What Went In There? (2)

I deliberately ignored Park Seongjeong's crimson face and the deep despair in his eyes.

That's right, Seongjeong.

Keep getting stronger.

I gave Park Seongjeong's shoulder one last pat, then returned to the station and issued a few more orders.

“The patient is in a lot of pain, so give him one ampule of ketorolac as an intramuscular shot for pain relief. And to get that thing out, his muscles need to relax a bit, so give him just 2 mg of midazolam slowly intravenously. He'll get a little drowsy and loosen up, and that'll make things much easier.”

“Yes, doctor....”

Leaving that soulless reply behind, I went back to my seat.

My role was truly over now.

I'd made the diagnosis, laid out the plan, and even assigned the people to carry it out.

What more perfect delegation could there be?

I took another sip of coffee, feeling thoroughly satisfied.

But that peace didn't even last five minutes.

“Aaaaaaaaah!!!!”

From deep in Zone B, a pitiful, horrifying scream burst out—one so awful it was hard to believe a human could make it.

Everyone at the station turned that way reflexively.

...Looks like Seongjeong failed.

I rubbed my forehead.

At that level of screaming, he hadn't just failed—he must have seriously messed with something he shouldn't have.

Sure enough, a nurse came running out.

“Dr. Han. Um... the patient in Bed B-8... I think you should go take a look. The intern doctor was doing something, and the patient suddenly....”

Damn, is there no one else?

I frantically scanned the area.

Another sacrificial lamb—no, no, another intern—to help me get out of this hellish situation.

Right, there was definitely one more. There were two interns today, after all.

Ah. Right.

My radar picked up another innocent soul on the opposite side of the station, busily sorting EKG paper.

“Minseong, let's go!”

Choi Minseong.

Right, there he was.

I sprang up from my seat and walked toward Choi Minseong like a man who'd found a savior. Then I grabbed his shoulder.

“Huh? Doctor? Where are we going?”

“There's a very rare, educational case. The kind of scene a doctor might see once in a lifetime, if at all. As your senior, I have to personally show you this. Come with me.”

Without allowing any objections, I practically herded Choi Minseong toward Zone B.

Don't worry.

There are plenty of interns.

Probably.

Bed B-8, where we pushed aside the curtain and stepped in, was complete chaos.

The patient was writhing and groaning on the bed, while Park Seongjeong stood there pale as a sheet, at a complete loss.

The latex glove in his hand hinted at the full story of the catastrophe that had just unfolded.

I let out a deep sigh at the pitiful scene.

Then I put on the mask of a highly competent, composed senior doctor.

“Seongjeong, what happened? Explain it calmly.”

“D-Doctor... after I gave the injection, it seemed like the patient relaxed, so I laid him on his side and tried to take it out... but then the patient suddenly started screaming....”

I nodded and examined the patient's condition.

“Seongjeong, did you by any chance only tell the patient to relax and not have him do diaphragmatic breathing?”

“Huh? Diaphragmatic breathing?”

“You should have had him take a big breath into his belly, then exhale slowly with a whoosh while relaxing his whole body. The sphincter naturally relaxes when you breathe out, so you should have aimed for that timing.”

“Ah....”

“And the position. You've just got the patient lying on his side. You should have pulled the knees up as close to the chest as possible to set the position. That way you make room for the foreign body to come out. In a half-baked position like this, it actually gets caught inside and won't come out as easily.”

I started analyzing the causes of the failure one by one, logically.

If nothing else, when I was an intern I studied this one thing especially hard.

Because I really didn't want to see anything too horrific...

“The most important thing is the direction. You were just trying to pull it straight out, weren't you?”

Park Seongjeong's eyes wavered. I must have hit the mark.

“Our intestines have an S-shaped curve that bends inward. Especially around the sacral bone

(* sacrum)

there's a curve that bends back once. If you ignore that and just yank straight, it won't work.”

The two of them looked at me a little differently after my perfect analysis.

In fact, this was all thanks to having just lurked through an info post like 'Rectal Foreign Body Removal.txt' on the gallery while drinking coffee.

“Both of you come over here and take another good look. They say failure is the mother of success. Using Seongjeong's noble failure as a foundation, we will now move on to success!”

I slipped on my latex gloves and declared gravely.

“From now on, we begin the second attempt....”

And then I came back to reality.

In front of me was still the patient writhing in pain and humiliation, and on my hands were the clean latex gloves I'd just put on.

And in my head, the cold, hard truth was echoing: 'You're a clumsy-handed idiot who can't even place a single IV line properly.'

Me? This? Personally?

