Original subtitles

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 advanced modern medicine,

as far as I know,

there is a will prepared in the event of his becoming a vegetable for many years.

Attorney Seo?

Yes.

Episode 19

This is the will.

Chairman Kang Dae Je Will, "During any emergency,

I transfer all my shares to my granddaughter,

Kang Jae In."

"However, when she's acting as 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.

But...Do you now 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.

Please sit here.

Excuse me, someone in this position needs to meet officials of Ministry of Health and Welfare,

and even negotiate with them. There are so many official work someone in that position must do, but how can...?

We can share some of the roles.

I can help her and here we have Director too.

Aunt and Uncle, aren't you going to help her?

Then, do you want to take care of the agenda about the audit of the Ministry of Welfare in this meeting?

About that, I will receive the report separately.

First of all, please hurry to prepare the data for the Insurance Assessment Team.

She's working as an intern, but how can she handle all together?

If she works as an acting Chairman, the intern's work can be neglected,

and she would worry about that work as well!

I've submitted my leave application.

I'm going to do my best to fill the empty position of Chairman Kang Dae Je.

However, if Chairman doesn't wake up and the period of his absence becomes longer,

whether I give up my internship,

or the position of Chairman,

I will choose one of them.

Are there any more questions left?

Oppa, let's go down by the stairs.

I'll go to Seoul by this afternoon's flight.

Grandma...

First, I will check how the helicopter business is going on and come back.

And about the Trauma Center, too.

Those are the matters for me to go to Seoul

and meet them in person and discuss.

Grandma...

Looking at you today, I think you can do well.

If you have anything you don't know well, call the people in charge and ask them.

And if you can't understand well,

ask the professors of the concerned department.

And you trust me, right?

Yes.

And you trust your grandfather's insight as well, right?

Of course.

When we both chose you, there is the reason to do that.

If you can't trust yourself, trust me or your grandfather

who chose you, will you?

Okay?

Call me often.

Okay.

♫ Are you crying?

♫ Are you crying because you are lonely?

♫ Do you know?

♫ For a very long time I welcomed love.

♫ I love you.

♫ You loved him even more than anything.

♫ I love you.

Grandpa,

please wake up, for sure.

I will do well until then.

You shed tears behind the laughter.

You know.

Professor, because of my leave, I came to say good bye.

I'm sorry.

There's nothing to be sorry about.

It's the leave guaranteed by the law.

Are you travelling to somewhere far from here?

No, I have some situation, that's why.

I see.

If the vacation season is over, many doctors take their leaves.

As I'm taking my total leave at once,

I understand well that my collegues will not be able to take theirs.

I'm sorry.

No, no, no, no, no, no!

If you submitted first, that's it.

Don't feel too burdensome, and enjoy your vacation.

Wow, as you're dressed like this,

you look like Sharon Stone!

Have a lot of fun,

a lot of fun and enjoy it.

Yes.

Have a good vacation.

Goodbye.

Rather than her circling in front of me,

it's much better if she takes her vacation.

She's really pretty anyway.

What are you looking at?

His fever is going away and the white blood cell's level is also gradually going down.

Can you recognize where you are now?

Do you remember you had an accident?

Pull out the tube.

Yes.

Patient,

will you cough loudly once?

Will you take a deep breath?

His breath sound is also normal.

Patient,

Your iliac artery and iliac vein were ruptured and blocked,

so we had a big surgery to attach artificial blood vessels.

Luckily, you're recovering well,

and at this rate, you can be moved to the general ward tomorrow.

Thank you.

How is her condition?

Yes,

the levels of hemoglobin and platelets is maintained stably,

but since this morning, her body temperature is 39 degrees C,

with sudden spiking.

She had a laparotomy in ER, didn't she?

Yes.

Did you wear a sterilized scrub suit?

No.

What about the scrub hat and mask?

I wore only the gloves.

You probably didn't have time to put those on.

Let's cover with triple antibiotics.

Infection is concerned.

Does she already have an infection?

