The Returning Doctor Wanted to Live Quietly - Chapter 374



Only Noblemtl

Episode 374. Decided to Live Quietly (6)

Charité Hospital main building.

Since I arrived earlier than the appointed time, I just waited in silence.

Then, Jinhyeok suddenly became suspicious and turned his head towards Jang Hyukjun.

“But why are you so serious?”

“What is it?”

“You’re always cheerful and act like you’re ready to quit at any moment. Now you’re getting all worked up over nothing.”

“It feels a little strange?”

“yes.”

“hmm…….”

Jang Hyuk-jun did not answer right away and waited for a long time.

It seems like an unexpected question.

He opened his mouth late.

“It makes me mad that they keep doing that. And also… … .”

“And what else?”

“Just um… … .”

“… … ?”

“Oh, I don’t know. I don’t know.”

You’re losing your temper for no reason.

It seems he also couldn’t find the reason.

Live however you want.

Spending money like water.

He is true to his feelings.

It may also be true to the present to argue with Charité Hospital.

A person who lives as his heart desires.

That was Jang Hyuk-jun.

When Jinhyuk laughed, he asked back.

“That teacher. This teacher is the same.”

“What am I?”

“You made so much noise. Now you say you want to live quietly.”

“That’s, um.”

“See? This teacher has nothing to say either?”

“That’s right.”

Jinhyuk also couldn’t answer properly and just looked up at the ceiling.

okay.

Perhaps he himself was also being faithful to the present.

On the topic of doctors, I didn’t even use contraception.

There were also many cases where they would act however they pleased when they were told to.

This is all because of regression.

It was possible because I only lived twice.

* * *

Amilon and Nakamura came down shortly after.

The greetings continued with a brief introduction.

There should have been no special events.

When I go to conferences or training sessions, the first thing I always do is say hello.

It was really a breeze to get to know strangers and network in case something unexpected happened.

But.

Kwaaaaak.

Kwaaak.

Shake hands with a lot of force.

Shusuke Nakamura too.

Jang Hyuk-jun too.

I used so much force that my face turned red.

When they wouldn’t let go of my hand.

Jinhyuk clicked his tongue.

It’s like a little kid holding a magpie’s cradle and claiming he’s bigger than me.

It just seemed like a childish prank.

so.

“Please stop.”

“If you put it down over there first.”

“Who would say that… … .”

“Let go first.”

“From you.”

I tried to dissuade them, but I had to watch them bicker for a long time.

Meanwhile, when Amilon also came to shake hands, Jinhyuk shook his head.

“The handshake is done.”

“Okay, let’s shake hands. How about we provide second assistance?”

“What kind of surgery is it?”

“yes?”

“We don’t have any patient information. We don’t even know what kind of surgery it is.”

“You are in a hurry.”

“Well, this is too basic.”

A phrase used to describe something that goes against convention.

An invitation surgery is something that requires you to inform us of various things in advance.

But I didn’t hear anything.

Even if it is a place to test themselves, it is not good for the patient.

That behavior was annoying.

* * *

I thought I would be headed straight to the ward or the rosette.

But the first place we headed to was the old building.

This building was built 300 years ago.

The exterior walls were clad in red bricks.

The vine boasted thick roots.

That’s not all.

The uniquely shaped windows clearly showed the passage of time.

Deep-rooted history.

You can feel it just by looking at the exterior.

After looking around the old building, we went to see the garden.

As he passed through the garden connecting the main building, which was a modern building, and the old building, Jang Hyuk-jun grumbled.

“We have a long history. I guess that’s what they want to brag about.”

“That’s childish.”

“That’s right. They’re not even real kids. What the hell are they doing?”

“Just endure it for now. Once you show your skills, that’s it.”

“But it still feels real.”

As Jinhyeok and Jang Hyukjun started talking in Korean, Nakamura suddenly intervened.

“You belong to a hospital, right?”

“yes.”

“How long has it been there?”

“yes?”

