There is no end to learning (2)
“You are here.”
Edward, a general surgery surgeon, approached me and spoke.
“I sent an urgent test to find the cause of the hemoptysis. A chest X-ray and angiography… That should be enough to find out what the problem is, right?”
“That’s enough.”
“It’s shameful. Actually, I have no intention of calling Chief Yasada, but the patient is not an ordinary patient…” “I’ll
just let it go this time, but I hope this doesn’t happen again in the future. All patients are the same. VIP. “Just because you’re a patient doesn’t mean your life is more precious.”
“….”
“And the staff at the thoracic surgery department are excellent. There are many doctors who can see this patient even if I’m not in surgery.”
“I’m sorry. I’ll make sure nothing like this happens again in the future.”
Edward avoided Yasada’s gaze as if he was embarrassed.
‘also.’
Ki-Seok Choi smiled happily at Yasada’s podium.
My stomach felt refreshed, as if I had emptied a can of cider at once. Yasada said what he wanted to say on his behalf.
No matter how I look back, it was true that the general surgery department made an excessive call in this case.
Jiiiing.
The door opened and patients and staff entered the rosette.
“Are you done with the test?”
“Yes. I asked the radiology department for an emergency review, so the results will be available right away.”
“Let’s watch it together.”
At Edward’s words, the staff gathered in front of the computer.
Eventually, the test results appeared on the monitor, and the staff’s expressions gradually darkened.
“There’s nothing wrong?”
Edward clicked his tongue as if it was absurd.
“Chief Yasada. What happened to this? Clearly, the patient suffered severe hemoptysis during surgery. There is no way the test results would come back normal.”
“Please give me a little more time.”
Yasada narrowed his eyes and looked at the results, and Choi Ki-seok also could not take his eyes off the monitor.
Surprisingly, there was nothing to tackle in the radiology department’s interpretation.
The patient was normal except for hemoptysis.
Ki-Seok Choi thought it was strange and used the Eye of Hippocrates on a patient.
Then the diagnosis suddenly occurred to me.
In this case, two cases could be suspected.
One is that the test itself was completely wrong, and the other is that the radiology department’s interpretation was wrong.
Just as surgeons often make mistakes during surgery, other staff members could also make mistakes.
Choi Ki-seok withdrew his gaze and looked at Yasada.
What kind of judgment will Yasada make?
“Let’s operate on this patient.”
“Surgery? The radiologist said there was no problem, so is surgery really necessary?”
“Yes. I need it.”
“What is the reason…”
“This patient suffers from esophageal perforation.”
At Yasada’s words, Rosette’s mood froze coldly.
Esophageal perforation.
It is a disease that causes a hole in the esophagus.
Due to the structure of the esophagus, it is easy for various bacteria and digestive elements to enter, and if problems occur in the esophagus, sequelae such as mediastinitis and sepsis may occur.
The degree of aftereffects increases exponentially over time.
Even two days after an esophageal perforation occurs, the patient’s mortality rate rises to 60 percent.
“I have never had an esophagus endoscopy and there has been no special external trauma, so it is correct to assume that a spontaneous perforation occurred.”
“How… how did you know that? Even the radiology department couldn’t catch it…”
“Look here carefully.”
Yasada’s index finger pointed to a part of the monitor.
“Is there a shadow here? This can be overlooked, but if the patient says hemoptysis, the story is different.”
“….”
“And the most important thing is that surgery is needed immediately.”
“…I will follow Chief Yasada’s wishes.”
“Please leave one intern to assist, and leave the rest of the staff.”
“Understood. We will obtain the consent form for the surgery.”
The situation ended with Yasada’s neat traffic control.
While the disinfection nurse was preparing surgical tools, Ki-Seok Choi and Yasada took their seats next to the patient.
“Head Chief. You are truly amazing.”
“what?”
“I didn’t know that the radiology department would detect an esophageal perforation that was overlooked.”
Choi Ki-seok still couldn’t hide his surprise.
