Original subtitles

Episode 18

It's a trauma patient!

Ah yes.

Wha...what happened?

She got into a car accident.

But, why is her stomach... is she pregnant?

Even though she was wearing a seatbelt, she hit the guard rail while trying to avoid hitting an oncoming car.

What's the blood pressure?

It's 60.

When we rescued her at the scene of the accident, she was able to maintain 90,

it kept dropping on the way here.

While she was still conscious, she kept begging us to save the baby.

She's at the 35th week of pregnancy.

35 weeks?

Hey, hey.

One, two, three!

Patient?

Can you hear me?

Can you hear me?

Her consciousness is at a coma state.

She's a trauma patient and Professor Choi In Hyeok isn't here. What do we do?

First, I'll call Dr. Song Kyeong Hwa.

No, that's not it.

Call OB/GYN first.

OB/GYN.

You're right.

Her blood pressure keeps dropping.

First, OB/GYN. Second is,

Pediatrics.

Then third is Dr. Song Kyeong Hwa.

Then after that...should we take a C...CT?

-Okay. -Good.

Her blood pressure... how is her blood pressure? Hurry!

It keeps dropping.

Did you order the blood?

Oh right.

Please call the specialists to find out

whether her abdomen is getting bigger

because of hemmorhage or because of pregnancy.

OB/GYN first. Hurry up and call please.

I'll get OB/GYN.

Dr. Jae In, you call Pediatrics.

I got it.

Quickly!

Hyung, should we get an ultrasound?

What's the point of getting one when we can't even read it?

RIght... that's right.

Yes, this is the ER Intern, Jang Hyeok Chan.

A moment a go, a 35 weeks pregnant,

car accident TA

came into the ER.

Yes, yes. Her blood pressure is 60 but,

it keeps dropping. An emergency c-section is needed.

I'll contact the doctor right away.

He'll arrive within 15 minutes.

I'll get the OR ready right away.

Ah yes. Thank you.

Yes, this is the ER Intern Kang Jae In.

A moment ago, a 35 week pregnant woman came into the ER due to a car accident.

She needs an emergency c-section.

However, there is a chance that she won't make it to the OR.

Yes.

I think you need to come down right away and examine her.

Yes, I'll contact the Neonatal unit.

Yes, I understand.

Ah... when I'm hungry, my heart pounds.

Yes, what is it? Did something happen?

Yes, a 35 weeks pregnant car accident victim

came into the ER.

Her blood pressure is 60 but it keeps dropping.

She may need an emergency c-section.

We can't take her up to take a CT.

We can't see any sign of trauma on the surface.

I got it. I'll be right there.

Dr. Hyeok Chan!

Why isn't the OB/GYN here yet?

Oh, no.

No!

Arrest! It's cardiac arrest!

What?

Hurry up and perform the CPR!

Give me the Ambu bag.

Please give me an epinephrine.

One, two, three, four, five, six, seven, eight. One, two, three, four, five, six, seven, eight.

This is crazy.

One, two, three, four, five, six...

She's not coming around.

Switch places.

Dr. Jae In. Call Professor Choi In Hyeok right away.

This is an OB/GYN matter.

The obstetrician will arrive in 15 minutes.

We still need to report this to him.

One, two, three, four, five, six...

Yes, what's the matter?

Hello, Professor.

A 35 week pregnant patient came into the ER,

her blood pressure is 60, but it's not going up,

and she's having a cardiac arrest.

Yes, it has been less than one minute.

Before you do anything else,

you need to take the baby out first.

You don't have any time to waste getting ready to take her to the OR.

Don't worry about the method, just call the obstetrician,

and prepare the surgical tools for a laparatomy.

If this isn't resolved in 5 minutes,

you need to give up on the baby,

and focus on the mother.

If they don't remove the baby, the mother's survival rate drops further.

If you don't remove the baby,

the chance of the mother's heart returning

falls further.

That is all. -...six, seven, eight, nine, ten.

Yes, I understand. -One, two, three, four, five...

Please prepare the laparatomy tool set.

Scalpel,

scissors, sutures. Quickly!

The pregnant woman is having a cardiac arrest?

Yes, that's right.

It hasn't been a minute yet.

Tell them to try 3 more minutes.

While waiting for the OB/GYN. If they don't show, they need to perform the laparatomy within a minute.

How can something like this happen now... Since Chief Kim Min Joon is General Surgery, he probably doesn't have experience.

What are you doing?

I'm sending the protocol.

Wouldn't it be better to send them a guideline?

Send it to the intern's phones as well.

Send it to the intern's phones as well.

Okay.

What is this?

1. After 5 mins of maternal arrest, perform C-section.

What is this?

Ah, Chief Na. What is this article you just sent?

What?

Aren't you in the ER?

Yes, Professor.

I'm in front of the hospital. I'm about to go inside right now.

Since they said that they called the OB/GYN,

I told them to perform the CPR and give an epinephrine.

Okay, then I'll go down there right now.

Okay, then I'll go down there right now.

- I've prepared the tools. - No way...

