For what purpose (5)
“Does this require other measures?”
“I have the same thoughts as you. Even with mechanical ventilation, the patient’s condition is not very good…”
Ethan and Jose expressed their concerns, and Choi Ki-seok also nodded slightly.
“I guess I’ll have to use ECMO.”
“Ecmo? You mean extracorporeal membrane oxygenation?”
“yes.”
Choi Ki-seok nodded slightly.
The mortality rate of acute respiratory distress syndrome exceeds 40 percent.
Relying solely on mechanical ventilation could result in failure.
“Hmm. It’s not that I don’t trust Mr. Choi. I think it would be a good idea to request a collaborative consultation with a pulmonologist.”
“Okay. Ethan, there are other scrubs, so you can go in first. Jose can only help with moving the patient to the intensive care unit.”
Choi Ki-seok obediently accepted Ethan’s offer.
Even though Randy is a general surgery patient, the acute respiratory distress syndrome he is currently suffering from is the domain of pulmonology.
Even if you majored in thoracic surgery in Korea, it is beyond your authority to treat someone arbitrarily.
Choi Ki-seok and Jose moved the patient to the intensive care unit and requested cooperation from the respiratory department.
Soon, Philip, a pulmonologist, examined the patient.
After checking the capacity of the patient monitoring device and mechanical ventilation, he was silent for a while.
“What’s wrong?”
“Oh… no. Honestly, I was surprised. I had no idea that mechanical ventilation could be done so accurately in general surgery.”
Philip paused before continuing.
“If I can’t breathe with mechanical ventilation, I’ll have to use ECMO. That’s the only option right now.”
“Then let me set it up.”
Ki-Seok Choi placed ECMO in the intensive care unit next to the patient. Then, the oxidizer and monitor settings, including the ECMO flow Cardiac index related to the flow rate of the conduit, were adjusted.
“Are you a new general surgery resident?”
“Yes, that’s right.”
“But how do I set up ECMO?”
Philip asked with surprised rabbit eyes.
To him, Choi Ki-seok’s actions are a mystery.
As a fledgling resident, even though my training department is general surgery, how can I handle ECMO, which is a treatment tool for pulmonology and thoracic surgery?
“I majored in thoracic surgery in Korea.”
“But that’s true…”
“Can I even insert the catheter?”
“If you can, do it.”
As soon as Philip finished speaking, Choi Ki-seok moved.
He began treatment after widely disinfecting the area to be punctured.
Fuuuuuk!
A catheter was inserted into the femoral vein.
Ki-Seok Choi carefully removed the guide wire, leaving the tube in the blood vessel.
A neat Seldinger technique.
In the same way, a tube was connected to the internal jugular vein.
This marked the end of veno-venous (VV) ECMO.
As a result of the portable X-ray, both cannulas were inserted normally.
‘You really did it.’
Philip clicked his tongue inwardly.
This is the moment when, just in case, it happens.
Drurrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
As the pump turned, Choi Ki-seok and Philip’s eyes stayed on the patient monitoring device.
“So… you’re Mr. Choi, right? The resident who saved the patient who tried to commit suicide.”
“Yes, that’s right.”
“I heard that he was even the chief interviewee. A person who spreads word of mouth is different no matter what.”
Philip indirectly praised Choi Ki-seok, and Choi Ki-seok scratched his head with an embarrassed expression.
“Anyway, you can’t feel safe just because you used ECMO. It would be better to keep the patient until breathing returns to normal.”
“I think the same.”
Choi Ki-seok took a chair and sat down next to the patient.
“If there is any problem, please contact me right away.”
“yes.”
As Philip left, Ki-Seok Choi remained with the patient.
His eyes never left the patient monitoring device and the patient.
* * *
That evening.
Choi Ki-seok smiled and stood up.
I watched the patient for a long time without going to the bathroom once.
Did heaven recognize sincerity?
The patient regained normal breathing.
When I reported this to Philip, I was told that I would keep ECMO but that I would no longer need Keep.
