Chapter 88
Chapter 88
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Translator: crow
Chapter Title: Tutoring (3)
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“......Six cans?”
For a second, I couldn’t believe my ears.
This twenty-year-old kid had chugged six cans of energy drinks—or whatever they were—in the dead of night for exam studying?
Did he still have a liver?
No, did he still have a heart?
Tachycardia, sure, but the cause was obvious.
Caffeine overdose.
I let out a quiet sigh.
The worst disasters you face in the ER usually hit when you can’t pinpoint the cause or do a damn thing about it.
At least this one had a clear origin.
Right then, Baek Eun-seo came rushing up, panting hard.
An intern trailed behind her, dragging the EKG machine.
“Doctor! EKG’s here!”
“Yeah, okay. Good work.”
I gave Baek Eun-seo’s shoulder a light pat.
“Eun-seo, let’s move the patient to Bed B in section B for now. Section A’s too good for this. There’s an empty one in B—get him settled there.”
“Start an IV while you’re at it and give him a liter of saline. Normal saline.”
“Ah, got it!”
Baek Eun-seo hurried off to guide the patient to the bed.
“Kid.”
“Y-Yes... Am I dying? Is my heart gonna explode?”
“Right now, it looks like you drank way too many energy drinks. Downing that much caffeine would be weirder if your heart *didn’t* freak out. A rate of 160 is par for the course.”
The patient’s face shifted from terror to embarrassment and confusion in an instant.
“Oh... so... I’m okay?”
“We’ll see from here on out.”
I got the patient settled on the bed and headed back to the station.
I grabbed the EKG strip the intern had printed.
Baek Eun-seo was already glued to my side, peering at it intently.
I tapped the paper with my pen.
“Alright, take a look. What do you see?”
“Sinus tachycardia.”
“Right. Sinus tach.”
I let out a big yawn and set the paper down on the desk.
I pulled back the curtain to section B where the patient lay and approached him.
“Hmm, no major heart issues for now. Not like an acute coronary blockage or myocardial infarction kicking in. Think of it as your heart throwing a massive panic attack.”
“Oh, really...”
Baek Eun-seo asked cautiously, like she was double-checking her textbook knowledge.
“Doctor. I have a question.”
“What?”
“What if the heart’s beating so fast that the P wave overlaps with the T wave and you can’t tell if it’s sinus tach or PSVT? They’re both narrow QRS tachycardias, so...”
*Oh. Good question.*
I was quietly impressed, even through the fatigue.
“When the heart rate hits 150-160, the P wave gets buried in the T wave and vanishes. So you can’t differentiate if it’s sinus tach with hidden P waves or PSVT where the P’s are messed up from the start.”
“Yes! So what do you do then...”
“Just use adenosine.”
I pointed at the crash cart.
“Ah! Not for treatment!”
Baek Eun-seo’s eyes lit up.
“Exactly. Diagnostic purposes. It shuts down the AV node* (*atrioventricular node) for a few seconds.”
I snapped my fingers.
“Picture this: You push 6mg of adenosine into a confusing tachy patient. The tachycardia stops, then normal rhythm returns? That’s PSVT. The reentrant circuit through the AV node got zapped by the adenosine. Diagnosis confirmed.”
“Wow...”
“Case two: You push adenosine, and boom—sawtooth waves appear. F waves, right? Atrial fibrillation. Blocking the AV node lets the chaotic atrial activity shine through.”
“Scenario three: Adenosine slows it briefly, then it speeds up again. But during that slowdown, P waves are still marching right in front of every QRS. What’s that? Pure sinus tachycardia.”
“Oh... adenosine...”
“This patient’s cause is blatantly caffeine. Diagnosis is clear: sinus tach. Pump fluids and monitor.”
Just then, the patient called out from the bed in a shaky voice.
He’d clearly overheard our whole chat.
“So, Doctor... can I go home right now...?”
Baek Eun-seo and I both turned to look at him.
I stared blankly for a moment.
“...No?”
“What? But you said there’s no big heart problem. It’s just... the energy drinks.”
“Yeah. But those energy drinks are still swimming around in your bloodstream. Where do you think you’re going? Your heart’s running a full marathon right now.”
I rubbed my dry face with my hand.
“Kid, just sleep it off. I’ll discharge you once you’re fully better.”
“Huh? When?”
