Decision (5)
“Four…murder?”
Choi Ki-seok was so surprised that his body shook.
The words that came out of the guardian’s mouth were completely unexpected.
“I understand that the patient came to the emergency room because of a car accident…”
“So that’s murder.”
Unlike Park Jimin, Park Jinpyo continued his explanation calmly.
Patient Ko Jeong-ok has been living alone for ten years after her husband passed away due to a chronic illness. However, six months ago, she started seeing Kim Yong-min, who is five years younger than her.
It is said that Ko Jeong-ok, perhaps because of her deep loneliness, fell in love with Kim Young-min.
“The misfortune started there.”
Park Jin-pyo sighed.
“I went to my mother’s house a month ago, and I discovered something surprising. There were three life insurance policies in my mother’s name.”
“….”
“What’s even harder to believe is that the recipient of the insurance money is a human sitting shamelessly in the emergency room over there.”
“So what you two are saying means that Mr. Kim Young-min instigated the patient’s accident for insurance money?”
Choi Ki-seok felt his heart trembling even as he spoke.
I thought I had been in the hospital for quite some time, but this was my first time encountering a situation like this.
“I’m sure.”
Jinpyo Park and I nodded vigorously.
“I just went to the police station. I checked the CCTV, and the car that caused the accident had its license plate number covered. Does it make sense that two people were walking side by side on the street and the car hit exactly one person?”
Choi Ki-seok couldn’t answer and just sighed.
If what Park Jin-pyo said is correct, this is an obvious murder.
If the patient dies like this, Kim Yong-min may receive the insurance money.
“Teacher, you can pretend you didn’t hear this story. But please save my mother. You really shouldn’t pass away like this, okay?”
Park Jimin begged earnestly and held on to the gown.
“Okay, I’ll find a way.”
Choi Ki-seok returned to the emergency room with a heavy heart.
“What did you two talk about?”
“It’s not an important story.”
He cut off Kim Yong-min’s question and looked down at the patient.
Even though he was receiving mechanical ventilation, the patient’s respiratory condition was gradually declining.
If we continue like this, an unexpected accident may occur.
Choi Ki-seok thought about the treatment method while recalling the papers he had read.
[The Frozen Heart Bravery effect is active.]
[Brave: The ability to analyze the cause and come up with a treatment method is doubled.]
Is it because of the passive?
The knowledge I had gained so far unfolded in my mind like a movie.
‘Is this my limit?’
Ki-seok Choi bit his lip and picked up the call phone.
There is nothing I can do now.
I had no choice but to ask Professor Park Yong-il for an SOS…
But the moment I dialed the number, a brilliant idea crossed my mind.
An exhilarating shiver running down your spine.
I thought this could save the patient.
“Professor, I’m sorry I’m late at night. A car accident patient came into the emergency room and I have something I’d like to ask.”
Choi Ki-seok connected the call and explained the patient’s condition in as much detail as possible.
Even though the notice was over, Park Yong-il remained silent.
He also couldn’t easily come up with a solution.
“Professor, I have been thinking about something. Is it okay to use ECMO on a patient?”
[Ecmo?]
“Yes. I think that’s best for now.”
Choi Ki-seok expressed his opinion cautiously.
ECMO (ECMO Extracorporeal Membrane Oxygenation)
is a device also called an extracorporeal membrane oxygenation device.
The role of ECMO is to remove blood from the patient’s body, oxygenate it, and return it to the patient’s body.
[Hmm… I don’t think it’s that bad?]
“I think so too. The patient’s lung function is currently greatly reduced. If we use ECMO to give the patient’s lungs a rest, I think they can return to spontaneous circulation.”
[But do you know how to use ECMO?]
“I know… No. I will call Mr. Min and install it together.”
Choi Ki-seok stammered his answer.
In the past, he was in his third year as a resident, but now he is in his first year as a resident.
He is also a hot newbie who has been working for less than a month for just one year.