Bring it down. Turn at the belly button.

We head towards the uterus, on the bottom.

Hyung, what are you doing right now?

Take your hands off.

-Start. -Yes.

Hyung, what are you doing?

Two minutes has passed.

If she doesn't come back this time, then we need to perform the laparatomy.

What?

If we don't take the baby out within 5 minutes,

the baby will die from suffocation.

Scissors.

Dr. Kang Jae In, please start with the intubation.

Betadine.

Give me a whole bottle.

But Dr. Lee Min Woo.

It's possible that she'll come back with the CPR.

Right, but we need to prepare just in case.

Then, we should check the baby's heart beat first.

Whether the baby is alive or not,

we need to take the baby out to save the mother.

I heard it very softly.

Dr. Lee Min Woo,

Let's give up on the baby.

Let's save the mother first.

In this situation, how can you cut the abdomen and take out the baby?

Then, what about the mother?

If we can't take the baby out,

the chance of the mother's heart coming back drops.

So, start the intubation right away!

Give me the intubation set.

Yes.

Kang Jin, switch with him.

Oh, oh, okay.

Hey, hey!

Kang Jin, get your head on straight.

What ever happens, you need to perform the CPR for one minute. Got it?

Yeah, yeah.

If you fail to provide her even minimum oxygen,

Both the brains of mother and the baby are going to be damaged. Got it?

Hyung, I'll do it.

No, you have no strength left.

Stay there.

We have exactly three minutes left.

Betadine.

Betadine: a topical antiseptic.

Have you ever opened up the uterus?

The uterus is right below the abdomen.

We can find the way around the abdomen and open up the uterus.

During pregnancy, the uterus is right below the abdomen. So, it is do-able.

Hyung, I'm scared.

Concentrate!

Scalpel!

What if it was because the bleeding in the abdomen?

If there was a bleeding in the abdomen,

The blood pressure will drop as soon as we perform laparotomy.

The mother will die because of the bleeding anyways.

In this situation, do you think that the mother's heart will come back to normal?

Dr. Song Gyeong Hwa is going to come.

She said that she was around this area.

It already passed 30 seconds. Kang Jin, wake up!

Switch. Switch with me.

If you guys don't help me,

There's a high possibility that we will lose both the mother and the baby.

In order to save the baby and the mother,

I need to take the baby out.

Do you understand?

If the abdomen moves while I'm performing CPR,

Will you still be able to do it?

We can't stop the CPR but if it's moving while you cut the abdomen,

wouldn't the baby get hurt?

It's the worst condition.

There's nothing else we can do.

Surgical drapes, please.

I'll take the baby.

Please take the Ambu bag.

When is the Neonatal Intensive Care Unit coming here?

Turn at the belly button.

Yes.

It's about 10cm below the epigastrium.

Since it's above the belly button,

How can you cut it so roughly like that?

What if the organs get messed up?

We have no time to worry about the skin, the muscles, and the abdominal wall separately.

Move aside for a second. I want to see if the heart came back to normal.

Oh, sure.

- Let's switch. - No, I'll take care of the CPR.

Take care of the rest.

Okay.

I finished opening it. Hyeok Chan,

-Hold it right here. - All right.

The mesentery is torn.

I also see the uterus.

Scalpel.

Wait a moment.

For the uterus...Do we make a horizontal incision?

Or was it vertical?

Horizontal!

I think it's horizontal!

Are you sure?

I'm not sure about it.

Huh?

Then, I'll try calling the OB/GYN doctor.

Okay.

Ay,

When there's no one in the ER...

Sit down.

The OB/GYN staff are on call.

Even if they come down quickly, it would take them about 15-20 minutes.

Even if Dr. Kim Do Hyeong was there,

he's only learned the theory.

He never even opened up the abdomen. Would that be possible?

It's hard to grab the scalpel even for me.

This...

It's amazing that he even thought about taking out the baby first.

You may get this kind of case only once in several years in the whole nation.

This is a case for papers and journals.

Should I call them?

I told them everything I need to tell them. Chief Na already sent the protocol over texts.

They said that the surgery team came down.

They should be able to cut the abdomen and wait for the OB/GYN.

Do you perhaps think that they can't even open the uterus?

Chief, Chief! Haven't you get to the ER yet?

You said that you were on-call.

I was planning to finish up my paper and leave.

How can you leave the ER when there are only interns available?

I thought it would be enough time to eat for just 20 min. I just went outside.

They said that you have to cut the abdomen in about 5 mins.

How can we do that by ourselves? The OB/GYN has to help us.

Are you going to do it?

Have you done it before?

I've never done it, of course.

What will happen if a dying mother gives birth to a dying baby?

How can you say such a horrifying thing? Of course, that shouldn't happen.

So, let's hurry up!

Hello, you are the OB/GYN professor, right?

Professor, where are you right now?

I see the hospital.

But even if I arrive there... if the mother's heart doesn't come back...

We already opened up the abdomen.

You did what?!

We see the mother's uterus.

Aigoo, oh my!

