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24ES | Chapter 1.2
by RAEBaek-o visibly shuddered at Yesung’s sudden switch in demeanor, but his reaction lasted only a moment before he cheered.
“Yes! Then let’s go together after our shifts tomorrow! I’m off tomorrow evening too!”
Having known each other for so long, they understood each other well. Just as Yesung knew Baek-o’s ways, Baek-o had no trouble handling Yesung’s dual nature. Cheerfully, Baek-o announced he’d let the others know about the plan as he tapped away on his phone.
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Yesung watched with a sigh.
The carefree days of pulling all-nighters and drinking recklessly had long passed for him. Yet somehow, Baek-o remained unchanged.
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He still loved meeting people, drinking, and especially going wild at social gatherings.
Unlike Yesung, who wanted nothing more than to collapse in bed whenever he was off-duty.
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Letting out a deep sigh, Yesung shook his head and turned his attention back to the chart—just as the ER phone began ringing loudly.
“Yes, this is Hanguk University Hospital ER.”
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A nurse inside the station answered the call. Baek-o tucked his phone back into his pocket, and Yesung set down the chart in his hands.
“Yes, understood.”
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Just looking at the nurse’s expression, it was clear—this was an emergency. Sure enough, as soon as the call ended, the nurse quickly relayed the situation.
“A 9-year-old boy. In car TA1. He was in the backseat of an overturned vehicle. Currently unconscious, hypothermic, with abdominal distension symptoms.”
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“Three minutes.”
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“Request emergency blood packs immediately and prepare warmed IV fluids! As fast as you can!”
“Yes!”
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The nurse, receiving Yesung’s rapid-fire instructions, dashed off.
The previously calm ER became a whirlwind of activity with just one phone call. Yesung, Kang Baek-o, and the rest of the medical staff prepared everything they needed, waiting for the ambulance’s arrival.
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Soon, the wailing siren signaled its arrival, the ambulance stopping in front of the ER entrance. The automatic doors slid open wide, and paramedics rushed in with the patient.
“Oh my god… What do I do? Seungchae! Seungchae!”
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The child’s mother, presumably seated in the driver’s seat during the accident, followed them in. Thankfully, she didn’t appear to be seriously injured, with just a minor bruise on her forehead and a cervical collar in place.
“Ma’am! Please come over here for a moment…”
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A nurse approached the crying mother while the other medical staff immediately surrounded the patient.
Even at a glance, the child’s condition was dire. Yesung grabbed the bed and moved it into the treatment room.
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“What are the patient’s vitals?”
“Body temperature is 35 degrees, BP is 80/60, and pulse is at 130. Not good!”
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Pulling on the latex gloves handed to him by a nurse, Yesung barked orders.
“I’ll intubate! Dr. Kim, stabilize the cervical spine3! Dr. Kang, handle the C-line!”
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“Got it!”
“Bring me a pediatric tube4, 5.5 mm in diameter!”
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An eager surgical resident handed over the pediatric endotracheal tube, and Yesung carefully completed the intubation.
Meanwhile, thanks to Baek-o’s swift actions, fluids were already being administered through the central line.
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“Increase the fluid pressure. Let’s check the patient’s vitals now! What’s the status?”
“The pulse is improving slightly, but the patient’s breathing remains poor! Oxygen saturation is below 90%!”
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Despite securing the airway and providing warm fluids to raise the child’s temperature, the oxygen saturation wasn’t stabilizing.
Lung damage!
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“Call cardiothoracic surgery immediately! Prep for an emergency abdominal CT and chest X-ray…”
Before Yesung could finish, the automatic doors to the treatment room slid open. Only authorized personnel could enter.
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“Cardiothoracic surgery is here.”
A man Yesung had never seen before walked in. Dressed neatly in a white coat over a shirt, with the hospital’s ID badge hanging from his neck, he confidently approached the patient.
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“Let me take a look.”
Pulling on latex gloves, he began examining the patient skillfully, palpating and listening to the lungs with a stethoscope. Straightening up, he spoke decisively.
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“It could be hemopneumothorax5. Proceed with a chest X-ray immediately. If confirmed, we’ll need to insert a chest tube and start drainage. Quickly.”
“Yes!”
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“Doctor! The patient’s BP is dropping further!”
