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24ES | Chapter 3.1
by RAE“Code Blue. Code Blue. Main Building NICU. Code Blue.”
Yesung sprinted as the mechanical voice of the hospital announcement system echoed. A Code Blue is one of the emergency codes used in hospitals to signal a cardiac arrest patient.
All emergency codes in the hospital are important and urgent, but a Code Blue is the most critical. And of all places, a cardiac arrest occurred in the NICU (Neonatal Intensive Care Unit)?
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At the time of the announcement, Yesung had been making rounds in the pediatric ward on the third floor of the main building. He leaped down the stairs three at a time and rushed into the NICU one floor below. A cluster of medical staff came into view, and Yesung ran straight toward them.
An incubator was open, and an alarm, signaling the dire state of the baby, was beeping urgently. Yesung saw an OB/GYN resident performing CPR on the baby and quickly pushed through the crowd of medical staff.
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“What happened?”
A nurse, connecting a neonatal ambu bag to the tube inserted into the baby’s mouth to supply oxygen, shouted over the chaos.
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“28-week premature baby! BP suddenly dropped, and now we’re in arrest!”
Premature babies had underdeveloped bodies compared to full-term infants, making them vulnerable to unpredictable complications. Yesung urgently rolled up his sleeves.
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“How long has it been?”
“Just over a minute!”
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Yesung gently but firmly nudged the OB/GYN resident aside and took over the CPR.
“Give 0.01 mg of epi every five minutes.”
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“Yes! Administering epi now!”
“Dr. Deont, switch with me in two minutes.”
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“Understood!”
The baby was already small, but a preemie was tiny beyond comparison. To save the fragile heart of this minuscule being, all he could use were two fingers.
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After completing his two-minute round, Yesung stepped back, and the OB/GYN resident swiftly took over. Meanwhile, other doctors were arriving at the NICU. Yesung glanced around and spotted Seong Yugang, the cardiothoracic surgery resident, and Shin Yesuh, the chief resident of pediatrics. Taking a breath, he checked the time.
“How long has it been?”
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“Three minutes and thirty seconds.”
“Pause for a rhythm check! No vitals yet?”
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“No change.”
“Resuming compressions!”
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Yesung switched places with the OB/GYN resident again, compressing the tiny chest with his index and middle fingers. His hospital phone buzzed in his pocket. It was undoubtedly an urgent call, but he couldn’t answer at the moment.
The nurse next to him took the phone out of his pocket and answered on speaker.
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“Emergency room here, Doctor.”
“Emergency room? What’s going on?”
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“Ah, hello, Doctor! This is Im Dowoon, the emergency medicine intern. There’s a pediatric trauma patient who came in an hour ago, so I called you.”
“What? An hour ago? Then it’s not an emergency. Where’s Dr. Park Joohyuk?”
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“Ah, um, yes! It’s not an emergency! Dr. Park is in the OR and won’t finish for quite a while, and Dr. Seol, the other pediatric surgery fellow, is off today, so I contacted you, Doctor!”
Yesung frowned as he continued compressions, listening to the intern’s explanation. The intern claimed that Yesung was their only option, but that wasn’t true. If no pediatric surgeon was available, a general surgeon could have been called instead. Pediatric surgery was, after all, a subspecialty of general surgery.
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‘There must be a general surgery resident on-call in the ER right now.’
But for some reason, they’d called him instead. Just as Yesung was about to tell the intern he’d head over after this, the nurse monitoring the baby’s vitals shouted urgently.
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“Doctor! The baby’s BP is dropping even further!”
“Damn it! Hang up! This takes priority!”
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Yesung ended the call and refocused on CPR. After five minutes, a second dose of epinephrine was administered. Slowly, the baby’s pulse returned.
“ROSC (Return Of Spontaneous Circulation) achieved.”
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The red warning lights dimmed, and the baby’s breathing stabilized. Only then did Yesung and the rest of the team let out a collective sigh of relief.
The open incubator lid was lowered once more.
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“Whew.”
Letting out a deep breath, Yesung leaned against the incubator. The OB/GYN resident collapsed onto the floor, his legs giving out, while Shin Yesuh clutched her chest in relief. Seong Yugang wiped the sweat off his forehead, and Yesung’s gaze briefly flicked toward him.
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A Code Blue was an emergency code for all doctors, but it was especially pertinent to cardiothoracic surgeons. This meant that a cardiothoracic surgeon would always rush over upon hearing the announcement. Yesung felt a twinge of relief that the person who had arrived wasn’t Jung Hageon.
He wasn’t ready to face him yet—not now, not for a long time.
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As Yesung straightened up, a nurse cleaning up the chaotic scene approached.
“Good work, everyone.”
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“You too. Thank you for your hard work.”
“Not at all! I’ll take my leave now.”
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The OB/GYN resident, perhaps embarrassed by Yesung’s encouragement, stood up abruptly, bowed, and left the NICU in a hurry.
“I should go too…”
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With Seong Yugang gone as well, only Shin Yesuh and Yesung remained. Yesung inspected the baby inside the incubator. The tiny child, born at just 28 weeks, was heartbreakingly small.
It felt wrong to see such a fragile being hooked up to multiple medical devices. Especially after just pulling them back from the brink of death.