“I worked at the University of Tokyo Hospital and then came to Charité Hospital as an exchange doctor. Our University of Tokyo has been around for about 120 years.”

Random remark.

Jinhyuk answered half a beat late.

“As you know, the hospital opened in 1989. It hasn’t even been 15 years yet.”

“1989?”

“yes…….”

Nakamura Shusuke was startled by Jinhyuk’s answer.

The response was, “Has it only been 15 years?”

What followed was small talk.

How good is the University of Tokyo Hospital.

How many SCI-level papers are published each year?

There was a lot of bragging about this and that.

Jinhyuk didn’t say much to this.

Because he seemed to not know anything about himself.

Just show me what a ridiculous privilege it is to regress.

No, all that was needed was to perform the surgery successfully and discharge the patient properly.

* * *

At the end of the tour, we arrived at the general surgery conference room.

Chief Amilon stood in front of the screen.

“The patient is a 49-year-old male. He presented with portal hypertension and was found to have a tumor in his bile duct.”

“A history of diabetes, hypertension, tuberculosis, myocardial infarction, and stent placement was also confirmed. There is also a history of endoscopic submucosal resection for gastric adenoma.”

The explanation went on for a long time.

Jinhyeok and Jang Hyukjun frowned.

That makes sense.

A patient in the prime of life.

The condition was serious for his age.

At that level, you could call it a walking general hospital!

Jinhyuk muttered as if talking to himself.

“I think it’s more of a lifestyle issue than genetics. Eating habits and such. Hmm.”

As soon as he finished speaking.

Amilon continued the briefing.

“I have been smoking for over 30 years. I enjoy beer and wine every day.”

“I guess you didn’t even exercise.”

“I traveled short distances by car. I didn’t ride a bicycle either. It was also a big deal that I had an office job.”

“hmm.”

“Let’s look at the chart first.”

The screen changes and various test results appear.

As well as the basic blood test results, it was confirmed that there was a tumor inside the bile duct.

Gamma-glutamic acid dehydratase.

Alkaline phosphatase.

Tumor marker levels.

And even the CEA numbers.

A series of numbers related to liver, bile duct, and biliary tract diseases were displayed.

Jinhyuk, who had been looking at this with a serious expression, tilted his head belatedly.

“Wait, wait. It’s been three months since I first came in.”

“What’s the problem with that?”

“The stomachache must have been severe. Why did you only do pain control? Why didn’t you go into surgery right away?”

This is because contextual hypertension can also cause abdominal pain.

Amilon answered a little late.

“The surgery schedule was pushed back. Pain control was also done properly. It was just a little uncomfortable. It wasn’t like he was complaining of severe pain.”

“Still, it’s been delayed for three months.”

“To this extent, it can be said to be a normal schedule.”

“under.”

Jinhyuk, who knew it well but couldn’t hide his shock, clicked his tongue briefly.

The same goes for Jang Hyuk-jun.

Contextual hypertension.

The large vein (portal vein) that carries blood to the liver was exceeding normal pressure.

As a result, other blood vessels also developed problems.

Even the bile duct and biliary tract were not affected.

But they delayed it because the schedule was behind schedule.

Something that would never happen in Korea.

No, that was ridiculous.

In the case of a refund, even a non-existent schedule is added.

Isn’t it the Korean medical community that forces nighttime surgery to save patients?

* * *

In fact, it wasn’t just Germany’s problem.

Canada was like that too.

In other countries that are considered advanced countries, surgery schedules are also scheduled much later.

so.

“What’s the problem? Why do you look like that?”

It’s natural for Amilon and Nakamura to be puzzled.

Jinhyeok waved his hand, not wanting to explain how good Korea’s medical accessibility was.

“Okay. Show me the video.”

“Let’s look at the ultrasound image first.”

“When was this taken?”

“This was taken this morning.”

The screen changes again with a clicking sound.

At this, Jinhyeok and Jang Hyukjun bent down towards the screen.

“My liver is fibrosed.”

“It’s so huge.”

