Last chance (4)
There was severe bleeding in the thalamic area.
The accumulated blood caused swelling around the area.
Although I have been in many surgical scrubs, this is the first time I have seen a patient with such severe thalamic hemorrhage.
“Catheter.”
Choi Ki-seok received a catheter from a disinfection nurse and sucked out the blood accumulated in the thalamus.
Cheeeeeeeek.
Bright red blood was continuously sucked into the duct.
After blood was drawn and examined under a microscope, thrombi (hardened lumps of blood) were found in various parts of the thalamus.
“Mr. Choi. What do you want to do? I don’t think you can aspirate the blood clot.”
“Let’s dissolve it with a solvent and then suck it up.”
“okay.”
When Claire, the first assistant, administered the thrombolytic agent, the blood clot began to dissolve.
Choi Ki-seok waited long enough for the blood clot to dissolve before sucking out the blood.
“Whew… we’re barely halfway there.”
“We’re halfway there. Let’s think positively.”
Choi Ki-seok added a word to Larry’s words.
Treatment of acute subdural hemorrhage and intraparenchymal brain has been completed, and now treatment for traumatic hydrocephalus and brain herniation remains.
Regarding these two things, I have never been in a scrub and certainly never trained. However, Choi Ki-seok was not afraid and chewed the cud over the manual he had memorized.
The principles of surgery do not change regardless of the area.
The words Hyukpil Jang said when I was training at Uijin University gave me courage.
“How do you treat hydrocephalus?”
Claire’s eyes turned to Choi Ki-seok.
Hydrocephalus is a condition in which the cerebrospinal fluid, which provides nutrients to the brain and removes waste, is blocked or does not flow properly.
In Fried’s case, the Sylvian aqueduct (the tube connecting the third and fourth ventricles) was blocked due to trauma.
The blocked cerebrospinal fluid had to be circulated quickly.
“Right now, the only thing I can do is a shunt. Get the shunt and catheter ready.”
“…is it possible?”
Claire asked with a worried expression.
“It’s not a question of whether it’s possible or not, right? We must succeed. And there’s no way we can fail if we’re together.”
“If the surgeon wants to do it, he should do it. Is there any other way?”
“Okay. I’ll trust Mr. Choi.”
While Larry and Claire spoke to each other, Janet, the third assistant, busily began preparing for the shunt surgery.
“Here we go. Catheter.”
Choi Ki-seok held the catheter in his hand and stared into the ventricle.
Fuuuuuck.
When the ventricle was pierced, clear cerebrospinal fluid flowed out along the catheter, and Larry caught it with a curved plate.
Meanwhile, Claire finished attaching the tube to her abdominal cavity.
“I’m ready.”
“okay.”
Choi Ki-seok connected the tube connected to the abdominal cavity to the catheter inserted into the ventricle.
The shunt between the ventricle and the abdominal cavity was successful.
This allowed the blocked cerebrospinal fluid to be absorbed back into the brain.
We gathered momentum and began treatment for brain herniation.
As time passed, the surgery was completed successfully.
All bleeding areas were controlled, and the soaring cerebral pressure returned to normal range.
Ki-seok Choi covered his skull and stared at the wall clock.
The current time is 1 am.
I went on a journey of six hours with my classmates.
I am just grateful to my friends who rushed to help me when I was suddenly called.
“Everyone worked hard and I’m grateful.”
“That’s all you need to know.”
“Of course Mr. Choi will be the one to eat the late-night snack, right?”
“Of course. Order whatever you want to eat.”
He smiled and answered his classmates’ words.
* * *
Early that morning.
Ki-seok Choi visited the surgical intensive care unit after having a late-night snack with his classmates.
Even though the surgery was successful, I couldn’t completely relax.
Although the patient’s condition was non-emergency, the outcome was still poor. This is because the damage to the brain was so severe.
“Jane. Have you eaten?”
I spoke to Freed’s wife who was in the waiting room.
She was just staring at the intensive care unit.
“Oh, Doctor Choi. I’m sorry. I didn’t hear what you said.”
“Did you eat?”
“No. I’m not in the mood to eat anything.”
Jane shook her head and continued.
“Dr. Choi. Actually, I spoke to an acquaintance a little while ago, and I heard a very terrible story.”
“A terrible story?”
“Yes. Freed didn’t fall and get hurt! An acquaintance said he was watching carefully.”
Jane’s explanation continued.
According to her, and more accurately, according to an acquaintance, Freed was hit on the head by a baton that was swung at a police officer. It is said that he fell at the same time and hit his head on the floor.
“…It’s different from the police’s explanation.”
“That’s what I’m saying. The police said it was my husband’s fault, but in reality it was completely the opposite.”
Jane clenched her fists and trembled.
“I thought something was strange, but I didn’t expect it to be like this. I think it was probably because my husband was black.”
“If we’re looking for a reason, that seems to be the most likely possibility.”
Choi Ki-seok nodded slightly.
The harsh treatment of black people by white police officers was often reported in the media.
Jane’s guess made perfect sense.
“This matter will never be overlooked. For my husband’s sake and for mine.”
“….”
“So, Dr. Choi, please save my husband. I can’t let Freed go in vain like this. It’s too unfair. Yes?”
“As I said before, I will do my best.”
“Yes. Please.”
Ki-seok Choi finished talking with Jane and entered the intensive care unit.
