Dr. Taesoo Choi - C4

Arrival

The moment Tae-su arrived, he was once again shocked.
The man before him was an elderly foreigner, his face wrinkled with age.
“Ugh…”
Blood began to pour from his mouth.
There was no time to think in this situation.
Tae-su quickly moved toward the elderly man’s head.
“Hey, hey!”
He called out in English, and the elderly man’s unfocused eyes trembled slightly. With great effort, the man managed to make eye contact with Tae-su.
“Cough!”
A rough cough followed by a spray of red blood hit Tae-su’s face and neck.
Tae-su had no time to dodge.
In an instant, his face was drenched in blood.
But Tae-su’s gaze never left the elderly man.
‘Hematemesis? Or hemoptysis?’
Hematemesis is when blood comes from the stomach, while hemoptysis is when blood comes from the lungs.
Though both involve vomiting blood, the underlying causes are completely different.
There were no tools available in the mountains.
He couldn’t afford to be distracted.
Tae-su had seen countless amounts of blood.
And countless deaths.
For most people, this would be a situation that could cause panic.
Of course, Tae-su was scared.
His heart was racing, and he felt a tightness in his chest.
He had dealt with many patients, but this was the first time he was alone in such a situation.
But he couldn’t just stand still.

• • Doctor.
    That was his profession.
    He had vowed to make it his lifelong career.
    “Calm down, Tae-su.”
    The first priority was to steady his own racing heart.
    He recalled the chaotic moments from his internship.
    Especially in thoracic surgery.
    It was a place where you couldn’t stay in one place for even ten minutes. During that hectic time, Tae-su had unknowingly developed a tolerance to blood and injuries.
    Maybe that’s why his mind began to slowly calm down.
    Pushing aside his fear, his vision began to clear.
    First, he had to address the blood in the elderly man’s mouth.
    It was important to accurately distinguish whether it was hematemesis or hemoptysis.
    Only then did Tae-su focus on the first priority.
    He needed to clear the blood from the elderly man’s mouth.
    As soon as he made that decision, Tae-su reached into his backpack and pulled out a bottle of water.
    It was a 500-milliliter sports drink he had bought earlier. After opening the cap, Tae-su carefully poured water into the man’s mouth.
    He spoke with a shaky voice, trying to stay calm.
    “Spit it out. Spit it out.”
    Since he had learned English for medical studies, he was able to communicate simply.
    However, the elderly man couldn’t manage to spit out the water on his own.
    The damage was severe, and his physical responses were dull.
    Tae-su had no choice but to gently turn the man’s head toward him.
    Slowly, the blood and water mixed together and trickled down from his mouth. Though it wasn’t completely cleared, Tae-su kept trying.
    Once, then again.
    After two quick repetitions, the blood stopped flowing, and only water came out.
    For a moment, Tae-su felt a little relief.
    The elderly man was breathing through his mouth, but there was no more blood mixed in.
    So, it wasn’t hemoptysis.
    Even if it was hematemesis, there was no further bleeding.
    Though it was too early to relax, it was a relief that the labored breathing hadn’t stopped.
    Now that the airway was clear, it was time to check the heart.
    Tae-su placed his right hand on the elderly man’s neck.
    The pulse was faint, but it was there.
    He looked at his wristwatch.
    Thump. Thump.
    He counted the weak pulse in his head.
    The heartbeat was irregular.
    There was a chance this could lead to ventricular fibrillation (V-fib).
    Startled, Tae-su carefully unzipped the elderly man’s jacket.
    Ssshhh.
    “Ugh.”
    A deep groan came from the man, even from the slightest movement.
    But Tae-su couldn’t just leave him there.
    Sweat trickled down his forehead as he continued his work despite the tension.
    With trembling hands, Tae-su managed to unzip the jacket, spreading it open.
    A hiking shirt came into view.
    What caught his attention even more were the raised bumps on the shirt. It looked as if small pebbles had been scattered across the fabric.
    At that moment, Tae-su instinctively knew.
    Multiple fractures of ribs.
    It was certain.
    To put it simply, the elderly man’s ribs had been shattered.
    The ribs protect the internal organs, and with them broken into pieces, it was unimaginable what had happened inside his body.
    The arrhythmia hadn’t progressed yet.
    The priority now was to find a way to move him.
    There was no time to waste.
    Tae-su’s face quickly changed to urgency.
    What about his surroundings?
    “Damn it!”
    There was nothing.
    The faces of the people he had seen during his ER rotation flashed through his mind.
    Tae-su quickly took out his phone and dialed.
    The voice of an emergency responder came through the line.
    “911, what’s your emergency?”
    “We’re about 1 kilometer south of Buwangsa Temple on Bukhan Mountain. It looks like a fall. Please send help immediately!”
    “1 kilometer south of Buwangsa Temple?”
    The responder asked for confirmation, and Tae-su shouted in frustration.
    “Didn’t you hear me?!”
    “Hold on, please!”
    The responder’s voice became faint as he quickly made inquiries.
    “Emergency! Fall accident! Fall accident! Bukhan…”
    Listening to the repetitive commands, it seemed the responder was dispatching help.
    Not even a minute passed before the responder’s calm voice came through again.
    “Please stay calm. We’re on our way, and we’ll be there soon.”
    “How soon is ‘soon’?”
    “Because it’s in the mountains, I can’t be sure…”
    The responder hesitated, and Tae-su yelled again.
    “Is this a joke? Get a helicopter right now!”
    “A helicopter? We can’t just deploy a helicopter like that.”
    “Then ask the National Park Service to help!”
    Hearing Tae-su’s urgency, the responder’s voice grew more tense.
    “Is the patient in critical condition?”
    “Multiple fractures of ribs, ruptured lung, and possible gastrorrhexis! When… damn it!”
    Tae-su couldn’t finish his sentence and just groaned in frustration.
    Though he wanted to say that the patient might die, he couldn’t say it outright.
    But perhaps understanding his intent, the responder’s voice grew serious.
    “What do you mean by that?”

