The One-Star Amusement Park (1)
I temporarily paused my battle with a wailing child and headed in the direction the nurse was pointing. Bed C-8. What a clever name. It sounded suspiciously like a curse word when slurred.
Pulling back the curtain, I saw a small child wrapped in a blanket lying on the bed, with a young couple standing beside them looking as if they were about to collapse at any moment.
"Are you the baby's parents?" At my question, the woman who appeared to be the child's mother nodded, on the verge of tears.
"Yes, Doctor... He's completely limp, and his fever is at forty degrees... We gave him fever reducers at home, but it won't drop below thirty-nine, and he just wants to sleep... He's going to be okay, right, Doctor? Please?" The mother's voice trembled with terror.
The words that came out of her mouth. He's completely limp. In pediatric emergency medicine, there is no phrase more terrifying than that.
"..." I silently observed the child on the bed for a moment. His face was flushed bright red, and he was breathing in shallow, rapid wheezes. His eyes were closed, but he wasn't completely motionless. He faintly knit his brow at the sensation of my approach.
I turned to the parents and began my questions. "Excuse me... Mother, when did you give him the fever reducer, and what kind was it?"
"An hour ago. We gave him the proper dose of Champ Syrup..."
"How old is he?"
"He just turned two... twenty-four months."
I nodded, continuing the basic medical history. Was he eating well? Was he producing wet diapers? Did he have any other symptoms like a cough or a runny nose? Though rambling in their panic, the parents did their best to answer my questions.
While taking the history, I rubbed my cold hands together to warm them before gently touching the child. First, the neck. I gently examined it to see if there was any stiffness. This was to check for nuchal rigidity, the most critical sign of meningitis. Fortunately, the child's neck moved smoothly.
Next, the chest. I placed my stethoscope against his tiny chest. His breathing, though rapid, was still even. His heartbeat was regular. His abdomen was soft, and he didn't seem to be in any particular pain when I moved his limbs.
Finally, I decided to try waking him up a bit. "Hey there, little buddy. Can you look at the doctor?" When I lightly shook his shoulder, the child whimpered and opened his eyes. Seeing my unfamiliar face, his lips pouted as if he were about to burst into tears. Then, he weakly reached his arms out toward his mother.
At that moment, I almost let out a sigh of relief. I called over the nurse who was standing nearby to assist with the treatment.
"Nurse."
"Yes, Dr. Han?"
Looking at the rookie nurse, a relieved smile slipped onto my face. "He's not limp at all... Whew, that shaved ten years off my life..." I cleared my throat. "He's just a bit lethargic because his fever is so high. This isn't lethargy or a 'limp' state in a medically dangerous sense."
Ahem. I turned back to the parents, a gentle smile on my face. "You must have been very frightened. When a fever hits forty degrees, even adults lose all their energy and feel completely wiped out, as if they have a severe flu. It's the same for children. You don't need to worry too much."
I made eye contact with them as I explained slowly. "From what I've examined, there are currently no signs pointing to highly dangerous illnesses like meningitis or sepsis. It is most likely just a severe feverish cold."
Yes. Based on everything I had seen so far, a feverish cold was the most likely culprit. "Because his fever is so high and he hasn't been eating well, he's dehydrated, which is why he has absolutely no energy. Of course, if this state persists, it can become dangerous, but that is not the case right now."
At my explanation, the tension on the couple's faces began to melt away. "First, we're going to start an IV right away. We'll give him an IV fever reducer along with fluids to replenish his hydration. To find the cause of the fever, we'll also run blood tests and screen for respiratory viruses like influenza and RSV. Until the results are out, we'll keep him on the IV here and monitor his progress."
After placing the orders, I asked the nurse to start the IV and stepped out of the curtain for a moment. "Seriously, that shaved ten years off my life..." Whew.Limp. To a doctor, especially one treating children, those words are terror incarnate.
This is because a "limp" state is the worst possible signal that a child's brain and nervous system are failing due to infection or shock. A truly limp child is as floppy as a ragdoll. If you lift their arm and let go, it drops instantly, unable to resist gravity. They barely respond to stimuli and can't even muster a proper cry. Their eyes lose focus and stare blankly into space.
It could be a decline in brain function due to sepsis, or the result of increased intracranial pressure from meningitis. Whatever the cause, the moment a doctor faces a truly limp child, they instinctively know the patient already has one foot in the river of death. I felt as if I had just walked up to the edge of that river and back. I was incredibly glad it wasn't the case.
After checking on the child, whose condition had improved slightly after receiving the injection, I returned to the pediatric ER station with a sense of relief that I had survived at least one hurdle. The surrounding area was an absolute madhouse. Screams and wails of children erupted from every corner, accompanied by the anxious voices of parents trying desperately to soothe them, and the incessant, shrill beeping of monitor alarms.
I looked around for Lee Min-jae, who was covering my back today. Ah. There he was. Over at Bed C-3, he was checking the pupillary reflex of a child who had just finished a febrile seizure. Why on earth do my shifts always overlap with this guy's the moment I get back from a conference? What did I do to deserve this fate? I grumbled inwardly, waiting for Lee Min-jae to finish his treatment.
"Senior."
"Oh, Hyun-jae. What's up?"
"The twenty-four-month-old male in Bed C-8 who came in with a chief complaint of high fever—his temperature dropped to thirty-eight point two after the fever reducer, and his consciousness is clear. He's currently playing quietly in his mother's arms. We're observing him while he gets IV fluids, and the parents have calmed down a lot."
Lee Min-jae nodded at my briefing. "Really? Good job. Kids seem to be getting sick unusually often lately. Is it because of the change of seasons? I heard yesterday was packed with RSV patients, and today it's a feverish cold party."
"All the beds are full right now, aren't they?"
"Yeah. All ten beds in Zone C are full. As soon as one leaves, the next patient comes right in. It's an infinite loop. Why?"
"No, just... it's been a while since I've been in the pediatric ER. I'm having a hard time adjusting."
"You'll adjust soon. People always get used to hell quickly."
Lee Min-jae patted my shoulder and walked off to see the next patient. I sat down in front of the station computer to organize the charts. As I began charting, I logged onto the gallery at the same time.
When I had posted on the gallery this morning that I was assigned to the pediatric ER, Pediatrics Ghost 77 had instantly transformed into an incredibly serious, star tutor.
At that question, I instinctively pressed a hand to my forehead. The secret weapon Pediatrics Ghost 77 had shared with me was more effective than I could have ever imagined, but at the same time, it was also far more painful than I could have ever imagined.
'Kids are scared of doctors. But they aren't scared of someone who is stupider and sillier than they are. Play peek-a-boo, and then pretend to slam your head against the corner of the table. Then, pretend to cry, going, "Ouch! Ouch! It hurts!" Kids will usually stop crying and stare at you like, "What is this idiot doing?" That is your window of opportunity!'
Yeah... it was effective, all right. But...
"Now, peek-a-boo!" I had tried my best to play peek-a-boo.
"Wow~ Harim, where did the doctor go and where did he come from?" The mother had enthusiastically played her supporting role.
"Now, peek-a... boo! Argh!" I had only intended to pretend to hit my head, but I had actually slammed it.
The child had burst out laughing at the sight of me, while the mother asked in panic, "Doctor! Are you okay?" I had tried my best to act fine, but in truth, my head still throbbed.
Yeah. To survive here, I had no choice but to become a madman myself.