After the surgery, Freed is receiving treatment in an isolation room. Choi Ki-seok’s forehead wrinkled as he looked down at Freed.
Jane’s words about being beaten by white police officers kept ringing in my head.
Looking back, the police’s explanation had many doubts.
At the time, I didn’t delve deeply into the idea that treatment comes first.
‘For sure…’
Choi Ki-seok stroked his chin.
Freed’s injuries were too serious to be considered as a simple scuffle.
Jane’s words had much more credibility.
To give her strength, she looked closely at Freed’s head, but found no special evidence.
There were bruises on the temporal area, but they could not be evidence of assault. Because if the police say Freed fell sideways, that’s enough.
“Teacher, let me use the computer for a moment.”
“Yes. Please do so.”
Choi Ki-seok asked the nurse for permission and sat down in front of the computer desk. I looked at the emergency report written by the paramedic, but there was no significant result.
It simply states that head trauma occurred during a scuffle with the police and provides simple treatment.
“Fuuuu….”
I took a deep breath and filled out the first visit record.
We took great care in writing this because there is a possibility that legal issues may arise depending on the cause of the patient’s trauma.
As time passed, the surgery records and other charts were completed.
Choi Ki-seok returned to the isolation room and sat next to Freed.
As Freed was a critically ill patient, it was necessary to keep him overnight.
Even though I am on duty, I only have to go down when the emergency room is called.
‘cheer up.’
His gaze toward Freed was filled with affection.
* * *
The next morning.
Ki-Seok Choi completed the handover and attended the morning meeting and morning rounds.
Even though my duty was over, I couldn’t rest in peace.
“Mr. Choi. Look at me for a moment.”
After the rounds were over, Matthew caught him.
His eyes looking at Choi Ki-seok were filled with hostility. I’m sure he’s very angry because of yesterday’s order rejection.
“Would you like to go to the common room?”
“Sure.”
The two people sat on the sofa in the lounge and stared at each other.
A heavy silence oppressed the lounge.
The two remained silent, as if they were playing a game where the person who speaks first loses.
It was Matthew who spoke first.
“Are you out of your mind?”
“Yes. I’m perfectly fine. Manager, do you think there’s a problem with me?”
“Of course. I recommend that you see a neurologist right away.”
There was anger in Matthew’s tone.
“Do you think I’m funny? Does the head of brain tumor surgery seem easy?”
“no.”
“Then how should we interpret the behavior shown yesterday?”
“I would be grateful if you could see that I worked hard to save the patient.”
“What! Are you saying that because you know I’m making fun of you?”
“The chief called the surgeons waiting for surgery for personal business. It was an obvious mistake on the part of the chief.”
Choi Ki-seok continued calmly.
“Are you delaying the surgery to cover up that mistake or just to embarrass me?”
“….”
Matthew gritted his teeth at Choi Ki-seok’s question.
“There’s one more thing I’d like to ask you, Chief. Are the two reasons I mentioned earlier more important than the patient’s life?”
“You bastard! How dare you use your mouth!”
Matthew’s face turned bright red.
“Then why did you order the surgery to be delayed? I hope you can give me a justifiable reason.”
“Regardless of the reason at the time, it is true that there was no surgeon available to perform the surgery. In that case, it is right to wait. It is you who violated the procedure.”
“The patient suffered from cerebrovascular disease, and I received prior permission from Manager Lucas to perform the surgery. There were no problems with the procedure.”
“Then do you think it is normal for a new resident to perform cerebrovascular surgery?”
“Is it okay for Leon to operate on a brain aneurysm, but not for me? The manager’s standards are double.”
“Are you going to argue with me now?”
Matthew trembled.
“This is not an argument, but a logical process of resolving the problem between the manager and I. I am sorry that you are dismissing this moment as just an argument.”
“Mr. Choi. Do you think your surgery was successful?”
Matthew changed the topic.
“The patient is still unconscious. If the surgery was completed properly, he should have recovered properly!”
“You want to take issue with the surgery itself. In that case, it would be a good idea to check the surgery report and the pre- and post-surgery brain CT. The surgery was completed successfully.”
“….”
“The damage from trauma is so severe that he is just unable to regain consciousness.”
At Choi Ki-seok’s words, Matthew suddenly stood up. And I glared at him with an angry face.
“You made a mistake now. You touched the nose hair of a sleeping tiger. The position of head of brain tumor surgery is much more powerful than you think.”
“….”
“You shouldn’t have had the surgery yesterday.”
“Are you dissatisfied that the patient is still alive?”
Choi Ki-seok continued calmly.
“Then go and kill the patient again. That would be cleaner.”
“You’re fluttering all the way to the end. Okay, let’s see how long you can be fussy.”
Bang!
Matthew nervously closed the door and left.
Ki-Seok Choi watched where he was standing and then leaned back on the sofa.
Matthew’s threats were not scary.
What he was afraid of was Because the only thing I saw was the patient dying and the guardian’s tears.
I turned on the TV to take a breather.
[This is Julian from KCC News. Last night, around 7 p.m., a black man and white police officers were arguing in a residential area on Cliff Street, and the black man cut his head. An injury occurred.]
[The police claim that this incident was an accident, and the victim’s family claims that there was a harsh assault by the police. We will now listen to both sides’ opinions.] Choi Ki-seok was watching the news
. I rubbed my forehead.
Things were getting bigger.
