Original subtitles

Episode 16

He's 30 years old...

It was only his spleen, which was injured.

Why didn't they think to transfer him immediately?

If they took his CT scan, they must have found the spleen rupture.

Then, they should've thought his belly would become bigger soon.

Well..

As he looked fine by his appearance, they probably didn't expect it would get worse that quickly.

When we first started to work here,

do you remember that patient who had to be transferred to Ulsan?

On our first day as interns,

we knew the patient's state was critical after seeing the belly getting bigger.

Worrying if the patient would "expire" on our way to Ulsan,

Professor said he would go with the patient himself.

As one intern alone can't handle it,

he sent us together.

Nowadays, as we see trauma patients often,

we can foresee how the patient's state would progress,

but if there were no Trauma Team here, we would've done the same as they did.

30 years old...

He's the same age as my younger brother...

Chairman?

Chairman!!

Chairman!

Where do you feel uncomfortable?

Head... my head...

Your head? How does it hurt?

As if a hammer is striking it...

Would it be alright for me to take you by the car, not 911?

Please stand up.

This is the secretary of the Chairman.

Can I talk to the Chief of the Emergency Medicine Department?

He is off work now.

What's the matter?

Right now, I'm heading to the ER with Chairman.

This is a very urgent situation!

He's suffering from so much pain,

and he collapsed at the living room of his house.

Please prepare everything quickly!

We will arrive within 10 minutes.

Yes, I understand!

Are you alright?

Chairman!

Chairman!!

Chairman!

Chief! Chairman will arrive here within 10 minutes!

Chairman?

It has been for just a little while since he was discharged.

Where does he feel unwell?

I was told that he has a severe headache as if his head is about to be cracked!

What?

He has a headache?

Yes. I will also call Professor Choi In Hyeok!

Okay. As for Neurosurgery and Neurology, I will call them.

Does he have any bone fracture?

Pardon? That's... I couldn't ask about that.

--Okay, I'll be there soon. Wait. --Yes!

- Yes, Doctor Kim Do Hyeong. - Yes, Grandma.

Chairman is coming to the hospital now.

The Trauma Team needs to be ready STAT!

- Chairman was discharged, wasn't he? - Grandpa was discharged, wasn't he?

- 10 minutes? - 10 minutes?

- Yes, I understand. - Yes, Grandma.

It was Doctor Kim Do Hyeong,

but he said that Chairman is coming here again,

The Trauma Team...

he orders us to stand by. What was your call about?

It was my grandmother. She said that my grandfather is sick now.

Ah.. Was your grandfather hospitalized in our hospital?

No. He's in another hospital.

It hasn't been long since he was discharged, but this time, he has a severe headache.

Let's go. He said that the Trauma Team needs to stand by.

We should show the Chairman what's so good about having the Trauma Team.

Uh.. of course.

Wow...

Well.. what's...?

What's going on? Chairman was discharged.

I don't know what's going on, either. I'm going crazy.

I don't know what's going on, either. I'm going crazy.

He said they would arrive soon, but why aren't they here yet? I'm really going crazy!

-Uh? What's that? -An ambulence? We haven't received any call!

- What happened? - This patient's BP is dropping.and he's losing consciousness too!

Consciousness? Since when?

It started from the day before yesterday.

Aish.. Chairman is about to arrive... This drives me crazy!

Kang Jae In! What are you doing now?

Quickly take this patient!

I will go with her.

Okay!

For now, move him over there.

What kind of patient is he?

That wasn't a case of Trauma.

Hasn't he arrived yet?

Ah, he said they would arrive soon,

but not yet.

Bring a guerney quickly!

Where would he have a problem?

As he's suffering from headache,

there must be a possibility of cerberal hemorrhage.

Professor, you need some rest too..

What is the patient's name?

Kang Dae Seon.

Mr. Kang Dae Seon!

Mr. Kang Dae Seon?

Hold on, one, two, three!

Be careful.

Can you hear me?

Can you hear me, Mr. Kang Dae Seon?

Since when was he like this?

Since the day before yesterday, he has kept falling asleep.

Does he have any chronic disease? Such as high blood pressure or diabetes?

No, he doesn't have such things.

Did he get hurt on his head?

No.

What about vomitting?

He didn't vomit.

Well, he always complained the pain at his knees,

so he used to get physical therapy at Orthopedics.

Patient!

Patient!?

His mental state is "drowsy".

I guess we need his CT scans and blood test.

I will submit the orders.

Didn't he have any trauma injury?