They said that we need to take the baby out to get the mother's heart back to normal.

Who?

ER Chief Na Byeong Gook.

First of all, put the scalpel into the uterus.

And with one hand, cut it open with scissors.

Put the scalpel into the uterus.

He said to take one hand and cut it open with scissors.

Wait a minute.

Scissors.

We cut the uterus.

The baby?

I don't know.

If you press the top of the abdomen,

The baby's head will come out through the opening of the uterus.

Then, carefully grab the head and bring the baby out.

Hyung, the head, the head!

Hyung, the head, the head!

Oh, it's coming! It's coming!

Dr. Jae In, what about the umbilical cord?

The baby came out. What about the umbilical cord?

With 2 Kellys, in two places on the unbilical cord,

Hold it within 3 cm.

He said to cut it in between that.

Dr. Jae In, hold it.

Did the baby come out? How is it?

Please take the baby quickly!

Please wait a minute, Professor. The Pediatrics Dept. staff came down.

The baby's condition is really bad.

Let's hurry and go.

Professor, what about the placenta?

Put your hand inside the uterus.

-As you put your hand inside the uterus, -And gently pull it out,

pull out gently and separate it.

Oh, oh! It came out!

Now, what do we have to do?

What about the uterus that's been opened?

Yes.

Yes, I understand.

Please give me the chromic.

Until the professor gets here, start making big stitches as an emergency measure.

Dr Jae In. Can you press down on the hemorrhaging area in the mesentery?

Alright.

Be careful.

Oh my, oh my... Chief!

I think that the baby is alive.

What is this? Did the OB/GYN already get here?

Oh my god, thank you! Thank you!

Come on!

Come on!

Yes, thank you!

Oh my, what happened here?

What are you guys doing here?

Due to a car accident, we performed CPR, but the heart wouldn't come back to normal.

Through C-section, we took out the baby. We are currently performing suturing on the uterus.

But, the uterus isn't contracting smaller

and it doesn't stop bleeding.

And the mesentery is also bleeding.

What about the OB/GYN?

He is on his way. He will arrive in about 5 minutes.

Is the mesentery torn a lot?

Yes, there is bleeding in about 2 or 3 places.

Is there any other place that's damaged inside the stomach?

I'm not quite sure about that. I wasn't able to check that.

But, there isn't that much bleeding.

The blood supply to the intestines looks bad, and the color of the organs look terrible, too.

Call the OB/GYN.

Ask them what we have to do since the uterus would not contract. Call the OB/GYN.

Ask them what we have to do since the uterus would not contract.

Everything will be pointless if her heart doesn't come back.

Yes, this is the ER.

The post-partum female in the ER's uterus is not contracting.

What should we do about that?

Administer oxytocin and massage it..

I'm going to arrive soon.

Yes, I understand. Please come quickly.

Hey, Lee Min Woo. He said to hold and massage it.

Please give me oxytocin quickly!

Oh, I'm losing strength.

Hey, I'll switch with you. I can let go of the abdominal cavity, right?

Ah, no no! Move aside. I'll try doing it.

Wait a minute!

Oh, it came back to normal!

Give her to the OR right this instant! And contact the anesthesiologist.

I don't think that the baby is in good condition right now.

There's a lot to say.

But, let's talk after we have saved the mother.

Bring her to the OR!

Yes, we understand!

Her heart came back to normal?

We did give her epinephrine. But, I can't guarantee anything.

Let go of it.

Yes.

There was bleeding in the mesentery, so we are pressing it down to stop the hemorrhage.

Did you administer the oxytocin?

Yes, I did.

I will inject it directly to the uterus.

Give me one more.

A mother who had to get CPR,

cannot contract her uterus very well.

Should I press it again?

I'll do it.

Yes.

The lower uterus is loosened up and is flacid.

What about the blood pressure?

It keeps going up with transfusion and then back down again.

If this continues, there could be an arrest.

The uterus is still bleeding.

Did the guardian arrive yet?

Yes, they say that they are coming in right now.

- How old is this patient? - 33 years old.

The blood pressure is 70. It's dangerous. Hey, squeeze the blood.

Ok.

Call the guardian first directly.

Yes.

Doctor,

You aren't saying...

We will perform hysterectomy.

Remove the uterus?

If there was more time,

It would be good if we could perform an angio . But, there's no solution now.

Ah, doctor. But still...

Because the uterus doesn't contract...

If we can't stop the bleeding, she will die from it.

The blood pressure keeps dropping. Hey, bring me more blood.

Yes.

Didn't you cut open the abdomen to save her?

Yes, I did.

Then, what would happen if there was another arrest in this situation?

It's not an easy decision.

But,

If there's a life on the line,

It's clear as to what decision we have to make.

I was able to get through to the guardian.

This is Sejung Hospital's Gynecologst, Dr. Yeo In Joon.

Are you the guardian of patient Jo Young Hee?

Yes, the patient...

has gone through an emergency C-section.

But there is too much bleeding in the uterus and she is in danger of Cardiac Arrest.

Right now,

This is the ER of Sejung hospital.

