The Returning Doctor Wanted to Live Quietly - Chapter 305



Only Noblemtl

Episode 305. Vice Resident (1)

Vice resident.

Vice Chief.

3rd year or R3.

There were many titles, but one thing was clear.

Before I knew it, I was an old man.

It’s time to focus on surgery rather than caring for patients.

It was a time when assisting the professor as a first assistant and sometimes even becoming the surgeon became routine.

The problem is.

‘Nobody thinks about the gap.’

That there is no one who cares for him.

Jinhyeok went to see Professor Sangsoo Seo of the Department of General Surgery after hearing that he would be given an opportunity to perform surgery right away.

“Professor, I have something to tell you.”

“What is it?”

“Loop lieostomy. Can’t you just put it off a little bit?”

“what?”

“I would like to do it after I have been a bit more experienced than before. To be honest, I am not confident.”

“Are you not confident?”

“yes.”

A situation that came out of nowhere.

Professor Seo Sang-soo tilted his head as if he was puzzled.

It wasn’t a difficult surgery.

Work to develop residents like CS.

Moreover, it seemed like no one else but Jinhyuk Lee was acting like this.

‘It’s a simple surgery, so it’s right to do it when given the chance, but still… … .’

“I’ve been away for a long time. I need time to adjust.”

“hmm.”

“I’m sorry that I wasn’t able to learn properly while working as a member of the True Medical Support Team… ….”

Jinhyuk scratched his head, making the same expression a third-year student should make in front of a professor.

It means it’s a burden.

It was full of implications of asking for more time.

At this, Seo Sang-soo burst into laughter.

“I know the situation… … Heh heh. Are you serious? Wouldn’t Professor Han Dong-soo be disappointed if he found out? Well, you said you wanted to be like Professor Han.”

“that is…….”

Of course, it was true that I wanted to stand up to Han Dong-soo.

Why else would he have gone to see the hospital director?

but.

‘But you have to give them time to learn. This isn’t it.’

It was against the law to ask him to perform the surgery immediately after returning.

At least you have to stand there a few times.

As Jinhyeok scratched his head again, Seo Sangsu burst into laughter.

“Well, okay. That’s enough. You know how to be humble. You know your place. Well, that’s enough.”

“yes?”

“He has a good personality. He’s really great. What’s between us? Image making. We don’t have to do that. Haha.”

“No, that’s… … .”

“Well, you can do it all. It’s not a difficult surgery. It’s just an ostomy, an ostomy. All you have to do is make it so that the stool can be excreted from the body.”

“That’s true, but… … .”

“Wow! They’re treating me like a thoracic surgeon.”

“Okay, Professor.”

A situation where you can’t say you can’t do it anymore.

His expectations and aspirations for himself were completely absorbed into it.

Well, that makes sense.

He has won awards at academic conferences in the United States and is famous for his outstanding drinking skills.

* * *

Jinhyeok, standing in the doctor’s chair, bowed his head.

“i look forward to!”

“Don’t be nervous.”

“Yes, Professor!”

“Your voice is good! Very good! Let’s start now.”

“Yes! Now, we will begin the loop lieostomy surgery! Scalpel!”

Jinhyuk declared the start of the surgery and took hold of the scalpel.

A patient who underwent colectomy two weeks ago.

This was an additional surgery because a defect in the anastomosis could have allowed stool to leak into the abdominal cavity.

A bypass for excreting stool from the body.

So, all you have to do is take the stoma out of the abdominal wall and suture it together with the skin.

Of course, for a general surgery professor, it was an easy surgery.

It was not an easy surgery for Jinhyeok, who was a former thoracic surgeon.

first.

‘The navel and the pubic bone. Then, connect the anterior superior iliac process to form a triangle… … .’

I wasn’t even sure about deciding on the location of the stoma.

Well, shouldn’t there be something to see and learn?

The patient’s immediate concern is the patient’s health.

A patient who must live with a colostomy bag for a period of time.

If you make a mistake, it could interfere with your daily life.

Wasn’t that a shameful surgery?

Jinhyeok hesitated for a moment and then took up the scalpel.

Diagonally upper left of the navel.

A point located inside an imaginary triangle. That is, in his opinion, it was the best location.

Then draw a short line horizontally.

Peel off the subcutaneous fat.

Incise the fascia.

In addition to that.

I isolated the rectus abdominis muscle.

“It’s clean. I didn’t touch the veins.”

“hmm…….”

