Chapter 16
Chapter 16
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Translator: crow
Chapter Title: Lesson
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Right after the conference wrapped up, I headed straight to the emergency room.
I spent the time handling various minor cases.
A college student who scraped his knee falling over drunk, a guy who came in for a tetanus shot after getting scratched by a cat, and...
Today's first problem patient made his entrance.
A perfectly healthy-looking middle-aged man showed up with a super serious expression, claiming that his back had been hurting since last night. He'd Googled it, and all his symptoms matched end-stage pancreatic cancer.
"As far as I know, pancreatic cancer has a five-year survival rate under ten percent, right? Am I dying now? Run a CT, MRI, and whatever that P-something CT is. Do the cancer marker tests too."
I pressed my temple hard.
*This isn't some middle-aged guy's health check center.*
My inner demon roared, but on the outside, I flashed a gentle smile.
"Sir, let's start with basic blood work and an X-ray, then we'll talk. The most common cause of back pain is muscle strain."
"No, Doc! You don't believe me? Do you know how much I researched on the internet?"
After a 30-minute back-and-forth, I finally showed him the normal blood results, and he grudgingly got up.
As he left, I clearly heard him mutter, "The doctors here suck. Guess I'll try another hospital."
Good luck to whatever poor soul's on duty at that other hospital's ER.
***
Lunchtime.
I hunkered down in the corner of the lounge and poured hot water into my cup ramen. Kim Ji-hoon plopped down next to me and let out a deep sigh.
"Hey, I saw the director smile at you. That was a first. You really switching to internal medicine?"
"No."
"Bullshit!"
This guy wasn't listening to a word I said.
***
Colds, gastroenteritis, headaches, dizziness.
And interspersed among them, the problem patients.
By the time the sky outside darkened, I stared blankly at the EMR screen for a moment.
It was still packed full of patient names.
Ha, I'm exhausted.
Where did my day off go?
I'd gotten robbed of yesterday entirely.
But in exchange, I survived today's conference.
Was this a good trade?
Who knows.
Human update: ER's new star. The lunatic prepping for double boards.
All sorts of shitty labels stuck to my name, but reality hadn't changed. I was still a first-year intern.
"Aaagh! Doc! My back! My back feels like it's snapping in half!"
Bed 15, Zone B.
A guy in his mid-30s was rolling around on the bed, screaming his head off.
"Sir, try to calm down. Where exactly does it hurt, and how?"
"I don't know! Just! Just my back feels like it's breaking! Aaagh! I think my old herniated disc burst! Please, give me something strong for the pain...."
The guy was practically in tears, looking like he'd grab my pant leg any second.
I pressed on his back and legs, running a neurological exam.
No clear signs of weakness or sensory loss.
But the guy's face was desperately pained.
"That stuff I got before... Pethidine, right? It helped a bit. Can't you give me some of that? Please?"
I pressed my temple hard.
I ended up back at the station, sitting at the computer. I pulled up the guy's chart and opened the order screen.
[Pethidine 50mg IV]
My finger hovered over Enter.
Really?
Is it okay to just give it like this?
Something felt off. Unsettling.
Was it my instinct as a doctor, or my survival sense as a slave?
*Fuck it, I don't know. Let's check it out.*
I pulled up the blue interface in my vision.
This wasn't something I'd ask a senior about, so the gallery felt perfect.
Title: 30/M Severe low back pain. Claims disc history. Demanding Pethidine. Okay to just give?
Poster: HellJoseonSlave1
The comments were quiet.
The internal medicine ghosts didn't care about pain patients like this, and the surgeons were the same.
Eh, fuck it.
Just give it.
As I moved my finger back to Enter—
God's Scalpel: You check DUR? (*Drug Utilization Review, med safety service)
DUR.
Ah.
Fuck.
I muttered curses under my breath and frantically pulled up the DUR. A new popup filled the screen.
And I couldn't believe my eyes.
[Rx: Pethidine Inj | Date: 3 days ago]
[Rx: Fentanyl Patch | Date: 4 days ago]
[Rx: Oxycodone ER Tab | Date: 1 week ago]
[Rx: Tramadol ER Tab | Date: 8 days ago]
The screen overflowed with opioid prescriptions.
