The Returning Doctor Wanted to Live Quietly - Chapter 371



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Episode 371. Decided to Live Quietly (3)

Hematoma.

hematoma.

A bruise.

Or a blood clot.

The names were varied, but the meaning was clear.

A condition in which blood has leaked out of a blood vessel for any reason.

Also, the large blood vessels (aorta, pulmonary artery, vena cava, etc.) and organs that lead to the heart.

And since it was located in the mediastinum where the bronchial tubes are, further investigation was required.

so.

“When was your last meal?”

“It’s not time to eat yet.”

“It’s past lunch time.”

“I’m not feeling well.”

“Then there’s no need for NPO (fasting). First, we’ll inject contrast agent and take a CT scan. That’s… … .”

The explanation went on for a long time.

Permission (consent) is obtained in an instant.

Whether to proceed with conservative treatment.

Or because I had to decide whether to have surgery.

So much time has passed.

As Jinhyeok and Jang Hyeokjun followed them to the CT room, the radiologist who had no idea what was going on belatedly tilted his head.

“What are those people?”

“These are doctors from other hospitals.”

“Another hospital?”

“Yes, because I am a doctor who provided emergency treatment at the scene.”

“Still, this is a bit… … .”

“First of all, the filming is urgent.”

The young German doctor, Dr. Levy, defended himself in a strange tone.

In fact, according to the rules, he should have been kicked out immediately, but this was a situation where his ability was confirmed.

I felt a little bad about being rude to someone who helped me create an impression.

The radiologist clicked his tongue slightly and turned his head.

“Okay, we’re going to start filming. Patient! Take a deep breath and hold it!”

CT rotating with a whirring sound.

The radiologist finished filming in an instant and went out the door and approached the patient.

“This time, the contrast agent will be added.”

“Oh, yes.”

“It might be hot. That’s just how it is.”

After a brief explanation, the radiologist returned to his seat and began to operate the computer.

He immediately shouted as he changed from non-contrast mode to contrast mode (photographing mode after contrast agent injection).

“Okay, take a breath and hold it!”

The filming ended in an instant.

As images began to flood into PACS.

The radiologist said.

“I will request a reading right away.”

“How long will it take?”

“Well. An hour? Two hours? I’m not sure.”

“hmm.”

“It’s reading time, it depends on how you push it.”

“Even if I push, they won’t accept it.”

“Well, you’re so laid-back.”

Jinhyuk immediately frowned when he heard gossip that wasn’t really gossip about a radiologist.

That makes sense.

The situation where Lee Hyun-ah and Jeong A-reum are waiting for them at a cafe.

Jinhyeok said in a hesitant tone, wanting to finish it off and go back quickly since it had already come to this.

“PLAV (right parasternal long-axis view) is the main one.”

“… … ?”

“You can see a hematoma.”

“yes?”

“About 3cm. No. It would be around 2.9cm.”

“What are you talking about… … . I didn’t even zoom in.”

The radiologist immediately burst into laughter as if he found it ridiculous.

Then he looked at Dr. Levy as if seeking his sympathy.

But when Dr. Levy, who had already heard the size through the X-ray image, said nothing, he frowned this time.

In the first place, it is impossible to allow doctors from other hospitals into the CT room.

His eyes were filled with reproach, as if he had done something useless.

but.

“Let me just check.”

Dr. Levy reacted unexpectedly and snatched the mouse away.

What followed was video selection.

He quickly flipped through the CT images taken from various angles, then immediately brought up the PLAV image on the screen.

Then the left end and the right end.

I started clicking on the very bottom and very top of the hematoma again.

Then the length is displayed on the screen.

The height is never stated exactly, but the major axis length is 2.93 cm.

When the sizes matched, the radiologist’s eyes grew so large that they almost popped out.

“Is it really 2.9cm?”

“… … .”

“I’ve never even zoomed in, so how can I… … .”

“That’s right… … .”

“Heh heh… … .”

“under…….”

Those who are at a loss for a while, their words trailing off.

That makes sense, from PSLA to PLAX.

The images from various angles were just in the bottom right layout. So they were just floating in the list.

But you just glanced at the image without even enlarging it and then guessed the size.

Something absolutely ridiculous was happening.

