After the vice dean’s presentation, a large number of central faculty members from the department of internal medicine gathered inside the office of the department director.
"Strengthening cooperation? When people hear it, they’ll think we used to be enemies with the other departments."
Kang Beom Seok, the chief of the nephrology department, lamented which led to a series of complaints from the heads of other departments.
"Isn't this all to help neurosurgery, which has been the center of the media these days? You’d think they're earning all the money for the hospital just because they’ve treated celebrities a few times."
"That's right. Where was the highest yield from last year? Wasn't it the cancer center? Shouldn't we put the oncology clinic at the forefront?"
Among them, Won Dong-Gil, who was sitting with a lost expression, waited for the room to calm down and started to talk.
"Everyone, calm down. I don't think we can solve this just by getting angry. The vice dean was a surgeon, so he is too ignorant about how the outpatient office is run. Let's take this opportunity to show that the center of treatment is internal medicine.”
"How?"
"I mean we should all cooperate. We should diligently ask the neurosurgery department for a second opinion. Have you met a patient who doesn’t have a headache?"
Most of the professors nodded after realizing the true intentions hidden within Won Dong-Gil's words.
No matter how experienced a surgeon was, he couldn’t master each specialty of internal medicine. It would be humiliating if a doctor failed to respond properly when asked for a second opinion.
"In particular, I think we should show the young doctor who’s starting this week what happens if he messes around."
At Won Dong-Gil’s next words, professors around him coughed awkwardly. Because it was not something to be said by the person who got taught while acting up recklessly during the briefing session.
"Director Won. I think you should change your mind when it comes to Park Dowook."
Everyone's attention was drawn to the voice of Yeon Jung-woong, a VIP professor and influential person in the field of endocrine medicine. Won Dong-Gil asked back.
"Professor Yeon, you were also there when he diagnosed Tom Brand and you still say that?"
"Aren’t I saying this because I saw him in the act? Dr. Park is not a normal doctor. Professor Lee Won Seok of the Neurology Clinic also acknowledged it."
"Oh, but he’s still a surgeon."
Won Dong-Gil muttered like this, but due to anxiety in the corner of his chest, he turned his head toward Lee Ki-cheol, the head of the tumor department.
"Director Lee, are you close to the head of the cancer center?"
"Well, we're from the same school."
"There's no reason for only the internal medicine to act. Other surgical departments will also have a lot of complaints about neurosurgery. Tell me. There's also the undisputed No. 1 surgical outpatient doctor.”
The discussion on countermeasures held inside the office of the integrated internal medicine department’s director continued until the afternoon.
* * *
Wednesday afternoon.
Dowook was heading to the outpatient area on the fourth floor.
‘How many patients did they say had made an appointment?’
When he opened the schedule sent from the outpatient nursing department on his cell phone, he saw that he had 11 people.
Considering that each patient had up to 15 minutes of treatment time, the number was not as large as expected. This was enough that he could also go in for surgery and emergency room duty without much difficulty.
Dowook, who yawned and got off the elevator, turned to the wide outpatient area.
From dermatology to respiratory medicine, it felt like he was standing at the entrance of a supermarket.The space was crowded with patients waiting for medical treatment.
He focused his attention in the outpatient area of the neurosurgery department, where three private clinics were attached. It was quite small compared to the nephrology department right next to it with eight clinics.
The reason why the neurosurgery department occupied such a small area was because the region of spine was separated into another clinic.
Even so, he couldn’t help but be envious that the clinic had a waiting room with a good atmosphere.
‘It’s not like our department doesn't have many visiting patients, but it isn’t a lot either.’
He approached and bowed to the nurse standing at the reception desk.
"I'm Park Dowook."
"Welcome, doctor. It's your first outpatient today, right?”
"Yes."
The nurse who checked the reception desk's monitor proceeded.
"Professor Shin is looking at his last patient, so please wait."
Dowook waited for a professor who was performing outpatient treatment in the morning, but he didn't come out even at 1 p.m.
At around 1:05, Dowook walked back to the reception desk.
"It’s past the shift. Should I still wait?"
"That's strange. He took over a patient at the end because they said it was a mild case."
“He took over?"
"Oh, there's the patient."