It is normal to not know how to use ECMO.
[As you said, connect ECMO and then watch. If the patient’s condition worsens, please contact me again.]
“Yes. Thank you.”
Choi Ki-seok hung up the call and explained to his guardians.
That ECMO is needed and that the patient needs to be moved to the intensive care unit.
With the consent of the guardian, the patient was moved to the intensive care unit.
While he was making the settings needed to operate ECMO, Minjoohyuk stood next to him with a tired face.
“Professor Kwon, you haven’t finished organizing your thesis yet, right?”
“Huh~ I think it will end somehow this week. But is this patient an ECMO patient?”
“Yes. Hypoxemia occurred even though I was on mechanical ventilation.”
“After all, no patient is as docile as one with your burnt hands.”
Min-hyuk Min stood next to the ECMO machine and continued.
“So, today is your first training as a resident? From now on, I’m going to teach you how to use ECMO, so don’t just listen to it and keep it in your head. Understood?”
“yes.”
“First of all, there is something we need to do before touching the machine: give the patient heparin (an anticoagulant) to prevent circuit blockage and thrombosis.”
“I put it back in advance.”
Ki-Seok Choi pointed to the syringe on the dressing cart.
“It’s pretty good, right? Then, let’s administer heparin IV (intravenously) and set up the machine.”
“yes.”
“What…what is it?”
“Why are you doing this all of a sudden?”
“Surely you did all this?”
Min-hyuk blinked in surprise.
All plans went to waste due to Choi Ki-seok’s pre-setting.
Originally, I was planning on showing off a lot and telling people how to use ECMO.
I planned to teach Choi Ki-seok that no matter how much he received recognition from the professors, he still had a lot to learn as he was only in his first year of college.
However, Choi Ki-seok had already completed the pre-setting.
“Yes. I looked at the manual and guessed it before my senior came.”
“Is that so?”
Minjoohyuk looked at the setting in detail, hiding his embarrassment.
You can’t back out of here.
Today was decided as a day to honor the dignity of seniors.
‘You bastard. ‘Isn’t it too much to do?’
Min-hyuk Min’s eyebrows twitched.
The oxidizer and monitor settings, including the ECMO flow Cardiac index related to the flow rate of the conduit, were absolutely perfect. It’s not even about simply following the manual.
This is a setting that takes into account the patient’s condition.
“How are you? Senior?”
“Hmm. Well done for a first time. Now it’s time to catheterize.”
“Can I try inserting the conduit as well?”
“Try it.”
With Min-hyuk Min’s permission, Ki-seok Choi looked at the conduit he had prepared in advance.
What you need for ECMO is the seldinger technique.
This is a treatment in which a cannula is inserted into a blood vessel and only the wire with the puncture needle is removed. This is a method mainly used when inserting a stent in circulatory medicine.
Suuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuu
Choi Ki-seok disinfected a wide area of the area to be punctured and then began treatment.
Fuuuuuk!
First, the cannula was inserted into the right thigh vein, and then the cannula was placed in the inferior vena cava (the vein that allows veins from the lower body to flow into the right atrium).
Next, the cannula was placed into the right atrium through the right neck vein.
As a result of taking pictures with a portable X-ray, both cannulas were located in their normal positions.
“Senior. I think it’s okay to use ECMO now?”
“Huh? Okay. Let’s spin it.”
Drurrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
ECMO started up with the sound of the pump running.
Ki-seok Choi and Min-hyuk Min took turns looking at the patient and ECMO and then sighed in relief.
ECMO installation was successful.
“Wow. Teacher Choi is amazing.”
Yang Mi-hyang, the nurse in charge of the surgical intensive care unit, approached me and spoke to me.
“At this level, ECMO ran it alone. How can you do this just by looking at the manual?”
“When I was an intern, I was sent to a rural area and saw people using ECMO. I took good notes that time.”
“You said you learned it by watching it once? Awesome. Is that possible? Yang
Mi-hyang clicked her tongue.