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As he gazed at the unnamed baby, Shin Yesuh, tidying the wires connected to the preemie, caught his eye.
“Shouldn’t you check on the emergency room?”
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Given the urgency of the earlier call, the other staff had overheard it. Yesung gave her a sheepish smile.
“Yeah… I should go now.”
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“The baby’s parents must be waiting. Don’t worry about here—I’ve got it covered.”
Yesung hesitated, lightly brushing the baby’s tiny hand before finally being nudged out by Shin Yesuh.
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Normally, he’d have gone straight to the ER after finishing, but this time, his steps dragged.
“It’s not the baby’s fault. It’s not even hard to see them. I should just go. Right.”
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Muttering to himself, Yesung fished his phone out of his pocket and made a call. The other end picked up before the first ring even ended.
“Hello? Dr. Han?”
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“Yes, it’s me. I’m coming now.”
“Th-thank you!”
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Hearing the intern almost crying with relief, Yesung ended the call and quickened his pace.
As he entered the ER, Im Dowoon, who had been waiting for him, nearly ran to greet him.
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“D-Doctor, you’re here!”
Im Dowoon was the same sharp-witted intern Yesung had noticed when Jung Hageon was treating Seungchae.
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Seeing Dowoon’s face brighten as if he’d just seen his savior, Yesung asked, “Where’s the patient?”
“Over there!”
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Dowoon led Yesung to the patient’s bed, and Yesung followed.
“What’s the name and age?”
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“Four-year-old male, Ahn Beomjun.”
“And what’s his condition?”
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“While playing at daycare, he fell and hit his head hard on a desk. We performed an emergency CT just to be safe, but there were no significant findings.”
As Yesung walked briskly, listening to Im Dowoon’s explanation, he first had to face the boy’s guardian, who stood firmly in front of the patient.
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“Doctor! How can you show up now when the intern called you ages ago? We’ve been waiting for an hour and a half! An hour and a half! I’ve been asking for a pediatric specialist since we arrived, and it’s only now—”
Yesung glanced at Dowoon, who fidgeted under the barrage.
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“Dr. Im, didn’t you explain the situation?”
“I-I did! I explained everything, but…”
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Yesung sighed, noticing Dowoon’s tightly clenched lips and frustrated expression. Even without details, Dowoon would have understood the urgency from the broadcasted Code Blue and the tense phone call. But it clearly hadn’t been enough for the guardian.
Turning back to the father, Yesung bowed his head slightly. “I apologize. A cardiac arrest occurred in the NICU, and I was performing life-saving measures. That’s why I was delayed.”
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Although he wasn’t at fault, Yesung apologized, adding a detailed explanation for the parents to understand the situation better. As expected, the father finally closed his mouth, his frustration cooling.
But before Yesung could relax, an elderly woman, the boy’s grandmother, clasped his hands tightly.
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“Oh, Doctor! Please, take care of our Beomjun! He’s the treasured child of three generations in the An family—our late-in-life blessing. Please, there won’t be a scar on his pretty forehead, right?”
Politely pulling his hands free from the pleading grandmother, Yesung scanned the room. Mother, father, grandmother, grandfather. Four guardians for one child.
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This wasn’t unusual when dealing with pediatric patients, especially nowadays, with the declining birthrate. Among pediatricians, there was even a joke that every pediatric patient came with several extra “patients” in the form of guardians.
“Alright, Grandma. Let me examine Beomjun first, okay?”
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Yesung patted the grandmother’s hands gently, then headed to the boy’s bed.
“Waahhh!”
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He thought the hardest hurdle was behind him, but the biggest obstacle yet awaited. As soon as the boy in his mother’s arms saw Yesung, he burst into loud wails.
Yesung didn’t panic. He calmly reached into his pocket and pulled out a lollipop, waving it in front of the boy’s tear-streaked face.
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“Beomjun, do you want a lollipop? How about some candy?”
“Waahhh—hic.”
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The boy’s cries stopped abruptly at the mention of candy. His teary eyes widened as he looked up at Yesung, who smiled warmly at him.
“If you don’t cry and let me treat you, I’ll give you another candy. How does that sound? Can you be a brave boy?”
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The boy, still sniffling, nodded hesitantly. Only then did Yesung look up at the boy’s mother.
“Alright, ma’am, let me take a look at his injury.”
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“Yes, Doctor. Please.”
The boy’s injury, as described, was deeper than expected. Inspecting the gash on Beomjun’s forehead, Yesung straightened up.
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“First, we’ll clean the wound and disinfect it. Dr. Im, bring me normal saline and Betadine.”
“On it!”
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As Dowoon rushed off, Yesung turned back to the boy’s mother.
“Ma’am, we’ll clean and disinfect the wound. Did the daycare say they heard a loud ‘thud’ when he fell?”
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“Ah, yes! The teacher said Beomjun was running and fell pretty hard.”
“In that case, I’ll ask the plastic surgeon to suture the wound under sedation. The intern already mentioned the CT scan showed no abnormalities, but I’ll double-check myself.”
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“Will there be a scar? The wound looks so deep…”
“The plastic surgeon will suture it carefully to minimize scarring. We’ll also monitor him during follow-up visits. At home, please keep a close eye on him, and come to the hospital immediately if anything seems off.”
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“Thank you, Doctor.”