Chapter 20
Chapter 20
-----------------------------------------------------------------
Translator: crow
Chapter Title: Another Peaceful Day in the ER, ER, ER (1)
-----------------------------------------------------------------
After sending off the myocardial infarction patient, a brief peace settled over the emergency room. I was just sitting there in an empty chair, staring blankly with a look of utter disillusionment on my face.
I'd gotten double praise from cardiology and thoracic surgery.
Heh heh.
Oh right, I think shop points came in again earlier. Wonder how many this time. I was just about to check.
But the peace didn't last long.
"30s male patient, persistent vomiting!"
The ambulance crew's loud shout rang out as the ER's automatic doors slid open once more.
The stretcher wheels screeched down the hallway. On top lay a man who looked to be in his 30s, curled on his side clutching his stomach and groaning.
I jumped up reflexively and stuck by the stretcher's side.
"Are you conscious? What brings you here?"
The patient didn't have the energy to answer. He glanced at me once, then buried his face in the plastic bag and started retching violently.
"Uuueeeck!"
The paramedic standing nearby answered awkwardly in his place.
"According to the patient, he ate... a whole bag of dried seaweed tonight."
My brain froze for a second.
"..."
Did I hear that right? Dried seaweed? The stuff you soak and put in soup?
I asked again, doubting my ears.
"You ate dried seaweed?"
"Yeah... uuueeeck...."
The paramedic added pityingly.
"He said it was crunchy, so he just ate the whole bag like snacks."
I'd never heard a chief complaint like this in my life.
Dried seaweed gourmet.
Is this guy insane?
"So, what are his vitals?"
"BP 140/90 at the scene, pulse 110, respirations 24. Conscious and alert. Took 15 minutes to arrive on scene, and he's been vomiting nonstop during transport. About 25 minutes total since hospital arrival."
BP a bit high, tachycardia and tachypnea.
Classic response to pain and dehydration.
Not immediately life-threatening, but not something to ignore either. Ambiguous state.
"Sigh... Let's put him in Bay A for now."
Prolonged vomiting like this can cause severe dehydration and electrolyte imbalances.
So we moved him to a Bay A bed.
Once transferred to the Bay A bed, the patient curled up like a shrimp and kept vomiting.
I gloved up in latex and palpated his abdomen. It was distended all over, and he winced with every press.
'Is this a bowel obstruction?'
Worst-case scenario flashed in my mind.
Dried seaweed expands dozens of times when it absorbs water. That massive amount could be blocking the narrow small intestine after passing through the stomach.
If so, this wasn't just a funny mishap—it could be a surgical emergency needing immediate intervention.
"Doctor! I'll get two IV lines on this patient and order fluids. Also, abdomen X-rays supine and upright. And stat labs!"
***
A bit later, the X-ray results popped up on the monitor.
I scanned the screen intently for classic signs of bowel obstruction.
"No sign of it?"
The X-ray was clean.
Well, not perfectly clean—the stomach was dilated, but no other findings suggesting obstruction.
Bloodwork showed mild dehydration but otherwise normal.
Radiology read came back the same. No bowel obstruction.
Ah.
Not a bowel obstruction.
This is just...
The seaweed exploding like crazy in his stomach.
Not blocked in the intestines—from the stomach on down, it's already saturated.
The massively swollen seaweed pressing on the stomach walls, and his brain signaling his body to puke out the foreign material.
I gazed helplessly at the patient, still clutching his bag and heaving.
Sheesh.
Bowel obstruction my ass.
Better this way, honestly. If it were obstruction, we'd have to call surgery and raise hell, and the patient would suffer even more.
"Doctor... am I gonna die...?"
The patient asked between retches.
I looked pityingly at his desperate plea.
Die? Why would you die?
It's just a seaweed party in your gut.
Problem is, how to end the party.
First thing that came to mind: Levin tube. Shove a thick tube up the nose to the stomach, hook it to suction, and suck out the contents. Primitive but reliable.
'Could it work?'
I pictured it.
Me jamming the Levin tube into the patient's nostril.
Tube hits stomach wall, suction starts. But what comes up the tube won't be gastric juice.
Definitely gonna be slimy, slippery, unidentifiable green clumps of rehydrated seaweed. The moment those clumps clog the tube opening, the suction machine would scream and die.
Could scratch the stomach mucosa, maybe cause GI bleed.
End result? Disaster.
Patient in agony, me standing there dazed with a seaweed-smeared tube in hand.
