All language subtitles for Golden time E09

I'm the Chief of General Surgery.

And do you think that there is anyone here
who knows less about surgery than you?

In the last surgery,
we saw very important points, so..

I've already read the surgical notes.

Well, let's start.

Yes.

Anesthesiologist, is it ready?

Yes.

Then, let's start.

Irrigation.

It's too rough inside his abdomen, though...

What if he hasn't experienced a patient like him

whose organs are too swollen
and torn off at many parts?

Since he's specialized in large intestine,
small intestines are nothing to him.

And about that it's marked respectively
with silk and Vicryl,

Professor Choi must have written it
in the surgical notes.

Platelet status is just 58,000.
Would it be okay?

Well, the patient's state isn't very good now, huh?

Pancreatin seems also leaking.

Well, for more than two days,
his intestines have been tied up,

so it's not desirable either.

We need to proceed with the operation
while continuously giving blood.

A Whipple surgery is also required.

Will you do it yourself?

I did that operation all the time before!
The results were good too.

Ah, yes, they must have been good.

Irrigation.

Suction.

Forceps.

Oh my god!
What is this?

They are totally adhering to each other!

Is it because of the pancreatin?

The adipose tissues have all turned to white!

Wow, I've never seen this kind of thing in my life!
Only I heard about it.

It's a big problem.

It's saponification!

I anticipated that the organs must have been damaged a lot, but did not expect it would be this much.

Will you do the Whipple surgery first?

Or at least, the small intestines need to be...

Well, but Whipple is the main surgery here.

Aish, it drives me crazy!

Everywhere is bleeding!

All organs are tangled now like this,

but will you continue to proceed with this surgery?

But we should still try it.

As per the surgical notes of Choi In Hyeok,

here, the parts marked with same thread, it would be fine if we connect those same thread marks.

Here, at Treize,

it's marked with Vicryl.

I think it would work
if we connect this part and that part.

And this part marked with silk,
we can connect it to there.

Yes.

Well, he marked well anyway.

What?

But what happened here at the mesentery?

Eeeww!! On the ruptured pancreas,

the mesentery is adhering all over!

Silk!

Here it is.

Aigo, why is it like this?

Oh my God, Professor! Wherever the needle is coming out, the blood is leaking!

Mosquito clamp!

Oh, why is it like this?

The bleeding doesn't stop!

Give me Prolene.

Professor! The bleeding doesn't stop!

Can't you prepare the surgery properly?

I'm sorry!

Usually for cancer patients,
this much preparation was enough.

It's because I've never prepared for surgery
for a severe trauma patient before.

But at least, I gave him
blood transfusion continuously.

How important this patient is!
You should've prepared in advance!

Once the platelets are ready,

please bring them over.

Chief, I did prescribe it yesterday.

I think it must be on its way here!

But as you know well,
platelets are so hard to secure.

What about PT?

I ordered 50%.

Did you give him blood plasma?

Of course! Do you think I'm an idiot?

I gave him 2 packs per every 8 hours,
without fail!

But then why is he in this state?

Although I gave him plasma,
he's not stable;he's not stable.

Chief Kim...

It seems like DIC!

For today, we'd better stop the surgery here,

and after fixing the problem of blood coagulation,
we should try again.

Reporters are waiting outside
but how can we just leave the OR with nothing?

Anesthesiologist!

How are the patient's vitals?

His vitals are quite okay,
but will you keep doing the surgery?

I need to know to prepare for it, too.

Intestines are important,

but I should do the Whipple surgery too.

Fixing small intestines is impossible now,
but do you think we can do a Whipple now?

Call for Doctor Lee Young Hak
of Hepatobiliary Surgery.

Yes.

Chief, earlier you said
you would do the Whipple surgery yourself...

CALL HIM!!!

Yes.

Irrigation.

Why is the next room so noisy?

Chief Kim Min Joon is performing
the 2nd surgery for the patient Park Won Gook.

Ah, surgery is surgery,
but why is it so noisy?

Well, there are also Chairman and Director too.

Is that so?

Then, he must be so excited now,
but why?

It seems that the patient is having DIC now.

Wherever they touch, the blood is leaking,

so it doesn't seem that the surgery would be easy.

Uh oh.. he's quite a showman on stage,

but this time, he's totally hooked
in front of VIP spectators.

Doctor Park Sung Jin.

Yes, Chief.

That patient Park Won Gook, once his surgery is done, go and disinfect his leg wound well.

If he has some infection,
it will become a big problem.

Yes, I've already prepared for it.

Would it be really okay
even if we're not there?

Well, we saw the first operation well,

and know everything about how to connect them.

Even if we're not there,
do you think the surgery will fail?

Professor Choi definitely wrote everything well,
not only trusting us, the mere interns.

But still...

wouldn't there be anything we can do?

These kids must feel the same way we do.

Well, he's like a father to these kids.

What if something goes wrong with him?

Can these young kids handle that big loss?