Yes, Chief.

What's the status on the Cardiac Arrest mother?

The baby was taken out and the mother went into the OR.

The OR?

The patient's heart came back to normal?

What about the baby?

Yes, the heart came back to normal and the baby was taken by Pediatrics.

They say that Apgar score is 4.

How long did it take?

It took about 7-8 minutes for the baby to be taken out.

Really?

And 2-3 minutes later, the mother came back.

I understand.

What did they say? What did they say?

What did they say?

The baby's Apgar score is 4.

And they say that the mother's heart came back after 10 minutes.

If it was 10 minutes...

Then, she doesn't have absolutely no hope.

They say that Dr. Song Kyeong Hwa doesn't have experience, but she was able to pull through.

But still...

They say that she's still alive.

Even though they are the Surgery team, they don't know about the OB/GYN's side of it.

It must have been difficult in such a critical condition.

I'm sure that your guideline was a big help to them.

It's a case that I've never seen before.

I only heard about a similar case at a conference last year. There was an expecting mother just like her.

But in the end, they couldn't open the abdomen.

And in another hospital in Seoul metro area,

There was a pregnant woman who already came in with a DOA.

They opened the abdomen, but it was too late. So, they both died.

If I had not heard of that case, I would not have known what to do.

Even if I did know... if the OB/GYN didn't arrive, with what method would we open the abdomen?

How is the patient's condition?

Its getting better.

I'm giving her platelets now.

Hey, bring more platelets.

Yes, I understand.

We are done.

The baby is out and we took care of the uterus.

So, I think the work of OB/GYN is done now.

As there are other parts with hemorrhage in her abdomen,

your General Surgery will take her over here, right?

We will see to it.

Work hard.

Take out your hand.

We need to stop the bleeding here.

Jae In, Move a bit.

Yes, I understand.

Gauze.

Mixter clamp.

Tie.

Cut!

Off.

Gauze.

Mixter clamp.

Tie.

Cut.

Off.

As you tie them all, the color of intestines has changed.

Will you cut them and do anastomosis?

We don't have time for that, so I'll do GIA.

Please prepare EEA too.

When the surgery ends,

You guys should have a talk with me.

We understand.

Please give me Nylon 1.0.

Chief, why are you closing the abdominal wall like this?

When can we finish it by stitching one by one? We need to use one layer running suture.

Hold the opposite side.

Yes.

Yes, I understand.

Hyung.

Huh?

Was it a baby girl or boy?

Oh, yeah.

I saw, but I can't remember.

It seems that some huge event passed by..

Oh yeah, I'll be going down to the Emergency Room.

We came here without any proper handover to the next shift of ER.

If the next shift people didn't come yet,

the remaining two interns must be having such hard time now. I'll leave first!

Yeah, that's right, I'll be going down too.

The emergency room must be in chaos, but why haven't they called at all?

Are there no patients?

There has to be new patients though.

Patient, your CT scans are normal, and

I'll prescribe you a medicine and take it once you get discharged from the hospital.

If the headache continues, you need to contact us.

They must be crazy, crazy.

They must be crazy, crazy.

How can they do...

This was possible because they were in Se Jung Hospital.

This kind of incident can never happen in other hospitals!!

By the way, did the mother and the baby both survive?

Doctors! How come you are in ER...?

Oh, Chief Na called us.

Oh, yes.

I will do hand-over for the next shift.

I roughly took care of the patients who need some hand-over for the next shift.

I finished the treatments for the patients, Yang Soon Young on bed#6 and Kim Seong Soo on bed#8.

Nurses called the interns for the next shift, so they came one hour earlier and now are working.

You guys....

Come out early tomorrow. Do you understand?

Yes, we understand.

And about the stuff you guys did today..

There are a ton of professors who have a lot to say about it.

We will talk later.

Yes, we understand.

We took care of most of the situation, so you guys finish it up well.

Yes, we understand.

Work hard.

Thanks.

But anyway, even if we would get scolded sometime,

shouldn't we celebrate?

We pulled out the baby safely,

and the mother is also back to life.

By the way,

wow, hyung, you're really amazing.

What?

How could you think to open her abdomen?

If it were Doctor Kim Do Hyeong, it would never have happened!

So tired...

Aigo...

It's Kim Do Hyeong.

What should we do?Don't answer it.

Just ignore it!

Ignore it!

Hello.

Teacher...

What are you guys doing!

I don't think its time to be sitting around.

We had to do some stuff, so we switched shifts early.

What? Did you cause trouble again?

Aish, this is why I can't enjoy my vacation!

Even if I'm out of the hospital, I can't think of anything else but the hospital. What should I do!?

I'm going crazy.

Ah.. yes.. that was...

a pregnant TA patient, who needed an emergency C-section,

so Doctor Lee Min Woo did a laparotomy,

and saved the lives of the mother and the baby.

What?!

Really?!

You thought I would fall for it, right. How dare you lie to me?

How dare a mere intern play around with "Sir me"!!?

Hello?

What!