He was sitting on the floor of the living room, but he said that he didn't fall down.

Help to move him!

Careful, careful!

Hurry and move!

Chairman! Chairman!! What happened?

Yes?

Careful, careful!

Chairman?

Chairman?!!

Doctor Min Woo!

I submitted the orders.

Please take care of this patient.

Yes.

Do an electrocardiography test first.

And submit the order for blood sugar test.

He was conscious until 15 minutes ago,

and he said his head hurt as if a hammer was striking it.

He complained of a severe headache in the car again,

and it took about 2~3 minutes until he lost his consciousness.

Call the Cardiology Department too.

I already called Neurosurgery and Neurology, so they will be here soon.

Yes.

And... he had an alcoholic drink a little.

Because of his personal reason...

Doctor Kim Do Hyeong.

Regarding the patient Kang Dae Seon,

his mental state is declining without any reason. Will you examine him?

What?

Go quickly and examine him.

Yes.

He said he suffered from a headache as if the head is about to be cracked.

Just in case, if it's myocardial infarction, it's a super emergency, then.

Doctor Intern!

Hey, Intern!

Yes?

Oh. I'm sorry.

There is nothing wrong here.

His B/P is 140/80.

Hmm, although it's a bit high, this range is considered to be normal.

What about the blood sugar test?

It's 105 mg/dL.

It's also within normal range.

Wait a second.

It doesn't look good. What about the CT scans?

Not yet.

He just arrived, so we only checked his blood sugar level and B/P.

How are they?

Other than his B/P being 140, nothing is abnormal.

Blood sugar level is also 105mg/dL and electrocardiography showed nothing.

Let's do the CT scans first.

Yes, I understand.

Chairman wasn't conscious at all. I'm so worried.

Didn't he have CT scans last time?

At that time, there was nothing wrong.

Hello.

Patient? Patient?!

His mental state is in "drowsy".

His BP and body temperature show nothing suspicious.

Do you want me to consult with Neurology?

- Did you submit the order for CT scans? - Yes.

Then, for now, let's take his CT scans first.

Yes, I understand.

It's on the monitor now.

It's a subarchnoid hemorrhage.

Oh.. there it is!

Will you perform the surgery right away?

Is it a traumatic injury? Did he get hit by anything?

We can't conclude it quickly.

Shouldn't we take angio-CT?

We should.

Submit the order for angio-CT.

Whether it's traumatic or not,

it's unavoidable to have an emergency treatment or an emergency surgery.

Did you contact the Director?

I will contact her.

Why is an intern here?

As it's done here now, go to the ER and wait there.

I will call you if we need you.

Yes, I understand.

Leave.

Director.

It was just found that the Chairman has a subarchnoid hemorrhage.

Subarchnoid hemorrhage?

Then, does he need to have a surgery?

Since they weren't sure if it's a traumatic hemorrhage or not,

now they're taking angio-CT scans again.

I'm on my way to there. How is Jae In?

She's calm.

Let's talk again when I get there.

The scan is done.

There, there, over there!

Isn't that cerebral aneurysm at P-com?

Yes, it looks like that.

Then, there must have been some symptoms such as visual field defect or drooping eyes.

Its size looks like about 1 cm.

Then, do you have to perform a surgery?

Does he have to open the head of the Chairman?

Looking at the shape of cerebral aneurysm,

I should be able to treat it with coiling.

Contact the Angiography Room and prepare for coiling.

Yes, I understand.

Hold on!

From now on, he must not have any kind of stimulation.

This cerebral aneurysm means that there is only thin scab on the artery.

Even by a little bit of stimulation, there can be rebleeding.

So, move the bed very gently

and don't make any big sound.

Ah, is the isolation unit in ER vacant?

Yes, it is.

Close with thick curtains and make sure not to make any big sound.

I'll be at the Angiography Room for preparation.

Don't let interns set up even a urination catheter.

Do it yourself or let the residents do it. Got it?

Yes, I understand.

And give him morphine and trandate him immediately.

Yes.

Then.

Hey!!

Are you out of your mind?

Go away!

I'm sorry.

Doctor Kang Jae In!

Yes?

You!

Looking at you, you seem to be in very bad shape today.

Don't ever come near Chairman, never!

Yes, I understand.

What's the matter?

Cerebral aneurysm.

What?

Then, does he need any surgery?

We're taking him to the Angiography Room for coiling.

But then, why did you treat him so carefully, as if you're carrying a new-born baby....?

Right now, he's like a time bomb!

She's acting like that because there is a possibility to have a rebleeding.