“Hey! This is not the time to be arguing!”
“I’ll check right away. But before that, one more thing—are you a doctor?”
“I’m an intern at Yeonseong University Hospital!”
Tae-su’s voice carried a hint of frustration, but the paramedic actually sounded relieved.
“Oh, thank goodness. Please take care of the basic steps until we get there.”
“I’m doing that, but there’s nothing here in the mountains.”
“Then can you tell me more about the patient’s condition? We’ll need to act as soon as the ambulance arrives.”
The paramedic sounded as if they had just found reinforcements.
But Tae-su’s expression suddenly hardened.
Could he give the right orders?
His limited experience weighed heavily on him.
But he had no choice; he had to act.
Tae-su gritted his teeth and focused on stating the top priority.
“The patient shouldn’t be moved during transport.”
“Okay, and anything else?”
“Please dispatch the nearest university hospital. We need to prepare for emergency surgery right away. The patient also shows signs of hypothermia, so either warm saline or a heating device is necessary. And…”
Tae-su started adding more instructions when the paramedic interrupted with another question.
“How’s the blood pressure?”
“How am I supposed to measure the blood pressure right now?”
Tae-su couldn’t hold back his frustration and snapped.
At that moment, the elderly man’s mouth opened slightly, and a groaning sound escaped.
“70 over 50…”
Tae-su heard the words clearly in his excited state. Luckily, his proficiency in English, honed during his studies abroad, allowed him to understand without trouble.
Tae-su’s gaze shifted back to the elderly man.
“Hey, hey!”
“Roughly… ugh, around that… I think.”
The elderly man’s struggle to speak in broken English caused Tae-su’s expression to flicker with uncertainty.
The man’s confidence seemed unshakable, despite his condition, and it didn’t feel like words from someone near death. Tae-su was surprised at the old man’s effort to speak despite his labored breaths.
However, Tae-su couldn’t take those words at face value.