It's a serious situation.

For now, giving her some medicine, let's keep monitoring her.

Yes, I understand.

Professor.

Oh, I heard that you took some leave.

Yes.

Is it related to the issue with Chairman?

Yes.

Then, enjoy your vacation.

Don't worry about the hospital.

We will watch over it.

Her grandfather is here so where do you think she's going on her vacation?

Well, maybe she wants to take a rest as many people are watching her,

or care for the Chairman staying next to him. Something like that.

Ah.

We should go to watch over the hospital.

Please sit down.

No, I will report here, standing.

It would be more comfortable for you to work if I keep the boundary.

Then, what's the first thing I need to work on?

Chairman came to Haewoondae Se Jung Hospital one day per week.

Seoul Se Jung Hospital, Kyeong Ki Se Jung Hospital,

and Boon Dang Se Jung Hospital doesn't have any urgent issues.

For Gang Nam Se Jung Hospital, its reconstruction is still left to be finished,

but Director Park Geum Nyeo will check about that.

For now, you can deal with the matters for Hae Woon Dae Se Jung Hospital only.

If the work required only one day per week to him, I might be able to learn the work within a few days.

That's right.

And, Chairman used to tell me that you have a good sense about numbers,

so you will not have a big problem to read the reports from each department.

Yes, I know how to read the account books.

Then, the helicopter business, Trauma Center and the audit from Ministry of Welfare,

those three are the current problems, right?

Yes, that's right.

Yes?

Welcome. Please take a seat.

Yes.

I was reporting to her about the urgent current issues of Se Jung Hospital.

In case of Helicopter business and Trauma Center,

we can say it would be great if we win, but even if we're dropped, it's not a problem.

But in case of the audit of Mnistry of Welfare, depending on its penalty amount,

it can be a big impact to the hospital.

In terms of the overall hospital's management, you're right, but if we're also dropped from Trauma Center application...

We have been running this business so far without the government's support.

How much longer can it last just from an individual's sacrifice?

It's harder than I thought.

Yes.

You must have seen a lot closely.

Well, the result of helicopter business will be announced in this week,

and the audit team of Ministry of Welfare will come in this week too.

That's right.

As for the helicopter business and Trauma Center, Director Park went to Seoul to find its process,

so we can focus on the audit for now and prepare it.

Oh, right, what about the committee for the OR...?

Assignment of the OR is a pretty difficult issue.

Leaving one OR empty, with just one remaining OR,

the existing surgery schedule was managed, so there were many problems followed.

So, at the end, the committee is going to be convened.

I understand. I will attend that meeting too.

And I would like to talk about the ICU beds for the Trauma Team,

but I will visit the major departments first

and after that, I will discuss with you.

Please do that.

It's okay.

Right...

What?

Look, over there.. Dr. Kang Jae In.

I thought she was going on a vacation so what's she doing over there?

That looks just like a tour of inspection.

There is the Leader of Planning and Control, too.

What..

Should we at least say hello?

Well, there is the Director too, so we should say hello.

This is the new Chairwoman.

Hello.

We're from the Ministry of Health and Welfare for the field inspection.

Oh, I see, please wait a moment.

Chief!

Oh, Director, you're here.

What's your business?

We're a Field Inspection Team of Ministry of Health and Welfare.

Director, you came on the right timing.

I was going to guide them to the Director's office.

Hello, I'm the Director of this hospital.

Wait a second.

Why is the Chief of Administration acting like that to them?

I heard there would be an audit. Wouldn't they come for that?

Should I go and check?

Please!

Chairwoman, please postpone the next visit for a moment.

I will come down again after greeting these guests.

I'll be fine. Please go do your work comfortably.

No, as I know all the details of the hospital well,

I will escort you round the hospital.

Please go to the Chairman's office and wait for me for a moment.

Yes, please do so.

Yes.

Okay, please come this way.

Let's go.

Yes.

They seem like guests...

She's from the Ministry of Welfare.

