Chapter 19 : ER (1)
Chapter 19 - ER (1)
— Are you perhaps a ‘person who returned’?
Sihyeon lay on my bed in the dormitory, but the final words Choi Se-young left behind continued to swirl in his head.
— Be careful from now on. There might be eyes watching.
Do you know other regressors?
What do you mean by ‘eyes watching’?
What happens if I’m exposed to them?
There were a mountain of questions Sihyeon wanted to go and ask Choi Se-young, but he had to be cautious.
Because such questions themselves would be tantamount to confirming that he was a regressor.
‘Would it have been better to say something in response?’
For instance, something like, ‘A divorcee...? I’ve never even been married.’
However, Choi Se-young’s question was far too unexpected for him to come up with such a remark.
‘How does she know?’
No matter how much he retraced his memories of the past, he had no significant information about the person named Choi Se-young.
He only knew her as Kim Min-hong’s wife or Woo-hyeon’s mother.
‘Still, the fact that she told me to be careful means she at least doesn't have bad intentions.’
He had many thoughts, but it wasn't a situation where he could specifically do anything.
‘Let’s just wait and see for now.’
When one's mind is complicated, putting things off was a fairly useful strategy.
……
Weekend duty.
Once the Saturday outpatient clinic hours are over, patients who need medical attention over the weekend visit the Emergency Room.
If it were the original March, Sihyeon would have faced Saturday trembling with anxiety, but now he felt no particular emotion.
12:04 AM
After making it through Saturday afternoon safely, it was now past midnight. If he could just hold out a little longer, it would be time to swap shifts with Hwang Jin-ho.
‘There aren't many calls today, surprisingly.’
Sihyeon was about to lie down on the folding bed in the department office to catch some shut-eye when the phone rang as if it had been waiting.
[02-20xx - 0119]
It was the Emergency Room.
In the ER, medical treatment is carried out in such a way that an intern performs the initial examination and then calls the resident of the relevant department.
—Doctor, hello. This is ER intern Noh Min-hye. I am giving you a 'noti'. A 38-year-old female patient has visited the hospital with a chief complaint of dyspnea that has persisted since an hour ago. The patient is...
Noti (Notify)
This referred to the act of an ER intern examining a patient, classifying them according to the medical department, and reporting.
Because a resident’s thunderous scolding would fall if something was missed during the examination or if the wrong department was called, interns giving a 'noti' always felt as if they were walking on thin ice.
Sihyeon brought up the ER patient list at the same time he listened to the 'noti'.
[Lee Jeong-mi F/29 Intern Noh Min-hye / Dept. Undecided]
He recognized the patient at a glance.
He remembered her clearly because she was someone who used to come to the ER almost every week during the early part of his first year in the past.
‘Ah, this person is a panic disorder patient.’
Panic disorder.
It was a type of anxiety disorder accompanied by sudden severe anxiety, a fear that one might die, and a feeling of suffocation.
‘She used to come mainly during the dawn hours.’
Since she was someone who repeatedly woke him from his catnaps, it would be more accurate to say she was a patient he simply couldn't forget even if he wanted to.
She was a familiar patient whom he had seen not only in the ER but also for a quite long time in the resident outpatient clinic later during his third year.
The primary symptoms were chest pain and dyspnea.
And the factor that worsened the symptoms was excessive stress.
“Understood. I’ll go down and see her immediately.”
Sihyeon answered right away without listening to the 'noti' until the end.
“Yes. Thank you.”
Intern Noh Min-hye’s 'noti' ended abruptly in less than 30 seconds.
In the past, I had definitely said this:
— Intern, I think excluding other diseases is the priority. Call Internal Medicine first, and notify me once things are sorted out.
In cases of chest pain and dyspnea, missing a potential cardiovascular disease is far more dangerous.
This is because there are instances where a doctor treats a patient thinking it's panic disorder, only to face a predicament when it later turns out to be a myocardial infarction.
Therefore, in principle, doing as Sihyeon said is the correct approach. However, Sihyeon, who had found a sense of leisure after his regression, thought a bit differently.
'I already know the diagnosis, so there’s no need to make the intern suffer for nothing. It’s my patient anyway...'
Sihyeon headed straight for the Emergency Room.
"Min-hye, did you already succeed with the 'noti'? Did you do a really intense history taking?"
When the resident of the relevant department appeared as soon as the phone was hung up, the surrounding interns looked on with envy.
This was because some residents, in an attempt to establish discipline in early March, would reject reports or humiliate interns if the content of the 'noti' was insufficient.
"No... Dr. Cheon Si-hyeon just said he'd come down and see her right away," Noh Min-hye said, sounding dejected.
She had spent twenty minutes taking the patient's history just to avoid getting cursed at during the 'noti', but it had ended far too anti-climactically.
"Where is the patient?"
Upon arriving at the ER, Sihyeon checked the initial consultation chart.
'She wrote it quite meticulously.'
It was early March. It was a point in time where only about a month had passed since the interns had obtained their medical licenses.
They were certainly doctors, but perhaps it would be more accurate to say they were still closer to medical students.
Nevertheless, Noh Min-hye’s records were quite reliable.
Sihyeon issued a few additional test orders and immediately met the patient.
"Ms. Lee Jeong-mi, where are you feeling the most discomfort?"
"I, I can't... breathe... I feel like I'm going to suffocate and die."
The patient looked as if she might stop breathing at any moment. Sihyeon immediately checked the monitor displaying the patient’s vital signs.
[O2 saturation 100%]
Oxygen saturation was at its maximum.
This suggested that while there was subjective dyspnea, there was no actual problem with the oxygen supply.
There were no special findings other than a slightly fast heart rate.