As they prepared to move the bed for the X-ray, a nurse’s urgent cry stopped them. The man, who had taken control of the situation seamlessly, responded.
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“I’ll insert another central line. You there—what are you doing? The patient’s BP is dropping!”
“Huh? Oh, yes, yes!”
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While another doctor might have yelled, the man simply furrowed his brows briefly, keeping his voice low and calm as he issued orders. His steady gaze made the nurse flinch but immediately spring into action, squeezing the IV bag with all her might.
Efficiently inserting the central line, he stood up straight.
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“What about the blood packs?”
“They’re on their way. Oh! Here they come!”
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Right on cue, a nurse rushed in with the blood packs. But the man’s gaze remained fixed on Yesung.
Caught off guard by the sudden attention, Yesung blinked in confusion while the nurses swiftly began the transfusion.
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The nurse monitoring the patient raised her voice.
“Doctor, BP is rising steadily! The patient can be moved now!”
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Only then did the man finally shift his gaze away from Yesung.
“Let’s move the patient. Make sure the guardian signs the surgical consent forms, and contact the OR6 immediately.”
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“Yes!”
Following his orders, the staff bustled about. Still dazed, Yesung watched the man’s retreating figure. Regaining his composure, he stopped a nurse who was about to leave the treatment room.
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“Since the patient shows signs of abdominal distension due to internal bleeding, proceed with an abdominal CT right after the chest X-ray.”
“Yes, doctor.”
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Ensuring the nurse understood, Yesung let go of her arm. She hurried out of the room, and Yesung pulled out his phone to make a call as he exited the treatment room last.
“Professor, it’s Yesung. Can I report the case?”
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“Go ahead.”
“A 9-year-old male patient just arrived in the ER. In-car TA. He shows signs of internal abdominal bleeding and hemopneumothorax. He’s being moved for a chest X-ray and abdominal CT. While we need the imaging results to confirm the location and extent of the injuries, emergency surgery seems inevitable.”
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“It’s a case that will need a combined operation with cardiothoracic surgery. I’ll head down immediately.”
“Yes, sir.” Ending the call, Yesung quickly dialed another number.
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“Hey, Yesung! What’s up?”
“Hey, Dr. Yeon. We’ve got a pediatric7 trauma patient who’ll need emergency surgery. Can you help with suturing?”
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“Got it. I’ll contact Dr. Dent from our department and send them down right away.”
The person on the other end, Dr. Yeon Eunhyeok, a plastic surgery fellow and Yesung’s college friend, understood the urgency. For a pediatric patient, precision in suturing was critical, making help from the plastic surgery department essential.
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Ending the call, Yesung heard a shout announcing imaging results.
“The chest X-ray for the in-car TA patient is out!”
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Yesung instinctively started toward the station but hesitated. The abdominal CT results weren’t ready yet. The new man, now at the station, examined the monitor and immediately moved to the patient.
Yesung’s gaze followed him naturally.
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“Seungchae… Seungchae! Oh no…”
“Ma’am, I’ll take a look now.”
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The man who had separated the guardian from the patient immediately performed a chest tube insertion. When he reached out his hand, a rare sight occurred—an intern handed him a scalpel. It’s not easy for interns to do that… Maybe this one’s quick on the uptake.
As Yesung observed the intern’s actions, the man swiftly sliced between the patient’s right ribs with the scalpel. As soon as a gap opened, blood pooled in the chest burst forth, splattering onto the man’s white cheek, his white doctor’s coat, and even his white shirt underneath. It seemed he had dressed carefully for his first day, which was now quickly becoming a mess.
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It was a common sight. Nothing new. But why did it feel oddly striking?
What’s this? It feels like I’ve seen something I shouldn’t have…
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Yesung frowned. Meanwhile, the man, unfazed by the blood that had splattered all over him, skillfully completed the chest tube insertion. As he straightened up after seeing the blood collect in the drainage bottle, he asked, “How’s the saturation now?”
“It’s back over 90%, and vitals are stable!”
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“Then let’s move to the OR as soon as one becomes available.”
“Okay!”
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Following the man’s instructions, the medical staff around him dispersed. Yesung watched a guardian, weeping, returning to the child, and the man wiping his face with a handkerchief handed by the intern.
“The kid was on the way to school. The light turned green, and they started crossing, but it seems they didn’t see a car coming from the side. Luckily, the mom seems to have no major visible injuries. Still, just to be safe, we decided to run some tests and get a brain CT.”