* * *

The patient had to be moved back to the bed, but the strange silence continued.

Even Jang Hyuk-jun, who was well aware of Lee Jin-hyeok’s skills, joined late.

“Come to think of it, what did you do earlier?”

“Huh? What is it?”

“No, I said it was 3cm just by looking at the Chest PA (an X-ray image taken from the back to the front).”

“Yes, it was.”

“They also said it was in front of the right ventricle.”

“yes.”

When Jinhyeok answered so calmly, Jang Hyukjun asked again, as if he was astonished.

“So you’re saying that you estimated its size just by looking at the X-ray image. You even estimated its location.”

“It’s just a feeling.”

“You mean a feeling? What the heck… … .”

“If you do it a lot, you will get used to it.”

“under…….”

Jang Hyuk-jun also let out a long sigh and shook his head.

The truth we miss while praising ourselves.

That means Lee Jin-hyeok estimated the size of the hematoma by only looking at the white shadows that looked like hazy smoke in the black shadows on the X-ray image.

Well, some people say that after servicing their vehicles a lot, they can tighten bolts to the specifications of a torque wrench.

Many doctors say that even if they just hold a scalpel in their hand, it feels like they are directly touching the patient’s skin.

This is absolutely ridiculous.

As he was just admiring it belatedly, Jinhyuk said.

“First of all, it is certain that the sternum is fractured linearly.”

“I think we can just watch that.”

“It’s just a fracture. It’ll just heal naturally.”

“What are you going to do about hematoma?”

“Well, I guess we’ll just have to watch it for now and see if its size decreases. And… … .”

“… … ?”

“I should first apologize to the patient.”

“ah…….”

Jang Hyuk-jun, who understood the implications of those words, sighed belatedly.

It is not uncommon for the sternum and ribs to break during CPR.

There was an implied suggestion that the hematoma was somehow caused by his own CPR.

* * *

They returned to Peter again.

Jinhyuk, who asked for Dr. Levy’s understanding, briefly apologized to the patient.

It is said that while performing emergency treatment, the sternum, an elongated bone that resembles a tie and is located in the center of the chest, was broken.

He said that the shock may have even caused a hematoma.

hereto.

‘Why are you apologizing for this? It’s like I saved your life… … .’

Dr. Levy looked at the Asian doctor for a long time with a puzzled look.

Minor problems that occurred during emergency treatment.

Rather than receiving words of thanks, it was not an occasion to apologize.

As expected.

The patient was surprised and didn’t say much, only saying thank you belatedly.

At this, Jinhyuk slightly bowed his head towards Dr. Levy and took a step back.

This is also a thank you to himself.

Dr. Levy bit his lip at the body language that expressed gratitude for opening up space to communicate with the patient.

To just ignore him, or rather to just disparage him as just another insignificant Asian doctor working at another hospital.

It was uncomfortable in many ways.

so.

“This is Doctor Levy.”

He introduced himself belatedly and extended his hand.

Jinhyuk smiled at this and also grabbed his hand.

“This is Doctor Jang.”

“Then this side… … .”

“You can call me Doctor Lee. I work with you at the Plattenbau Hospital.”

“I’m in my third year. Teacher… … .”

As Dr. Levy trailed off, Jinhyuk smiled brightly.

“It’s hard to guess our age because we’re Asian. We got the board.”

“ah…….”

“I think there’s something more to check.”

“yes?”

“I think we should do a TTE (transthoracic echocardiography) before doing emergency PCI.”

“Didn’t you suspect ST-segment elevation myocardial infarction (STEM)?”

“Yes, it was.”

Jinhyuk nodded his head shallowly.

Then Dr. Levy continued speaking quickly.

“Once the blood test results came out, I planned to consult a cardiologist right away.”

“It’s still a long time before the blood test results come out. It would be better to consult by taking a sonography and then sending it over.”

“hmm…….”

It was a valid point, but Dr. Levy vomited it out in a slurred voice.

A transthoracic echocardiogram clearly shows cardiac structures such as blood clots.

It might help you find out the cause though.

This is also a task that requires skill.

To be honest, I wasn’t confident.

* * *

When Dr. Levy went to see Professor Noh, Jang Hyuk-jun immediately started grumbling.

“If it were my kids, they would do it right away.”

