Famous (6)
“Right atrium rupture. Obtain consent from your guardian. “I’ll look into the operating room.”
“How should I treat it? “Can I give you some more vasopressor medication?”
“no. “It’s of no use if you don’t suture the ruptured area.”
After answering, Choi Ki-seok secured the operating room and called an auxiliary staff member. Along with Yongjun Shim, he was Haecheol Yang, a second-year resident who was the youngest resident in the Department of Thoracic Surgery.
As soon as Choi Ki-seok arrived in the operating room, Yang Hae-cheol stood by his side like lightning.
Looking at his face and head soaked in sweat, it looked like he had run from the dormitory until his feet were sweaty.
“As I said, it is an emergency surgery for right atrium rupture.”
“yes. “I was already picturing the surgical process in my head while I was on the way.”
“Good posture. “There is a big difference between thinking about it before coming in and helping without thinking.”
“By the way, Chief. “The other staff…”
Yang Hae-cheol looked around and tilted his head.
The only people waiting for surgery were Choi Ki-seok and Yang Hae-cheol. The rest were crew members filming a documentary.
“doesn’t exist. “This surgery will be handled by the two of us.”
“Chief of department. I am not yet capable of assisting with this type of surgery. If it catches your ankle…”
“It’s okay. “That won’t happen.”
Choi Ki-seok put his hand on his shoulder with a smile.
After becoming manager, I was holding one-on-one interviews with staff every morning.
The purpose of the interview was simple: to accurately and specifically understand the staff’s tendencies and abilities through the eyes of Hippocrates.
[Title: Man with a Big Liver]
– Effect 1: Maintains a relaxed mind without fear or panic in an emergency situation.
– Effect 2: If you succeed in a surgery or treatment that you cannot handle, your understanding of the surgery increases threefold.
Yang Hae-cheol had a special title: a man with a big liver.
What you should pay close attention to is the second effect part of the title!
If Yang Hae-cheol had been guided by a more skilled doctor, he could have developed his skills quickly.
Under the assumption that he would receive Choi Ki-seok’s teachings, the person expected to grow the fastest among the Sewon Hospital staff was Yang Hae-cheol.
“Keep your wits about you and just do what I tell you. okay?”
“Oh, I understand.”
After a while, the patient was sent from the emergency room to the operating room.
Buck. Buck. Buck. Buck.
Choi Ki-seok and Yang Hae-cheol stood side by side and scrubbed their hands and arms with a brush dipped in disinfectant. Afterwards, we entered the rosette where the patient was lying.
The process of connecting the time-out patient monitoring device, surgical tools, and general anesthesia continued smoothly.
“From now on, we will begin right atrium repair surgery for TA patients.”
Yang Hae-cheol nodded his head vigorously at Choi Ki-seok’s shout.
He disinfected the patient’s chest area and covered it with a cloth.
“What kind of thoracotomy is used to approach right atrium rupture?”
“It’s a median sternotomy.”
“Then you try it.”
“yes!”
Without saying anything, Hae-cheol Yang slashed the patient’s neck from the solar plexus with the scalpel given to him by the disinfection nurse.
I didn’t know why Choi Ki-seok was teaching so actively.
But there is only one thing you can be sure of.
It was refreshing, like someone scratching an itchy back.
I entered thoracic surgery with the dream of becoming a cool and talented surgeon. However, even though I was in my second year as a resident, I could only perform very simple procedures and assist in the operating room.
To him who was thirsty for treatment, Choi Ki-seok’s instructions were like a sweet rain in a drought.
Weeeeeee. Drumming.
Crash. Crash.
While Yang Hae-cheol made a sternotomy and wore a retractor on the surgical site, Choi Ki-seok quietly watched him and did his best to help him.
“Chief. Do residents usually take the lead in administering treatment like this? “It looks like the manager is helping teacher Hae-cheol Yang now?”
A broadcasting staff member who came into Rosette with me spoke to me.
“you’re right. Now I am helping Hae-cheol. If you try to provide treatment in an actual emergency situation, your skills will improve significantly. how is it? Are you alert?”
“of course.”
“It’s shift again. “Watch what I do.”
Suuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuu
Ki-Seok Choi’s scalpel carefully cut open the pericardium.
As the membrane slowly peeled away like a fruit peel, the blood accumulated in the pericardium was revealed.
When I looked at it, the amount was approximately 150cc.
Cheeeeeeeek.
He sucked in blood and spoke slowly.
“It is quite natural for chest trauma to occur in a traffic accident. Among them, heart damage is easy to miss, so why is that?”
“Hmm… I’m not sure.”
“This is because it takes a long time for clear symptoms to appear after heart damage. “If surgical treatment is delayed like that, the patient’s condition gets worse.”
“So is there a way to detect heart damage early?”
“I have low blood pressure. Do you know what they said in the emergency room earlier? The patient said he had low blood pressure, but his blood pressure did not rise even if he used vasopressors. So, if low blood pressure continues, you should suspect heart damage.”
“As expected, you are the manager. Great.”
“I studied for over ten years more than you, so I should know this much.”
Choi Ki-seok chuckled and pointed to the right atrium with his index finger.
There was a tear of about 8 millimeters in the area connecting the superior vena cava and the right atrium.
“You can also do the suturing.”
“My me? “I’m not confident about suturing…”
“It’s a simple interrupted suture and you don’t need to tie a lot of knots. “Is this enough?”
“It’s still scary. “If anything goes wrong with the patient, it’s all my responsibility.”
Yang Hae-cheol lowered his eyes with a frightened expression.
“That’s the weight the surgeon feels. The pressure of knowing that the patient’s life is in my hands. But if you can’t bear that weight, you can’t be a surgeon.”
“….”