And these are the employees of Health Insuarance Review and Assessment Service.

Please get in.

No.

See you later. I will go up with Director.

Yes.

Then, Director...

They finally came, the Field Inspection staff.

I don't know if they prepared all data well.

When the Chairman is sick, why do the bad incidents happen?

Let's go eat.

Let's go. Let's go. Let's go eat.

Let's go.

Please come inside.

Here.

With this space, it's enough.

We will start from the medical charts.

You can bring the charts of the concerning organization,

as we need to check if there was any overcharged excess.

Yes.

How long would it take?

Usually, it takes 5 days to 7 days.

The inspectors of HIRAS today

are all well experienced for 10~20 years.

We will finish as soon as possible.

I understand.

What is that?

It seems the audit of HIRAS started. You'd better go there first.

Aigo, Mother, now the marriage isn't important!

Excuse me!

It's not the time to look into your cell phone! HIRAS came now!

Oh my God, that must be it!

Hello!

What are those?

These are the charts of receipt for physical therapy.

Please give them to me.

What are the ones next to them?

These are the medical charts.

Please give them to me.

What's going on now?

Please work hard.

I feel nervous.

I know, right?

How much data are they reviewing?

At this rate, our hospital... - What? - Be quiet!

- Our hospital... - Hey!

At this rate, what if a big trouble happens in our hospital?

It will take more than one month if they review all of them.

This is why I can't leave the hospital.

If I'm not here, the hospital is always in chaos like this!

That's right, Doctor Kim. When you weren't here,

interns made a big trouble. Did you hear that?

What? What trouble?

Aigo, I don't know, I don't know! You explain that.

Again?

So, that was... So, that was...

So, that was...

Doctor Kyeong Hwa and I went to eat dinner,

as she told me to buy the beef broth soup and meat.

But then, she got a phone call from Doctor Hyeok Chan, ... Doctor Jae Won, let's go.

Uh, my story isn't...

How is the patient's fever?

She still has a fever up to 39 degrees C at least 4 times per day.

How is her BP, then?

It used to be normal, but now it's between 90 to 100.

You're giving triple antibiotics and vancomycin, right?

Yes.

Excuse me..

Yes.

I want to see the prescription details used for me.

Yes, please wait a moment.

Professor, about the patient Choi Jeong Gi,

he's asking to give him the details of prescriptions issued for him.

Yes, please show him.

Yes, I got it.

Please print out the prescription details for the patient Choi Jeong Gi.

Here it is.

Is there anything more you need?

Can I see the test records?

Pardon?

Oh, umm... yes, just a moment.

Although we expected, they must have come with a full determination.

Our hospital doesn't have any false records.

Even if one or two are caught, those will be just unintentional mistakes

Then, at the end, as for the cases of unauthorized drugs or treatment for insurance payment,

how much penalty we would receive, that's the only problem here, right?

Oh, I heard one influential person of HIRAS is now hospitalized here.

He's hospitalized under Choi In Hyeok.

Can't he give some favor to us?

Like extenuation.

He would know as he's also hospitalized.

The department which especially gets more cut back is the Trauma Team.

While he's getting treated, he would be able to find why those drugs must be used.

I have no expectation about that.

If he doesn't make a fuss, I think that's enough.

Hello.

How is your pain?

It's bearable.

Oh, is that so.

Oh, you look fine.

From today, please try to walk.

Would it be alright if I do that?

Yes. But you should walk carefully.

Okay.

Please do the dressing.

Please help him for the finish.

Doctor,

Yes.

Did I even have kidney failure?

Huh?

I had CRRT and even dialysis.

Oh... yes.

You had a huge massive hemorrhage,

and rhabdomyolysis, a symptom of which was very dark urine,

so it was critical at that time.

Oh, so I was even in that situation...

But...

as per the record, before I got the dialysis,

the urine kept coming out

and the creatinine level was also normal.

I don't think it was critical enough to conclude it was kidney failure.

Ah, well, rather than me, an employee of HIRAS,

you doctors made a better judgement, I guess.

