Tutoring (1)

Just completely screwed.

Might as well work.

The devilish emoticon (^^) Professor Kim Hyeok-jae sent still wouldn't leave my mind, but what could I do.

Tomorrow's disaster would be dealt with by tomorrow's me somehow; today's me had to get through tonight's night shift.

I finished up the chart for that Osung superfan uncle who had almost grabbed me by the collar and called me a scammer just moments ago.

“You even turn writing one line on a chart into a whole drama, a drama.”

I slammed the Enter key and leaned back in my chair.

The fatigue that rushed in where the adrenaline had drained away was vicious.

Even after the Osung superfan uncle had left, the ER door never got a break.

Because after midnight, the emergency room was a gathering place for people closer to abnormal than normal.

"Doctor! My head feels like it's about to split open! Please do a brain CT!"

A man in his thirties, reeking of booze, walked in insisting that he definitely had a brain hemorrhage.

When I shone the penlight into his pupils

he foamed at the mouth and shouted, "Ah, flashbang! The doctor flashbanged the patient!"

In the end, after struggling with him for an hour, his guardian arrived, smacked him on the back, and dragged him out, asking me to just prescribe something for his hangover.

Next came a woman in her twenties, brought in clutching her ankle.

"I think I was dancing in heels at a club yesterday, and my ankle twisted. I'm sure the bone is broken! Please take an X-ray!"

The X-ray was clean.

A clear sprain.

"Patient, your ligaments are just a bit stretched. The bones are fine."

"That's a lie! It hurts this much; there's no way the bone isn't broken! Is there no orthopedic doctor here? Are you some quack?"

...Yeah, I'm a quack, you old man.

I quietly wrapped a half-cast and prescribed Tylenol.

By the time all that chaos was over, it was around 3 a.m.

The station briefly settled into a lull, and the first-years, showing no sign of fatigue, were waiting for the next patient or flipping through charts and studying something.

Impressive bastards.

At the seat next to mine, first-year Baek Eun-seo was flipping through EMR charts with sparkling eyes.

When will that fire ever go out?

"Eun-seo."

At my call, Baek Eun-seo straightened up as if she had sprung out of her chair.

"Yes, doctor."

"Aren't you tired?"

"Huh? Oh, I'm really fine!"

Baek Eun-seo replied, her eyes shining brightly behind her glasses, as if she was enjoying this immensely.

"I think I'm totally made for emergency medicine! I'm not tired at all—in fact, I'm actually excited! Just seeing patients come in like that appendicitis guy earlier gets my heart racing!"

...A constitution?

I doubted my ears.

You're just like that because you haven't been ground down enough yet.

Stay up a few more nights.

It won't feel like your heart is racing; you'll feel like your heart has stopped.

I couldn't bring myself to tell her that cruel truth, so I stared at Baek Eun-seo with dead-fish eyes.

"I see... I'm tired, though..."

"Ah, doctor. Then maybe you should go to the on-call room and sleep for a bit..."

"For some reason, I can't sleep in the on-call room bed."

That's actually true.

I'd rather sit in this station chair than lie down on a mattress mixed with the smell of sweat and some unidentified stale odor.

And also.

'...You have to be sleepy before you can sleep.'

After hearing my answer, Baek Eun-seo hesitated for a moment, then as if making up her mind, thrust a stack of EKG printouts she had been holding toward me.

"Doctor! Then could you look at this EKG for me once? It's something I found online, and I've been making my own copy to study..."

"What's this?"

I reluctantly picked up one of the printouts.

"He's a 72-year-old man who said his chest just felt a little tight. But to me, there doesn't seem to be any ST-segment elevation or depression, and no T-wave inversion or anything... so it looks like a normal finding, right?"

At Baek Eun-seo's innocent question, I stared hard at the EKG paper.

Normal?

This?

"Eun-seo."

"Yes?"

"Don't you see this?"

I pointed at the T waves in leads V2, V3, and V4.

"They're pointed. Symmetrical. What do you think this looks like?"

"Umm... They're really pointy. How did I miss that."

"It's like a tent. A pointy tent. And from the shape alone, that's a textbook Hyperkalemia T wave

(*hyperkalemia T wave)

finding, right?"

I jabbed down at the paper as if I were about to tear it with the tip of my pen.

"If we don't check this patient's potassium, then a few hours from now, when he goes into V-fib

(*ventricular fibrillation)

and goes into arrest, we'd have nothing to say for ourselves. Well..."

"Ah..."

I flipped to the next page.

"What now? An 80-year-old grandma? Came in dizzy."

"Seems slow, but..."

"The slowness isn't the issue, is it?"

I used my pen to point to the interval between the P wave and the QRS complex.

"The PR interval. It's ridiculously long, right? Normally it's 0.2 seconds, but this one has to be over 0.3. It's first-degree AV block."

"Ah, that can just be watched and followed..."

"There's digoxin on the medication list in this grandmother's chart. This is how the first sign of digoxin toxicity appears. In this case, we need to order a digoxin level and stop the medication right away."

Baek Eun-seo couldn't say anything and just bit her lip.

I picked up the last page.

"This one is... ugh..."

A sigh slipped out of me. The ST segment was oddly elevated in leads V1 and V2.

"Is this... Brugada...?"

"Correct, this looks like suspected Brugada syndrome. Even if the patient has no symptoms right now, they're a ticking time bomb that could drop dead at any moment, so call cardiology immediately, admit them, and start a full workup."

I set the EKG stack down on the table with a thump.

Baek Eun-seo flinched.