Dowook turned toward the first clinic.
A frowning patient walked towards the reception desk.
"My doctor told me to get a shot. Where should I go?"
"Wait a minute."
The nurse, who checked the computer chart, printed it out and handed it out to the patient.
"You can complete your payment to the Department of Internal Medicine and proceed to the integrated internal medicine treatment room."
"This time, the integrated internal medicine department? Can't I get a shot here?"
"The treatment for thyroiditis is not within the jurisdiction of neurosurgery."
"Ugh. I'm dying of pain. Go this way and that way. You keep making me go around. What's wrong with these general hospitals?"
The nurse, who did not lose her kind smile to the patient who was grumbling and walking out, looked back to Dowook.
"I think you can go now."
Dowook left the nurse who seemed very good at dealing with upset patients and moved to the first clinic.
‘Wait. Thyroidism? Why did the internal medicine patient come here?’
Standing at the door, he could see one more person inside besides Professor Shin Sang-woong, a detailed cerebrovascular specialist.
He had a name tag with "Professor Kim Han-sung of Integrated Internal Medicine" on his chest.
Kim Han-sung opened his mouth.
"The medical history is only fever symptoms for sore throat, so I couldn't have diagnosed subacute thyroiditis right away. Anyway, thank you for your help. At least it's not a cerebral artery disease.”
Kim Han-sung walked outside, leaving Professor Shin behind with a disheartened expression. On his way out, he made eye contact with Dowook.
Dowook bowed slightly. Kim Han-sung soon disappeared from the clinic after receiving Dowook’s greeting with a stiff gaze.
Professor Shin, who was packing his bag, looked at Dowook.
"You’re here, Dr. Park?"
"Professor, thank you for your hard work.”
Dowook came close and pointed outside.
"What was that patient just now?"
Professor Shin sighed deeply.
"Didn't you hear? Because of the integrated outpatient or whatever, the internal medicine department is determined to act up.”
"Act up?"
Professor Shin pointed to the patient's chart on the monitor.
"They bring in a patient whose symptoms are ambiguous to cooperate and make it as difficult for us as possible. Of course, I doubted the brain side."
Dowook looked at the chart and groaned.
The most common reason for someone to have symptoms like headache and fever was a cold. But it wasn’t easy to diagnose if there weren’t any other signs such as swollen tonsils or coughing.
"Be careful, Dr. Park. If you don't intend to apply for integrated outpatient support, don't even take a request for consultation. They're quite determined."
Professor Shin walked out of the clinic while clicking his tongue.
Dowook sat in his seat and recalled the war of tension during the briefing a few days ago.
‘Something troublesome may happen.’
Ring, ring.
The intercom on the table rang. Dowook answered and heard the voice of the nurse at the reception desk.
-What should we do with the 1 o'clock reservation patient, Dr. Park? Should I let them in after 30 minutes?
Reservation No. 1 and the first outpatient treatment patient under his own name. He couldn’t help but feel a bit nervous.
"No, let him in right away."
Two hours later.
Dowook looked closely at the left eyelid of a woman in her late twenties and spoke as he felt the slight tremors transmitted through his fingertips.
"The facial nerves and nearby blood vessels are so close that they seem to affect each other. In this case, you can try surgery to reduce nerve stimulation."
"Other hospitals recommended Botox injections."
"That's one way. However, Botox injections have an expiration date so it will work up to six months."
"What about surgery?"
Dowook took his hand off the patient and smiled.
"If it wouldn’t completely cure it, I wouldn't have brought it up."
Dowook, who left, made notes on the chart as he said.
"I'll write you a prescription for migraines. If you're thinking of surgery, don't waste your medical expenses by moving around various hospitals.….”
"I'll do the surgery."
"Will you?"
"Doctor, I came here on purpose after reading the article."
"Then I'll schedule a thorough examination and contact you."
The 11th patient left the clinic, and Dowook looked at the clock. It was only 3 o'clock.
‘It ended faster than I thought.’
Choi Hoo’s sense was the fastest and most accurate diagnostic tool in front of symptoms requiring neurosurgery.
Now, he could get a clear idea of the surgical process just by touching the patient, and it was hard to consider this to be someone’s sense.