Ah... I'm sorry.

Shouldn't I mention "father" issue?

It's okay.

It will go well, surely.

Aish, I also wrote the surgical notes well.

Even if we are just mere interns,

it's better having us there anyway
than not having us.

Stop worrying about it.

Doctor Lee Young Hak,
check this out.

We need to do Whipple surgery now.

Wow, it's so messed up inside.

We're trying to fix DIC
and platelet data is increasing now.

Even connecting intestines would be difficult now,

but if we touch this ,
it's like self-destructing.

That's why I called you, Doctor Lee.

Are you telling me that you didn't know pancreatin had been dissolving the organs for the last two days?

In this situation, are you suggesting
to detach them and attach again?

Even if the DIC is handled,

Pancreatico-jejunostomy, choledochojejunostomy, gastrojejunostomy,

I can't guarantee that all those procedures will be successfully done.

Don't you know who this person is?

I know.

That's why I'm telling you this.

In Hepatobiliary Surgery, once something goes wrong, you know that it's hard to fix it.

And right now, re-connecting them is not important,

but approaching to cut them is more problematic.

Excuse me, Chief.

BE QUIET!

You can do the liver transplant,

but how can you say this is difficult?

This patient doesn't have a single organ
functioning properly now,

and he must have multiple organ failure now,

and as I read the surgical notes,
the cell-saver was used too.

That means there can be infection too.

That's why... we have to finish the surgery today.

Do you think the patient's state would get better
if we stop the surgery now and leave OR?

There would be even higher possibility
to have infection.

Until when can we leave him
with an open abdomen?

Since the surgery time needs to be shortened,
please perform the Whipple yourself.

Even if I perform it, the possibility
that the patient would die is high.

Well, Chief!!!

I told you to be quiet!

Aigo, that's not what I meant!

Over there, outside,

Chairman and Director are watching us.

What?

When did they come?

I don't know when they came,
but it seems to be for a while.

What is he hesitating for?

While the patient's abdomen is opened.

Probably, because the first surgery wasn't done by him,

it seems to be taking more time for him to check inside.

Choi In Hyeok, a doctor who used to handle trauma patients in the ER, performed the first one.

The person who brought this patient
to our hospital is also him.

You said he submitted his resignation.

Anyway, no matter what it takes,
save his life.

Hey, hey! News, news, news!
It's epic, epic!!

The entire hospital is material for news.

Right now, in the OR for Park Won Gook,
it's going crazy there!

Why? Why? Why?

In the middle of the surgery, the patient had DIC,
so they can't do anything while his abdomen is opened.

They say that although the level of platelet was low, they were forced to perform the surgery,

so it caused a big problem.

And the Chairman watched the surgery,
but it went so crazy too.

What about the patient? Is he okay?

Well, they tried this and that,
and after the blood transfusion,

the level of platelet was increased,
so the surgery was started,

but the pancreas was leaking,

so his inside is all messed up!

What? If Pancreas... it's leaking....

The internal organs must be all adhering
to each other and messed up.

Is it leaking a lot?

I heard it was so severe that even the next room could hear their yelling.

Ah, I'm going crazy....

How is the patient? Is he okay?

I don't know about that.
I just came to tell you this news.

Then, I'll get going.
Work hard!

Whenever he comes,
why is there always big news?

I'm going crazy, really...

Yes, this is Choi In Hyeok.

Oh, Dr. Choi.
Yes, this is Choi In Hyeok.

Oh, Dr. Choi.

Yes.

Oh, Dr. Choi.

Hello.

It's been a long time.

Have a seat.

Do you know why I called you here?

I don't exactly know.

Since I'm busy, I'll get straight to the point.

Patient Park Won Gook is in a critical situation.

It seems like the insides of his abdomen is a mess.

His pancreas is leaking again and he has DIC too.

It's a miracle that this patient is still alive.

Don't you think that you should at least save him?

That's why I called you.

I handed over all details
to Chief Kim Min Joon.

Cancer and severe trauma are totally different.

Even now, giving him more platelets,

they try to fix it, then....

Dr. Kim Min Joon is already his primary physician. And I am someone who already left this hospital.

After meeting with Dr. Kim Min Joon and his fellow residents,

I will talk to them about the procedures needed in order to treat this patient.

Regarding his blood transfusion and damage control life support, I will leave the details thoroughly as well.

If they contact me later on, I can give them advice.

But, I don't think it's my duty to get involved after that.

But why are you suddenly so interested in that patient?

Haven't you heard the news?

He's a famous figure who has even been invited to the Blue House for a luncheon.

The Blue House?

He was reported by the media many times
for his moving story.

While living in a tiny one-room place,
he has continuously given donations.

He's a very likeable man for the media.

If we turn him away without even doing surgery and he dies,

The hospital will become chaotic for a while.

Why are you hesitating? You brought this patient here because you wanted to save him.

I put a hold on your resignation letter.