“Do you know what Teacher Min here was like when he first got ECMO?”
“Hmmmm… Teacher Yang. It looks like the story is going astray.”
Minjoo-hyuk noticed Yang Mi-hyang.
“If you want to hear the story behind it, I’ll tell you later.”
Yang Mi-hyang said something playful to the end and returned to the station.
“I think the treatment is over. Would you like to have a cup of coffee after a long time?”
“Yes.”
While leaving the intensive care unit with Minjoo-hyuk, Choi Ki-seok turned back and
stared at patient T.A.
Suddenly, the words he heard from his guardian earlier came to mind.
[Doctor. Please save my mother. This is it. It’s not an accident, it’s a murder!]
“Sir. Wait a minute.”
Choi Ki-seok stopped by the station and asked the charge nurse for a favor.
* * *
The next morning at the hideout.
Choi Ki-seok was busy practicing surgery.
Today, he is reviewing CABG (coronary artery bypass surgery) for the first time in a long time. Korea This is because it is the day of surgery for Park Soon-jae, Vice President of the Thoracic Surgery Association.
Sigh.
The internal thoracic artery was carefully removed with a scalpel. Then, using the removed internal thoracic artery, a bypass was created in the left anterior descending artery, which was assumed to have stenosis. Continued alone
. A fierce struggle.
Click!
The surgery was completed when the sutures were cut with scissors.
Tiring!
[I’m Ambidextrous The skill has risen to Lv.2. The Special Effects Skills Test is open.]
[I’m Ambidextrous Lv.2]
– As the level increases, the killing speed and accuracy of both hands increase.
– Grows up to level 5.
– Mastery: The decrease in accuracy and speed decreases even after long-term killing. Hand tremor is reduced by 1.5 times.
Status window Choi Ki-seok, who checked, smiled and finished cleaning up.
The place he left the hideout and found was the VIP room.
Park Sun-jae always woke up around this time, so it wasn’t rude to visit him.
Knock, knock, knock.
When he knocked, a voice told him to come in. I heard,
“Hello. Vice President.”
Park Soon-jae nodded slightly in response to Choi Ki-seok’s greeting.
“Did you practice surgery in the morning?”
“How did you do that….”
“Because it smells like blood. “Seeing you practicing early in the morning, you definitely seem like Professor Song’s student.”
A smile appeared on Park Soon-jae’s lips.
Amid a moment of silence, Choi Ki-seok opened his mouth.
“You may think this is presumptuous, but I have a question.”
“Tell me.
” I still don’t know why the Vice President asked Professor Yoon to perform the surgery. If you are the Vice President, you probably know that Professor Yoon will be under a lot of pressure…” ”
I know.”
Park Soon-jae nodded.
“What kind of doctor would enjoy using a scalpel on his advisor? But….”
“….”
“The doctor’s mind and the patient’s mind are different.”
“The doctor’s mind and the patient’s mind?”
“Yes. Professor Choi, please take this opportunity to take note as well.”
Park Soon-jae continued calmly.
“If I were a doctor, I wouldn’t tell Professor Yoon to perform surgery on a friend of his. Because I know how big the burden is. But now I am a patient.”
“….”
“Patients want to be treated by a competent doctor. I can’t help it.”
A bitter smile appeared on the corner of Park Soon-jae’s mouth.
Choi Ki-seok was able to realize it too late.
Park Soon-jae had been going through great worries due to conflicting feelings between his mind as a doctor and his mind as a patient.
“The surgical method has changed . “Did you hear the story?”
“I heard. You made a bolder choice than I thought.”
“…I think so too.”
Park Soon-jae’s surgery was originally scheduled to be a conventional CABG. However, Yoon Ji-hye changed the surgical method two days ago.
MIDCAB (Minimal Invasive Direct Coronary Artery) Bypass).
This is the so-called minimally invasive coronary artery bypass surgery.
