Famousness (4)
At the end of lunch time, Choi Ki-seok and Jeong Seol-hwa were heading to the pediatric ward.
It was to grant the wish of Kim Tae-hwan, whom I met in the morning.
“wow! “It’s heart-warming!”
When Kim Tae-hwan saw Jeong Seol-hwa, he jumped up and down as if he had met a celebrity.
A 180 degree different reaction from when I encountered it.
Choi Ki-seok could not shake off the feeling of having suffered a mysterious loss.
“I heard our Taehwan is going to become a doctor?”
Seolhwa Jeong said as she signed her autograph.
“Before that, you should get good treatment at the hospital and never upset your parents, right? “You can promise, right?”
“yes!”
When she stroked his head, Kim Tae-hwan looked excited, like a puppy meeting its owner.
The two people leave the ward after a brief meeting.
It was Jeong Seol-hwa who spoke first.
“honey. “Did you hear the news?”
“What?”
“The news came out earlier. “They decided to close the Jeongju Medical Center.”
Jeongju Medical Center was a public hospital in charge of local medical care, and the provincial governor was forcing its closure. There was a clear conflict between the company and the governor over whether to close the business, but in the end, the governor seemed to have won the power game.
“The country is doing well. “Why on earth are we needlessly blowing up public hospitals?”
“Young teacher there. Are you talking about Zhengzhou Medical Center?”
An elderly patient nearby, who heard Choi Ki-seok muttering to himself, spoke up.
“yes. “What’s going on?”
“I think the teacher views the closure of the Jeongju Medical Center in a negative light, so I’m going to teach him properly.”
The patient continued speaking with his arms crossed.
“The financial deficit in the province is ridiculous because of the Jeongju Medical Center. “Isn’t it impossible to run a public hospital while ruining the provincial finances?”
“….”
“It’s not just that. The union that is currently on strike is called the Strong Aristocrats Union. It means that they are a people who cannot understand words at all. Now do you understand the true meaning of this medical center’s closure?”
Choi Ki-seok snorted at the patient’s words.
Any other doctor might have laughed it off, but this patient chose the wrong person.
He was very interested in this strike and had a lot of information.
“Jeongju Medical Center is a public hospital, not a for-profit hospital. It is a natural consequence that there will be a deficit.”
“A deficit is natural?”
“yes. Unlike other hospitals, we do not provide excessive treatment or testing, and our medical expenses are relatively low. In addition, we also maintain essential medical services that cannot be paid for. Because it is a public hospital. “It is nonsense to talk about profitability in public hospitals in the first place.”
Choi Ki-seok gave strength to ‘public hospital’.
“You mentioned the province’s fiscal deficit, but the province’s annual budget is 15 trillion won. The deficit incurred by the Jeongju Medical Center is approximately 3 to 6 billion won. Now, let’s talk. Does it make sense that the province is reeling because of the Zhengzhou Medical Center?”
“no. That’s it. In the news….”
“Not everything they say in the news is right. “Each news has a different way of approaching facts.”
He continued speaking rapidly.
“The patient’s thoughts on the union do not match my thoughts. Strong Aristocrat Union? Do you know exactly the wages and strike days of the Jeongju Medical Center union?”
“….”
The patient became dumbfounded by Choi Ki-seok’s point.
“I would like to add one word: the biggest reasons for the Jeongju Medical Center’s financial deficit are its expansion and relocation to places with poor accessibility and the problem of low prices. This is a completely different problem from what the patient is talking about now. “Is there anything else you want to say?”
“Nothing in particular.”
The patient left with his shoulders slumped.
Trudging. Trudging.
Ki-seok Choi was lost in thought as he parted ways with Seol-hwa Jeong and moved to the operating room.
Our country’s public hospital system was far behind compared to other countries.
While the proportion of public hospitals in OECD countries reached 70%, in Korea it was only 5%.
Even those included university hospitals such as Seoul Hospital, so people’s accessibility was not high.
That’s why Ki-Seok Choi was sad about the closure of Jeongju Medical Center.
When Samjeong Seoul Hospital allows telemedicine, they will build more public hospitals.
“Chief. Something bad has happened. “I think you don’t look well.”
“I just have a lot on my mind.”
Upon entering the operating room, Daniel Lee spoke to him, and Ki-Seok Choi waved his hand as if it was no big deal.
“Let the briefing begin.”
“yes! The patient’s name is Jeomrye Park, and she is 60 years old. An echocardiogram showed an ejection fraction of 50 percent, a left ventricular wall thickness of 12 millimeters, and afferent hypertrophy.”
“….”
“In addition, I was diagnosed with aortic stenosis due to decreased movement of the outer and posterior walls of the heart, and I am scheduled for TAVI (sutureless aortic valve replacement) surgery.”
Jaehoon Lee, a third-year resident, finished the briefing clearly.
“good job.”
Choi Ki-seok shook his head and continued speaking.
“Honestly, there is no way you would do TAVI. Originally, it was a treatment in the field of internal medicine. “Right now, there are no TAVI skilled workers in our hospital’s internal medicine department, so I’m doing it myself.”
“….”
“Still, pay attention. “There are many cases where a thoracic surgeon accompanies a TAVI surgery in an internal medicine department.”
“I’ll keep that in mind.”
“Then shall we begin?”
Buck. Buck. Buck. Buck.
The staff, including Choi Ki-seok, went to scrub. While I was lathering my fingers, wrists and arms with a brush dipped in povidone, Daniel Lee, who was nearby, spoke to me.
“Chief. “I had a good time watching Schritel yesterday.”
“Did you see it too?”
“Well… I can’t watch it from beginning to end, so should I call it a highlight video? I watched a few short videos. “It was nice to see you and Professor Jeong.”