He himself has the eyes of Hippocrates and can see through the patient, but Yasada’s situation was different.
Even though he had no special abilities, he accurately recognized the diagnosis.
What would it have been like if a cardiothoracic surgery staff member other than Yasada had come here?
I would have trusted the reading results and missed the golden time.
I felt once again that Yasada is a world-renowned authority on obstructive esophagus.
“Doctors must always maintain sharp senses. If the mind and heart become dull, problems like today will arise. You too, keep that in mind.”
“I will engrave this deeply in my heart.”
“You’re good at giving answers.”
Yasada smiled and continued.
With Choi Ki-seok’s courageous answer, preparations for the surgery were completed.
“By the way, are there too many surgical gowns today? They are performing lung cancer surgery and esophageal perforation surgery.”
“I usually have an abundance of scrubs. You can think of it as getting a vaccination before being sent on a cruise.”
“Is that really true? It seems like an incident will occur on the cruise ship as well?”
While we were talking, preparations for surgery were completed.
As a result, the friendly atmosphere of the two people suddenly changed.
A sparkle poured from both eyes, and the friendly conversation was suddenly cut off.
“From now on, we will be performing endoscopic metal clip surgery for spontaneous esophageal perforation.”
Following Yasada’s words, Choi Ki-seok disinfected the patient’s neck widely and covered it with a cloth. Yasada then pushed a guide port with a camera into the patient’s mouth.
Sooooooooooo.
The guide port placed in the esophagus clearly illuminated the inside of the patient’s esophagus.
Yasada’s judgment was correct.
There was a very small perforation in the cervical esophagus.
At first glance, you might not think it’s a big deal, but if left alone, the patient would suffer from measles due to various infections.
“Clip number 17.”
Yasada connected the clip he received from the nurse to the endoscope tool and inserted it back into the patient’s esophagus.
In the meantime, Choi Ki-seok started to secure the surgical field of view.
Yasada performed the clip ligation as skillfully as the surgery. Even though clip ligation is originally a medical procedure.
Click!
As the clip held the puncture site, the slight leakage of digestive fluid stopped.
“Mr. Choi. Look down a little further. Look at the mediastinum and pleura.”
“All right.”
When Choi Ki-seok lowered the guide porter, an inflamed and pus-filled mediastinum was discovered.
As expected, the word “yasada” comes out.
“Would you like to try the drainage technique yourself?”
“Yes. If you give me the chance, I’d like to try it.”
Ki-Seok Choi used an additional endoscopic tool and placed it in the inflamed mediastinum. Then, I lightly cut the inflamed area with a scalpel attached to the end of the tool.
The surface of the mediastinum was torn and yellow pus flowed out.
Choi Ki-seok squeezes out the pus with an endoscopic tool while applying moderate force.
Even though it was my first time doing this treatment, there was no hesitation.
“It looks like all the pus has been removed.”
“I’d like to kill one more Head Chief.”
“…Surely you even know that?”
Yasada burst into laughter, and Choi Ki-seok responded with action.
Cheeeeeeeek.
He adjusted the pressure and strength of the saline solution and then injected it into the mediastinum where the abscess had formed. This is to prevent the fact that pus may remain even if sufficient pressure is applied to the skin.
“I think this will be enough.”
Choi Ki-seok said while looking at the monitor video, and Yasada nodded slightly.
Eventually, the endoscopic tools were removed and the surgery was completed.
When the patient was examined with the eyes of Hippocrates, the patient’s progress was found to be good.
Treatment of patients with emergency esophageal perforation is a great success.
Tiring!
[You have completed the hidden mission ‘Successfully assist with esophageal disease.’ A new surgery mastery has been created as a reward.]
[Esophageal Surgery Basic Mastery (1/1): If you acquire this mastery, your surgical and internal esophageal treatment proficiency increases by 30 percent.] After checking the notification,
he walked out of the rosette with light steps . .