'No, I can do it. I just have to follow the theory I explained a moment ago. Set the position, guide the breathing, adjust the angle....'

A perfect simulation was running in my head.

But my body, my hands, looked like they had no intention of following that simulation.

My fingertips began to tremble slightly.

The intern Park Seongjeong's failure and the patient's horrifying scream flashed through my mind.

What if, what if I failed too?

What if I, after rattling off that grand theory like I was some amazing expert and solemnly declaring a second attempt, failed the same way?

Then even among the interns, the nickname 'Han Hyeonjae, the theory-only loudmouth' would start making the rounds.

Besides, this wasn't something that absolutely had to be done right this second, or anything where the patient's life was at risk, right? Right?

I suddenly stopped moving.

Then I put on a grave, cautious expression.

The two interns held their breath, waiting for my next move.

No.

Huh?

...This won't do.

I took off the latex gloves I'd only had on for less than a minute and threw them into the medical waste bin.

Not right now.

What... do you mean, not now?

Park Seongjeong asked.

Manually removing it. We can't do that right now.

I began explaining, pretending I was making a very serious medical judgment.

Listen carefully, you two. Seongjeong made the first attempt earlier. Although it failed, it was a very important attempt from a diagnostic standpoint.

Question marks popped up over the two interns' faces.

That attempt told us one important thing: this patient's sphincter tone is higher than you could imagine. And because of the pain and anxiety from the first failed attempt, the chance of succeeding with a second attempt right now is extremely low. In fact, if we force it and injure the rectal mucosa, we could end up with bigger complications like bleeding or perforation.

I buttoned up my white coat and drew the conclusion like a very wise senior.

In a situation like this, you don't let pride make you rush in recklessly. Choosing the safest and surest method is what a real pro does. For the patient's sake, too.

I declared solemnly.

“Let's call Gastroenterology!!!”

At my declaration, the two interns stood there blankly for a moment, then nodded as if deeply moved.

This was, above all, a decision for the patient's sake. Yes.

Leaving the two interns behind, I trudged out of Bed B-8 with a completely natural-looking stride.

Cleanup was the interns' job.

I returned to the station at a leisurely pace, feeling as if I'd set down a heavy burden from my shoulders.

I sat down in front of the computer and logged into the EMR.

I clicked the 'Consultation Request' tab and selected 'Gastroenterology.'

[Consultation Request Form]

- Requesting Department: Emergency Medicine

Yeah, right, I'm in Emergency Medicine after all.

- Receiving Department: Gastroenterology

Since we need an endoscope, the receiving department has to be Gastroenterology.

- Main Diagnosis: R/O) Rectal Foreign Body

(* rectal foreign body)

That's obvious enough.

- The patient came in today with a rectal foreign body. After the initial manual removal attempt failed, the patient's pain and sphincter spasm worsened, so further manual removal is judged to carry a high risk of rectal injury. Endoscopic removal is considered necessary, so we are requesting a consultation. The patient's vitals are currently stable, and abdominal X-ray shows no findings suspicious for perforation. Please reply as soon as possible.

The moment I hit Enter, I was freed from all responsibility and duty.

Bwahaha.

Now this troublesome problem was the on-call gastroenterologist's burden.

I sank back deeply into my chair.

***

About 20 minutes after I submitted the consultation request.

A man with a face worn down by fatigue approached the ER station.

It was the gastroenterology on-call doctor.

“Dr. Han Hyeonjae from Emergency Medicine?”

“Ah, yes! I'm Han Hyeonjae.”

I shot up from my seat.

“Rectal foreign body... first removal attempt failed. So what's the situation now?”

“The patient is being monitored after being given a sedative and a painkiller. His vitals are stable, and there are no signs of perforation.”

“Hmm....”

He stroked his chin and studied the X-ray carefully.

Even after seeing the clear silhouette in the photo, his expression barely changed.

Come to think of it, maybe this sort of thing doesn't faze him.

After scrolling down to check my charting, he tilted his head and asked,

“The chart just says foreign body. So what exactly was inserted?”

Here it comes.

I looked around for a moment.

Nurses and other doctors were moving busily around the station.

I lowered my voice as much as possible, moved closer to him, and admitted it in a very small voice.

“Uh....”

“Yes?”

“For adults... yes....”

“....”

The gastroenterology on-call doctor's movements froze.

“Ah... yes....”

He tried hard to keep a straight face, but he couldn't hide the corners of his mouth twitching on their own.

“Heh heh... heh heh....”

Without asking anything else, he headed toward Zone B, saying, "Let's take a look at the patient first."

Following behind him, I thought.

It was the most awkward consult scene in the world.