If you let Dr. Kim Min Joon be in charge,

I think it's best if you have faith and leave it up to him.

If there are too many cooks,
the soup will be spoiled.

It won't be good for the patient.

Then, I'll be leaving.

When are you going to give that advice?
After the patient dies?

Yes, this is Director Oh Gwang Cheol.

Yes, hello. This is Go Yoo Mi
from the Public Relations team.

Yes. The doctor's name who performed the surgery?

After I verify it for you, I will call you right back.

Ah, yes.

Yes, hello. This is Go Yoo Mi
from the Public Relations team.

Professor!

The reporters keep asking about the person
who first brought Patient Park Won Gook,

and the doctor who performed the surgery.

Can I tell them the truth about Dr. Choi In Hyeok performing the surgery?

If a doctor that left the hospital...

If I tell them that he did it, wouldn't it be a problem?

Truthfully, if they search it up, they'll find out the truth. So, we can't keep telling them a lie.

His resignation letter hasn't been fully processed, so it won't be an issue with the law.

Who is the person that first brought Patient Park Won Gook here?

They say that his medical procedure was done very precisely.

Is he a resident or an intern?

Oh, Dr. Choi In Hyeok?

Dr. Choi In Hyeok?

What department is he from?

He was originally from the trauma department.

Is it that person?

Oh, that person is the chief of the emergency department.

Choi In Hyeok was involved with traumas.

But, he's not at the hospital anymore.

He's not here...?

Yes...

What are you doing over there?

Dr. Kim Do Hyeong, please give them an explaination.

Yes, hello. This is Go Yoo Mi
from the Public Relations team.

Yes?

Dr. Choi In Hyeok?

After I verify it for you, I will call you right back.

Ah, yes. It is true that he doesn't come out to this hospital anymore.

If you go to our home page, there's a picture of him there.

Ah, yes... yes.

Department head, they are looking for Dr. Choi In Hyeok.

What should I tell them?

Should I tell them that he quit?

Forget that, ah!

First of all, after you verified it...

you'll call them back. Tell them to wait.

Yes, I understand.

Even if we perform the surgery, who will take care of him afterwards?

The person who performs the surgery should do it!

You know that my team performed a liver transplant a little while ago.

We're about to go crazy over that patient alone.

So?!

Why don't you let the person who started
finish it as well?

The first person to perform the surgery

should have had their own agenda.

Excuse me, doctor...

Surgery is surgery.

The fact that the aftercare is important

is also true.

What will you do?

Anyway, we need to connect
the small intestines again, so..

Let's do this while we think about it.

Yes.

I understand.

Oh my god!! Whenever the needle is out,

the tissue is torn off!

Lactic acid index level is also rising, so acidosis is getting worse!

Aish!

Bovie.

Bovie: An electrocauterer which handles the bleeding of a small blood vessel.

Catcher.

Why is this happening?

Tie!

I'm going to go crazy!

Whatever we do,
the bleeding doesn't stop.

Aish!

Wow, this is swollen.

Over here, it's ripping!

I know that too!

What about the platelet level?

It went up, but came back down. 60,500.

The main problem is the body temperature.

It has been a while since it dropped to 35 degrees.

Platelet index is low, and lactic acid,

acidosis, body temperature, and all!

There is absolutely nothing that is normal right now.

Professor, are you going to continue with this?

Yeah...

Call Dr.Choi.

What?

Don't make me speak twice.

Yes, Chief.

You need to come to the surgery room immediately.

Huh?

You said that I should call you whenever I needed help.

We are performing surgery for the Patient Park Won Gook that you abandoned.

DIC has occurred.

Did you give more platelets?

We were trying to suture him up, but blood is spilling. And the intestines are swelling.

You made the intestines in pieces,
so how can the organs endure that!?

Pancreatin is leaking a lot!

You said it's DIC. If so, close the abdomen.
After closing and leaving the OR, ...

Hey, Choi In Hyeok!!

Yes?

Hurry up and come look at the patient's condition!

Do you want this patient to die?

Irrigation.

Why is the water so cold?

I will prepare some warm water.

Hurry up. Quickly and get a lot.

--Suction.
--Yes.

How is the platelet count?

60,000.

What about blood plasma?

So far, I gave him 8 packs.

Well, considering you gave a little,
it's maintained quite well.

The problem is that acidosis, hypothermia
and DIC are all happening together.

It's a vicious cycle.

Can't you see that pancreatin is leaking?

I see it.

What are you going to do about it?

If I were you, I would set up drainage tube, and stop the bleeding on critical parts by gauze packing,

and close up the abdomen for now.

And I'll leave.

Hey, do you think I called you in here to hear that kind of stuff?

Either Whipple surgery or the small intestines,
at least one of them needs to be fixed!

I think it's best to delay this surgery.

What about the intestines?

After disconnecting it,

If you don't connect it and just leave it like that, it'll just swell up.

From the mesentery,

There is a limit to how much nutrients it can receive.

