Level Up Doctor - Chapter 404
Towards the end (1)
Eight hours of sitting next to the patient.
Choi Ki-seok finally got up and left the hospital room.
“Has the patient gotten better?”
Nurse Jiyeon Kim continued speaking with a worried expression.
“Whew… the new prescription doesn’t help much.”
“Is there really nothing we can do but keep watching?”
“Now I’m going to try a slightly different method. “I can’t guarantee that this will be effective, but I have to try everything I can.”
Choi Ki-seok stood in front of the station with a forced smile. And then I called the pulmonology department.
‘What on earth are you thinking?’
Kim Ji-yeon watched Choi Ki-seok with curious eyes.
A cure for MERS has not yet been discovered.
It is known that there is no other method other than medical treatment, including antiviral drugs.
If medical treatment does not work, the patient dies.
Considering that Yang Jeong-hwan has chronic diseases including high blood pressure and diabetes, we should not think like this, but his life was like a candle in the wind.
What decision did the world’s only triple board thoracic surgeon make?
As time passed, my curiosity grew.
After some time, a pulmonologist wearing sterile equipment visited the gastroenterology surgery ward.
But he wasn’t alone.
He stood in front of the station, dragging a rather large machine.
“Chief. “I brought it.”
“great job.”
“The manager is doing the hard work. “If I were locked in a closed ward, I think I would pull my hair out and scream.”
“are you okay. “There are only a few days left.”
Choi Ki-seok stroked the machine brought by the pulmonologist as if it were a precious treasure.
The name of the machine is ECMO.
ECMO (Extra Corporeal Membrane Oxygenation) refers to an extracorporeal membrane oxygenation device. It is a device that removes the patient’s blood from the body, supplies oxygen, removes carbon dioxide, and puts it back into the patient’s body.
“But why are you looking for Ekomo all of a sudden?”
“I want to try using it on severely ill MERS patients.”
“Oh, I see.”
The pulmonology doctor on duty smiled awkwardly.
I had never heard of treating MERS with ECMO.
Not only overseas but also domestically.
Honestly, if someone asked him about the effects of ECMO, he would say ‘I don’t know…’ and trail off.
It was difficult to find a clear connection between ECMO and MERS.
“You worked hard, try to move up.”
“yes. Manager. Thank you for your hard work.”
“Nurse Kim, please take the catheter and treatment tools and go to the hospital room with me.”
“All right.”
After some time, the two people who finished the preparations finished disinfection and entered Yang Jeong-hwan’s hospital room.
The patient’s condition was still critical.
It was swinging precariously on a single-wooden bridge placed on both cliffs of death and life.
‘It will work. For sure.’
Choi Ki-seok strengthened his resolve as he prepared to operate ECMO.
What is the name of MERS?
Isn’t this Middle East Respiratory Syndrome?
While I was thinking about possible treatment methods related to breathing, ECMO flashed past me like a flash. ECMO was able to perform a variety of roles that ventilators could not.
It was a card that had a good chance of winning the fight against MERS.
“Please give me IV heparin (anticoagulant). “I’ll be setting up the machine.”
“yes.”
belt. belt. belt. belt.
Flashy moving hand movements to press buttons.
He quickly completed setting up the oxygenator and monitor, including the ECMO flow Cardiac index related to the flow rate of the conduit.
And that too by carefully considering the patient’s condition.
“Shall we begin?”
Choi Ki-seok lightly cleared his throat and held the catheter in his hand.
There are two main ways to connect ECMO: VA (which takes blood from a vein and puts it into an artery) and VV (which takes blood from a vein and puts it into a vein). Today, I was planning to use VV ECMO.
“I’m ready.”
Jiyeon Kim rubbed the internal jugular vein at the base of the neck with an alcohol swab and held the patient’s body firmly. Then Choi Ki-seok pierced the blood vessel with the catheter he held in his hand.
Fuuuuuck.
As the catheter pierced the blood vessel, blood pooled around the head.
He placed an arterial cannula in the right atrium and a venous cannula in the right thigh artery.
With this, ECMO is ready for sortie.
Ki-Seok Choi maintained the patient’s blood flow at 3.1-3.5 L/min and the ventilator at FiO2 0.6 TV 270 mL RR 14 times/min.
“Chief, are you finished?”
“yes. “I will be protecting the patient, so go and do your work.”
At his words, Kim Ji-yeon bowed her head and left the hospital room, and Choi Ki-seok sat on the chair and looked down at the patient.
I did everything I could.
Time will tell whether ECMO is effective or not.
As he waited anxiously, his gaze never left ECMO. If someone had been watching the hospital room from outside, they might have thought that time in the hospital room had stopped.
A patient lying motionless.
Choi Ki-seok is blankly looking at ECMO.
A watch whose minute and hour hands do not turn due to a discharged battery.
Everything in the hospital room was still.
How much time has passed?
widely!
Choi Ki-seok slapped his knee and stood up.
The stable breathing values and graphs shown by the machine made him happy.
Yang Jeong-hwan is back.
He, who had been in the underworld, returned to this world.
* * *
Two weeks later.
A lot of things happened in Korea.
First, the government declared the end of MERS.
There was a lot of talk about the declaration of end, but the announcement was never overturned.
The total number of MERS infections was announced at 55, and the number of deaths was officially counted at 7.
The Minister of Health, who failed to properly prevent MERS, was dismissed, and the government’s infection measures were criticized from all over.