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Suddenly, Kang Baek-o, who had left the treatment room with other medical staff, reappeared and explained. Yesung raised an eyebrow at his sudden presence.
“You… How’s the OR?”
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“It’s full right now. Other departments have surgeries lined up, so it might take a bit longer. Maybe three minutes? I just went and begged them to do something since it’s an emergency…”
It was a tight situation on both ends. The results of the abdominal CT were also delayed. Yesung’s gaze shifted from Kang Baek-o back to the guardian next to the patient. He muttered, almost to himself,
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“…Hopefully, there’s nothing serious.”
The guardian was gently stroking the face of the child, who had just finished a CT scan after being treated for a bruise on the forehead.
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“It will be okay. It has to be.”
Kang Baek-o nodded to his own words then added, “But isn’t it amazing?”
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It was clear who he was referring to.
Yesung’s gaze moved from the guardian to the man cleaning the blood off his face, and at the same time, Kang Baek-o gestured towards him.
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“That guy. Starting today, he’s working at our hospital as a cardiothoracic surgery attending, Dr. Jung Hageon.”
Yesung was already aware of that fact. He had seen the name on the badge swinging from the man’s chest when he entered the treatment room. It was impossible not to recognize a new face.
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“I know.” His response was blunt, but Kang Baek-o didn’t mind.
“Did you see him do the chest tube insertion earlier? Wow… He was so decisive. It’s his first day at the hospital, and he was on his way to work, yet he didn’t panic at all. I thought Dr. Jung was an old staff member from our hospital.”
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Kang Baek-o stuck out his tongue as he watched Jung Hageon, who had put the bloodied handkerchief in his pocket and was now making a call to someone who seemed to be a cardiothoracic surgery professor.
“I had some expectations before he arrived, but he’s definitely not ordinary.”
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“Considering that hospital systems are similar?”
“Even so, not every hospital system is exactly the same from start to finish! I’m telling you, it’s confirmed.”
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“Okay, then.”
Kang Baek-o couldn’t help but marvel, though Yesung continued to respond bluntly. He added more to the conversation, but Yesung easily ignored him.
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How eccentric Dr. Jung Hageon was on a scale from 1 to 10 wasn’t Yesung’s current concern.
It wasn’t just Yesung in the treatment room. But when an ER nurse had asked for blood, Dr. Jung had clearly looked straight at Yesung.
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He’s sure. Dr. Jung seems to know him. But Yesung couldn’t figure out how.
He had a face that wasn’t common; if he had seen it, he would surely remember.
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It was baffling. No matter how much he thought about it, he couldn’t understand. Yesung’s brow furrowed deeper. Suddenly, Kang Baek-o nudged him with his elbow.
“Hey, look at that.”
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He gestured in the direction he was intently eyeing, and the bed with the child came into view.
There, a second-year cardiothoracic surgery resident was crying, and the child’s mother, surprised by the sudden tears, was there too.
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Yesung couldn’t hold back and asked, “…What’s going on?”
“It must be overwhelming having a competent attending appear. You know, up until now, Dr. Seong Yugang was the only cardiothoracic surgery resident. It must have been really tough for them.”
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It meant that the alleviation of the heavy workload was so relieving it brought tears.
Of course, Yesung, who was also specializing in pediatric surgery under similar circumstances, wasn’t without sympathy for the crying resident. But still…
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It seemed a bit much to cry over that. It was just hard to understand. Yesung’s attention soon drifted elsewhere. The sound of an ambulance siren accompanied the announcement that the child’s abdominal CT results had arrived.
Footnotes
- TA stand for traffic accident, which is an injury sustained in a road traffic accident.
- estimated time of arrival
- The cervical spine is the first seven vertebrae of the spine, located in the neck. It supports the head and neck, protects the spinal cord, and allows for a wide range of head movement.
- Pediatric Gastrostomy/Gastrojejunostomy procedures place feeding tubes into the stomachs of children who are unable to eat or drink by mouth. Feeding tubes allow caregivers to inject nutrition, liquids, and medicine directly into the stomach or intestines.
- Hemopneumothorax is a condition where there is both air and blood in the chest cavity, putting pressure on the lungs.
- Operation Room
- relating to the branch of medicine dealing with children and their diseases.