In case of trauma patients,
rather than finishing the surgery well,

damage control by minimizing the time of surgery

and improving the patient's condition
is more important

so that the patient can have another surgery later.

Did I ask you about that?

Even if we give up the part of small intestines
and pancreas,

if I were you,
I would close the abdomen and leave OR.

After raising his body temperature,

giving him more blood plasma,

and fixing acidosis and DIC,

then I would bring him back to OR again.

What will you do for bleeding then?

I will use hemostatic.

Will you be able to handle that?

It can't be perfectly stopped with just one thing.

But with hemostatic, gauze and packing and so on,

it can be helped a little.

The most important thing right now

is to finish it up as soon as possible.

And to leave this place.

Chief, you must make a decision quickly.

We came to check upon the progress of the surgery.

That's because we have to disinfect the leg's wound.

Since the belly is opened up right now,

You should do it after we close it up.

Ah, yes. We will wait and do it later.

Please answer the phone.

I will answer it.

Yes, it's Professor Choi In Hyeok's phone.

Where are you calling from?

Yes, just a moment.

It's the Chairman.

He wants to talk to you directly.

It's Choi In Hyeok.

Are you in the hosptial sitll?

Yes, I am, Chairman.

Can you meet with me for a moment?

Right now I am in surgery.

I'll contact you later.

Excuse me, Professor, what are you going to do?

What do you mean, "what are you going to do?"

Set up the drainage tube
and stop the bleeding.

Close the site with wrap and disinfect the site.

Chief Kim Min Joon!
How's the patient?

How did the operation go?

Those reporters are still here.

Don't they have any other news to report?

Please give us some information.

What is going on now?
Did the operation go well?

The patient is in a critical condition right now.
More so than expected.

We're dealing with life-and-death situation here.

Did you succeed on reconnecting the pancreas and small intestine?

It is not of the upmost importance for Patient Park Won Gook's case that he finishes this operation successfully.

The most important point
for the care of a trauma patient is

that you minimize the operation time, and do the demage control,

so, the patient will be ready to get in shape for subsquent operations.

Even if that means we need to give up some part of his pancreas and small intestines,

the most important thing here is to save his life.

What is your plan for the subsequent care for him?

It's called Demage Control Resuscitation...

Who performed the first operation on the Patient Park Won Gook?

It was a General Surgeon on call.

I learned while I was intervewing the paramedics,

that the Patient would have died, had he not received the proper emergency care

by the doctor at the scene.

It's said that the traumatologist
who accompanied the patient to the hospital

resigned this hospital.

Is it true?

Yes, it's me.

Ok. I'll be there shortly.

For that, you'll hear from our PR team.

Then, I'm a bit busy.

Chief!
One more question!

News! News!

Breaking news!
It's big!

Come here, quick!
What is this again?

Dr. Choi...

Dr. Choi In Hyeok is in the OR right now.

What???

And the Chairman called him.

That's BIG!

What? If so...possibly...
Is he coming back?

Well, I don't know about that.

Could... he be the human shield?

Damn you...

It sure looked like that!

Kang Jin, I heard Orthopedics is very busy.
But, you seem to enjoy your leisure time here.

I heard the patient's abdomen is in a very bad condition. What is happening now?

Are you curious? Are you?

Then, I'll text you the updates.
Dr. Park Seong Jin is still there.

Just tell me now!

For return, you need to help me with organizing the orthopedic patients' list.

I have been having headaches because of that list.

I got it. I got it. Make sure to text me about the updates.

OK. I will!

Send the text to me!

I will!

He always brings the trouble.

He should have considered the massive bleeding and the damaged pancreas.

What could he have done when saponification has occured?

Pancreatin is sticky
and the blood is clotting as well.

Let's hurry and finish up quickly as patient is not in a good condition. Yes!

How's the temperature of the irrigation solution?
It is warm.

Now, that's better.

Let's raise the internal temperature
by using the warm irrigation solution.

Wait.

Suction!
Yes.

Chief Kim Min Joon left the OR.

Dr. Choi In Hyeok only worked on installing surgical drains.

The patient will probably be sent to the ICU shortly.

Hey.

Yes.

I'll be going to the ICU for a short while.

Why?

I'm dying to know about the update.
I'll be gone for only 30 minutes.

Page me if it gets busy here.

I understand.

Dr. Kim Do Hyeong is not around, is he?

Me too! Sorry!

Just me? How can I?

I'll send over Kang Jin or something.
Do me a favor!

We'll be back soon!

Come right back when I page you!

Now, it has gotten a bit cleaner.

Are the surgical drain tubes ready?

Please prepare cigarette drains as they might clog again.

Yes,
Scalpel.

How about the tail of the pancreas?

One for the tail of the pancreas.
The other for the pelvic cavity.

There is bleeding over here.

Let's just put out the most urgent fire.

There's another bleeding here.

Put some pressure on it.

How about over there?

Give me an hemostatic.

Please give me some plastic pieces.