Ring, ring.
The phone rang while he was entering the second examination schedule for patients who needed surgery among those he diagnosed today. Dowook pressed the speakerphone button and replied while typing.
"Yes, this is Park Dowook."
-I'm Professor Lee Il-sang of Infectious Diseases. I'm contacting you because I heard you're done with today's appointments. A dizziness patient visited here, but the symptoms seem a little complicated.
What Professor Shin warned him about suddenly came in.
If he rejected it by saying he was busy, there would be no problem but if the position of neurosurgery was reduced in an integrated outpatient environment under the pretext of this process, it would not only be a big loss, but also hurt the pride of their department.
"What kind of symptoms?"
– It's the 190117-3501 chart.
"I'll check and call you."
-I'll be waiting.
Dowook jumped up and ran out of the clinic. And immediately told the nurse standing at the reception desk.
"I'm going to the bathroom for 5 minutes".
"What? Yes."
Although he said the bathroom, the place where Dowook was headed was in front of the outpatient clinic of the infectious medicine department.
There were a total of 6 clinics here.
HeI just pretended to pass by and reached out his hand. A tingling sensation was felt coming from two places.
‘Oh, there are a lot of great doctors here.’
After accepting the more intense stimulating sensation as much as possible, he quickly returned to his clinic. Then, he opened the chart of the patient who requested consultation.
Dowook picked up the phone and called Professor Lee Il-sang and slowly started to speak.
"It seems to be a patient with symptoms of consciousness disorder and some paralysis."
-That's right. There's no abnormality in the head CT, but paralysis is the only clue.
A state in which anyone could only diagnose cerebral infarction. However, it must have been taken out because it would not be a cerebral infarction.
Dowook carefully browsed the information on the monitor and stopped at the blood test part from the diagnostic medicine department. At first, he didn't understand it, but he was able to recognize it right away because his hands wrote down the prescription by itself as he looked at the chart.
"That's strange. Isn't there a doctor who can analyze blood antibodies properly in the Infectious Diseases?"
-What?
Came the flustered answer.
"There is a significant rise in influenza A virus antibodies. This is not a case of cerebral infarction, but an influenza encephalopathy. It has nothing to do with neurosurgery. Do you still want to collaborate? I can help you, but still…….”
-Uh…
"I don't know who was in charge of diagnosing this patient, but I'm very sorry. If a person who can't even judge this much is sitting in an outpatient clinic, the hospital image could be in trouble."
-Excuse me, doctor. This request for consultation was not from the integrated outpatient case.….
"Oh, my. I've already recorded it.”
Tap tap ta-tap.
Dowook finished typing the prescription and clicked the mouse on the confirmation button.
-Oh my…
Dowook hung up and bowed briefly toward the direction of the infectious diseases department. Come to think of it, this was also an accumulation of evaluation points.
Ring, ring.
The phone rang again.
-Dr. Park. I'm the chief of nephrology.
Dowook was slightly surprised by Chief Kang Beom Seok's call.
"Yes, sir."
-There's a patient who's in shock due to dizziness. Can you give me a second opinion?
Dowook reached out once because the outpatient clinic for nephrology was right next door.
Tingle.
The professor in the next room seemed to be a very good person.
"Do you have a chart?”
-If you look at number 3613…….
As soon as he saw the computer chart, Dowook continued to write down a prescription.
"The patient has an abdominal aortic aneurysm and high blood pressure underlying chronic kidney disease, but is taking a hypotension drug. The symptoms are complicated."
-Right. That's why we need the neurosurgical department’s judgment.
Dowook, who confirmed the direction suggested by the sense, said after showing gratitude toward kidney medicine.
"Wait. Angiotensin 2 receptors can cause hyperkalemia.”
-huh?
"Didn't you know that the patient's symptoms were not the problem, but the drug was causing arrhythmia?"
-It's not that I didn't know…….
Click.
"I'll write a prescription and send it to you, so check it out. It’s not a patient who needs neurosurgical surgery, but I'll help you as much as I can."
-Wait a minute. Hey, Dr. Park. Let's pretend this didn't happen.….
Dowook smiled as he hung up. 4th floor, outpatient area. It was really the best place to respond to these acts.