‘okay. If this is enough…’
Choi Ki-seok used the Eye of Hippocrates on the patient and left the intensive care unit.
On the way back to the ward, I stared out the window and the sky was dark.
The day ended with pancreatic cancer surgery and patient care.
Time passed as if stolen.
“Mr. Choi. Thank you for your hard work.”
Ethan, who I met in the hallway, waved his hand.
“I heard you kept the patient after the surgery?”
“Yes. The condition was so bad.”
“Then you couldn’t even eat dinner?”
“Of course I couldn’t eat it. I was going to check on the patient first and then eat it.”
“In the meantime, you’re taking care of a patient… After all, you’re Mr. Choi.”
Ethan smiled and placed his hand on Choi Ki-seok’s shoulder.
“By the way, the Head Chief wants to see you for a moment, so go to the office.”
“Me? Why?”
“I don’t know about that. There won’t be anything particularly bad, so don’t worry. I finished scrubbing well today.”
“Okay, I’ll go now.”
After breaking up with Ethan, Choi Ki-seok visited Smith’s office.
Knock. Knock. Knock.
When I knocked, I heard a voice telling me to come in.
Smith was reclining on the sofa, drinking coffee.
“I heard you called me.”
When Choi Ki-seok sat across from Smith, Smith nodded slightly.
“I have a lot to say to Mr. Choi today. First, I should talk about the patient who had surgery today.”
“….”
“After I left the operating room, the patient developed ARDS (Acute Respiratory Distress Syndrome), right?”
“you’re right.”
“I heard that the treatment was carried out under the leadership of Mr. Choi.”
“I treated him using my experience as a thoracic surgeon in Korea.”
Choi Ki-seok explained step by step what happened after Smith’s absence.
“What is the patient’s current condition?”
“Breathing is close to normal and ECMO is still maintained.”
“Good job. I don’t know if Mr. Choi knows, but the patient is a friend of the head chief of the dermatology department. Although we are strangers, we can say that we are not strangers at the same time. If a problem arises….” Smith trailed off, but Choi Ki-seok had a hidden meaning
. read.
“Are you still thinking about majoring in general surgery?”
“I’m sorry, but there isn’t one. It probably won’t happen in the future.”
“I insisted…”
Smith clicked his tongue and pointed with his index finger to the table in front of the sofa.
There was a folder on the table.
“This… this…”
“This is the consent form for surgery for Jace, a patient hospitalized with cirrhosis. Please read it and sign it tomorrow.”
“yes.”
Choi Ki-seok looked through the consent form in the folder.
His eyes and mouth got bigger and bigger.
“Head Chief. Are you serious?”
“Why? You think I can’t do it?”
“That’s not true… It was too sudden.”
Choi Ki-seok looked down at the consent form again.
Jace’s living liver transplant surgery is scheduled for two days later.
It was caught through laparoscopic surgery.
Just as Choi Ki-seok used in his past case presentations.
“I understand that Meijo Clinic does not perform laparoscopic liver transplantation, but…” “
So, we are going to do it this time. Do you understand why I was away a while ago?”
“…Have you ever learned laparoscopic liver transplantation in Korea?”
“That’s correct.”
A mischievous smile appeared on Smith’s lips.
“Korea’s liver transplant surgery is definitely the best in the world. I didn’t know how many years it had been since I attended a surgery with the feeling of learning. I asked them specifically to bring me surgical tools. Now all that’s left is the surgical tool.”
“okay.”
“The second assistant has already been chosen as Mr. Choi. You better be prepared.”
“I will keep this in mind and prepare hard.”
Choi Ki-seok answered bravely.
Mayjo Clinic’s first laparoscopic liver transplant surgery.
It is a great honor to be able to participate there.
In a moment of silence, Smith crossed his legs and rested his chin on the back of his hand.
A unique gesture that appears when you feel uncomfortable.
Choi Ki-seok straightened his back and woke up the tension.