Gosh. What is this plastic piece?

I have never seen this type of plastic...

To prevent intestines from drying out...

They are sterilized. It is effective and cheap.

Yes~~

Prepare Rapid Deployment Hemostat.

Yes.

We'll need to use warm IV and blood,

if we want to keep the internal temperature in check.

What? You brought back Choi In Hyeok?

Yes, he did.

You were so confident before going into that operation.

What a show!
Too bad you guys had to miss it.

Oh, gosh.

You even skipped the Chief Medical Officer,
and reported directly to the Director.

I was just passing by,

But the Chairman was asking me what was happening.

Is that so?
Is that why you took charge of the press?

Chief Kim loves the stage.
Didn't you know?

I loved your performance.

Anyway...

Is Choi In Hyeok going to use that patient
as an excuse for coming back here?

The Chairman is quite interested
in establishing a Trauma Center.

With that and this patient, there's a high probablity that Choi In Hyeok will return.

When Choi In Hyeok returns,

he will be counted as General Surgery personnel.

He cannot use Emergency Medicine's quota.

Who said he's coming back?

How's the patient?

He could not be worse.

He has low body temperature, acidosis, kidney failure,

infections, dropping platelet level...

It is usually an immediate death when you are in a motorcycle accident like this.

What is the chance of him surviving?

I think his survival rate will be about the same as Choi In Hyeok's chance of returning.

It is too early to call.
Let's wait and see how it turns out.

Wouldn't it become a scandal if he quits

as all the media is following this closely.

There will be a lot opposition from the professors if this goes all the way to the HR hearing.

He RESIGNED.

What's with the HR hearing?

Of course, it will bring us good press if the patient lives, but

the media attention is short-lived.

No one will remember him after a month.

Let's push for his termination if an HR committee hearing happens.

Where are you going?

I am going to check up on the patient.

He should have arrived at the ICU by now.

Professor!

What brought you here?

We are here to help.

We probably won't be of much help, but...

Trauma patients are different from General Surgery patients.

This patient doesn't have one part of his body functioning properly.

His vitals are barely making it.

Sepsis is also in progess.

If you keep giving him crystalloid,

he will not produce urine,
but his body will swell instead.

There will not be any effective volume left in the blood stream.

Therefore, we're going to keep the level with albumin and platelets.

Please order blood.

Yes.

We'll need one more line.
Place a central venous catheter.

Yes.

How's the norepinephrine mixed?

It's a mixture of 200cc and 16mg.

We're administering 5.3 cc/hr.

Give him 500cc more of normal saline.

Please reduce norepinephrine to 0.08 mcg/kg/min.

Okay.

The patient is 70kgs...

When you multiple 70 kg by 0.08...

It is 4.2cc/hr.

What is it?
It probably isn't easy.

Yes, his body has swollen a lot.

It doesn't even seem like the needle is reaching to the vein.

It went it once,

the guide wire didn't go in, so I failed.

Of course, that's not an easy job.

As his condition is critical, all the veins are shrunken,

It's not hard to imagine that you have difficulties.

Move over. I'll try.

Move.

Hello, my patient Park Won Gook.

Let's see if you and I are a good match.

Well...

Well... he's not a good match with me either..

When the volume of blood is increased after transfusion, then should we try it again?

Yes, we had tried the needle so many times,
and even if we find his vein,

since he doesn't have much blood now,
the needle is not going in well.

We're still correcting his DIC,

so after the level of platelet is increased, then..

To increase it, we're trying to set up one more line.

Then, can't we do it on his leg?

This patient's left leg was injured, so he got a surgery to attach it back.

If you put the needle accidently on his femoral artery,
his leg can be disabled.

Then, we can do it on his right leg.

Just in case if the injured leg
can be amputated later,

the right leg must be saved no matter what.

Give me gloves.

I think it will work if you approach
from more outside.

Why do you think so?

Pardon?

Ah, that's.. subclavian vein is usually located between the first costa and clavicle.

And regarding to this patient,
I've been tracking and observing him in ER,

so I found his chest shape looks like a barrel
unlike other people.

His apex of lung is wider than regular body shape,

so if we keep poking inside like we did,
I don't think this approach would work.

Since it's much swollen now,
it would be even more difficult.

Yes! And when I saw his chest X-ray again,

if we put the needle a little more outside
from where you tried, then I think it would work....

Wear the gloves.

Huh?

Do it!

Yes, I will.

Professor! He's a critical patient.

He said he studied this patient's body shape.
That means he took a lot of care of this patient.

That's why he can imagine the location
of the patient's veins.

Yes, you're right.

If you put it in incorrectly, it will cause pneumothorax.
Do you know that?

Pardon?

Yes.

If you imagined where his subclavian vein would pass,

touch there by your hand.

If you touch there,

you might be able to feel the pumping of an artery,
not vein.

His BP is low and the body is very swollen now,
so it will be hard to feel that.

Can you feel that?

No.