But as per these data, ....

Of course, you weren't exactly within the range which can be diagnosed as kidney failure.

Yes..

But then, why did you use CRRT and dialysis?

That was because our professor

judged that kidney failure was developing because of rhabdomyolysis,

and toxic substances which occurred when the muscles were damaged

would be too much to be filtered by only your kidneys,

so he made a call as per his experience.

Yes.

At the end, you're saying that he "anticipated" it would progress to kidney failure.

Yes, he anticipated, that's right.

But still, the records show it didn't have kidney failure.

So, these are just numbers,

and in the Surgical Department, there are still some areas which depend on the experiences and insight.

When HIRAS made rules based on certain levels,

don't you think there is the reason to do that?

Then, after the kidney failure came,

do we have to use drugs as an ex post facto prescription?

If you would go through all the suffering

and the kidneys would be ruined,

then the drugs are anyway needed as well as dialysis.

For that, you can request HIRAS to make a decision.

How about the infection, was it serious?

During the first few days, your fever didn't go away,

and the white blood cell's level went up to 18,000.

CRP went up to 12.

Okay, so that's it.

However, even without infection, trauma only can also cause those readings, right?

Well, I don't know about that well..

Anyway, our Professor thought through a lot.

How much Procalcitonin is there?

It was 0.5.

The number isn't enough to call it infection exactly, is it?

Yeah, that's it.

Honey, that's enough.

Do you know what kind of condition you were in when you were admitted?

A patient checking if any drugs were misused or abused on him,

Is there something wrong with that doctor?

No, it isn't. If you're curious, you should ask. Please go ahead and ask.

Isn't there any result of cuture test?

Huh?

Uh...

about that... I don't really...

If you have anything else to ask me...

The Professor... I think you need to talk to the Professor.

As he would have a round visit in this evening, please ask him then.

If you want to know anything else, write it all down.

And please make sure to ask him then.

Please make sure to make a note. We will start the dressing, then. And please make sure to ask him then.

Please make sure to make a note. We will start the dressing, then.

-Gloves. -Yes.

Wow

There wasn't anything he didn't know.

Doctor, that person is strange.

I think we need to study more. What a total embarrassment it was!

He seems like a type who can confuse you even more if you study more.

And I don't think he really wanted to know the truth.

He already fixed the answer as the standard of HIRAS, and now he's trying to find the grounds.

That's right.

-Right? -Yes.

Aish, this puts me in a bad mood.

I wonder what's going to happen to the hospital.

Letting this crisis be handled by a young girl who is still wet behind her ears...

I can't understand what on earth they are trying to do.

Dae Je Oppa is a bit weird, isn't he?

What's so weird about hyungnim when he's lying on bed?

To give whole things away at once like this, did he struggle to run those hospitals even by sacrifcing his own son?

Wouldn't he be dispirited?

How come you always.... Won't you be more careful at what you say?

Why are you being like that? Did I saying something wrong?

This time, the audit of Ministry of Health and Welfare is also a big problem.

Oh, right, didn't you say one of your friends is a high ranking officer at the Ministry of Health and Welfare?

He moved to Ministry of Land, Transport and Maritime Affairs.

You heard that one employee of HIRAS is now hospitalized here now, right?

I guess I need to find out how that would affect the hospital's situation.

I don't think this investigation is going to pass easily.

If Jae In resolves this situation well,

What will we do then?

That's.. well.. if she has a will to keep working on the hospital's management,

she will remove that "acting" name and become the official Chairman.

She's too young.

If anything goes wrong, whether an acting Chairman or what-not,

we can just remove the name "Chairman" from her.

Her BP was dropping to 80, so we started to give dopamine.

As per the test result, the white blood cell level is also dropped to 1,900,

and Creatinine is also rising to 3.2.

The body temperature is high and she's not conscious...

and the amount of urine is decreased...

I think she's having septicemia.

Submit the CRRT support request to the Kidney Internal Medicine Department.

