Chapter 61
Chapter 61
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Translator: crow
Chapter Title: A One-Star Amusement Park (4)
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“…Hey, Hyunjae.”
A cautious voice came from behind me.
It was Lee Min-jae.
“Yeah, sir.”
“How did you know?”
“Oh… um… well…”
My mind went blank for a moment.
What should I say?
‘A dead ghost living in my head told me’?
“Tell me. It’s fine. I’m just curious.”
“Well, you see… At first, I considered other possibilities too. But…”
I paused for a bit, pretending to recall the earlier situation.
“The meal history with the spinach and carrots that the patient’s guardian mentioned, and the child’s obvious cyanosis—I was trying to connect them somehow. Then I glanced at the oxygen saturation level and it hit me.”
“Hmm. Because it was 85%?”
Lee Min-jae asked.
That’s right.
“Yes. That number was just too suspicious. A pulse oximeter should normally show readings very close to the actual arterial blood oxygen saturation. But in methemoglobinemia, no matter what the real saturation is, the machine tends to freeze around 85%.”
“Hmm, yeah, that’s true. A limitation of the pulse oximeter. But still, this is super rare, right? I’ve only read about it in books—this is my first time seeing it in person.”
“Yes, that’s what I knew too. In Korea, it’s reported in fewer than five pediatric cases per year. Mostly in infants who’ve eaten baby food or drunk contaminated water.”
Of course, it was all complete bullshit.
There’s no way I’d know that.
I just made up a plausible number since it’s rare.
But my overly specific answer completely erased the last shadow of doubt in Lee Min-jae’s eyes.
“…You even know that much?”
Yeah, that’s how you hook ’em.
If you act like you know it this perfectly, no one will suspect you.
They’ll just assume you’re some insane study freak who pulls all-nighters poring over papers and memorizing incidence rates for every rare disease.
Lee Min-jae stood up from his seat.
“…You really belong in the ER.”
“Haha, you think so?”
I gave an awkward smile and scratched the back of my head.
He’s not making a fuss today.
“Hey.”
“…Yeah?”
“You…”
Lee Min-jae grabbed both my shoulders.
And started shaking me like crazy.
“You little shit!!! You’re the real deal!! The real fucking deal!!!”
The fuss had finally begun.
“While I was barking up the wrong tree! You! You were already seeing the truth way over there!!”
Lee Min-jae showered me with praise using exaggerated gestures and voice.
The nurses and interns glanced at us with looks that said, ‘Here he goes again.’
“Uh… yeah, yeah…”
The enthusiastic shaking was starting to rattle my brain.
“You’re not just a genius! You’re… you’re a medium! A shaman of the ER who sees the souls of diseases in dying patients’ symptoms that we mortals can’t spot!”
Shaman? What the hell is that nonsense.
Well, it’s not entirely wrong…
Someone please come drag this guy away.
“Anyway, good work. ER shaman. I’m off to see other patients.”
I was left alone in the now-empty resuscitation room, mulling over Lee Min-jae’s parting words.
Shaman…
That’s why I hate overlapping shifts with him.
Of course, Lee Min-jae is a competent doctor.
As a fourth-year resident.
As a chief resident.
His judgment and skills are beyond question.
But his problem lies elsewhere.
He’s too hot-blooded.
I stared blankly into space, recalling next month’s schedule.
Please.
Please keep this guy away from me.
***
That’s how countless patients passed through my hands.
“Doctor, the kid swallowed a coin!”
X-ray showed a round 100-won coin smack in the middle of the esophagus.
I explained that it needed to be removed with an endoscope.
“My head’s split open!”
A five-year-old who’d tumbled down.
I played cartoons for the kid, applied local anesthetic, and stitched up three cuts.
“Fever… the fever’s spiking again!”
A kid whose temperature wouldn’t drop below 38.5°C even after antipyretics.
Flu test, IV fluids, and a urine test to rule out possible UTI.
Drowning in kids’ cries and parents’ sighs like that, time flew until the clock neared 3 a.m.
“Hyunjae!”
A nurse at the station called me urgently.
“A 15-month-old boy fell from his walker after it caught on something. Since then, he won’t put any weight on his left leg and keeps crying…”
“Huh? Got it. On my way.”
I set down my mix coffee and hurried to bed C-7.
Walker fall. One of the most common mechanisms in pediatric orthopedic trauma. But ‘won’t bear weight’ always set my nerves on edge.
A little boy on the bed was crying his face red.
I reassured the parents first, then approached the child.
“Let the doctor take a look. It’s okay.”
I soothed him as gently as possible and carefully examined his left leg.
Visually, nothing seemed wrong.