“I’m going to have to say some harsh words from now on. Do you remember the shooting incident that occurred in the ward two days ago?”
“Yes. I remember.”
“It was a very troublesome incident. I’m still sweating because I’m still cleaning up after it.”
Smith frowned and continued.
“I have a lot to say, but let’s leave everything else out and focus on Mr. Choi’s actions. What on earth was he thinking when he rushed at the man with the gun?”
“That… actually…”
Choi Ki-seok stuttered, trying to find something to say.
However, he could not explain the immortal Carlisle, who was the basis of his actions.
“That was a completely idiotic thing to do. Are you crazy because you want to die?”
“That’s not true.”
“Then why did you attack me?”
“I thought I could take it down if the gun missed.”
“I heard that it was close. Are you saying that is an excuse?”
“I decided there was no other way at the time…”
“That’s stupid!”
bang!
Smith got angry and slammed his fist on the table.
“Not only that. Several patients said you provoked Rick. When Rick said he was going to kill you, you told him you couldn’t kill him, right?”
“…yes.”
Choi Ki-seok bit his lip.
In fact, it was an action to divert the attention from Morgan to himself, but on the surface, what Smith said was correct.
“Do you remember what you said at the last meeting?”
“I remember what you said when you saved a patient from suicide.”
[Everyone else praised your courage, but I disagree. Don’t do such nonsense again. It’s good to help others, but don’t risk your life for it. If something like this happens again, I won’t hear any good news.]
At the time, Smith’s advice crossed my mind.
“Then I did something even more stupid. Mr. Choi, do you think what I said is funny?”
A spark flashed in Smith’s eyes.
“no.”
“Then why did you act like that when you weren’t?”
Under Smith’s suffocating pressure, Choi Ki-seok had no choice but to repeat that he was wrong.
“If the same thing happens again, I know it will be nothing but training and nothing. Get out of here!”
Smith waved his hand nervously.
Choi Ki-seok bowed his head and left the office.
My heart felt heavy, as if a stone had been placed on it. The words Smith said rang through my mind.
His thirst far exceeded Choi Ki-seok’s expectations.
But it is that moment.
Tiring!
[You have been affected by the invisible hand debuff.]
[Your confidence is greatly reduced and your surgical treatment level is reduced by two levels.]
[Debuff duration: one week.]
Choi Ki-seok checked the notification and smiled bitterly.
I never thought I could get a debuff this way.
“Phew…”
I sighed naturally while walking down the hallway.
Smith pecked so hard that even my hunger disappeared.
Now I can understand how Ethan felt while suffering from the debuff.
Drurr.
While looking at patients, I entered a hospital room.
“Gail. How are you feeling?”
“….”
“Gail?”
When he spoke again from close range, the lawyer, Guil, finally noticed him.
“Ah, Dr. Choi. Are you here?”
Guile smiled and wiped his eyes.
He had been watching a courtroom drama recommended by Choi Ki-seok on his laptop.
“When did you say you didn’t want to see it and now it looks like you’re completely immersed in it?”
“Yes. I hate to admit it, but it’s really fun. Because it’s a drama about lawyers, I can empathize well.”
Guile continued speaking.
“Seeing the main character here reminds me of my old self. I used to think that there were people before logic. I felt many things in many ways.”
“I’m glad it helped.”
“Oh. And I finished the other homework the teacher gave me. I talked to my wife and daughter on the phone earlier.”
“What do you two say?”
“He asked if I had taken medicine. He asked why I was calling.”
Guile smiled.
“Dr. Choi, thank you so much. Thanks to you, I feel like I’ve regained something I had forgotten.”
“Yes. Now all I have to do is get my health back.”
Choi Ki-seok also smiled at him.
Right at that moment!
Tiring!
[You have completed the hidden mission ‘From the bottom of my heart, the third time’.]
[A new skill has been created as a special reward.]
Active skill
NEW [Question – I have an objection!]
Choi Ki-seok checked the skill description and shook his head. .
‘What is this?’