Should we change the antibiotics?

The culture test's result will come out tomorrow morning, right?

Yes.

Let's make a call after reviewing its result.

If her BP keeps dropping, increase the dosage of dopamine.

We'll need to monitor her closely all through the night.

If she has another arrest, there will be no way to save her.

Results are back, but there wasn't any type of bacteria.

Looking at my prescriptions,

I see that you used vancomycin and even meropenem.

Did you need to prescribe such powerful antibiotics

when there was no sign of bacteria?

We initially used lower grade antibiotics,

however, they weren't effective, so we had to use the powerful ones.

I don't see the grounds for

using vancomycin anywhere.

Honey, I was told that the artificial blood vessels are susceptible to the infections.

If infected, it will be very dangerous.

As your wife said,

when we reconnect the blood vessels,

we have to be careful about infections.

Since the artifical blood vessels are particulary susceptible to the infections,

if infection occurs, it could be led to sepsis.

And also because your bladder was torn during the surgery,

it was possible that you could have gotten infections from the vesicourethral canal.

While I understand your concerns,

I believe the negative culture result

proves that there is no infection.

I think you can stop using these types of antibiotics now.

We cannot.

It is true that we couldn't prove that there are bacteria in the culture.

However, your condition improved after we used those antibiotics.

It proves that those medicines work for you.

I know that you use powerful broad-spectrum antibiotics

when bacterial infections are suspected.

However, you need to adjust or replace antibiotics

according to the culture results.

That also is one of the principles of using antibiotics.

Those antibiotics were definitely effective.

That is your personal conclusion.

I, am not only a staff member of the Health Insurance Review & Assessment Service, but a patient

would like to know the objective medical grounds why these powerful antibiotics need to be used.

It hasn't been long since you got better.

If infection of the artifical blood vessels happens while not using antibiotics,

we have to remove previously implanted artifical blood vessels,

and need to have a second surgery implementing them elsewhere.

That... is just your personal opinion.

For me, I would like to see more objective medical grounds.

When you do the culture test again, and if the bacteria are present,

then, I'll take this vancomycin.

Until then... I refuse to receive that medication.

This is not healthy food or anything. A powerful anitibiotic like this?

You wouldn't dare using a medication against the patient's will

without providing objective medical grounds, would you?

Gosh, what kind of a patient is he?

He's impossible!

What he said made logical sense, though.

That's what makes him scary. He understands all the words,

but he doesn't even try to listen to you.

Professor, what are you going to do about it?

Are you really going to stop giving vancomycin?

Stop it.

Pardon?!

Wh... What can we do?

It's not like we can sneak it in wihout him knowing.

The whole hospital is in a commotion because of the HIRAS audit.

At a time like this, we cannot give him a medication that way.

Let's discontinue vancomycin and see how it goes for a couple of days.

Yes, I understand.

You came in at the right moment.

I would like to discuss with you about the OR Committee,

and I saw the blueprint for the ICU area where the new beds are going to be placed.

On there, I saw that ICU beds won't be equipped with the oxygen supply. What does that mean?

I'll explain more fully a lttle later.

The final selection for the beneficary of the Ministry of Health & Welfare's medical helicopter project is out.

Is that so?

We didn't get it?

No, we didn't.

It is not announced yet

but it is more likely that the Cheong Hae Hospital in Changwon will be selected.

It's a hospital I've never heard of.

It's a Grade 2 hospital.

A Grade 2 hospital?

Yes.

Having a medical helicopter means

that you are going to take care of trauma patients until the end.

How could a Grade 2 hospital in Changwon, not even in Busan be a more likely candidate?

I can't understand why our hospital wasn't selected.

It is not a matter of how good a hospital is.

That hospital is the only hospital which meets the distance regulation

among the candidates.

That is not a university hospital, nor even a Grade 3 hospital.

How on earth could a hospital like that get the medical helicopter?

How many patients are they going to transfer on it?

Myocardial infarction, stroke, and epityphlitis...