Doctor Kim Do Hyeong, we can't see your dazzling visual!

Hello? Hello?

You did well.

Why did he call?

Aren't you guys hungry?

By the way, Doctor Hyeok Chan, you have quite a strong heart.

How can you be hungry in this situation?

I used too much of my energy,

So I am super hungry.

Hey!

I'll go to the nursery.

Let's go together.

Yeah, let's go.

Wow. That Lee Min Woo.

The laparotomy he did wasn't bad, was it?

Well, I'm not saying he did well,

but I can say that level is a bit better

than what a monkey could do..

What's going on in this hospital so that mere interns dare to...

But still, the mother's heartbeat came back, and...

Even if the heartbeat came back, it's still too problematic to just cover up.

What about her guardian?

He was contacted, so he's now waiting in this hospital.

Go first and clean up the patient.

As the mother would have a serious infection,

so give her broad-spectrum antibiotic in high dosage.

Yes, I understand.

As I explained you earlier,

we had no other option but to remove the uterus.

The baby is now in the Neonatal ICU.

As the blood vessels of mesentery were broken, we tied them.

More details will be explained by our professor later.

Then, wouldn't there be any problem for her to regain her consciousness?

We will have to wait and see.

It's me.

Well, is the mother alright?

There is nothing we can guarantee as she was in shock from the hemorrhage.

But still, as General Surgery was on duty,

the laparotomy was possible before it was too late.

The General Surgery Department didn't perform the laparotomy.

Pardon?

Then, who?

Who could do that? There was no one to do it!

Today, there were only interns, not even a resident

Who could perform a laparotomy there?

You said Doctor Song Kyeong Hwa was on duty!

Then, did they wait until the OB/GYN doctor came?

The interns must have done it.

W... What??

The interns did it.

Although the mother's heatbeat is back now,

neither the mother nor the baby can be guaranteed now.

If anything goes wrong, we would need to hold a conference.

How long was the mother's arrest lasted?

I think it was more than 8 minutes.

Then, what will you do?

First, I will check the condition of the mother and get back to you again.

How to straighten out this issue,

let's talk together when you come back.

Okay, I understand.

What, interns performed laparotomy? Does it make sense now?

Are the baby and the mother alive?

It seems so for now.

The most important point is that they pulled out the baby on the right timing.

I thought somehow it was done too quickly.

If they were residents,

even if they know how to perform laparotomy, they would argue which department would take over,

and do nothing saying it's not their responsibility. But...

Now it is the most important time for the mother and baby.

There should be no mistakes.

Well, we are the ones who saved the baby and the mom, right?

Yeah, we saved them.

I thought I would be more proud and fulfilled but

I'm more scared and it feels strange. Why is that?

We did our best, the rest is for staff doctors who are better than us.

So, go ahead and enjoy the chicken, Kang Jin.

- Have some. -That's what I should be doing, right?

By the way, isn't it about time that we interns need to think about our future?

Have you guys decided what your specialty going to be?

Hyung, are you going to do the General Surgery residency?

I haven't decided it yet.

Would Chief Kim Min Joon accpet me?

You?

I haven't, either.

How about you, Jae In?

I don't have any specific department in mind yet.

Am I the only one with a definite goal?

So, you've decided to go to your lovely Orthopedics?

I've decided to set my bar a bit higher.

To where?

- Ophthalmology or Dermatology? -Huh?

Jae In said she'd go to Opthalmology or Dermatology. I'm planning on following her.

Realistically, with this incident that will hurt our grades, Orthopedics may be far fetched.

Whether patients getting recovered or not is not within our work scope.

What are the use for Staff doctors?

Anyway, I was surprised by Hyeok Chan earlier.

Me what?

He wasn't scared and was telling us which way to open the uterus all while doing CPR.

While I was scared and going weak in the knees.

Kang Jin, that 's because it's your first time in the ER.

We were like that at the beginning as well.

Is that so?

They wouldn't severely punish us including the Chairman's granddaughter, would they?

Do you want to talk about her family relation here, again?

I, for one, cannot forget who I am and the surroundings around me at any time.

- You guys think I'm a fool who doesn't even think, right? - Yes, I do.

No, I am NOT.

My dad supported me through tutoring and the medical school on a humble salary.

I'm a man with a lot of responsibilities. That's me!

You father must be so proud of you!

Of course!

Min Woo, did you know that Jae In is a granddaughter of the Chairman?

You didn't know, did you?

You didn't know, did you?

I heard.

What is this? How are you so calm?

You guys shouldn't attach a stigma to her because of that.

I hear you made her call in other departments for three hours?

No, we didn't make her! She volunteered for the job.

I was the one with the on-call phone. Why did you guys make her work?

-That makes sense. -That is right.

Whoa... It wasn't even that hard!

They all flew in right away. What was the hard part?

The situation she's in is hard. Her grandfather being hospitalized and all.

Can we call ourselves friends?

You are so insensitive.

So insensitive.

Whoa, whoa, whoa. Look at this. You guys are making me a jerk.

It's not like that, Hyung!

