Translation of Sensation
Oh Jae-hyeong tapped the tip of his pen against the station desk in irritation. "Did you check the lab results for room 406?"
"Yes. All inflammatory markers are within normal range," Baek Ijun replied calmly while clicking the mouse. "His vitals remained stable overnight as well."
"Then we'll advance his diet today and pull the drain tomorrow or the day after if there are no issues." Oh Jae-hyeong's instructions were dry and precise.
Choi Byeong-su. Sixty-seven-year-old male. Third postoperative day following laparoscopic cholecystectomy. It was the recovery phase that textbooks described as the most uneventful.
"Understood." Baek Ijun gathered a copy of the chart and stepped into the corridor of Ward 4. He stopped in front of room 406, the sixth room along the hall. The moment his hand reached for the sliding door handle, the edge of his vision subtly distorted. A translucent layer gently overlaid his retina. The tab that always crouched in the upper right corner began to flash blood-red.
Bile leak possibility detected.
Baek Ijun's steps halted for a split second. The text was concise, yet the implications it carried were anything but light. He took a short, deep breath and opened the door to the room.
"Mr. Choi Byeong-su, did you sleep well through the night?"
Choi Byeong-su, perched on the edge of the bed, offered a kindly smile. At sixty-seven, the rough hands that had run a hardware store for decades rested on his knees.
"Ah, Doctor, you're here."
His wife, who had been folding blankets on the guardian's bed, chimed in with a bright voice. "My husband has been bouncing around like he's flying since yesterday."
"The store's been closed for days, so my shoulders are killing me." Choi Byeong-su rolled his stiff shoulders and joked. "We're going home the day after tomorrow, right?"
The patient's complexion was calm, with not a single bead of cold sweat on his forehead. There was no sign he was enduring any pain. Baek Ijun moved right up beside the patient.
"Did the thin rice porridge you had this morning digest well?"
"My stomach feels perfectly comfortable." Choi Byeong-su lightly stroked his abdomen. "No tightness or blocked feeling around the solar plexus?"
"Not at all."
The chart numbers and the patient's subjective experience matched perfectly. A dizzying series of calculations spun through Baek Ijun's mind. Labs normal. Vitals normal. No subjective complaints of pain. Yet the Archive was clearly pointing to an abnormality inside the abdomen.
Baek Ijun gently lifted the blanket covering the patient's abdomen. "I'd like to examine your belly once."
With a gloved hand, he pressed firmly around the right upper quadrant with consistent pressure, then released. "Does this hurt?"
"No, I just feel the pressure."
No tenderness. No rebound tenderness. The bowel sounds heard through the stethoscope were perfectly normal as well. Baek Ijun hung the stethoscope around his neck and fell silent for a moment.
Patients like Choi Byeong-su, who had lived a physically demanding life, tended to dismiss most pain as unworthy of mention. He needed to change the angle of his questions.
"Mr. Choi Byeong-su."
"Yes, Doctor."
"When you woke up this morning and went to the bathroom, didn't the inside of your right abdomen feel a little different from usual?"
Choi Byeong-su tilted his head, looking puzzled. "Different how?"
"Not necessarily painful, but perhaps a sensation of something pulling downward or feeling heavy."
Baek Ijun's gaze sank deeply into the patient's wrinkled eyes. Choi Byeong-su stared into space for a moment, searching through fragments of memory.
"Now that you mention it..." His hand, which had been smoothing the blanket his wife had folded, suddenly stopped. "Right after I got out of bed this morning, the inside of my right flank felt heavy and drooping, like a sponge soaked with water."
Baek Ijun's eyes sharpened. "How about now?"
"After I went to the bathroom and walked around a bit, the feeling completely disappeared." Choi Byeong-su laughed heartily, as if it were nothing. "I figured it was just the surgical site pulling as it healed."
Baek Ijun carefully pulled the patient's gown back down. "Thank you for explaining that so clearly."
The puzzle in Baek Ijun's mind clicked into place with precision. The localized sense of pressure that shifted with changes in position. It was an early sign caused by a tiny amount of leaked bile pooling downward under gravity.
"I'll step out to double-check the results and come right back."
"Alright. Thank you."
As soon as he left the room, Baek Ijun headed straight for the station. He approached Oh Jae-hyeong from behind as the senior was writing a consultation request for another department.
"Sir, I think we need to change the orders for Mr. Choi Byeong-su in 406."
Oh Jae-hyeong kept typing as he asked indifferently, "Why? What's the problem? The patient is scheduled to be discharged the day after tomorrow."
"I believe we should get an abdominal ultrasound immediately."
Oh Jae-hyeong's fingers froze on the keyboard. "What?" He spun his chair halfway around and glared sharply up at Baek Ijun. "You said all his labs were normal."
"They are."
"And his NRS pain score is 1."
"Yes. The objective pain scale is indeed that low."
Oh Jae-hyeong furrowed his brow fiercely. "Then why the hell are you ordering an ultrasound?"
"A subtle bile leak is suspected."