It can probably take care of those patients.

They won't be able to provide services for trauma patients.

I hear that the regulations for the type of the medical helicopter has changed.

When government planned to introduce the medical helicopters,

didn't they plan to cover the whole region?

That's right.

Then, how come the regulations have changed?

Probably because of the budget, don't you think?

The smaller model medical helicopters are cheaper than the big ones.

The small ones won't work!

When you are assigning one for Incheon, that one should at least cover Yeonpyeong Island.

I hear they can't even make a round trip there!

Look, Jeonnam Province has a lot of islands.

That distance rule is the reason why they chose a small hospital,

instead of Chonnam National University Hospital.

Chief Na, how do you know that well about it?

Emergency medicine has been deeply involved in medical helicopter projects.

After all, the red tape is the problem.

How much the helicopter uses for fuel,

what is the distance for the round trip,

if a helicopter can cover a region,

make it Gyeongnam or Jeonnam...

they should have studied all of the above!

What are they going to do when they run out of gas

on the way back to the hospital after picking up a critical patient?

If they make an emergency landing in a tiny island, would there be a gas station?

So, we didn't get chosen because of the smaller gas tank of a smaller helicopter

which is because of the change of the regulations?

This is exactly what happened when they selected a hospital for Jeonnam region.

Oh geez.

Did you hear the news?

Yes.

We're talking about that now.

It will still leave a lot people in the medical blind spot, while the government spends a lot of money.

Jeez, it turned out like this again. $3 million isn't even a small amount of money.

Medical helicopters sure are expensive.

I heard they even went to see the Doctor Helicopter system in Japan.

If so, why did they choose such a small model?

The expense will occur anyway

while patients has to go to the smaller hospital.

Well, that's that.

So, we didn't even meet the distance regulation.

Geez!

Are you okay?

Oh yeah, yeah. Of course, I'm okay.

Are you really okay?

When are you leaving for Canada?

I am going to Canada!

I'm going now.

Where are you going?

Yes, this is ER Chief Na Byeong Gook.

This is Provost Kang Soo Gyeong.

Yes.

Huh?

What makes you..., Ms. Provost? Huh?

What makes you..., Ms. Provost?

I would like to discuss the hospital management issues with you in private.

Oh I see. I'll come to see you.

Chief Kim Min Joon? This is Provost Kang Soo Gyeong.

What's the matter, Ms. Provost?

Yes, Director.

Are you free tonight?

Yes, I don't have any particular appointment tonight.

Thanks for taking your time to meet me tonight.

Don't mention it.

If it's you, Provost Kang Soo Gyeong,

of course I should come, even if I am busy.

By the way, what brought us two here?

I'll cut to the chase.

You are interseted in the Head of Trauma Center, aren't you?

The Head?

That position appoints tens of doctors, as you know.

General Surgery, Emergency Medicine,

Orthopetics, Neurosurgery,

Anesthesiology, and Thoracic Surgery.

There are only a few staff at the moment,

when the whole team is set up with the rotation staff,

there will be tens of doctors.

It is not impossible to hold Chief of General Surgery concurrently, either.

Of course it is possible.

Other hospitals do the same.

Among the current issues we have, the medical helicopter application was not selected,

you can't do much about the government audit. Then, the Trauma Team is the only matter we have.

Wouldn't Professor Choi In Hyeok be in charge of the Center

if everything goes smoothly in ths current system?

I very well know that you're taking a neutral position right now.

You know the most about my brother's condition...

You are holding a high position already,

however, if you set your bar high and manage this hospital successfully,

you could not only become a dean of medical school, but you may retire as a University Chancellor.

Think hard about it.

It must be hard to share the ER space

with the Trauma Team.

You also support them with staff when trauma patient comes.

If you cannot expect to become the Head of Trauma Center,

Isn't it like

"One man sows and another reaps".

You mean the Head of the Center...

The Trauma Center is like a control tower where you connect all the departments involved.