If a rebleeding happens, it will cause a death right away.

Despite the hemorrhage being barely stopped by a thin scab,

if any kind of stimulation affects the patient

and makes the BP increase and the artery explodes, then it will become irreversible.

You shouldn't hit the bed,

and even a single urination catheter must not be set up roughly.

Even by a little pain, it can cause a funeral.

But in any case, if an intern of the ER does something wrong,

and Chairman has a rebleeding, then what will you do?

You guys, today,

don't ever go near Chairman. Got it?

Yes, we understand. don't ever go near Chairman. Got it?

Yes, we understand.

And, you, when the CT scans of the patient Kang Dae Seon come,

put them on the monitor first.

Yes, I understand.

Alright.

There is nothing wrong.

It's clean.

Call Neurology.

I understand.

The treatment for aneurysm will not be done by opening the skull

but by obstructing the burst aneurysm first through the blood vessel.

The problem here is that if a rebleeding or any blood clots happen,

those will block other blood vessels.

I understand all treatments have some potential problems.

I'm a bit concerned that he was already unconscious before arriving here.

Yes. As you know,

depending on his mental state when he arrived at the hospital,

it can take some time until he fully recovers

even if the treatment is successfully done.

So, you mean it's not easy.

We don't have any other option here.

Once the preparation is done, we will start the treatment.

I heard that the rebleeding....

is pretty dangerous.

Yes, you're right.

Since the wall of artery is now so thin, it can burst again.

If that happens, we should open his head immediately, remove the hematoma,

and stop it with clips.

We already prepared the OR just in case.

Well, Director, here, please sign this form.

As you know well, this treatment requires the consent from the family.

Aigo...

Well, please don't consider this unpleasantly.

There is a possibility to have some side effect depending on the patient's constitution.

No, it's not because of that.

While we are separated,

I guess you all know that we have been working on a divorce suit.

We've already gone to the court,

so I'm not sure if I have the right to sign this form.

Well, we have a granddaughter, though.

Oh, there is a granddaughter?

Is she coming now? The consent by phone call is also workable.

Oh, at this hospital, she is now...

Director, you haven't submitted the documents yet, have you?

As far as I know, you should submit the documents to the district office to make the divorce effective.

You're still his legal guardian.

Legally, yes, I am, but..

We're not asking you to take the responsibility.

Please give me that form.

Whoever signs it, as we need to save his life first...

Did you call Anesthesiology?

I didn't call him yet.

Who will do the intubation?

Ah, I was going to do it...

Ask the Chief of Anesthesiology.

Huh?

Yes.

I'll make contact direclty.

Patient!

I will raise your knees. Please stay still.

Excuse me, Patient!

I will raise your arms, arms!

Keep them like this.

Patient!

What's your name?

Patient? What's your name?

There is nothing wrong as per his CT scans.

At the end, I suspect cerebral infarction...

His symptoms are different from cerebral infarction, Doctor.

Ah, I had worked in an oriental medicine hospital for two years.

I've seen hundreds of patients with cerebral infarction,

but his symptoms are very different.

That is, what I mean...

Intern doctor!

Yes?

If the patient's mental state is declining without any specific reason

and there is no problem found on CT scans,

then we should try even MRI

to find out if there is anything wrong or not. Don't you think so?

Well, you're right too, but..

I think his symptoms are a bit vague for us to explain cerebral infarction.

I think his symptoms are a bit vague for us to explain cerebral infarction.

And to take MRI, it costs much more than 1 million won , so...

For me, too,

it's hard to tell the guardian to do an expensive test which will cost more than $1,000.

But, is there any other option?

I don't know how you did at the oriental medicine hospital,

but we have a good method called MRI.

Why aren't you going to use that?

Well... CT scans were all clean....

I think it's vague, though....

1 million won?

CT scans, blood tests, Neurological tests, we tried all we can do,

but nothing abnormal has been found.

However, I suspect cerebral infarction.

Well, if there is a stroke, I heard the patient wouldn't be able to use the half of the body.

Well, maybe it's not the case, is it?

It's possible that it's not the case.

If we confirm it's not cerebral infarction,

then we will test his cerebro-spinal fluid.

Cerebro-spinal fluid?

If it's not encephalitis, it can be encephalomeningitis.

Encephalitis?

Of course, its possibility is slim,

but still, we can't rule out its possibility.

Well, that... cerebro-spinal fluid test, how much does it cost?

And, which one do you think has higher possibility?

Since he didn't have any fever,

cerebral infarction is more possible.