The air at the station suddenly grew cold. The nurses who had been organizing the medication cart nearby stiffened slightly.
"Current abdominal exam findings?"
"No tenderness or rebound tenderness at all. Bowel sounds are completely normal."
"Did you check this morning's labs?"
"Both CRP and white blood cell count, the inflammatory markers, remain within normal range."
A deep crease formed between Oh Jae-hyeong's brows. "Then what the hell? All objective clinical findings are completely normal. On what basis are you suspecting a serious complication like bile leak?"
Oh Jae-hyeong's voice dropped even lower. Baek Ijun met his gaze without the slightest tremor.
"Right after waking up this morning, when the patient stood, he complained of a heavy, sinking pressure in the lower right upper quadrant, as if fluid were pooling there."
"You're calling that a bile leak based on one complaint?"
"It is a classic early presentation before clear signs of peritoneal irritation appear."
"Bowel sounds?"
"Normal."
Oh Jae-hyeong let out a short, incredulous laugh. "Hey."
"Yes."
"All objective clinical findings are normal, and you're going to issue orders based on one subjective feeling from the patient?"
"If bile is slowly accumulating due to a tiny defect at the surgical site, there will be a time lag before inflammatory markers rise." Baek Ijun's voice was calm yet firm. "If we wait until the symptoms explode and it turns into peritonitis, it will be too late."
Oh Jae-hyeong stared piercingly into Baek Ijun's eyes. This wasn't the reckless stubbornness of a first-year resident. It was the tenacious defensive mechanism of a surgeon who refused to let even the smallest clue slip away.
Oh Jae-hyeong spun back toward the monitor. "Call Radiology." The sound of the mouse clicking echoed sharply. "We'll pull an emergency ultrasound. Send him down bed and all right now."
"Understood."
One hour later.
The ultrasound report from the Department of Radiology appeared on the EMR screen.
Small amount of fluid collection observed around the gallbladder fossa. Bile leak strongly suspected.
Oh Jae-hyeong sat with his chin propped on his hand, staring at the text on the monitor. Baek Ijun approached silently and stood beside him.
"Haa." Oh Jae-hyeong let out a deep, heavy sigh. "Cancel all existing discharge orders."
"Yes."
"Keep the patient NPO immediately."
"I'll prepare for drain insertion."
Oh Jae-hyeong stood up and glanced at Baek Ijun. "For now, we'll manage it conservatively, draining the leak while monitoring his progress."
"I'll go explain the situation to the patient myself."
"Baek Ijun." Oh Jae-hyeong stopped and called out to him. "You bet everything on one patient's words when all the numbers were normal."
Baek Ijun waited silently for what would come next.
"There's no guarantee it'll be right next time too."
"I'll keep that in mind."
"But you were right again this time."
Oh Jae-hyeong tossed out that short acknowledgment and disappeared into the procedure room.
Three o'clock in the afternoon. Baek Ijun opened the sliding door to room 406 once more. Choi Byeong-su and his wife stared at him with tense faces, hanging on his every word.
"Doctor, is the result bad for my husband?"
Baek Ijun approached the bedside and spoke in a gentle voice. "We confirmed that a very small amount of fluid is leaking from the surgical site and pooling inside."
Choi Byeong-su's face turned ashen. "Does that mean another surgery?"
"No." Baek Ijun shook his head firmly, reassuring him. "Fortunately, because you reported the abnormality very early, we won't need to reopen your abdomen."
"Really?"
"If we stop eating for a few days and simply drain the pooled fluid through a thin tube, it should heal on its own."
His wife let out a long breath she had been holding and sank into her chair. "Oh my, what a relief. We don't have to go back to the operating room."
"Yes. Just stay in the hospital a few more days so we can safely monitor your progress."
Choi Byeong-su clutched the hem of his gown with a dazed expression. "If you hadn't asked me so many detailed questions this morning, I wouldn't have said anything."
"......"
"I was going to just endure it because I didn't want to seem like I was making a fuss when everything was going so well."
Baek Ijun gently placed his hand over the patient's rough one. "Because you described that small discomfort so accurately, you saved your own abdomen."
Only then did a deep smile of relief spread across Choi Byeong-su's lips.
After leaving the room, Baek Ijun paused for a moment by the corridor window.
"Doctor." Nurse Jeong Dain, passing by with a blood collection tray, slowed her steps. "Room 406—you really caught that at exactly the right moment."
Baek Ijun answered calmly while gazing out the window. "It was thanks to the clue the patient gave me."
Jeong Dain smiled lightly as she looked at his profile. "That subjective feeling is sometimes far more honest than lab values."
"It seems so."
"And the fact that you didn't miss it and drew it out is your skill, Doctor."
Jeong Dain walked briskly away toward the station. Baek Ijun quietly watched the sunset painting the end of the corridor red.
The truth that the numbers on the chart couldn't reveal was hanging at the edge of the patient's lips. More than the invisible system alert, the real-world conversation that uncovered that heavy pressure had saved the patient today.
Baek Ijun slipped both hands into the pockets of his white coat and slowly walked back toward the ward.