“When? Look at that monitor number. When it drops below 100 from 160. When your chest doesn’t pound, you’re not short of breath, and you can walk around fine. Then.”
I patted Baek Eun-seo’s shoulder.
“Follow-up EKG every 30 minutes. Another liter of fluids once the first one’s done.”
“Yes, sir!”
Baek Eun-seo replied with gusto.
Her enthusiasm felt oddly unfamiliar, and I chuckled as I drew the curtain and turned back to the station.
Right then, the patient called out urgently from the bed.
“Doctor! Um... Doctor.”
“Yeah, kid. What?”
“Um... isn’t there some medicine that’ll fix me right up?”
He still hadn’t let go of the idea.
I stopped and stared at him.
Even in this mess, his drive to get out and do something was impressive.
“Oh, med student? Pharm student? Nursing student?”
How else would he zero in on meds in this situation?
“Oh... no, not really. I just... looked it up...”
Ah, the internet.
I sighed deeply and walked back to the bedside.
“‘Looked it up,’ huh? What’d you search? ‘Heart palpitations ER’ or something?”
“Yeah... like... treatments for when your heart races...”
“Hmm...”
I crossed my arms.
“So what’re you gonna do if I discharge you now, kid?”
“Huh?”
“What would you do if I sent you home right this second?”
He didn’t catch my angle and glanced at his bag at the foot of the bed.
The corner of a thick exam book poked out of the zipper.
“...Uh, study...?”
I couldn’t help but snort at the answer.
What a specimen.
I glanced back at Baek Eun-seo, who stood behind me with the same baffled look.
“Hmm, Eun-seo.”
“Yes, Doctor.”
“No way, right?”
She got it instantly and shook her head vigorously.
“No. Absolutely not, Doctor.”
I turned back to the patient.
“See? Even the first-year doc says no.”
“But why... just give me some meds...”
“Kid, what you looked up sounds like PSVT, but this is sinus tach. Different beast.”
“Huh? What’s the difference...”
“Your heart wants to beat normally, but caffeine’s come down from your brain like a whip cracking, telling it not to stop. That’s sinus tach.”
“Oh...”
“So that magic shot you mentioned? Probably won’t do squat. Maybe.”
“Oh... okay...”
The patient’s face flushed bright red with embarrassment.
I pulled up a chair by the bed and sat.
“This is case-by-case stuff. Person by person.”
“Case-by-case...?”
“Some folks are built like steel—chug ten cans and just go, ‘Eh, can’t sleep.’ I’ve seen it.”
“But you? Some crash after two. Heart goes, ‘What the hell, boss?’ and freaks out. You drew the short straw on constitution.”
His face fell.
“Anyway, we gotta flush this caffeine out of you. This IV filters it through your kidneys—out as urine. So it’s not a one-shot fix; we watch till the toxin’s gone. Means you rest too, right?”
I nodded at the IV line in his arm.
I glanced at his monitor.
158 bpm.
Still fast.
“Oh... yeah...”
He finally nodded, convinced.
That defeated look reminded me of myself a year ago.
Without thinking, I asked,
“It’s early March now. Semester just started—why the rush this late? At twenty, you should be out having fun.”
“Oh, I... retook last year...”
*Ah.*
Silence fell.
*Stepped on a landmine there.*
Retaker.
My tone softened unconsciously.
“Studying’s a marathon, not a sprint. Chug six cans to grind now, and your body’ll collapse before June mocks. Pace it, manage your condition. Cramming without sleep doesn’t make it stick.”
“Yes, Doctor...”
“Anyway, rest up. I’ll check back after the fluids. See that nurse call button? Chest pain worsens or more shortness of breath, hit it. Got it?”
“Yes, thank you...”
I signaled Baek Eun-seo and drew the curtain.
Back at the station, she shot me that role-model gaze again.
Ugh, too much pressure.
Maybe change the subject.
“Ever done that? Back in high school, during exam crunch, I’d mix energy drinks with coffee late at night. Heart pounding in my ears. Crazy in hindsight...”
I looked at her, hoping for commiseration.
But Baek Eun-seo stared back like I’d spoken gibberish.
“Nope! I was always in bed by ten sharp!”
“...”
I blinked at her blankly.
“...Until when?”
“Until med school graduation!”
Baek Eun-seo beamed proudly, chest puffed out.
“...”
*...I picked the wrong junior.*
Human?
Bed at ten?
Possible?
Even in clinical years? During boards prep?
AI?