“I’m glad you enjoyed it. By the way…”
Choi Ki-seok paused before continuing.
“Did you think I was too good at explaining things?”
“A little bit of Joe?”
Choi Ki-seok just sighed at Lee Daniel’s reaction.
I think I’ll have to change the way I do things the next time I appear.
Jiiiing.
The rosette door opened and the staff took their seats.
The process of connecting the time-out patient monitoring device, preparing surgical tools, and providing general anesthesia went smoothly.
Choi Ki-seok, who was watching the process, suddenly turned his gaze to the observation operating room.
Assistant Professor Shin Ji-hoon was looking this way with his arms crossed.
Did he attend the observation at least at the instigation of an associate professor?
There was nothing to be read from his expressionless face.
“Chief. “Preparation for surgery is complete.”
“From now on, we will begin TAVI surgery for aortic valve stenosis. Preparation for transesophageal ultrasound.”
“All right.”
Daniel Lee moved busily following his instructions.
He intubated the patient and slowly passed the ultrasound tube to the back of the patient’s neck. At the same time, I stared at the monitor, looking for a location to secure the tube.
This was an essential treatment to secure visibility in future TAVI surgeries.
“Is this enough? I don’t think the visibility is bad…
“Good job.”
Choi Ki-seok’s eyes drew a half moon.
“Since the aortic annulus is about 25 millimeters in size, Jaehoon, set up a replacement valve in advance.”
“Should the type of valve be a balloon-expandable type? Or should I use the self-inflating type?”
“With balloons. “Daniel, let’s secure the femoral artery.”
“yes.”
After busy preparations, Choi Ki-seok finally had a catheter in his hand.
But his face was crumpled as he looked down at the catheter.
“Jaehoon Lee!”
The staff members flinched in surprise at his sudden yelling.
This is the exact opposite of the angelic appearance that Choi Ki-seok showed in the operating room.
Everyone was busy looking with scared expressions.
“yes. Manager. Even if there was a problem…”
“Of course I called because there was a problem. Don’t you know what you did wrong?
“That’s it.”
Jaehoon Lee stuttered and looked back on his actions.
The surgical process was not slow, and no action was taken to contaminate the surgical instruments. Even after racking my brain hundreds of times, I couldn’t figure out what I did wrong.
“sorry. I do not know.”
“Daniel. you?”
The situation was the same for Daniel Lee, who received Choi Ki-seok’s attention.
Wasn’t the surgery preparation process perfect?
There seemed to be no reason for Lee Jae-hoon to be scolded.
“It seems like everyone doesn’t know. “The problem is this.”
Choi Ki-seok pointed to the catheter insertion device with his index finger.
“This is Karit Medical’s catheter insertion device, which was recently recalled due to a manufacturing defect. “A problem was discovered that the tip could break away from the outer shell and enter the blood vessel.”
“Ah…”
“Preparing for surgery isn’t just about having the necessary tools. It even includes the process of checking whether the tool is working properly. “What do you do if a patient has a problem using a product like this?”
“sorry. “I didn’t know.”
“From now on, even the surgical tools will be thoroughly checked. “Contact the central supply office and replace all of these products.”
“I’ll keep that in mind.”
“I will be careful.”
While Choi Ki-seok, who finished scolding, manually replaced the catheter insertion device, Lee Daniel stared at him with a mesmerized expression.
I never thought Choi Ki-seok would pay such attention to detail.
Usually, sergeants use the tools prepared by the staff.
Because surgery is so complicated and requires a lot of work, the rest of the work is left to the staff.
‘wow. ‘This is the first time in my life that I’ve been scolded for using surgical tools.’
Even though Lee Daniel was scolded like Lee Jae-hoon, he actually experienced thrilling pleasure.
I became confident that if I trained hard under Choi Ki-seok, I could become a great thoracic surgeon.
“Why are you looking at me like that?”
“Oh no. “I just respect the manager…”
“I respect you.”
Choi Ki-seok held the catheter with the aortic valve and stent in his hand again with a calm expression.
Suuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuu.
A catheter that travels through the femoral artery to the heart blood vessels.
Ki-Seok Choi’s eyes never left the ultrasound monitor as he was performing the treatment, and his hand movements were as careful as handling a child.
If the catheter accidentally pierces a blood vessel or moves to a distant location, the surgery could end in failure.
While everyone watched with bated breath, the stent was placed in the aortic valve annulus.
“Daniel.”
“yes!”
Daniel Lee fully understood Choi Ki-seok’s call and expanded the balloon.
While checking the monitor and intra-aortic pressure.
After a while, the balloon inflated and the stent pushed the malfunctioning aortic valve ring to the side. And the existing valve annulus was replaced by an artificial valve included in the stent.
“I got a good seat. Stop the bleeding and remove the catheter.”
Cheeeeeeeek.
Choi Ki-seok suctioned blood near the valve annulus using a previously attached hemostatic device. In addition, we looked at the presence of aftereffects such as aortic rupture or stent dislodgement with the eyes of Hippocrates.
If you see that the progress is good, TAVI is successful.
Suuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuu
The catheter insertion device that had done its job was completely removed.
Subsequent coronary angiography showed that peak cardiac pressure decreased from 30 mm Hg to 2 mm Hg.
‘There’s no time to catch a pod.’
Shin Ji-hoon, who was watching TAVI in the observation room, clicked his tongue.
TAVI surgery, a not-yet-widespread medical procedure that has barely made up its hundredth case even in university hospitals.
It was surprising that Choi Ki-seok, a thoracic surgeon, did it.
‘I have no choice but to acknowledge your skills.’