Then... what if it's not found from MRI?

Then, we can confirm it's not cerebral infarction,

so you can be at ease.

His mental state is continuously declining.

Here,

please prepare for intubation.

Yes, I will.

In the past, there was a case that the hospital called an ace of specialists

to let him do the intubation for a VIP patient,

but at the end, he broke a tooth of the patient.

I'm saying this is really burdensome. How nervous he would be!

If you're jealous, just say so.

This is really burdensome; there's no comparison with the patient Park Won Gook.

Well, that's true that he won't ruin this important opportunity on purpose,

but we can compare it to the Royal Doctor in history.

Well, if a Royal Doctor couldn't heal the King,

he lost all the privileges of high position.

If it goes well, he will get a promotion.

He's already the Planning and Controlling Leader of this hospital.

If he gets a promotion, then, well..

He must have a pretty strong gut.

Without even thinking, he stepped forward to do the procedure.

I don't know..

he could've handed it over to the Radiology Department.

Oh, how is it going?

Isn't Director coming together?

She said she can't watch it.

The catheter is going into the cerebral carotic artery smoothly.

Oh, there it is.

Luckily, it doesn't seem that rebleeding will happen.

Micro catheter is....

It's going into the aneurysm well.

Well, now, there is only coiling left.

If it blocked well, let's check it out.

I will shoot here once again.

Coiling: A procedure using a metal coil to prevent the aneurysm from bleeding.

By the way, if the treatment for Chairman is done well,

will the Leader of Planning and Controlling get a promotion?

Well, even if it won't happen immediately, we can say it will happen eventually.

- Right? - He won't become a Director right away,

but in future, maybe the president of Sejung University,

or at least he might become the dean of College of Medicine , don't you think so?

Wow, then even if it's risky, he must do that!

Hey, even the bed can't be pushed hard

and the foley catheter can't be set up roughly.

If the treatment isn't done immediately, there will be rebleeding!

There are only two doctors in this hospital who can do that treatment,

but he shouldn't hesitate to do it, should he? As a doctor?

But still, if it's for Chairman, it's burdensome.

Right, earlier, even Jae In was so nervous when she pushed the bed.

She almost hit it to the wall!

Hey, then you try it, you punk. You try to do that!

By the way,

if the procedure for Chairman goes wrong,

what will happen to Trauma Team?

Will it still be maintained?

Do you think the Trauma Team only will have a problem?

The hospital itself will fall into chaos as it has been running around the Chairman.

Will it also affect the Trauma Team much?

That's right...

Even if only one bed of the ICU is vacant, its deficit is no joke, I heard.

I also heard that it costs so much money to make 5 beds more in the ICU.

Dr. Jae In, where are you going?

Dr. Jae In is going somewhere?

It will cost about 0.8~1 billion won.

Well, let's check it once more.

His BP is rising now.

Why is his BP rising?

There is only the final check-up left with contrast media.

What's that over there?

Aigo, it seems that it couldn't block it.

We need to move to the OR immediately.

It's already prepared.

I'm sorry.

Right before blocking it with coiling, it started to hemorrhage again.

The Chairman is now moved to the OR.

We should do the surgery to open his head immediately.

The OR is ready now, and as he came to the hospital right after it was discovered,

please don't worry.

I'm sorry.

Please perform the surgery well.

I understand.

Dean Kang Soo Kyeong called me.

She said they would arrive soon. Dean Kang Soo Kyeong called me.

She said they would arrive soon.

I see.

Then, how long would the surgery take?

In this state, it will take at least 6 hours.

It must be critical...

Then, please take care of him well.

Yes.

Grandma.

It would've been better if there wasn't rebleeding,

but it happened.

Grandma, are you all right?

After seeing the son dying before we did,

now that wasn't enough so...

Grandpa will be all right.

The thing happened although it would've been better if that didn't happen.

When he was hospitalized last time,

if he had the scan for his brain too,

the cerebral aneurysm could've been found.

Then, as it was before it burst, it could've been easier,

simpler to treat it than now.

At that time, we all thought it was lucky that he didn't have myocardial infarction.

Aigo.. how come a person...

can't see even a step ahead?

How can you come here?

I heard you went to the court.

Are you feeling better now?

What do you mean by "feeling better"?

Who do you mean is feeling better?

What are you saying now?

Sorry, Sister-in-law.

She's too hot-tempered, you know.

If it's cerebral aneurysm,

it could've been better if he had a total general check-up earlier.

Since he's a doctor himself, he must have been overconfident.

