall patient came in ten minutes before clock-out, and when I touched the loose tooth, it just slipped right out. I didn't pull it. It came out on its own. Anyway, I called dentistry and sent him off.

The moment I posted it, the ghosts started laughing just as I'd expected.

ㅇㅇ (210.94) : Hahahahahahahahahahahahahahahahahahaha

Operating Room Ghost 3 : You crazy bastard, hahaha. You're really doing every kind of crazy shit, lol.

Respiratory Ghost: Hahaha, now you're even doing extractions.

I stared blankly at the ridicule.

Yeah, laugh, laugh, you bastards.

None of you will ever have a tooth pulled, anyway. Yours are probably already all rotten to hell.

After a long bout of mockery, someone opened the door to a serious discussion.

Hippocrates' Descendant : What kind of structure is a tooth made of that it comes out so easily? Is it different from bone?

With that one question, the mood in the gallery changed abruptly.

These ghosts were always starving for intellectual curiosity, even if the subject wasn't their specialty.

BoneNerd88 : That's pretty close to my field, so I'll explain. Teeth are a kind of bone too. They're made of calcium and phosphorus, right? But they're a little different from regular bone. They've got nerves and blood vessels inside, and the outside is covered in something insanely hard.

Back in My Day : Then what's the principle behind them being embedded in the gums? Did they just glue it on?

BoneNerd88 : It's connected to the alveolar bone by a ligament called the periodontal ligament. That's why it doesn't come out from ordinary impacts.

ㅇㅇ (118.235): But that Hell Slave bastard pulled it out. Doesn't that mean he's insanely strong?

God of the Scalpel : It's not that he's strong; he's just stupid. The periodontal ligament was probably already almost completely torn by the impact. He just touched it without thinking, so it came out.

The discussion began drifting in an even more profound and idiotic direction.

Infectious Disease Ghost : Can teeth get infected too? Not cavities. Like, say, bacteria getting in through the bloodstream and pus collecting in the tooth.

Hematoma Is Hell : Could happen, right? Like pulpitis or something. Then what antibiotic should you use? Does penicillin work?

Nephrology Fossil : I heard rotten teeth are bad for the kidneys too. Bacteria can travel through the bloodstream and cause inflammation in the glomeruli.

And finally, they reached a stupid conclusion.

Hippocrates' Descendant : Then the conclusion is this, isn't it? Teeth are a sort of endocrine organ in the shape of bone, a breeding ground for infection, and a very dangerous organ that can cause systemic disease! Therefore, preemptively pulling them all out would help extend human healthy life expectancy!

…That's enough.

I quietly closed the gallery window.

Just… let's get off work.