Chapter 25
“Oh, right, Hyunjae.”
“Huh?”
I turned around at the shout calling me, and there stood Fellow Park Se-young.
Why had she called me when I was about to clock out?
Was she calling me to chew me out for doing something weird?
No, looking closer, I could see she was trying to hand me a stack of papers.
No way, was this my transfer order? Were they sending me to some branch hospital?
Or was it disciplinary action? For wasting too much time?
But my delusions ended there.
“This is from the family of the myocardial infarction patient who’d come in with a sore throat before. They asked me to pass it along to you.”
On closer inspection, it looked like it had been posted on the hospital’s ‘Praise Us’ board.
It was a long thank-you letter from the patient’s family.
「…After treatment, the patient was safely admitted and remained in a stable condition…」
「…Thank you for not dismissing it as a simple cold, for paying attention, and for saving their life.」
As I read it line by line, I felt something swell up in my chest.
A thank-you, and a person who got their life back.
…
No harm in studying a lot.
Let’s do this, Han Hyunjae.
I could get ready to head home with a bright smile.
***
The moment my shift ended and I stepped out of the hospital, all the tension left my body and my legs went weak.
With a sigh, I trudged toward the bus stop. The thank-you letter had lifted my spirits, but it hadn’t done a thing for my fatigue.
The one silver lining was that the bus arrived right away.
Oh yeah.
Only after I squeezed into a musty corner seat on the bus did a brief sense of relief wash over me.
The world outside the window was passing by so peacefully.
I opened the blue window in my head, my only outlet and vent.
To properly wrap up a shift, you’ve got to do it with those crazy ghost bastards.
I decided to throw out a new question.
It wasn’t some major exam or anything.
I was just… curious. What kinds of weird things these dead experts had gone through in life that were similar to mine.
Title : So, have you guys had any other experience like this?
Author : Hell Joseon Slave 1
Other than thinking it was heart disease when it was actually muscle soreness, what else have you been fooled by? Share your biggest doctor-life gotcha stories. I can’t be the only idiot here.
My post was a self-deprecating crap post begging for a little solidarity.
But it seemed to be more interesting to the ghosts than any medical debate.
The moment my post went up, the gallery turned into a story-sharing party.
Among them, one systematically organized info post especially stood out and made it onto the hot posts.
Title : [Info] A Complete Rundown of the Bastard Mimics You’re Screwed If You Miss in the ER.txt
Author : Back in My Day
I clicked the post, almost possessed.
1. Aortic dissection
(* aortic dissection)
- Mimics: myocardial infarction, herniated disc, abdominal pain, stroke, even fainting.
- Features: tearing pain is the classic presentation, but plenty of patients just come in saying it hurts a bit. A blood pressure difference between the arms matters, but in more than half of cases there’s no difference. In short, a motherless disease.
Under that post, countless ghosts began dropping tearful stories in the comments.
God of the Scalpel : Aortic dissection is the biggest bitch. Back when I was a resident, there was this old man who came in saying he just had back pain. Ortho said it was a disc issue and sent him home with painkillers, but the next morning he was DOA
(* dead on arrival)
. The autopsy showed his abdominal aortic dissection had ruptured. The ortho department was turned upside down that day.
ㄴ Operating Room Ghost 3 : We had a man in his twenties brought in after fainting, and we just thought it was vasovagal syncope
(* vasovagal syncope, the most common type of fainting.)
or so we thought. But when we got a CT, the ascending aorta was torn from end to end. We rushed him straight to the OR right then and there…
Reading their comments sent a chill down my spine.
Bench press was nothing.
True disasters show up with an ordinary face.
I scrolled down.
2. PE
(* pulmonary embolism)
- Mimics: simple shortness of breath, panic attacks, pleurisy, myocardial infarction.
- Features: a lot of patients come in short of breath, but their oxygen saturation is perfectly fine. The ECG is normal most of the time. D-dimer is maddeningly ambiguous. If the heart’s racing for no reason, you have to suspect it.
ㄴ ㅇㅇ (118.235) : Don’t miss PE. There are way too many cases where you brush off a patient because they’re just a little short of breath and their oxygen saturation looks fine, and then they get up to go to the bathroom and arrest right there. Unexplained tachycardia
(* a state in which the heart rate is abnormally fast.)
is something you absolutely have to suspect.
I etched those stories into the deepest part of my brain.
For one last time, I wrote a new post on the gallery.
Title : What other weird cases are being tossed around on the gallery right now?
Author : Hell Joseon Slave 1
In response to my question, the ghosts started spilling all kinds of outrageous stories as if they’d been waiting for it.