To Oppa who didn't want the divorce,

you insisted on getting a divorce at this old age,

so if you signed at the court, now you have nothing to do with him.

Then, you should separate with him without any hesitance.

Why do you show up here?

I heard that today his BP was rising.

He drank today for the first time in the last decade.

He's smoking again, although he quit before.

It's not like that Grandma made this pre-existing aneurysm.

After having a son die before you,

now your husband is like that, too.

Grandaunt...

Oh, what is it!

Please apologize right away.

Look at you, how dare you speak to your elder like that?

You spoke too much.

Apologize!

Quickly!

I was a bit too harsh.

Sister-in-law, please understand our feelings, too.

He became like that after coming back from the court for a divorce.

Although it's not medically related,

The fact is we have all kinds of thoughts emotionally.

Once the surgery result comes out, I'll go home, so don't worry.

Mr. Kang Dae Je is now in the OR.

You'd better go there now.

Sister-in-law, let's go together.

You, come over here. Have a talk with me.

You young thing are telling me to apologize or whatever.

Do you know the difference in rank between you and me?

It's not like you are my niece.

I am your Great Aunt.

Grand Aunt, when Grandmother decided to divorce Grandfather, she was choosing to live her life.

I don't think there is any reason to critize such a choice.

It is Grandmother's own life. You cannot criticize her just because she is not sacrificing it for someone else.

Hey.

Do you think your dead father will come back to life because of the divorce?

You didn't know?

They are divorcing because of your father.

The father who you think of as only good has hurt a lot of people.

Now, are you even talking about my father who has passed away...?

Doctor Jae In,

did something happen?

What seems to be the matter?

Are you a guardian?

That's right, I'm a guardian.

Who?

I'm an ER intern, Lee Min Woo.

But, is it possible that Dr. Kang Jae In did something wrong?

I'll see you later.

Dr. Jae In!

Dr. Jae In!

Are you okay?

Dr. Jae In.

Are you okay now?

I'm okay.

Dr. Min Woo go do your work.

No, no that's okay. Anyway,

it isn't urgent.

I have a question for Professor Choi so I was looking for him.

You know, that "drowsy" patient earlier.

I was told to get an MRI for no particular reason so I wanted to ask the Professor. You know, that "drowsy" patient earlier.

I was told to get an MRI for no particular reason so I wanted to ask the Professor.

To see if there was a different method.

When it comes to Neurosurgery, even the professor asks the residents.

Ah, well, that's right. It is.

But I still wanted to ask him one more time.

He's probably in the OR.

No trauma patient has come in.

Why all of sudden?

The Chairman...

Rebleeding?

Let's talk later.

Oh, okay. I need to find the professor anyway.

Are you okay?

No, no...sit.

Let me check you.

You have a little fever.

You look really pale.

Let me give Hyeok Chan a call. So why don't you lie down here and get some rest.

I'm okay.

No, no. I'll come right back after meeting with the Professor.

I'll swap shifts with you when I come back.

Lie here and rest a little.

Do you understand?

Yes.

Listen to me.

There is too much swelling in the brain.

There can be some bleeding spot...

The brain is swelling up.

We'd better remove the hematoma first

so that we can reduce the brain pressure.

If we touch the blood vessels even a little wrong, the bleeding will get worse.

Pay strict attention.

Yes, I understand.

Professor.

What's the matter? Did a patient come in?

I have a question to ask you about a patient.

What is it?

Right now, there is a patient with mental deterioration in the ER.

You're talking about the patient who came in before the Chairman?

Yes.

So then?

We couldn't find the precise reason for his mental deterioration.

Didn't you consult with the Neurology Department?

He keeps saying to take $1,000 worth MRI as cerebral infarction is suspected.

You came up here so urgently because you were afraid of waste?

Yes.

You still have a long way to go.

How come you think the patient doesn't need that examination?

Shouldn't a doctor have a reason for sure?

That's right.

So, could you just look at him once right now?

All right.

How is the Chairman?

Was there a problem with the treatment that he had to go to the OR?

That's right. But we were able to stop the immediate problem with coiling.

We just have to stop the bleeding as we could not prevent the rebleeding completely.

But he came to the hospital as soon as he could. Chief Kim Ho Young was available as well.

So it's not the worst case.

Who are those people

that were with the Chairman's executive assistant?

They must be his famiy.

I've seen them occassionally during the official events for the hospital.

A chancellor, a provost...

i'm not exactly sure who is whom.

Ah.

Why? Are you curious about that kind of stuff?

No, it's not that.