This is beyond my pay grade.
Still, just to confirm, I stared into space for certainty.
Title: Yo, patient wheeled in after eating dried seaweed—can I gastric lavage with an NG tube?
Author: HellJoseonSlave1
The gallery exploded in mockery and veered into totally unexpected debate territory.
Anonymous (210.94): Holy shit, first time seeing someone eat seaweed and get carted to the ER lmao. Oh wait, I'm dead.
God's Scalpel: Seaweed chunks probably bigger than the tube diameter? Yeah.
HippocratesHeir: Seaweed? What is that. Seaweed? Why eat such a thing. Koreans are incomprehensible.
Re: BloodClotIsHell: Hey Yankee, what do you know? Kimchi and seaweed are delicious and good for you. Full of iodine and iron, cleans the blood right up.
Re: HippocratesHeir: Such profound benefits! Then this patient is a martyr who nearly lost consciousness in pursuit of health via seaweed!
Re: LatteIsHorsecrap: Martyr my ass. Just an idiot.
My hunch about the tube clogging was confirmed, and reality hit hard watching these otherworldly docs bicker pathetically.
...Sigh. Call GI?
Yeah. This is their turf.
GI docs have endoscopes. They can go in with the camera, assess the seaweed field, and yank it out with fancy tools.
But a first-year intern calling the GI on-call for "patient ate dried seaweed like snacks and is puking" without even trying an NG tube?
Lucky if I don't get cussed out over the phone.
In the end, I went with the most traditional, safest option.
'Senior SOS.'
I left Bay A and scanned the station.
Fourth-year Yoo Sung-hoon was there, charting and rubbing his stiff neck.
I approached with my best pitiful, serious, urgent face.
"Senior."
"What."
Yoo Sung-hoon replied in his usual chronic-fatigue voice.
"Bay A-3 has a 30s male with vomiting. Weird case, so reporting."
"Weird how. Another drunk blackout asshole?"
"No, not that... Patient says he ate a whole bag of dried seaweed like snacks."
"..."
Yoo Sung-hoon's movements stopped.
Then he slowly turned to look at me. A faint "What did I just hear?" flickered in his eyes.
"What'd you say?"
"Dried seaweed. The dry kind. Ate a whole bag, now nonstop vomiting and abdominal distension. Thought bowel obstruction at first, X-rayed—no abnormal findings."
I reported as calmly and medically as possible.
When I finished, Yoo Sung-hoon went silent for a moment.
Then he let out a short "Ha," chuckled, and stood up.
"Let's go see."
He headed to Bay A to check the patient himself.
I followed.
Yoo Sung-hoon palpated the patient's still-heaving abdomen a few times, listened with his stethoscope, then turned to me with a resigned look.
"Levin tube?"
"Figured it'd clog, so held off."
"Good call."
Short praise, then back to the station for the phone.
Calling GI on-call.
I eavesdropped breathlessly from the side.
"Hello, doctor. This is fourth-year Yoo Sung-hoon from emergency medicine. That you on GI call?"
"...."
"Yes, doctor. We've got a patient in the ER with a bizarre case—might need you to take a look."
"...."
When the fellow asked what, Yoo Sung-hoon hesitated, then confessed.
"Patient ate a whole bag of dried seaweed raw."
"..."
"Yes, doctor. Not soaked—just like snacks. The whole bag."
Yoo Sung-hoon's brow furrowed slightly.
"Yes, I know, doctor. Doesn't make sense. But he's here puking nonstop. X-ray rules out obstruction, but stomach seems totally backed up. Wondering if endoscopy could handle it."
After a long call, Yoo Sung-hoon said, "Yes, understood, doctor. We'll wait," and hung up.
Then, setting down the receiver, he turned to me.
"Ha... weirdos everywhere. GI doc's coming down. Follow along for the endoscopy later. Sight you won't see twice in your life."
Of course, not literally to observe the scope. Just emphasis on how absurd it was.
***
Soon after, a thoroughly pissed-off GI fellow arrived.
He glanced at the patient, then said with the same resigned look Yoo Sung-hoon had worn.
"Prep for endoscopy. Gastric lavage won't cut it. Gotta go in and pull it out."
In the end, the patient was carted off to endoscopy under the unprecedented diagnosis of "suspected upper GI obstruction due to acute dried seaweed ingestion."
I watched blankly and thought.
The ER really gets every kind of person imaginable.