We can't talk about the Trauma Center

without mentioning Emergency Medicine

which works as a hub by making calls and connecting all the departments.

I'll pour you a drink.

Your clothes really fits you well.

Aigoo.

As for me, as long as they don't touch my area,

I really don't care about what others do.

I know very well that you don't have much interest in

climbing up the corporate ladder.

However, if the Trauma Center gets opened up officially,

there will be some significant impact on the number of staff from Orthopedics.

The Orthopedic department will not be able to control any Orthopedic professors that are in the Trauma Team.

That's true.

There is a reason why there are positions like a Director or a C-level positions

They are there to defend their own area.

My pride will not allow any action

that will blatantly harm the hospital.

It won't be too late to hear the offer first, then decide after that.

Kang Jae In, the acting Chairman, will ask for help regarding Trauma Center.

At that time, tell her that due to the different organizational system than that of Kang Dae Je's,

ask for an astronomical amount of budget and appeal your department's position.

Do not give your consent easily.

This is not such an unscrupulous act.

And it does not differ from Chief Hwang's usual position.

Yes, this is Lee Min Woo at ER.

Hi. I'm calling from the patient room.

Patient Choi Jeong Gi's temperature is 39 degree C.

His breathing is also uneven.

Since when?

Starting earlier this evening, his temperature has been going up slowly.

Yes, I'll be right there.

Please give him oxygen mask first and also put monitoring on quickly.

What's his blood pressure?

It's 95.

Patient Choi Jeong Gi.

Do you remember me?

Just a moment.

What is his temperature?

It's 39 degree.

Does that hurt?

Excuse me.

Professor. It's Lee Min Woo.

I'm calling regarding patient Choi Jeong Gi.

Oh, what's going on?

His temperature is 39 degrees and he is also having some difficulty breathing.

He is also shivering right now.

What's his BP?

The last measurement was 95.

I'll be coming up soon. So move the patient to the ICU.

Take the X-Ray and order the blood test.

Reorder the culture test.

Okay, I got it.

Could you move the patient now?

Yes.

From the arterial blood gas analysis, how is the oxygen level?

PaO2 is 67 mmHg

and the oxygen saturation is 88%.

X-Ray picture is on the monitor, professor.

It is Acute Respiratory Distress Syndrome.

Professor. Is it pneumonia?

No, it's not pneumonia.

If it's not pneumonia, can the lung function decrease so quickly?

It is possible for the lung function to get worse, even if there are problems in other areas.

It's a common symptom for a Trauma patient.

Should we get a new CT scan?

No. The latest CT scan showed that

there was no problem in the surgery area and the organs.

The timing doesn't match up for the organ to rot or for rebleeding. The time has already passed for that.

But it seems like he is having a really difficult time breathing right now.

Give him the NIV for now. And if he still has trouble, then let's do intubation.

Could you prepare the NIV?

Okay.

How's your breathing?

He says that he can breath OK but the mask is rather uncomfortable.

I know it's hard but please bear with it.

Otherwise, we will have to intubate you.

Is it bearable?

Then we will be back later.

He is asking if this is because he stopped taking vancomycin.

We are not sure yet.

We are not sure yet.

We will let you know after we look for the actual cause a little more.

We will let you know after we look for the actual cause a little more.

Professor. It's infection, right?

It is definitely infection this time.

But could it have been caused because we stopped vancomycin?

No,

Even if he stopped for one day, there should still be residual effect of vancomycin.

You've seen the patient's condition yesterday.

He had made that much progress.

Just because we stopped it for one day,

the possibility of recurrence is slim.

Moreover, if the culture test did not detect the infection. That could really mean...

Then?

This is a new infection.

What?

Even with the vancomycin

and meropenem injection,

a new infection has started.

Then, you are saying even those medications are not being effective.

That's how I see it.

Then if we get the new culture test done, it will take some time for the result to come out. But in his condition now...

Ahh, his stubbornness was no joke! He is going to complain like crazy...

Switch to linezolid

and colistin.