Well, it's ok. Three hour phone duty... It was a breeze.

Yes, it was!

It's similar to you buying a round after you cut open an abdomen for the first time.

By the way, the baby must get better.

That's what I mean.

The mom would be broken-hearted, when she regains her consciousness

then realizes that she had lost both her baby and her uterus.

Even when the baby gets better, but his mom doesn't wake up...

There's a chance that the baby will grow up without his mother.

We really did...

something huge.

I hope the mother wakes up.

She will, of course.

No wonder I was so nervous when we three were leaving.

Who would have thought that this huge bomb will be dropped?

But, they went through it.

Anyway, your successor seems to be very friendly.

She is. Isn't she nice?

I realized that you are leaving by looking at your successor in the ER.

When is your last day?

It's about two weeks away.

By the way, was that really you who recommended me for the Coordinator position?

That's why I told him that he is sneakier than he looks! He doesn't tell you know things.

That was why. I was wondering why you didn't come to me to complain.

Why did you recommended me for the job if you knew I'd complain?

Because all the nurses and paramedics were crying out loud. I did it because it was too noisy.

Who knew that you would last that long?

Nurse Shin, you are one tough cookie.

I thought I'd leave as soon as I wrap up my stuff in the hospital.

I even told him that!

That you're leaving to Canada within a year.

So did I.

But he said he doesn't care as the position is a contractor's position anyway.

A year became two and now going into the third.

Even though you love your job, you still need to get married, right?

Does your fiance have any plans to live in Korea at all?

Wouldn't you want to work at the real Trauma Center

after all these years working day and night?

I would.

Before you leave, let's go out for a dinner with all the members of the ER.

Sure.

I'd appreciate it.

Sounds like the interns managed to do the right treatment.

I wouldn't have sent the protocol, had I known that there were only interns at the ER.

That's why people call us the "Man on the Spot".

Other specialists think we are phone operators holding their patients until they arrive.

Are we fooling around at the ER?

We are there for THAT moment.

They are mocking us.

As the mom and the baby is not in the worst condition,

let's take a look at them tomorrow when we get there.

Ah, I hear that they are going to annouce the medical helicopter operators soon.

Is that so?

What a day!

I'm spent! I have a morning shift tomorrow starting at 6am.

I'll get going first. Good job, everyone!

- You too. - You did the same.

You also have the morning shift. Let's get going.

That.. that is true.

Go ahead. I'll clean it up.

Hyung, no I'll clean it up tomorrow. In the morning...

- It's okay. I'll do it. - Thanks!

Actually, I was impressed by you, Dr. Min Woo.

For what?

When you asked for the scalpel.

Experience makes all the difference. Your experience opening the abdomen once...

That is not it.

I wouldn't have been able to ask for the scalpel,

had I have enough experience since I had to think about all the stuff.

Is that how it works?

Of course.

Since I knew so little...

I was psyched about the incision I made, I had dreams about opening abdomens.

From that, I practiced it in my mind, I guess.

That's why you picked up the scalpel without thinking fear.

We didn't have any other way.

Even if I didn't open her up, her heart wouldn't have come back.

Then we would have just had to watch helplessly while the mom and the baby die...

Trying something is better than doing nothing.

I thought that will be easier on me.

You once said making an effort is easier.

Whoa. Are you using my words in this situation?

Nothing is easy even when I try! I always get scolded.

You're doing just fine, better than anyone else.

Yes, put that in there.

Oh, you came early! You said you would arrive in the afternoon.

It happened.

By any chance, because of those interns' trouble.... did you come early?

How is the mother?

After the hysterectomy, she hasn't regaine consciousness yet.

Oh, you came early.

Who was it?

Pardon?

Ah, yes... Doctor Lee Min Woo did...

If I really knew there was only you guys, I wouldn't have given that instruction!

How is the baby?

It's a baby boy and I'm not sure about his consciousness yet,

but he is really handsome.

Aigo... seriously...

Is there any more hemorrhage?

No, there is no more hemorrhage.

It has been one day since the surgery, but the level of hemoglobin is slightly dropping.

Well, there must be some oozing of blood.

That would be okay. What about the platelet count?

For the platelet count, we're maintaining its level be higher than 50,000 by blood transfusion.

As the hemorrhage is not serious now, keep maintaining that level.

Yes, I understand.

Why didn't you wait for the OB/GYN doctor yesterday?

Because the possibility to bring back the heartbeat of both the mother and the baby would be even lower if we didn't pull out the baby within 5 minutes.

Why?

Pardon?

Based on what kind of medical ground?

If it passes more than 5 minutes with no blood circulation of the mother, the oxygen and blood stream obviously wouldn't be supplied to the baby well...

The mother was getting CPR.

That's right, but we had to pull out the baby

so that the possibility to bring her heartbeat back would be much higher... that's what I was told..

Why?

Well.. I don't know the specific reason yet.

This is exactly your level. And that's why you are interns.

Although you experienced laparotomy once, can you open the abdomen wherever you are?

You don't even know the exact medical ground for it.