“A real doctor takes all the patients with him. From the patient’s life to death. “If you are not ready, I have no intention of forcing you to do so.”
“no. “I will try it.”
After finishing speaking, Yang Hae-cheol’s attitude changed 180 degrees.
His eyes were hot, and his words conveyed a sense of responsibility. Choi Ki-seok’s words seem to have been a great stimulus.
‘There’s nothing you can’t do. It’s called simple interrupted suture. It won’t even take a few stitches.’
Gigigigigeek.
He tightened the suture needle with a needle holder and began suturing in earnest.
My hands were shaking so I was slow to take action, but my accuracy was flawless. The suture needle penetrated the blood vessel appropriately, and the suture tightened the ruptured area appropriately.
click!
“Phew….”
As Choi Ki-seok cut the suture, Yang Hae-cheol sighed in relief. The pounding of my heart that felt like it was going to explode stopped. My hands didn’t shake anymore.
His gaze was filled with pride as he looked down at the area he had sutured himself.
“Look! “You’re good at it.”
“Thank you, Manager. I think I gained great insight thanks to you.”
“If that’s what you felt, I’m grateful. “I will finish it.”
Choi Ki-seok exaggerated a little, checking for leaks in the sutures in the blink of an eye and covering the surgical area.
Jiiiing.
After the surgery, the two people leave Rosette feeling relieved.
Ki-seok Choi looked at Hae-cheol Yang, who was standing next to him, with Hippocratic eyes and smiled.
[Due to the effect of the title Man with a Big Liver, the right atrium surgery skill level has increased significantly. If a superior is watching, if the patient’s condition is not severe, the surgery can be performed alone.]
Indeed, it was worthwhile to call Hae-cheol Yang alone and entrust him with the surgery.
Jiyiing.
When the cell phone he had placed in his gown trembled, Choi Ki-seok took it out and checked the number. I thought it was the emergency room, but surprisingly I got a call from the thoracic surgery ward.
“This is Choi Ki-seok, a thoracic surgeon.”
[Hello, Manager. [This is Min Ji-hye, the nurse on duty.]
“What’s going on?”
[The patient is waiting for surgery due to hemangiosarcoma in the heart. Suddenly, my chest hurt and I couldn’t breathe. And when I checked my Mac, it was beating at about 130 beats.]
“Have you done a test?”
[There was nothing special in the echocardiogram taken this afternoon. On the chest X-ray, only the right lower lobe of the lung and the right diaphragm appear to be slightly elevated.]
“I’ll go right away.”
“You just finished surgery, did you have another patient?”
VJ clicked his tongue and spoke.
I was exhausted even while filming Choi Ki-seok performing surgery.
But how difficult would it be for Choi Ki-seok, the person involved? The problem was that Choi Ki-seok could not rest even for a moment and had to see the patient again.
“On-call doctors not only see emergency room patients, but also hospitalized patients. “We have to take care of not only thoracic surgery patients, but also patients hospitalized in cardiology and other departments with heart problems more broadly.”
“You have so much to do. But are you doing this on your own?”
“In principle, yes. “If I’m busy, I call my colleagues in the dormitory or medical office.”
Choi Ki-seok took Yang Hae-cheol to the cardiology department.
Drurr.
When we moved to the room, Min Ji-hye, who had called, was having a conversation with the patient. The guardian standing next to her looked at her and the patient back and forth, not knowing what to do.
“Chief. “Are you here?”
“yes. “Shall we take a look at the patient?”
Ki-Seok Choi briefly greeted the patient and then shrugged his shoulders as if he was surprised.
The patient was in his early 30s, younger than expected.
Thoracic surgery patients were usually very young or middle-aged, so patients of this age were very rare.
The reason why there are so many young patients is because of the effects of congenital heart disease, and the reason why there are so many middle-aged patients is because the disease occurs in middle-aged people as eating habits and lifestyle habits accumulate.
Soon, Ki-Seok Choi began interviewing the patient.
We checked the specific symptoms one more time and asked when the pain started and where the most discomfort was.
Physical strength: 3/10
Main symptom: Chest pain / Difficulty breathing
Painful area: Heart
Diagnosis: Vascular tumor (terminal stage) / Hemothorax / Right atrium rupture
Current status: Emergency
Progress
: Poor Past history
: Pneumonia Family history: Paternal colon cancer Death
Precautions : A heart tumor has invaded the diaphragm and the right ventricle of the lung.
Using the eyes of Hippocrates, he clicked his tongue.
The average survival rate for hemangiosarcoma of the heart where metastasis occurred is 6 months.
Even with surgery and other treatments, it was difficult to last more than a year.
It was heartbreaking to see a patient who was terminally ill at a young age.
‘For now, we can only assume that the right atrium ruptured due to a vascular tumor.’
Choi Ki-seok stroked his chin and thought about the patient’s future.
Although surgery was needed immediately, it was necessary to think about the scope of the surgery.
Should only the ruptured right atrium be sutured?
Or will I have to suture the right atrium and have the tumor removal surgery scheduled for two days later?
For now, it seemed like a better decision to have surgery to remove the tumor, but that couldn’t be guaranteed.
The extent of tumor removal surgery was also a problem.
Tumor removal surgery was divided into two types depending on the scope.
One is called palliative surgery, which involves cutting out only the area where the tumor originally formed, and the other is called total surgery, which involves cutting out all other metastatic parts as well.
“teacher. “What happens to my son now?”
The guardian who was watching the situation grabbed Choi Ki-seok’s arm.
“I need surgery right away. However, since you are not my patient, I think I should call your attending physician first. Please wait a moment.”
Ki-Seok Choi’s expression on the phone to Associate Professor Han-Cheol Kim was not very bright.