Can you feel that?

Yes.

I can feel it very subtly.

Right on top of that artery, the vein is located.

Well, now, imagining the vein is pumping there,
try to put the needle in it.

It's in.

Aigo, thank God!

Well done, Lee Min Woo!

You're really something!

You have a good sense on your hands, too.

If we put him in General Surgery,
he will do well, right?

Well... since you succeeded in your first procedure,
you need to treat us for some food.

If you don't treat others,
it's not lucky.

Yes, yes.

Of course, tell me whatever you want to eat.

Yes, It's Choi In Hyeok.

Yes.

I've come out of surgery.

Yes, I'll come directly.

You did well.

Yes, thank you!

What will you buy us?

I want to eat Cool pig's feet meat.

You will buy that, won't you?

Of course....

Come in!

I heard what had happened so far.

You're the one who brought Park Won Gook,
pushed into the OR and performed the surgery.

Why did you do that?

That's probably because you wanted to save his life.

Of course, I did.

Then, save his life.

In case of trauma patients, there is usually
the first critical moment 1 hour after its accident,

and a few days later after the surgery
there is the second critical moment.

Even if the patient overcomes those two crises,
there will be the third one within one month.

Right now, this patient is going through
the second crisis of typical trauma patients.

Your resignation isn't approved yet,

so put out the urgent fire first.

Please approve the resignation.

I will fix that patient's DIC.

Then, within a few days,
the second surgery will be able to be done.

If DIC is fixed, even if it's not me, ....

There will be a lot of people
who want to perform the surgery.

Because the patient became a celebrity.

Did you decide where to move?

Yes.

For now, put out the fire for this patient.
After that, let's talk again.

You brought a dying patient here.

So, after saving his life,
then discuss it.

I will do my best.

And officially, the attending physician is
Chief Kim Min Joon.

You know that we can't appoint the person who submitted a resignation as the attending physician.

You know that we can't appoint the person who submitted a resignation as the attending physician.

You found this patient during your vacation,
so handed him over to Chief Kim Min Joon,

and as the state of the patient got critical,

you stopped by the hospital for a moment.
Let's say that.

Yes.

Other than that, discuss with Director.

I understand.

Okay.

Nurse Jung, where is the chart for Park Won Gook? Just a moment.

Yes, Grandfather.

When will you leave?

I will leave once the duty is over.

Then, I will be at the back gate of the hospital
one hour later,

let's go together.

Yes.

Is this the one?

Thank you.

Are you coming back?

You know I'm not.

If you're going to come here so easily when they call,
then why did you submit the resignation?

I'm not coming back.

Once this patient overcomes his crisis,
then my resignation will be accepted too.

Then, while you're taking care of that patient,

what if there is another trauma patient
coming into ER?

In that case, I guess they would perform
the surgery themselves!

Are you preparing well for moving to Canada?

YES!

What about you, Professor?

Did you decide where to go?

Please answer your phone!

Yes.

Yes, it's Choi In Hyeok.

Ah, the date for the job interview?

Yes, 13th would be alright.

Yes, I understand.

Yes, I will prepare the visa.

Yes.

Are you going somewhere?

I need to get a job.

I can't be unemployeed for a long time
like a wealthy playboy.

He says he will work for mercenary troop company.

Where? Pakistan?

No, was it Iraq?

Libya.

Oh, Libya.

I also...

want to work where they need me.

Did Dr. Min Woo go somewhere?

What's all that?

Groceries we ordered!

You didn't go yet?

Yea, I have a favor to ask.

What's this?

Isn't this alcohol?

Yes.

It arrived.

Are you having a rough time these days?
You can't sleep without a drink?

It's not that.

Dr. Min Woo, could you please take care of the patient in bed #7?

I'll be going. Work hard!

Dr. Jae In.

Take this.

What's this?

Last time, the necktie. . . that. . .

Even if I buy you a new one,

you don't have anyone to give it to, right?

Use this for your father's memorial service tonight.

Hey,

There's no one who cares but you.

It's not like that.

Let's go. I'll see you off.

Work hard.

Bye!

Oh I love these.

Go safely.

Cheer up.

Thank you.

Eat something yummy!

I'll go back up.

Did you wait for a long time?

Your ex-boyfriend is already in Seoul, why is he always hanging with you?

He's a co-intern.

Would you like it if I was an outcast?

It's just because he always stands out.

What's that?

He bought it for father's death anniversary.

Bought it?

Who? That guy earlier?

Yes.

Here.

What's this?

A report. I wrote it when I was bored.

Read it slowly at home.

Okay.

Let's go.

Unnie, I heard from somewhere. . .

Lo que quiero decir Young Soo...
Are you sure it was an accident in the US?

What are you saying right now?

I'm sorry, sister-in-law.

It's been over 10 years.
You don't need to make up stories about that.

Are you that free?

I know, right.

I am not sure why the rumors are circulating now.

The accident was because

of that old car he was driving,

as Dae Je stopped supporting his expenses.