“It also shows a unique pattern. It’s incredibly messy. It’s the worst.”

A short evaluation is given.

Fibrous liver.

The echo was messy.

In a word, it was noisy.

Next up was an abdominal CT image.

The enlarged liver did not appear significantly different from the ultrasound image.

The most crucial issue, of course.

There is a problem with the bile duct that carries bile produced in the liver.

A spot that appears to be a tumor inside the bile duct.

So there was a black shade with a white border surrounding it.

Its size was also huge.

Jinhyuk asked with an even more hardened expression, as he had never thought it would be this big.

“Of course you did a biopsy, right?”

“The pathology test results showed no malignant cells. However.”

“but?”

“Inflammatory cells were observed. Strictly speaking, there is no evidence of malignancy, but imaging studies cannot rule out the possibility of hilar cholangiocarcinoma.”

“So, let’s just cut it down for now?”

“yes.”

This is said because there are limitations in diagnosing lesions in the bile duct through tissue or cell examination.

If it was cancer, the recurrence rate after surgery was over 88 percent, so Jinhyuk started to get a fever.

“I also had ERCP (endoscopic retrograde cholangiopancreatography).”

“yes.”

“I also had a biopsy.”

“yes.”

“You also did a brush cytology test. It’s not clear if it’s cancer or not. That’s why you invited us?”

Let me repeat what he himself said.

Amilon and Nakamura Shusuke looked puzzled.

A face that seems to lack understanding.

Having only been a resident for three years, he looked like he didn’t know what was going on.

but.

“After all, this isn’t a patient you can mess around with. What are you doing now?”

Jinhyuk, with his face hardened, shot back strongly.

Their expressions also hardened.

* * *

“Why are you angry?”

“Are you asking because you don’t know?”

“This seems like a rash.”

An attitude that says you have no idea why things are like this.

Jinhyuk kept arguing for a while.

It would have been better if the surgery had been done at the time when Jang Hyuk-jun was being presented with a difficult problem.

He said that saying that it was because of a tight schedule was not an excuse.

In strict accordance with his own common sense.

Of course, it goes without saying that Jang Hyuk-jun also helped.

He also had a dumbfounded expression on his face, not knowing that the tumor would be this large.

“I should have had the surgery in time to send you a picture of the empty lunch box.”

When Jang Hyuk-jun lost his temper over the patient who had been neglected, Amilon shrugged his shoulders.

“I exchanged emails during breaks or after-hours. The surgery in question takes at least 6 hours, and up to 8 hours.”

An excuse that isn’t an excuse.

He said that they themselves could not do it. He also said that it was a surgery that needed to be done by a specialist.

In addition to that.

“The surgery was originally scheduled for six months later.”

“You shortened it by 3 months with an invitation surgery?”

“yes.”

After saying that, I couldn’t ask any more questions.

okay.

Perhaps this is only possible in the Korean medical community, where interns, residents, and fellows are treated like slaves.

* * *

Questions about several complications that may be observed only in patients with contextual hypertension.

Was there any extrahepatic portal vein occlusion?

The venous system surrounding the bile duct is developed and there is no cavernous change.

How was the fibrotic scar determined?

The anesthesiologist was questioned in detail about who he was.

It wasn’t like American hospitals where they would just kick you out if you didn’t have money.

Do everything you have to do.

Play around with everything.

Those who don’t work hard.

Of course, I couldn’t criticize them all, but they were completely different from the surgeons I’d seen in Korea so far.

So, I had to do my best first.

So two hours later.

After the pre-op is over.

The anesthesiologist came in.

In addition, the observation room was bustling.

Jang Hyuk-jun said.

“I’d rather have the surgery done quickly than have to wait and see.”

A situation where I still can’t control my emotions.

Although this has never been the case in places like Plattenbau Hospital, where patients don’t visit often.

A place that makes me so angry that I saw it with my own eyes.

In a place where they could not understand each other until the end, Jang Hyuk-jun picked up a scalpel and shouted.

“Cholecystectomy begins now!”