I heard that the patient's conscious level is going down.

I heard that they have examined cerebrospinal fluid first.

Even though he didn't have any fever.

Since they've done the cerebrospinal fluid test, I hope they can find the result from there.

Yes.

Is his level of consciousness still declining?

-Yes... - Yes, that is true.

The guardian?

Over there.

Since the patient is unconscious, why don't you interview the guardian first.

Yes, I understand.

Even though all test results are normal but his level of consciousness is going down.

This is a very difficult problem.

In your opinion, is this a simple case of unconsciousness?

I don't think it's necessarily that.

I am also very worried.

Then why are you stopping the Neurosurgeon from taking the MRI, with the last strand of hope?

Ah, that... at an oriental medicine clinic,

I have seen hundreds of patients with cerebral infarctions.

At a oriental medicine hospital.

It's possible that those patients were well enough for oriental herbal medication only.

It's not like the guardians are not agreeing to it.

It's not a shame to try one's best in order to find the cause.

Yes.

I'm going.

Pardon?

I'm a Traumatology doctor.

For a patient who is losing consciousness without any trauma,

a 1st year resident in Neurosurgery could be better than me.

Bye.

Even though the possiblity is low,

if it turns out to be the cerebral infarction, then you are delaying the care of the patient.

Do you understand, Intern?

Still, since our Hyung-nim asked him to take a look, he did right away.

Of course. If it were another professor, he could have been in big trouble.

What good is it if he comes?

He says he is worse than a Neurosurgery resident.

Well, did..did you eat?

It really doesn't seem like cerebral infarction.

You don't know how many times I've seen it.

Why are you working so hard? Let's just go eat.

They were specializing in cerebral infarction.

Hyungnim...

Let's go eat.

When did you check the expiration date for these dextrose and capsules?

The day before yesterday.

These syringes, there is so much dust on them, but is it alright?

There are still about six months left on them.

By the way, I thought it would be nice

to have a group text system when a trauma patient comes in.

Should I send out a notice to all the departments for cooperation?

When a patient comes,

all the interns who should be treating the patients, are busy calling all over.

What are we going to do if a trauma patient wihtout head injury comes in?

Should we call Neurosurgery again to tell them not to come?

I'll think more about the details like that and will write up a report for you.

Hello.

Ah, hello.

Are you happy?

Ah, yes.

Isn't it nice that she's so bright and cheerful in her greeting?

Brightens up the atmosphere, too.

You once said she's overly excited that it bothers you.

How is the Chairman's surgery?

It's still going on.

I came down to check up on a patient whose level of consciousness is dropping.

Is Doctor Lee Min Woo obsessing about that patient,

that he's acting like a guardian of his, again?

Guardian?

You're right.

Up to the point that he's paging me at his disposal.

He probably wants to learn how you would solve it.

You're his role model.

That's not the case?

What role model?

You said he had Orthopedics appointments and took high dosage of painkillers.

Ah, yes.

But, he was complaining that the painkillers didn't work much.

By the way, we had a neighbor who passed away recently after fighting a cancer.

I see.

After that person passed away, he was depressed for several days afterwards.

Why?

He was a friend for 30 years and he said, "I'll be going soon, too."

His leg hurts and his friend is gone.

He even said he was not in the mood for a trip that we planned to celebrate his 70th birthday.

Well, that's it. I can't think of anything special.

Umm, doctor?

Yes.

Cerebral infarction is a big deal, isn't it?

If not treated immediately, he may even get disabilities, right?

I consent to run the MRI scan on him.

No, ma,am. Let's wait a bit and see.

I'll check some more.

Will that be okay?

Yes. Please wait a little longer. I'll check some more.

If so... Thank you.

Did you find the cerebral aneurysm?

I'll just need to finish up.

Has Chairman's operation finished yet?

I think it'd take a couple more hours.

I'm so scared. What's going to happen now?

That's what I'm saying.

How are you?

Doctor, I don't want to jinx it, but...

If the Chairman doesn't wake up after the surgery, what happens to the Trauma Center?

I'm sure the Chairman will wake up.

If he doesn't wake up, there won't be the head of the organization at the hospital.

It will be difficult to create a Trauma Team.

The possiblity is rather high.

Then, you'll be screwed up if you join the Trauma Team now.

I wasn't talking about you.

You'll get affected the most, wouldn't you?

Still, the Chairman's care is priority.

As for me, I'll have a job where ever I go.

Doctor, your personality is really great.

You're going up, right?

Ah, yes.