“Well, since I strictly follow the work hours, I guess the learning curve is slow.”

“Well, this has its drawbacks.”

“But you grab the scalpel quickly instead.”

“Well, that’s true, but… … .”

Germany is different from Korea in many ways.

Instead of having the professor quickly stand in front of the operating table and take the lead, there was not enough time to practice the technique.

Insufficient working hours.

No, it was because the working hours in Korea were ridiculously long.

While we were talking like that.

Before we knew it, Dr. Levy had returned to the bed and was preparing to take an ultrasound of the heart.

It seems he got scolded after asking an old professor who was about to retire to do it for him.

Unlike abdominal ultrasound, the orientation marker was also on the right side.

It was a task that required a lot of attention.

First, lay the patient down in supine position.

Third from the left.

The probe was again placed in the fourth intercostal space.

First, let’s look at the PLAX view.

Simply put, the purpose was to view the heart from the right sternal aspect.

Click.

Click.

Click on the extension probe.

The patient’s position is then changed again and the probe is moved counterclockwise at a different angle.

AV level.

MV level.

Back to the midventricular level.

Up to the level of the heart.

While they were examining the items in order, Jinhyeok and Jang Hyeokjun started talking again.

Advice under the guise of a slanderer.

At first glance, it might have seemed offensive, but Dr. Levy was unexpectedly shameless.

Go down a little further and scan.

Or, they changed the mode when told to check for regional wall motion abnormalities due to coronary artery disease.

I didn’t hesitate to go back in time to check the papillary muscles.

After a while like that.

Everyone’s brains cracked at the same time.

“ST-segment elevation acute myocardial infarction (STEMI).”

It was the moment when the cause was clearly revealed.

* * *

“So what happened?”

Jeong A-reum’s question.

Jang Hyuk-jun wrapped the baby in a sling without answering and handed the baby over.

And then.

“Honey, you can look forward to it now.”

“Huh? What?”

“I’m going to be famous. You can look forward to it.”

“What did you say… … . So what happened?”

“Well, I went in for an urgent PCI (percutaneous coronary intervention). I’ll be discharged after observing the progress.”

“But why are you asking me to wait?”

“that is…….”

The explanation went on for a long time.

When Lee Jin-hyeok said that he was impersonating himself, both Lee Hyun-ah and Jung Ah-reum were shocked and opened their mouths.

It’s funny how I’ve decided now that I’m going to live quietly.

You mentioned someone else’s name.

Doctors are a really strange bunch sometimes.

Of course, I am a wife with a doctor husband who everyone envies.

When they were leisurely strolling through downtown Potsdam later on.

As Jang Hyuk-jun expected, Dr. Levy was moving.

First, a job advertisement for a doctor was posted on Stellenanzeige, which served as a sort of community.

[Is it true that you can determine the size of a hematoma just by looking at an X-ray image?]

└ After confirming that there was a hematoma by looking only at the chest PA image, we were able to pinpoint its size.

└ Stop joking, sir. You do realize that air appears as a shade of black, right?

└ I’m a doctor too. As you can see from the ranks, you can’t get promoted unless you’re a doctor.

└ Then what is this ridiculous question?

└ That’s… … .

The question-and-answer session went on for quite some time.

At the end, the comments started to flood in.

The reaction was enthusiastic.

It’s on a whole different level from 『Young Doctor』 or other communities in Korea.

It was typical of them to use their working hours strictly and scan job postings at every opportunity to escape to another country.

Their opinions narrowed down to one thing: nonsense.

So Dr. Levy wrote again:

[I’m uploading an X-ray image. Who is lying?]

└ How can you guess just by looking at this?

└ Did you measure the size by looking at the white shades clumped together?

└ X-ray images don’t appear in their actual size. They appear scaled down.

└ Didn’t you zoom in to 100% to see this?

└ Who is this? Who measured the size of this before even taking a CT scan?

The comments are going wild again.

Dr. Levy checked the business card Jinhyeok had handed him, then his face turned red and he began to write.

He himself couldn’t believe it, so he posted this.

But he treats himself as a liar.

It felt like the tables had been turned, but he was so upset that he pounded the keyboard hard.

[Doctor Jang, this is Hyukjun Jang. His Korean name is Jang Hyukjun.]