It has been a day since yesterday's emergency C-section.

But you didn't even check what its medical ground is.

Are you butchers?

No.

You know neither the principle, nor the reason.

If someone tells you to open it, will you just open it?

After you caused this huge trouble, haven't you even thought to check about it?

Well, by removing the baby, the mother's vena cava and aorta which were pressed could work normally,

and as her blood circulation of whole body could work better,

not only the possibility to revive the heartbeat from arrest was increased,

but also we could save the baby's life.

I looked into it when I went home yesterday.

When we performed laparotomy yesterday, I didn't know that, either.

The patient Jo Young Hee had a mesentery rupture, so I performed the surgery.

As she's a trauma patient, you take her over, Professor Choi.

Yes, I understand.

To avoid DIC , we're giving her platelets now.

Yes, I see.

It's now the calm before the storm.

The mother and the baby, both are not regaining the consciousness now,

and the husband copied the medical record.

If anything goes wrong for the mother and the baby, then the entire hospital would get a big impact.

And the rest of the medical staff who couldn't supervise them well would be sued one by one.

This is the reason why mere interns shouldn't act up recklessly.

Since yesterday, he has been having a fever of 38.2 degrees C.

His white blood cell's level is 17,000. Is he having some infection?

It's too early to conclude that. For a trauma patient, it can happen because of systemic inflammatory response syndrome.

As its symtoms are similar to regular bacteria infection, it's difficult to distinguish them.

I feel uneasy, so...

I also feel uneasy.

Take CT scans again today.

It can mean that other damaged parts got worse.

Yes, I understand.

It seems he has rhabdomyolysis.

How is his creatin kinase level?

Yes, it's 25,000.

How about his potassium level?

Yes, postassium... it's 4.3.

I think we need to start dialysis.

Pardon?

Urine is coming out at a rate of 40cc per hour,

his potassium level is normal and the creatinine is not increased from 1.4.

Isn't it too early to conclude he has renal failure?

What is the most common complication of rhabdomyolysis?

It's renal failure.

Looking at the current urine's color, it's highly possible to have renal failure soon.

We should sometimes make a preemptive attack, not always do just defence.

Change the antibiotic to Piperacilline and Ciprofloxacin.

But the patient is the employee of Health Insurance Review and Assessment Service , Professor.

It will violate the assessment standard a lot.

You can now understand why the hospital hates Professor Choi, right?

Well, they are also doing their work, just like we do!

Nurse Eun Ah likes him, though.

When did I?

What the heck...

Oh, sit down, sit down.

Sit down, sit down.

Sit down.

What are you doing?

What?

Oh, when there was an audit, they told us to make a separate OB/GYN examination room in ER.

It is next to the CT lab, isn't it?

That one isn't within ER, they say.

They said that we must make one within ER, so when I told them we don't have any space,

they told me to use here.

Well, even if it's small, what else can we do?

All departments would say they wouldn't give up their space.

Moreover, this is clearly instructed as "within ER", we have no other choice at all.

Well, we need to start the renovation next month.

Oh, right, you heard that there will be the Commitee of the Operation Room.

See you then.

Then, he means that this room would be divided into two

and he would make one as an OB/GYN examination room, right?

Aish, seriously! They can't even give us this tiny space?

Oh, you must be busy, but why are you doing that yourself? I will do it.

It's okay.

I thought this while I was cleaning Grandpa's face,

but he's really handsome!

Honestly, he doesn't look bad wherever he goes.

Director, please take a seat.

Director, please take a seat.

Oh, thank you.

Have you considered it?

Did you know that Grandpa started supporting the Trauma Team?

I know. I wondered what this old man was thinking.

But it seems that that support is getting taken away again.

Well, even if a big principle is suggested by Chairman, its follow-up is managed by each Head Director.

So, they are managing as per each hospital's situation.

When I heard that they would give 5 beds of the ICU to the Trauma Team,

I thought they would give the existing ICU beds immediately.

No, that can't be workable. All other departments which are already using the existing ICU beds

would scream that theirs are not enough either.

So, we can't take beds from them and give to the Trauma Team.

I heard there would be a commitee of the OR.

Oh, I heard that too.

So, the hospital management is to efficiently divide

the limited hospital properties and commodities by prioritizing the orders.

Yes, that's right. Same for politics, too.

It's always because commodities or spaces are not enough.

But, what if the arm is bent in?

Humans are always like that. That's why they vote for the person who would represent their own benefit.

If you don't participate, then they would eventually decide and distribute it as per others' intention.

Then, you need to just accept its result and move on.

If you can accept that, there is no problem even if you're not interested in the management.

If there is the special meeting for Board of Directors, who would fill the empty position of Chairman?

How is Chairman's condition?

We're doing Triple H therapy now,

but need to monitor him more.

If the Chairman wakes up, do you think he can return to his regular work?

We wish he could, but as he had to have the surgery, not only coiling,

We need to wait some more.

After 1 week to 10 days, its result will come out,

but why do they have that special meeting, not waiting a little more?