ㅇㅇ (semi-anon) : He just came in saying he had a headache after drinking, but the CT showed a ruptured cerebral aneurysm. Almost got us fucked.
Take Care of Your Mental Health : Sometimes it really does seem like mental illness, only to turn out to be a brain tumor; and sometimes it seems like a brain tumor, only to turn out to be actual mental illness. Life is a gacha. Totally random. You’ve just got to scan everything.
ㅇㅇ(39.7) : There are even people who get hit by a truck and walk in acting fine. They can still keel over from internal bleeding. Press on their belly once. They’ll scream and collapse.
I see. I need to keep that in mind.
That was when it happened.
I felt a very cold, sharp gaze beside me.
When I turned my head, the young woman sitting next to me was staring at me with a look full of suspicion.
When our eyes met, she jumped and slowly edged away from me.
‘What the hell, what’s with her?’
I cleared my throat and straightened up.
Then, absentmindedly, I caught sight of the phone screen in her hand. She was messaging a friend.
And then I saw it.
The yellow chat bubble she had just sent.
[The person next to me is weird;; just staring into space, laughing and muttering to themselves. Maybe they just got discharged from the university hospital psych ward]
…
My brain stopped.
I slowly turned my head and looked back out the window. My reflection in the glass looked like Patient A who’d just escaped the closed ward.
On top of that, I was a lunatic grinning at empty air.
Perfect.
..That’s not it..
I could only repeat the most pitiful, heartbreaking excuse in the world in my head, one she couldn’t hear.
The woman in the next seat got off in a hurry at the next stop.
In the empty seat she left behind, all that remained was the bitter self-loathing that maybe I really was a nutcase.
Yeah, to anyone watching, I probably looked insane.
Snickering to myself at empty air, muttering with a serious face.
I could already picture her telling her friends the story of the 'crazy guy on the bus.'
***
The bus had been rolling for about ten minutes now.
I was forcing myself to forget about the gallery and staring blankly out at the street.
That was when it happened.
Since my head was turned to the right, I could see a bit of the seats behind me, and the head of the old lady dozing by the window behind me suddenly jerked sideways.
The movement was so unnatural that my gaze went there before I even realized it.
One corner of the old lady’s mouth sagged, and saliva started dripping from her limp, open mouth.
At first, I thought she was just deeply asleep from being too tired.
Soon, the middle-aged woman sitting next to her gently shook the old lady’s shoulder in a worried voice.
“Excuse me, are you okay? You must be very tired.”
Only then did the old lady open her eyes faintly.
But the old lady’s reply cut through all the noise on the bus and stabbed into my ear like a dagger.
“Uh… I’m… I’m… okay…”
A slurred, strange pronunciation.
The words came out all mangled, as if her tongue had gone numb.
I started to feel that something was off.
Facial paralysis.
Speech impairment.
The thought ‘Could this be a stroke?’ flashed through my mind.
Two of the four most basic symptoms of stroke were unfolding right in front of my eyes in real time.
But I couldn’t move rashly.
No—what if it wasn’t?
The memory from just a few hours ago was holding me back. The bench press and the mala xiang guo combo. My overreaction and the massive reality check that followed.
What if the old lady was just too tired, or her dentures didn’t fit right and that was why her speech was slurring?
If I jumped in again, made a scene with ‘I’m a doctor! This woman is having a stroke!’ and it turned out to be nothing?
Everyone on the bus would treat me like a lunatic, just like that woman earlier.
I turned my head and tried my best to pretend I was looking out the window.
From behind, the woman beside her couldn’t hide her worry and kept asking the old lady.
“Are you really okay? You look terrible. Is something bothering you?”
“Uh… my head… a liiiittle…”
The old lady still spoke awkwardly. The drooping corner of her mouth still hadn’t gone back up.
Ah, hold on.
I squeezed my eyes shut.
The ghosts’ voices, their damn nagging, flashed through my mind.
‘Patients don’t come in like a textbook. Always think worst-case.’
‘That one tiny symptom you ignore can decide the rest of a patient’s life.’
When it comes to brain disease, time is worth its weight in gold.
With stroke, every second that passes means brain cells are dying off for good.
Even now, while I hesitated here, a vessel in that old lady’s brain might already be blocked or burst, and irreversible damage might be progressing.
Embarrassment. And one person’s life.
The scale had already tipped to one side.
So in the end, I turned my head back.
I stood up and headed to the seats behind me. The middle-aged woman looked at me with wary eyes. I took my wallet out of my pocket. Then I pulled out my ID badge and showed it to her.
“Hello, ma’am. I’m an emergency medicine doctor…”
My voice didn’t tremble.
I looked straight into the old lady’s eyes and said,
“Could you do exactly what I tell you, just once?”