“Have confidence! I mean, I still don’t know why you came. I don’t know. Haha.”

It was excessive praise, even though it didn’t touch the hypogastric vein that supplies blood to the pubic bone and belly button area.

It’s just encouragement, knowing that he himself is hesitating.

Jinhyuk immediately bowed his head in response.

Seo Sang-soo and the second assistant placed the retractor and pulled in the opposite direction.

Jinhyuk also did not stay still.

Remove the posterior rectus fascia.

The peritoneum was incised.

Now it’s time to check inside the abdominal cavity.

The first thing that catches the eye is the colon, which is shorter than the others. The marks of the anastomosis are still intact.

Once with your eyes.

I checked the anastomosis site again by touching it with my hand a few times.

The surgery performed by Professor Seo Sang-soo.

I think he did a good job, but I was careful to look into it as I was doing additional surgery out of concern for any possible aftereffects.

Next is the bottom chairman. That is, we examine the end of the small intestine.

Because the chairman had to be pulled and brought to the surface.

“I think this will be fine. The surrounding organization is clean.”

“But be careful. If you’re unlucky, it’ll explode. Don’t use too much force.”

“Yes, professor.”

“Let’s hurry up and do it.”

“yep.”

After a short answer, Jinhyuk immediately took action.

About 20 cm from the ileocecal valve (the junction where the ileum connects to the large intestine).

Touch the proximal part (closer part) with your hand rather than the distal part.

If the stoma is created close to the ileocecal valve, the bypass length can be shortened, preserving the absorptive capacity of the small intestine.

Because being too close can be a problem.

Excessive growth of bacteria.

Bile acid and vitamin malabsorption, etc.

There were a lot of things that could have influenced it.

Of course, the distance being too far was also a problem.

Because it can interfere with fluid absorption and lead to electrolyte imbalance.

The problem is.

‘In the end, it’s the feeling that matters.’

You have to try a lot to know.

He deliberately placed his hand on the spot he was thinking of and then looked at Seo Sang-soo’s expression.

But Seo Sang-soo did not move an inch and did not say anything.

‘Is it okay? Should I just go? What will I say later?’

Real-time education. No, the general hospital is where education is done like a post-mortem review.

Knowing this makes me even more hesitant.

It was good for him to be able to learn, but the patient must have felt like a burden.

I didn’t want to cause unnecessary harm.

but.

“Please give me sutures.”

“yes.”

“I will mark it.”

Jinhyuk silently proceeded with the surgery.

* * *

The mesentery supports the intestines.

And arteries, veins, and lymphatic vessels pass through the mesentery.

It can be said that there are bundles of blood vessels hidden inside the fat lump.

Now it’s time to make a hole in the mesentery.

Areas with fewer blood vessels. So we had to find avascular areas and drill holes.

That way, there will be less bleeding.

And at that moment, Jinhyuk’s movements changed.

The momentary hesitation and slowing down the tempo were nowhere to be seen, and the mesentery was quickly palpated.

Press with your finger.

Press again.

This is a behavior that allows you to discern differences in tissue density and texture with just one finger.

Jinhyuk, who made a quick decision, made a hole and inserted a rubber tube.

Seo Sang-soo, who was standing opposite that sight, stuck out his tongue.

‘When I see something like this, I can tell that he is a completely skilled scribe… … .’

In fact, it was Seo Sang-soo’s behavior that was completely incomprehensible.

When detecting blood flow with Doppler ultrasound, areas without a signal could be considered avascular areas.

You could also shine a light on it to highlight the bright areas.

Because the area where the blood vessels pass has low transmittance, it appears dark.

But if you touch it with your hand, it will be solved in no time.

The problem is.

‘Why on earth did you… … just now… .’

The tension is all over the place.

Sometimes cautiously.

Sometimes boldly and skillfully.

They were really polar opposites.

While he was lost in thought.

Jinhyuk moved on to the next step.

The incision area of ​​the fascia and skin that has already been incised. That is, the size of the incision is measured.

Because if the incision is too narrow, the stoma may be compressed.

‘I think this is enough?’

Jinhyeok, who had been watching Seo Sangsu’s expression, moved.

Take it out using the pre-marked rubber tube.

And at that moment, Jinhyuk hesitated again.

It is time to determine the height of the stoma.

That is because the time has come to make a value judgment.

* * *

There is no right answer in surgery.

Sometimes a ring-shaped colostomy is created.

Sometimes a transverse colostomy is created.