We've received a notice from the Ministry of Health & Welfare, sir.

They are going to conduct an onsite audit.

Ministry of Health & Welfare will conduct an emergency audit on us.

Why now when the Chairman is being treated here?

When are they coming?

It's not even a scheduled audit, but an emergency one?

They are not specifically targeting us, are they? Why a sudden audit?

Did anyone report us or something?

If needed, we'll go through the audit.

Please take a look at the medicine and procedures which usei items not covered by the National Health Insurance.

Also see if there are any high expense services that might cause problems.

If possible, please use insurance covered items to treat patients.

We'd like to treat patients with covered procedures and medicine;

however, new drugs take a long time, from getting Food & Drug Administration's approval,

then being covered by the insurance. They are always a few steps later than when the patients need them.

So that, it is not realistic to treat patients only with insurance covered drugs.

As for the anticancer drugs, there are so many new ones out there.

It'd take 1 to 2 years to prove the efficacy, then gets FDA approval, and then the regulation gets changed.

During the time things get delayed, dying patients want to try whatever is available...

We can't just sit and watch the patients suffer. Even though the drug is not covered by the insurance,

the drug's efficacy is proved in journal articles, and they are already on the market overseas.

Then, shouldn't we be using the uninsured drug?

I understand your point of veiw.

However, what are we going to do if we get a suspension from the government?

Can't we just pay the fine instead of the suspension of the operation?

Not all the fines are the same.

One of the biggest hospitals in Seoul got fined for more than $10,000,000.

Ten million dollars?

If that much, even Sejung Hospital will have a hard time.

Just a few million dollars will do that.

It was because of the hematologic cancer drugs. We don't do as much advanced treatments here.

When your family is sick,

wouldn't you use a new and effective drug

even if it's not covered by the insurance?

It is only natural to want the drug even if that means you'll have to pay out of pocket.

Even so, we should limit the use of the uncovered durgs for a while.

However,

there won't be any parents who wouldn't want to use surfactant on their baby with under developed lungs.

There won't be many doctors who wouldn't use it, either.

Those are the areas that we should just pay the fines.

Please use the covered drugs and procedures as much as you can

as this will not only affect this audit, but also other regularly scheduled audits.

So, the suspension is based on the amount of uncovered drugs charges,

and the fines are based on those charges then, double, triple or ten-folds.

You are absolutely right.

It's not like we're trying to intefere with your practice.

So, even if we cannot avoid the fines completely, let's try to minimize them.

We can't figure out why his level of consciousness is going down?

That's why no department is willing to admit him under them.

Then are we going to admit him under Traumatology?

Someone has to be responsible for his care after all.

If we're going to admit him under Traumatology, top to toe is the first step.

Top to toe? Ok.

Just in case we missed something, make sure to throughly check his back as well.

I'm going to check his pupils first.

For now, admit him under Emergency Medicine.

What are you doing?

We're examing from head to toe again.

Oh? What's this?

Yeah, those are the patches that he got from a neighbor.

Do you know from whom he got them from?

Yes.

Those are from the person who passed away recently...

He said they work wonders for pain and gave us some.

Your husband's friend who had a cancer?

Yes, that's right.

Doctor Kim Do Hyeong.

What?

Should I give him naloxone?

Naloxone? Why?

What are those?

Could they be? They look like the narcotic analgesic patches used by cancer patients.

My gosh! Why are they stuck to his back like that?

My gosh! Why are they stuck to his back like that?

Of course he was losing his consciousness!

Nurse Jang! Please give him narloxone 2mg, stat!

Patient! Patient Kang Dae Seon, can you hear me?

If you can hear me, could you shake your head once?

You are at the hospital.

Do you know what this is?

You got this from your friend next door?

This is very strong painkiller used by cancer patients.

You came to the hospital because of your level of consciousness went down due to these patches.

You don't have to worry too much.

The reason for his condition is these patches.

His consciousness should get better soon.

Thank you very much.

You don't have to worry too much and,

we won't have to take an MRI either.

Thank you so much. Thank you. Thank you.

My goodness!

What a relief.

Thank you. Thank you.

What is it?

Just...

Then, what is it for you, Doctor Min Woo?

Just.

Are you feeling better now?

Were you acting like that because your grandfather was sick?

You should be more cheerful in this kind of crisis, don't you think so, Doctor Jae In?

What, what? Why are you smiling?

Later, I will take your duty,

so go out and have some fresh air.

Ah, right, that hospital where your grandfather is hospitalized, is it far from here?

Dr. Min Woo...