No swelling, no bruising, no deformity like a broken bone twisting the leg.
Just a perfectly normal baby leg.
I very gently started pressing with my fingers.
Thigh.
Fine.
Knee.
Fine.
Ankle… fine.
And then the tibia.
The moment my finger lightly pressed the tibia.
“Waaaaaah—”
The kid started bawling.
Found it.
Classic tenderness from a hairline fracture in a bone that looks fine on the outside.
Toddler’s fracture.
In kids with soft bones, a fall or twisted foot can cause a spiral microfracture in the tibia.
I explained to the parents that we needed an X-ray.
Then I returned to the station and reported to Lee Min-jae.
“Sir, suspect toddler’s fracture in C-7 patient. Ordered tibia/fibula AP/lateral views (*front/back and side shots of shin and calf bones).”
Lee Min-jae, who was reviewing charts for another minor patient, tilted his head.
“Even an X-ray? No swelling, right? Can’t we just do a soft cast and pain meds? Overkill?”
Exposing a seemingly fine kid to radiation for an X-ray could look like over-treatment.
But I was confident in my diagnosis.
“The tenderness is too clear. Doesn’t feel like just a sprain.”
“Right! Our genius is different! Yeah! Eyes that see the unseen! Divine sight piercing to the tiniest bone cracks! Good! Go ahead and shoot it!”
Lee Min-jae once again dove into his own world, marveling and convincing himself.
Whatever, works for me.
Results took about 15 minutes.
I sat in the chair and closed my tired eyes.
Yawn.
A massive yawn tore at my mouth.
‘Well, my bones broke a lot when I was a kid too.’
Back in elementary school, I was the VVIP at the neighborhood ortho clinic.
Jumping off a wall—broke my arm. Playing soccer—broke my ankle. Bike crash—cracked my clavicle.
White plaster bandages wrapped like casts on my arms and legs were my childhood trademark.
Giggling at friends’ graffiti on the casts.
The musty smell of plaster poking my nose.
I didn’t know back then.
How much more my parents’ hearts must have hurt, racing to the hospital with my broken bones, than the pain of the breaks themselves.
Maybe becoming a doctor is learning the weight of others’ pain by overlaying it on your own past like this.
Lost in thought, an alert popped up on the EMR screen.
X-ray complete.
Lee Min-jae and I headed to the station monitor together.
The screen showed the small, white tibia of the 15-month-old.
“Let’s see…”
Lee Min-jae clicked to enlarge the image.
He scanned the bone contours from top to bottom meticulously, then let out a deflated laugh.
“Hyunjae. Look at this.”
He nodded at the monitor.
“Clean as can be, no fracture line. Just a stretched ligament. What’d I tell ya? Even geniuses mess up sometimes! Haha!”
He was right.
The bone on the monitor looked pristine to anyone.
‘No injury after all. Still, relief…’
I let out a sigh of relief.
The embarrassment of being wrong paled next to the relief that the kid wasn’t badly hurt.
Sure, I’d made a fuss for nothing and tired out the kid and parents, but no harm done was a hundred times better.
I was about to go tell the parents the bones were fine, suggest a soft cast and watch for a few days.
As I turned—
…Hold on.
I grabbed the mouse and zoomed the image max.
Then adjusted brightness and contrast.
The screen darkened, then flashed white.
Bone edges blurred, then sharpened.
Just below the knee, at the end of the tibia.
The faint area near the growth plate where cartilage meets bone in a growing kid’s skeleton.
There, a line too vague to call a fracture.
‘What’s this?’
A shadow? Or just normal shading from growth?
I tilted my head and zoomed further.
But the more I looked, the more confusing it got.
I tried to let it go, but the nagging feeling held me back.
In the end, I turned to my last resort.
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Title: 15mo boy won’t bear weight on leg after fall, X-ray looks like this. What is it?
Poster: HellKoreaSlave1
Looks fine visually, just tenderness, but X-ray shows something weird at the very end of the tibia right below the knee. Not a fracture line, kinda looks smudged? Normal finding? Or some other thing I don’t know?
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The first reply to my post wasn’t from the bone fanatic, but an unexpected figure.
PediatricsGhost77: Report it.
The moment I saw that comment, a chill ran down my spine.
Suddenly felt fucking cold.
What?
Some rare bone disease?
New contagious outbreak?
That’s why report to the Korea Disease Control Agency?
With shaking hands, I replied.
ㄴ HellKoreaSlave1: ?? What? Like a sign of some contagion? Report to KDCA?
ㄴ PediatricsGhost77: Not KDCA.
ㄴ PediatricsGhost77: Police.
……Police?