That’s not all.

In some cases, a tortuous colostomy was created.

Depending on the patient’s condition, it must also be decided whether to proceed with the surgery laparoscopically or open.

In mathematics, it could be said that there are multiple correct answers.

So, the doctor’s judgment is most important.

How to do it.

How much to cut.

How can we reduce side effects for patients who are carrying out their daily lives?

A comprehensive judgment must be made.

However, Jinhyeok, who had no experience in surgery, had no choice but to hesitate again.

If the stoma was pulled out even a little, a collapse could occur.

Placing or securing the ostomy bag may be difficult.

That’s not all.

Feces can get on your skin and cause infection.

The problem is that it can’t be too high.

Finally, after much thought, Jinhyeok adjusted the stoma to the height he thought was appropriate.

Once the adjustment work is complete.

Once again, Jinhyuk’s movements changed.

He moves his hands without hesitation, and plays again.

The process of making an incision in the stoma and turning it around the edges to suture it to the skin.

It’s over in an instant.

Without damaging the barrier.

The entire layer and skin are sutured with absorbable material.

That was enough to make the staff nod their heads.

Seo Sang-soo also did not stay still.

With the ostomy rod in place.

I did the fixing work.

Because I had to have a colostomy bag attached.

As Jinhyeok carefully examined the suture area, Seo Sangsu nodded.

Let’s end it now.

At this, Jinhyeok shouted.

“Thank you for your hard work!”

* * *

When I was washing my hands at the sink.

The steps passed by in a rush.

“Teacher! Today was great! It was over faster than I thought!”

“Oh, because I am still lacking.”

“No, it was perfect.”

“is it so?”

“Yes, yes. Please take care of me next time too.”

A nurse passes by, bursting into laughter.

And the resident.

It was clear that in the eyes of others, it appeared as if they had done it right.

When Jinhyuk shook his head.

Seo Sang-soo, who had been standing in line, approached.

“great job.”

“No, Professor. I still have a long way to go.”

“You’re good at it, so why are you doing that?”

“But still… … .”

“What? Why are you so insecure? CS isn’t like that.”

“that…….”

“Why? Am I worse than a professor?”

“Oh, no. That’s absolutely not it.”

Jinhyuk quickly waved his hand.

Although it is said that people in the same group have a strong bond, it could also have become a needless competition of pride.

Each person thinks they are the best.

No one had as high a self-esteem as Ssulzun.

When Jinhyeok handed a towel to Seosangsu who had washed his hands, he continued speaking.

“You can’t be perfect. You make mistakes. Well, sometimes you don’t even realize you made a mistake.”

“… … .”

“So, have confidence.”

“yes.”

Jinhyuk just smiled and answered because he couldn’t tell the details.

This is also something that happened because of his own lies.

Well, it was his own karma.

At this, Seo Sang-soo hit Jin-hyeok on the shoulder.

“I mean, Sisyphus. He was greedy. He was a very bad guy. So the gods punished him.”

“yes?”

“Don’t you know the myth of Sisyphus?”

“No, I know.”

“Yes. I had to roll the stone to the top my whole life. It was a very heavy and large stone.”

“… … .”

“If you roll a rock to the top, it will roll down. You have to roll it again.”

“It’s an endless punishment.”

“No, that’s not it.”

When Jinhyeok gave his usual answer, Seo Sangsu shook his head.

It’s not a punishment.

What on earth are you trying to say?

Jinhyuk’s face turned quizzical.

“Albert Camus said, ‘We too are like Sisyphus, rolling a stone. We keep living, knowing that it will fall down.’”

“… … .”

“That patient just now? The ostomy adjustment? What, the ostomy position? It’s all important. But no human is perfect anyway. And doctors aren’t perfect either.”

“Still, that’s… … .”

“No matter how absurd life is, we have to roll the stone. We will continue to see patients. We will continue to perform surgeries. We will continue to heal people.”

“… … .”

“So, have confidence. Think that Sisyphus would be happy.”

Words that embody his own philosophy.

I felt like I knew what you were saying, but I also felt like I didn’t.

Are you suggesting we abandon perfectionism?

Or is it to be enjoyed?

Since patients will keep coming in anyway, does that mean that little things don’t matter?

I didn’t know exactly what he was trying to say.

The important thing is.

“There’s trouble. There’s trouble.”

Professors who mistake themselves for geniuses.

Since they were trying to continue to develop themselves, they had to start studying right away.