Rubbing the stiff back of my neck, I said,

"Stay sharp. We have to keep our heads on straight if we don't want patients dying on our watch."

"......I'm sorry."

"No need to apologize, and anyway, studying in your spare time is good... If anything ever confuses you, bring it to me or another senior."

I stood up and worked the stiffness out of my shoulders.

"Go look at it again. From beginning to end. See what else you missed."

"Yes! Understood! Thank you, doctor!"

Baek Eun-seo hugged the stack of EKGs carefully and went back to digging into the charts with burning enthusiasm.

I stared blankly at her.

Just half a year ago, I was looking at those EKG sheets thinking, 'What the hell kind of worm drawing is this?'

Getting cursed out by those crazy ghost bastards and forced into all-night study sessions had definitely worked.

I was now at the point where I could handle most first-year questions with ease.

No, maybe I could even handle questions from second- and third-years.

I poured another packet of instant coffee into my empty paper cup and went back to the monitor.

Miraculously, the station was quiet.

Once it passed 3 a.m., even the obnoxious drunks causing a ruckus and the guys burning up with fever had all gone home or been sent up to the wards.

What remained was only the vicious fatigue and the pile of overdue charts to hand off to the next shift.

At the seat next to mine, first-year Baek Eun-seo was gripping the stack of EKG printouts I'd just lectured her about and furiously taking notes in red pen.

Her eyes behind her glasses were not showing fatigue at all; if anything, they were burning with a strange academic fervor.

'...That hard case... tough, really tough...'

I clicked my tongue to myself.

That stubborn one never sleeps?

What if she burns out and starts bawling about turning in her resignation the day after tomorrow?

Then again, with that kind of passion, I guess she did apply to Emergency Medicine even after seeing that insane laparotomy scene.

I absentmindedly stirred the coffee I'd poured hot water into and refreshed the EMR patient list.

Just then, Baek Eun-seo carefully called out to me from beside me.

"Doctor!"

"What now? What accident happened? What EKG is tormenting your brain this time."

I answered without even looking.

"Oh, no! Not that. Um, maybe..."

Baek Eun-seo was strangely fidgety.

At that, I finally turned my head.

Fidgeting with the red pen in her hand, she asked cautiously,

"Doctor. Are you free tomorrow?"

“...”

My brain froze for a moment.

"Tomorrow? Why? It's my day off."

Tomorrow was my God-given day off.

A sacred day I planned to sleep for 20 hours, wake up in the evening, order fried chicken, and watch OTT, and I did not want to be disturbed by anyone.

So why was this first-year asking about my day off?

'...What is it? Could this be a date request or something.'

At that moment, I started getting way ahead of myself.

No way, me?

Me, with these rotting dead-fish eyes, smelling of disinfectant and drenched in fatigue? This fresh first-year?

I quickly turned my brain over.

'No, when I was a first-year, I wasn't even thinking about dating, let alone making a move; if a senior passed by, I had to start by holding my breath, and I was dumping cup ramen into my stomach because even mealtime felt too precious.'

But a first-year who'd only been here for less than a month, asking a second-year senior—on their day off, no less.

'What a shameless little brat. Hm...'

They say today's kids are different.

She's really bold.

Unable to read my rotten expression and complicated inner monologue, Baek Eun-seo must have taken my silence as a sign of agreement, because she soon gathered her courage and got to the point.

"Then, if I run into something I don't understand while studying alone tomorrow, could I ask you about it!"

"...Huh?"

A stupid sound popped out of my mouth.

Studying?

On my day off?

By herself?

“Why? Why me?”

I asked back before I knew it.

There are other perfectly fine second-years over there, and there's Fellow Lee Min-jae too, or you could just open a textbook; that'd be faster.

Why me of all people?

At my question, Baek Eun-seo's face brightened.

As if she'd been waiting for this question, she answered without even a second's hesitation.

"Because you're my direct second-year senior! You're my role model! And above all, you're so good at answering questions here at the hospital!"

Role model.

At that one word, the corner of my mouth twitched without me noticing.

'Hmm, I guess I am.'

Yeah, I am pretty damn good.

I caught an MI from a sore throat, opened up a belly, did REBOA, and diagnosed TTP.

And just now, I taught EKGs brilliantly too.

At this point, don't I have more than enough qualifications to be a role model?

I forcibly held back the grin tugging at my cheeks and put on the coolest, most nonchalant senior tone I could.

"Oh, really? Well... uh... feel free to ask... no, don't feel free, ask me awkwardly."

"Huh?"

Baek Eun-seo's pupils wavered with confusion.

"I'm kidding. Ask me casually."

I waved my hand and turned my head back to the monitor.

What a pain. Looks like I'll be getting text notifications while eating chicken tomorrow.

But somewhere in my heart, it felt strangely ticklish.

'Yeah, I can answer anything.'

I looked down at the empty instant coffee cup and grinned wickedly.

'Even things that go beyond my own abilities.'

I recalled the familiar blue interface visible only in my head.

Go ahead, ask away.

Whatever you ask, behind me there are hundreds of long-dead physicians from every specialty, all assembled into study groups and waiting.

If you ask about EKGs, I can summon the cardiology ghost; if you ask about hematology, I can bring out the 'hematology is hell' ghost.

All I have to do is copy the answer and kindly tell it to you.

I can preserve the dignity of a role model.

You get the answer.

And those crazy ghost bastards get a channel through which to spew out knowledge.

What a perfect win-win-win ecosystem this is.

Heh-heh.