It was too late to disclose our own infection hospital.
Prevention was neglected.
The infectious power of super spreaders was overlooked.
Among countries where MERS occurred, the number of MERS patients and deaths was the second highest, etc.
Even after the end of MERS, reports related to MERS did not seem to stop.
Still, there was a glimmer of hope.
It was a fact that several hospitals, including Sewon Hospital, bravely revealed that there were infected people. This was because the number of additional infections did not increase as people avoided hospitals where infected people came from.
Additionally, ECMO treatment has been recognized as an official treatment for MERS.
After treating patient Yang Jeong-hwan with ECMO, Choi Ki-seok claimed the efficacy of ECMO to the media.
[Saving a severely ill patient with MERS with ECMO!]
[What kind of machine is ECMO?]
Many people became interested in ECMO through his media play. Although the medical community was skeptical at first, I started ECMO treatment with the feeling of grasping at straws.
As a result, we were able to obtain meaningful data showing that ECMO is effective for severely ill MERS patients.
Choi Ki-seok received a presidential commendation for his contribution, but he declined it.
Instead, he asked the government to urgently fix the loopholes in infection control measures.
Sewon Hospital, where three people were infected with MERS.
The number of patients in the hospital did not increase at all.
Even though the MERS incubation period had passed and the government had declared the end of MERS, anxiety was still overwhelming people.
* * *
A week after the announcement of the end of MERS.
Choi Ki-seok was processing paperwork in his office.
Because the number of patients had decreased, I had more time to spend. Although I wasn’t particularly happy about that leisure.
He got up, stood at the window, and looked out. And I slowly looked back on the times that MERS had scratched me.
Although the hospital suffered a blow when he disclosed the fact that there was an infected person, he did not regret his actions one bit.
Even if I were to go back to the past in a time machine, I would make the same choice. If the hospital had not been disclosed, the number of MERS patients would probably have increased two to three times compared to now.
Moreover, the economic losses incurred by the hospital were resolved at private expense.
It was concluded by selling some of the Mayjo Clinic stock and sending it to the hospital.
I believed that although the aftershocks of MERS would continue for a while, patients would eventually return over time.
Tiririring.
A phone ringing suddenly.
Choi Ki-seok tilted his head and picked up the phone on his desk.
“This is Choi Ki-seok.”
[yes. Manager. This is Yongjun. I have something urgent to tell you.]
“Is there an emergency patient?”
[No, there is good news. The lung transplant center contacted me and said that a lung transplant donor had appeared. It seems that surgery will soon be possible for patients Gwangjin Park and Gong Jihwan.]
“Okay. “Let’s do some tests and schedule the surgery in two days.”
[I understand.]
Choi Ki-seok put down the phone and stretched out.
Park Gwang-jin, suffering from stage 4 lung cancer.
Lee Tae-hyeon, a heart tumor patient who was abandoned by Associate Professor Kim Han-cheol.
Finally, it was possible to perform surgery on two people.
The surgery may not be easy, but as always, we will do our best to save their lives.
My hands naturally felt strong.
A short time later, when work time came, Choi Ki-seok changed into casual clothes and left the thoracic surgery ward. I had a date with Jeong Seol-hwa in an hour, but I had work to do before that.
So I drove to a jewelry store in the city center.
“Please give me this.”
After choosing an item he liked, he went back to the hospital.
As I parked my car near the hospital and was spending some time, Seolhwa Jeong soon approached me.
“It’s been a while since we had a date after work, Karl.”
“There should be days like this too.”
Choi Ki-seok chuckled, fastened her seat belt, and kissed her on the cheek.
“Today is the day, right?”
“that’s right. “I’m already looking forward to seeing other people’s reactions.”
He drove to a nearby hotel. Because it was rush hour, there was traffic, but it wasn’t frustrating. It was just a pleasure to be able to have a comfortable conversation with Jeong Seol-hwa.
“You’ve had a hard time.”
When the car stopped at the signal, Jeong Seol-hwa held his hand tightly.
“You were kept confined to the gastroenterology surgery ward because of MERS. “It was frustrating, wasn’t it?”
“It was a vacation of its own. You didn’t have surgery or see outpatient treatment. “This will never happen again in the future, right?”
“Well, that’s true too.”
Jeong Seol-hwa burst out laughing.
“There aren’t many patients in the cardiology department, right?”
“huh. It’s almost half of what it used to be. Although it is increasing little by little. “Do you know that some people at the hospital are gossiping about you?”
“of course. “Sometimes my ears itched so much that I was going crazy.”
Most of the hospital staff thought Choi Ki-seok’s disclosure of the hospital was brave, but there were also those who did not.
They whispered that his behavior was careless and that the impact it would have on the hospital in the future would be enormous.
“I don’t really care. “I’ve been used to being criticized for a long time, so my ears have become calloused.”
“okay. “Because everyone is jealous of honey.”
While we were talking, the car pulled into the hotel parking lot.
The two finished dinner in the lounge on the top floor of the hotel and entered their room. Afterwards, we took turns showering, dressed in comfortable clothes, and leaned back against the bed.
“The timing is fantastic.”
“I know.”
Choi Ki-seok fixed the TV channel and smiled.
[Documentary 7th Sewon Hospital Thoracic Surgery Episode Doctors with Warm Hearts]
Finally, the difficult lives of thoracic surgeons were broadcast.