* * *
Office of the Head Chief of Cardiothoracic Surgery.
Yasada and Choi Ki-seok, who had completed emergency surgery, were sitting on the sofa.
“Have you heard about the lung cancer patient?”
“Yes. I heard that Marilyn finished well. I checked the chart and her vitals were normal.”
“That’s a good thing. It would have been funny if our patient had a problem while taking care of general surgery patients.”
Yasada smiled and took a sip of the coffee on the table, and Choi Ki-seok stared at him in silence.
Unusually, he performed surgery twice in a row with Yasada.
In the meantime, Yasada showed off his skills worthy of his reputation.
It was not for nothing that they were given the title of being number one in the lung eating department.
Even thinking about it now, his penetrating eye for the patient and his neat and accurate treatment are something that amazes me. Thanks to this, I was reminded that I still have a long way to go to follow him.
“Head Chief, I have a question for you.”
“what?”
“I wonder who the Head Chief was trained by. Did you get to this point on your own?”
“It’s been a while since I’ve known Mr. Choi… but this is the first time I’ve heard this question.”
Yasada rubbed his chin as if he was interested.
“No one in this world can stand alone. I also received instruction from a great person.”
“….”
“Do you know anything about Dr. Oliver?”
“No, sorry, I’ve never heard of it.”
“Now that I think about it, it seems possible. Mr. Choi retired before even entering medical school.”
“What kind of person is this person named Oliver?”
“Hmm… Your goal was to become the best thoracic surgeon in the world, right?”
“Yes. It has been a goal that has not changed since I entered medical school. But why did that suddenly happen…” “
Oliver is probably the surgeon closest to your dreams. He is experienced in all aspects of cardiac surgery, pulmonary esophageal surgery, and pediatric cardiac surgery. “I did. He is someone who set an unprecedented record in the history of thoracic surgery.”
“Ah… did someone like that already exist? I had no idea.”
“Oliver was not one to reveal himself, so he received relatively little media attention.”
Yasada nodded and continued speaking.
“He placed the most importance on his attitude and heart towards patients. Even when Oliver was the head of the cardiothoracic surgery department, he was always busy like an intern… Only now did I realize that this was truly a great thing.”
“….”
“What’s even more amazing is that, as I said before, I’ve mastered all parts of thoracic surgery. I can’t believe I completed a triple board when only one wave wasn’t enough. That’s me.”
“Wouldn’t it have been possible if the Head Chief had put his mind to it?”
“No. I can’t.”
Choi Ki-seok tilted his head at Yasada’s weak voice.
Is there anything that is impossible even for Yasada in the world?
“It may be clumsy, but it’s impossible to learn the triple board perfectly like Oliver. That requires being born with superhuman talent and superhuman effort.”
“….”
“Considering that Dr. Song, whom you respect so much, is a double boarder, it’s understandable, right?”
Yasada said.
Master . Song Myeong-jin is a talented person in cardiac surgery and pulmonary and esophageal surgery, but he has not been able to touch the pediatric heart department. This
means that it is that difficult to obtain a triple board.
“Do you know why there were no triple board thoracic surgeons after Oliver?” “
…Yes. I thought I just had to work hard, but I think I thought my goal was too easy.”
“You don’t have to worry about that. If a triple board is born in this era, it will be Mr. Choi.”
“Thank you for the compliment, but I’m still lacking a lot.”
“Okay. That heart is the most important thing. Only those who know their own shortcomings can fly higher and see farther.”
The conversation stopped for a moment and silence fell in the office.
But at that very moment,
a notification flashed through my mind.
Tiring!
[Janggi ] The mission ‘Toward the Triple Board’ has been formed. Complete the entire Cardiac Surgery, Pulmonary Esophagus Surgery, Pediatric Pulmonary Esophagus and Cardiac Surgery fellow course. Special rewards will be given upon completion of the mission.] [The linked mission Finding Oliver has been formed.
Oliver Meet with and get a clue about the triple board.]