What is it?

You know everything.

What?

What, what? What do I know? I know nothing. What, what?

Your grandfather...

Your grandfather...

came to this hospital?

Is he all right?

My grandfather...

his cerebral aneurysm has burst.

So he got the procedure with coiling...

Now he's getting a surgery for hours.

I don't even know if he would come back,

but until he regains his consciousness, how long it would take...

nobody knows it.

He might pass away, too.

He's going to recover fully. Don't worry.

Huh?

Actually, there are a few excuses I need to talk to you, Doctor Min Woo.

What, what, what? What excuses?

What are you now talking about?

About that my grandfather has 5 hospitals and this hospital is also one of his.

That kind of talk.

I couldn't tell you that in advance.

What are you talking about, now?

Everybody thinks that kind of things are very important.

If I don't tell those things in advance to them, people think that I played them.

I'm not also in that mood to talk about such things.

So, who told you to talk about that?

Don't talk about such things.

To you, Doctor Min Woo,

I thought I should tell you about such things.

Honestly, because my grandfather is sick,

I am very scared.

I want to get consoled, and I hope someone

worries about him with me, together.

Me too. For Chairman, no...

for your grandfather, Doctor Jae In, I'm soooo worried.

Do you know?

The phone.

I'm saying to give me your "on-duty" phone. I will get the call from ICU.

There's no need.

Hurry, give it to me.

Is it enough with 3 hours?

For the next 3 hours, I will get the call instead of you.

So, go somewhere and get a sleep a little more,

or pray for your grandfather,

or console your grandmother, or what-not. Go and do something.

Right now, I guess anything you do won't make you feel easy,

but this is only thing I can do for you.

It's one thing if I didn't know the situation, but...

Aish, if you're here like this, I can't do anything because I'm worried that you might make some trouble now.

So, please, I'm begging you,

disappear from this ER, please.

We can do your intern job for you,

but being a granddaughter,

is something only you can do, Doctor Jae In.

Don't you think so?

So, listen to me.

Well, get lost!

A bicycle?

Yes... yes, that's right.

In our hospital, there is Professor Choi In Hyeok,

who is famous in Traumatology.

Yes, that's right.

He was on a documentary show.

Ah, is he working for Health Insurance Review and Assessment Service?

I see.

I will try my best. Of course.

Where did he get hurt?

I just heard that it was a traffic accident.

He was trying to go to Seoul, but I stopped him saying Busan is also good at it.

Send a traffic accident patient to Seoul?

That's because they didn't know well about that.

They said that because they had no idea that there are no Traumatology OR in Seoul big 4 hospitals,

so, don't care about that.

How is the patient's BP?

You know that there will be an audit in our hospital soon.

An audit?

If the Ministry of Welfare comes for an urgent audit, usually at least 5 people from HIRAS come together.

They are the ones who actually investigate.

As this guy is one of the powerful staff there,

if you treat him well, it will be beneficial for our hospital too.

Which hospital is he at now? How is the patient's status?

I heard it's Yang San Hospital.

Wait a moment, please.

Yes, this is from Se Jung Hospital, earlier you called.

I will let you talk to the doctor.

Yes, how is the patient's status?

It was a bicycle traffic accident, and the BP is now 70.

It seems that either iliac artery or vein is ruptured now.

Ah, is that so? I will check with Anesthesiology and call you back right away.

Please give IV and blood a lot,

and if blood vessels are burst, it's a super emergency case, so don't delay and transfer him immediately.

Please make sure to send him immediately.

Irrigation.

It's done now.

I wish he recovers well.

His vitals are now stablized. So far, it looks good.

I will finish it and bring him out.

Okay.

Then, I will go out and explain it to them.

Finish it well. Then, I will go out and explain it to them.

Finish it well.

For now, the surgery is done safely.

We removed all of the hematomae and nothing serious happened during the surgery.

Then, when will he regain his consciousness?

Ah, well, for now, for at least three days, we will give him strong sleeping drugs to let him sleep deeply.

After three days, then will he wake up?

The reason we let him sleep for three days is because the brain needs to rest well after the shock.

After that, we will reduce the dosage of sleeping drug and check if he regains his consciousness.

How much his brain was injured, how much the hematomae damaged his brain,

we can know only when we stop the drug after three days.

Then, do we not need to worry about rebleeding any more?

Ah, where do you think you are now?

I'm sorry.

Intern, go outside!

This not just an intern. She is Chairman Kang Dae Je's granddaughter.

She has a right to wonder about her grandfather's well being.