This bastard had been hopping hospitals for the last ten days, scooping up every narcotic painkiller he could.
Doctor shopping, plain and simple.
I slumped back in my chair, feeling the strength drain from my body.
These other docs handing out opioids without checking... No, it must mean his act was that convincing.
New comments started popping up on my post.
Anesthesiology Pain Medicine: LMAO caught him. Classic addict move. Those guys hit every hospital and memorize the names of docs who prescribe easily. They become regulars once they spot a sucker.
Psychiatry Ghost: That's past dependence—full-blown addiction. Needs psych.
Truck Hit Guy: Wow, faker scores fentanyl with fake symptoms. I got run over by a truck, whole body mangled, and they gave me Tylenol. World's so fucking unfair.
ㄴ Anon (223.39): For real? Got Tylenol?
ㄴ Anesthesiology Pain Medicine: Bullshit lol
I broke into a cold sweat reading the ghosts' stories.
If I'd hit Enter without checking DUR?
I'd have added "Sucker Doc Han Hyun-woo" to this addict's shopping list.
My senses sharpened. I moved the mouse to close DUR and delete the order.
"Huu...."
That's when it happened.
A massive shadow loomed over my back.
"What're you doing?"
No idea when he'd snuck up, but fourth-year chief resident Lee Min-jae stood there, arms crossed, staring down at me. His eyes locked on the computer screen where I'd almost placed the order.
I'm screwed.
"Trying to give Pethidine?"
"This easily? No DUR check, no real thought on the patient's condition—just handing out whatever they demand, easy peasy? This is why first-years can't have authority...."
I couldn't say a word.
*No, that's why I checked! Asked the gallery, saw the DUR, realized he's an addict, was about to cancel the order!*
My inner scream wouldn't come out.
To the chief, I looked like a thoughtless first-year who'd fallen for the addict's act and nearly prescribed narcotics, caught at the last second.
And half of that was true. Without the gallery, I really would've hit Enter.
The chief's scolding was long and brutal.
"The ER isn't a flea market. Not a vending machine spitting out whatever patients want. Get your head straight?"
"Sorry."
"Every order you place needs reason, evidence, and responsibility. If anything feels off, check it. Check again. Ask a senior. Still unsure? Hit the textbooks."
"..."
"DUR takes under 30 seconds."
After the storm of nagging, the chief sighed deeply and turned away.
"Don't let this happen again. Got it?"
"Yes. I'll keep it in mind."
Even after the chief vanished from sight, I stood frozen in place for a while.
Humiliating. Unfair.
But a thought crept in.
I'd been treating the gallery like an all-purpose cheat key.
Stuck? Post a question. Get an answer? Parrot it back.
Skipping the most crucial step: thinking like a doctor.
Doubting. Pondering. Finding evidence. Verifying.
"Ah. Gotta stop living on autopilot."
I muttered softly in the empty station.
***
After that day, subtle changes crept into my ER life.
Still shitty and exhausting as ever, but I decided not to rely on the gallery for everything. Trust my brain, my hands, my eyes first.
Of course, it wasn't smooth sailing.
A kid on an ER bed was crying. His forehead sported a nice 2cm laceration.
I reassured the mom, cleaned the wound, and numbed it with lidocaine.
Then, with a senior watching, I picked up the suture kit. My heart fluttered a bit.
*It's fine. Practiced all night.*
One stitch at a time, slow but careful, just like God's Scalpel taught.
No tangled threads or fumbling fingers like before.
Still clumsy, though. Fourth-year Yoo Seong-hoon watched my hands, clicked his tongue, and chimed in.
"Hey, you're tying the knots too tight. It'll scar bad when it comes out. Just enough to hold the thread."
"Oh, right! Got it!"
I adjusted the tension as advised.
After 15 minutes, I finished the suture on my own.
Yoo Seong-hoon patted my shoulder as he passed.
"Not bad, at least."
That casual remark made me grin without realizing it.