Is everything ready?

What?

That's when Dae Je opened Gangnam Sejung Hospital and

he put the blame on the kidney transplants on Yeong Soo..

That was when the third and the fourth attempts failed one after the other.

That was when the third and the fourth attempts failed one after the other.

It wasn't as though he forced him to go to the U.S.

It wasn't as though he forced him to go to the U.S.

It won't be strange if it was a suicide and not an accident.

He was a senstive person.

Just keep quiet.

I really can't say anything to you.

Dae Je Oppa was also a bit harsh that time.

Yeong Soo wasn't born a surgeon.

He didn't have much drive to be in charge of the transplantations.

Then, all the transplantations went bad.
Gosh.

Someone might hear.

What? It's something the whole family knows.

You're here, great aunt.

Hello, great uncle.

You're here.

You're suffering being an intern, right?

Everyone does it.

I'm here, Grandma!

Is there something I could help with?

You're getting prettier.

I heard that your ex-boyfriend was transferred to Seoul.

Omo. It's my fault not being able to hold in my curiosity. Sorry.

It's alright.

That boy was transferred to Seoul.

What good happened that you came in here?

It's a memorial service for your nephew. Not your parents.

It's not like you have many kids.

It's your only son.

And your only son left only daughter, Jae In.

Then hyungnim,

How could we not come over,

when we know that it will be such a small group
We live close by.

I wonder how people get all the gossips about you two.

Whose line is that university or whose line is that hospital.

People are so interested.

I hear you almost have agreed on the division of your assets.

Although the real estate was from your side of the family,

it was Dae Je's respectable reputation as a great surgeon

which made the Sejung Hospitals a successful business.

Why are you so interested in other family's business?

How could your family be other's business?

If the University is awarded to her, should I leave my appointment as a provost?

Shut up.

If you say one more word then I'll have your immediate resignation.

Do you still want to become a good housewife?

Yes.

Unni, should I introduce a guy to her?

There's a son of a veteran Assemblyman...

About the report earlier.

Yes, Grandfather.

I will look through it.
I'll talk to you about it later.

Yes.

What report?

About ER operations and trauma patient care.

That's not something that could be solved by the hospital.

More over, what could a mere intern know about those issues?

I'll make the call whether the report is worth something or not.

Ahh, Hyungnim, because of the patient Park Won Gook. . .

Wouldn't it be easier to establish a trauma center?

You sure got a lot of hype.

But you would need to save him.

You must be pressured, Oppa.

Jae In, I hear rumors often about you in the hospital.

In the end, is she really doing her internship
at Sejung Hospital?

Of course.

Won't it be better if she goes to the U.S.?

Since she's good in English.

My close friend is working at the Mayo Clinic.

If you'd like, I can write you a letter of recommendation.

I'm not ambitious for that kind of things.

Not being greedy, you took after Yeong Su.

Jae In, I'll give you a ride.

Yes, Grandma.

You've worked hard today.

You too.

Great aunt and great uncle, I'll get going.
Grandpa, I'll leave first.

Be careful on your way.

We're also going.
Be safe.

Okay.

You can go up. My car is coming.

Okay. Be careful on your way.

Yes.

Go on in, Oppa.

Professor, I'll do it.

You must be tired.
Why don't you go in and rest?

I came after resting for a few days.

Go in.

But still. . .

Professor, are you coming back to the hospital for good?

There had been a lot of noise in the hospital and there were all kinds of rumors flying...

Don't mind them.

I came here to check up on the patient going through the critical point whom I brought in.

Then the second surgery. . .

If I did it then I would test your homework.

Go and do your work.

I'm curious if there's urine that came out.

I check every 3 hours. . .

I'll be going in.

Since the pancreatic drain tubes are open, we have to be careful about preventing infection.

Metabolic acidosis is a condition that occurs when the body produces too much acid...

To treat metabolic acidosis...

Dr. Jae In!

Oh, you scared me.

Did it go well?

I'll show you some magic. I learned it from Kang Jin.

Look closely.

This is one man's heart.

One woman tried to catch one man's heart.

Unfortunately, that man's heart...

Went somewhere else.

It left.

That woman who was left alone

was so embarrassed and shy that she wanted to hide. She was shaken.

The woman who didn't know what to do, with that man...

She transferred him.

But, that woman's heart remained here.

Confidently,

She transformed into and is growing as an intern.

Why?

It's easier to work hard on something.

What kind of doctor will she transform into? Wait for it...
It's a big opening night!

Do you want a cup of coffee?

Did you have a good trip back?

Professor,

Are you okay?

I'm going to wash my face.

Perform a test on the arterial blood.

Yes, I understand.

Patient Park Won Gook's arterial blood test results are out.

The pH is only 7.3

Should we treat him with sodium bicarbonate?

If it's 7.3, isn't it not necessary to give it to him?

It is to correct the Metabolic acid symptoms.