As the Chairman's position is vacant,

they must think the hospital would be shaken and noisy, I guess.

Also, I heard there was a huge problem yesterday in the ER.

Even if there was a specialist in the Emergency Medicine Department,

he would have made the same decision as that intern did.

Okay, I understand,

but if anything goes wrong and it leads to any lawsuit,

then the laparotomy done by a intern can be a problem, that's what I'm saying.

I heard that they even had to perform the hysteractomy.

Even after a regular delivery in OB/GYN,

if the uterus is not contracted properly, they try angiography,

if the uterus is not contracted properly, they try angiography,

and if that's not working either, the uterus is removed.

Yesterday, when they went into OR to do angiography,

there was an arrest, so they had to remove the uterus.

It's not like there can be more hemorrhage because interns performed laparotomy.

But I heard that guardian even took the medical record too.

Well, he didn't make any big complaints to the hospital yet, staying quiet, so...

Actually, he should resent the person who caused the accident.

The interns who did their best to perform the surgery can't be blamed.

Let's avoid leaving the ER with only the Interns.

My own Fellow who was in charge left,

to go eat so I don't have anything to say.

I'm just grateful that nothing too terrible happened.

Aigo, anyway, these days the hospital is in unsettled mood, but why even that kind of incident?

By the way, you are going to attend the meeting for the Board of Directors, right?

I'm just a MC.

Dr. Jae In, what are you doing?

I'm going to request for some time off.

Why? Because we keep making you do the calls?

No, that's not why.

I just have something to do. I feel a bit disturbed too.

Also, I'm going to nurse Grandfather.

I can just stay to fill the position,

but what if something happens like yesterday when I leave my post for a moment?

But, what kind of vacation is this long?

Why? How many days is it?

Do you think they will approve?

No, maybe.

Since you are the Chairman's granddaughter, they will probably approve.

Wait a second.

We also need to go vacation soon, but if you take this long leave, we can't go until you come back.

I'm sorry.

I have a reason.

That's okay. Go and come back.

Right, go.

Thank you.

Don't forget to bring some presents when you come back.

Are you going somewhere far?

A little.

I see.

Doctor Min Woo.

What?

Yesterday, you said even if no one helped, you had no choice but to perform the laparatomy.

Yeah. It would have been better if I had help but,

even if no one helps me, I would have done what I can.

Since there was no other way.

But why?

You were really going to try by yourself without any help?

Yeah.

You had that kind of confidence?

First, because I trust Professor.

I had faith that the Professor wasn't telling me the wrong thing.

And I learned how to perform a laparotomy.

He said that the Golden Time can be extended if a doctor knows laparotomy and hemostasis.

You proved that.

But first,

the baby and the mother have to regain consciousness.

You would have done it whether they wake up or not.

There was no other way.

Are you leaving immediately today?

Once the leave application is approved, I will leave immediately.

Don't see me off.

This is a vacation I have to leave by myself.

Then, did you plan to go with me?

I'll be back.

From now on, the special meeting for the Board of Directors of Se Jung Medical Foundation will be begun.

There is an agenda about the election for the temporary Chairman to fill its currently vacant position.

Right now, many important issues are coming up in the hospital continuously,

so we can't keep the Chairman's position vacant.

I also agree about the election of a temporary Chairman.

But I think it's too early yet as the Chairman is now recovering

and he might regain his consciousness within a week.

Then, how will you handle all those many issues coming up in the hospital now?

Are you going to call for a special meeting for Board of Directors every time?

Will you take responsibility, Director?

What should I take responsibility of?

We've already applied for the helicopter support,

We've already applied for the helicopter support, and the application documents for Trauma Center are already prepared.

Regarding to the audit, our Insurance Assement Team is preparing all the data thoroughly.

I don't understand what's so urgent.

Helicopter support won't be done by only applying for it.

There should be some lobbying, meeting politicians and financiers,

and visiting the Ministry of Health and Welfare, etc. Do you know how many things need to be done?

Right now, nobody is working on those things and nothing was done!

About those matters, here Director Park Geum Nyeo is preparing thoroughly, one by one.

Even if the document isn't settled yet, she's already divorced in the court!

We can just elect a temporary Chairman,

but I'm wondering why a person in an awkward situation should take that position!

I agree.

Then, I will use only my shares, and instead, I will reveal the will of Chairman Kang Dae Je.

What will?

He's not dead yet!

Even if he doesn't pass away, because of the developed modern medicine,

there is a will prepared in the event of his becoming a vegetable for many years, as far as I know.

Attorney Seo?

This is his will.

Chairman Kang Dae Je will, in time of any emergency,

hand over all his shares and rights to his granddaughter, Kang Jae In.

However, when she's acting as a Chairman, her age must be over 25 years old.

Before that age, Director Park Geum Nyeo will be her guardian.

I'm Kang Jae In.

Aish, seriously!

Do you know how old Jae In is?

That young thing, how can she get through all this difficult time?

The will of Chairman states that she can take the position if she's older than 25 years.

Please sit here.

I will do my best to fill the empty position of Chairman.