"I’ll take care of it for you immediately. You’ll be fine soon."
Sihyeon smiled lightly at the patient and then spoke to the nurse in charge.
"Please prepare one ampoule of Valium."
When the nurse handed him the syringe, he injected some directly into the vein and the rest into the IV bag.
"How are you feeling now?"
"Phew. My breathing is finally settling down."
Before long, the patient found stability. In the early part of his first year in the past, when he truly didn't know anything, he used to hold onto patients who were having trouble breathing and ask them all sorts of things.
— Who were you primarily raised by when you were a child?
— What kind of people are your parents?
— How were your friendships during your school days?
Thinking back to those times, a smirk escaped him. In the current interview, something else was more important.
"You may feel a fear that you're going to die, but you know you won't actually die, right?"
"Is... Is that for real?"
"Of course. It’s because there isn't actually a problem with your heart. If your heart truly stops, you lose consciousness within seconds. The very fact that you are feeling this anxiety is proof that you are alive."
Reassuring the patient and correcting misunderstandings about panic disorder came first.
Ding-dong!
[System: Patient Lee Jeong-mi’s treatment progress increases.]
[Treatment Progress 11 -> 23 / 100]
“There are no abnormalities in the basic blood tests and EKG. The cardiac enzymes also don't show any particular issues. Rest assured.”
“Yes, I understand!”
The patient, feeling better after Sihyeon’s explanation, wore a much brighter expression.
“I’ve put in the discharge orders. Once your breathing stabilizes, you can go home and come to the psychiatry outpatient clinic in three days.”
Having finished his explanation, Sihyeon was about to leave the ER when he stopped as if he’d remembered something and went back to the patient.
“Ah, there’s something I forgot to mention. You know that not getting stressed is the most important thing for panic attacks, right?”
“Yes. But it’s not like that’s something I can just control...”
“But sometimes, there is stress that can be prevented.”
Sihyeon said with a smile.
“Well, for example, if there's someone who persistently pestering you to lend them money, wouldn't cutting ties in advance be a form of prevention? You can do that, can’t you?”
“Ah... yes...”
“I suppose the economy is bad lately because there are so many scumbags who borrow money and then vanish. Isn't that right, sir?”
Sihyeon asked while looking at the boyfriend standing next to the patient.
He looked like a truly caring boyfriend, holding the hand of the patient lying on the bed tightly, but in reality, he was the opposite.
— Thinking back now, if I hadn't met that guy back then, I wouldn't have gotten this illness.
Most of the stress the patient would face in the future would come from this man.
From being a violent drunk and a cheater to money issues.
He was closer to a villain than a boyfriend.
“T-That's right. Haha.”
The boyfriend’s expression as he answered Sihyeon was not good.
“I’ll prescribe some medication for you to take until your outpatient appointment. If you feel uncomfortable, please come back anytime.”
Hoping that this patient, who had always been taken advantage of because she couldn't say no, wouldn't have her hard-earned money stolen this time and would meet a decent man and live well.
“Wow, what is it with today? The beds are full, and even the waiting room and hallways are packed so there's nowhere to sit... and another patient is coming?”
As he returned to the station to write his charts, someone slammed the receiver down and grumbled.
A voice thick with irritation.
It was the ER charge nurse who had set up Sihyeon’s IV on his first day as a first-year.
On the other side, Noh Min-hye and the other interns were running around frantically.
Doctors and nurses alike were all exhausted.
“Tell the interns to just identify the chief complaint and give a 'noti' immediately when a psychiatry patient arrives. I won't give them a hard time.”
Sihyeon said while tapping on the keyboard.
“Oh~ Dr. Cheon Si-hyeon! Accepting ‘notis’ so readily, you're looking pretty cool!”
Starting their first rotation in the ER right after getting their medical licenses. The more he thought about it, the more he felt sorry for those poor souls.
Come to think of it, five years ago when Sihyeon was an intern, his first rotation had also been the ER.
‘I should treat them a bit better this time.’
Ding-dong!
[System: Achievement rewards are being issued.]
[Idol of the ER - The favorability of the ER interns has slightly increased. (Hard difficulty +500P)]
[Not a Malignant One! - The favorability of the ER nurses has slightly increased. (Hard difficulty +500P)]
New rewards appeared as if in response to Sihyeon’s thoughts.
Ding-dong!
[System: Cumulative points have exceeded 30,000P. New items are now unlocked.]
‘New items?’
Sihyeon’s eyes widened at the notification that followed. When he immediately opened the Item Shop, a few items marked ‘NEW’ at the top caught his eye.
[Potion of IPPA (D) - The user's senses are dramatically improved for a short period of time. (1,000P / Cannot be stacked)]
[Multi-tasking Potion (D) - Helps the user process various tasks simultaneously for a short period of time. (1,000P / Cannot be stacked)]
‘IPPA...’
IPPA was an abbreviation for Inspection, Percussion, Palpation, and Auscultation—the most fundamental methods in patient physical examination.
Although it was somewhat overlooked in the field of psychiatry, where clinical interviews, psychological tests, and radiological exams like CT or MRI are primarily used, it was a basic examination method that every doctor must master.
'I’ll have to use this later if I have a chance to examine someone.'
As Sihyeon was about to get up after reading the item description, someone approached and sat in the seat next to him.
Short black hair, snow-white skin, and eyes that looked particularly large and intelligent compared to her small face left a strong impression.
Perhaps because she had rushed out, there was still some moisture left in her hair that hadn't quite dried yet.
The name tag pinned to her lab coat pocket caught his eye.
[Internal Medicine Chae Yi-jin]
‘It’s been a while.’
Sihyeon offered her a faint smile.