This patient's carbon dioxide level is at 45 right now.

Rather than treating him with bicarbonate,
wouldn't it be better to increase the respiratory rate

and lower the carbon dioxide level?

In that patient's case, there is a good chance that the metabolic acidosis could get worse.

While lowering the carbon dioxide level is important,

lowering the intracranial pressure by using medicine
such as Mannitol is also important.

Don't worry too much about it.

When Prof. Kim Min Joon comes down, he'll make a decision.

But, aren't you guys working too hard?

You have so much energy now that Prof. Choi is here.

Aigoo, you guys are so much better
than our Chief Resident!

Ah, why do you have to say it that way?

Interns, all they do is create problems.

Ah, you came?

The patient's arterial blood test results came out.

His pH level is low. Should we use the bicarbonate treatment or adjust the ventilator?
Which would be better?

Consult with Internal Medicine.

Ah, yes. I understand.

Let's go.

I'm late.

What about the blood platelets?

It has been cancelled...

There should have been some leftover from what I ordered yesterday.

That...

I cancelled it.

It's not like we're going into surgery.

I cancelled it as he has more than 52,000 blood platelets.

The Insurance Audit Team said it was an unncessary transfusion.

Oh, she's coming.

I am from the Insurance Internal Audit Team.

If you keep providing the blood when the platelets are over 50,000,

it's over the budget

It was more than a $40,000 deficit just last year alone.

Those were all your patients.

I cannot agree to it.

If it's 50,000, unless if he gets an operation,

he should be able to sustain it.

For a trauma patient, even the surgery text book says to keep it over 100,000, if he has tendency to bleed.

Just give us the platelets for now and I will give a copy of the text book.

We can submit the objection together later.

Health Insurance Review & Assessment Service makes a decision on the basis of surgical patients.

They have no way of knowing if he is a trauma patient and they don't even want to know.

Would they consider each individual's situation?

You need to save the patient's life.

Now, we have given him this much blood platelets and the numbers aren't even going up.

Wouldn't it be pouring water into a cracked pot?

Yes!

We need to pour blood platelets into him!

If we are going to give it to him anyway, let's give it to him quickly.

If we give it to him after his condition gets worse,

then, it will really be like pouring water into a cracked pot!

If we are going to give it to him, we must give it to him as soon as possible!

This patient...

If you just step back for just one moment, he will die.

Once there's a cutback,

You must take responsibility.

Who lowered the PEEP?

I told them to lower it.

Since it's a acute respitory situation, I was trying to keep it high.

If the PEEP is high, the blood pressure will drop. That's why I asked them to lower it.

In this case, we need to keep the PEEP high.

And we need to find another solution to maintain the blood pressure.

I too used to live in the ICU.

Have you given him Lasix?

Yes.

I gave it to him an hour ago.

And still, there isn't any urine coming out.

He is having a kidney failure.
With diuretic, it can't be controlled.

Really?

Yes.

Then, raise the Lasix twice as much.

Pardon?!

You need to give him more IV
and increase the volume.

The patient's kidney might have been destroyed already.

But you want to keep giving him more IV?

What if it doesn't come out even after you keep giving it to him?

We will use the dialysis.

If you use dialysis, the blood flow to the kidneys will decrease even more.

Then, the renal function will be damaged.

Are you planning to make them useless?

In this situation, we can't do anything about it.

And most trauma patients recover from acute kidney failures.

What if he doesn't recover?

We need to wait upon it.

While we continue the dialysis?

What are you going to do about the lungs?

If there is any pleural effusion occurring,

you need to reduce the amount of IV
and remove that fluid from the lungs.

This is the basics of both the internal medicine and surgery department.

The patient's circulation is going to be worsened.

So, you will drown the lungs in water?

Used Lasix.

I will insert the tube and drain the water out!

This patient's physician is me!

You don't think I lived in the ICU?!

Are you the only one who knows how to handle the ICU?

Reduce IV and

use Lasix.

This patient! If he doesn't get more IV,

because the volume won't be enough,
it will cause circulatory failure! Then?

His metabolic acidosis will get worse!

And this patient will die.

I said, this patient's physician is me!!

Immediately, well,
get a dialyzer ready.

You two...

Come see me.

What happened?

This patient's lungs now are full of fluid...

Can you save him?

I will try my best...

Can you take responsibility and save him?

Can you put your role as Chief on the line and save him?

What's wrong with this?

What's wrong with his blood pressure?

Isn't it because of hypovolemia?

It's 70/40.

Please call Prof. Choi In Hyeok.

Shouldn't we do something,
like using some medicine?

Call General Surgery. Quickly!

Quickly call them!

What are you going to do now
when the professors haven't come yet!?

It's atrial fibrillation now!!

Put the gel!

Quickly!

100 Joules!

Charge.

Clear!

One.

Two.

Three.

Shock!

He's still fibrillating.

Gel!

200 Joules!

Charged.

Move.

One...two...three.

Shock!

HEY!