That patient doesn't even want vancomycin and you are telling us to use even stronger antibiotics?

Just inject them first.

When his condition is stable, then let's try to convince him again.

When his condition is stable and has more energy, he is going to drive us crazy, asking for the objective ground... I'm going crazy!

You ordered another culture test, right?

Yes, I ordered for blood, sputum, and urine, all of them.

Call Molecular Epidemiology Lab first thing in the morning to request for the gram staining.

I understand.

But if the test result doesn't come out, then all the bills will be rejected. Would that be all right?

How long will you be a doctor?

If possible, I'm planning for until about when I turn 65 years old...

How about being an intern?

1 year.

Then, at least for 1 year as an intern,

just focus on the patient and the medicine.

You can do enough of those types of worries later.

Okay. I understand.

For this patient, switch the antibiotics to linezolid

and colistin.

All right.

Wait. We have to control the infection first.

Then when you get better, we will debate with you again. You must fight the infection first.

Have you heard?

About what?

You see, Intern Kang Jae In...

Ah yes, her grandfather is the Chairman. That's right.

Not the granddaughter of the Chairman, but the acting Chairman!

What?

What are you talking about? She is on vacation now.

She must have gone on vacation to the 15th floor then!

I heard she came to the Patient Affairs office to look around with the Director on her side.

Then she is not the granddaughter...

Woah! She is becoming the Chairperson!

Oh, I had no idea and was acting all carelessly in front of her!

What should we do?

Dr. Min Woo.

Yes.

How is the mother doing?

It's highly possible that she has infection.

And her fever won't go down.

It's almost the time to have a meeting with the chief of each department.

Dr. Jae In.

Come back safely.

Come in.

Each interview is scheduled for 15 minutes. Chief Na Byeong Gook has arrived.

Welcome, Chief.

As you already know,

We can no longer have the medical helicopters.

To prepare the upcoming audit about the hospital,

please cooperate well.

Yes, I understand very well.

Yes, I understand very well.

And this is concerning the location.

Please find another location for the OB/GYN.

Huh?

It doesn't matter where it is. As long as you find another area, we will reconstruct it for you.

Unless the Trauma Center gets a separate facility,

It needs to stay near the ICU to operate effectively.

I didn't take that location due to personal feelings.

It was pointed out during the last inspection by the Government.

If we don't meet the provincial standards of Emergency Center,

All the funds will be void.

But, wouldn't there be another location if you really look for it?

Just because it's me,

Do you think I secretly tried to hide a room and placed it there on purpose?

I did it because we don't have that much space.

If you ask me to look for another location,

I don't know how I should respond...

Don't just say that you can't do it.

After you have searched for another location, we will talk again.

Okay.

What did she say?

She said not to mess with the Trauma Center near the ICU.

She's definitely trying to help out Dr. Choi In Hyeok.

Does she think that we have extra space? My goodness!

Do well.

You are the chairperson of the OR Committee, right?

Yes, that is true.

I heard that you're asking for the surgery room that you gave the Trauma team.

Please look for another solution.

There is an empty small-scale OR next to ER.

At night, as there is no pre-schedule surgery, they can use the regular OR.

And for the patients that come in during the daytime, they can use the emergency room.

But, we do need another team of anesthesiologists.

If there's going to take shifts, we need about 3 or 4 more doctors.

And we also need about 10 or more surgical nurses.

If the fund for manpower is secured,

we will hire additional manpower.

Money is the issue for everything.

We are pitiful everytime we see the trauma patients.

But if we continue to receive only trauma patients,

The hospital will keep having deficit.

And later, we will lose the ability to maintain the hospital's status.

Ever since the opening of this hospital, I've been in charge of the Orthopedics dept.

Our fellow is the foundation of our Orthopedics dept.

If you just send him to the trauma team,

There is such a big target on our part, Chairman.

Then, do you think that he should go back and forth like he's doing right now?

Well, until the Orthopedics gets back to normal, I suspect that he should.

From our perspective, isn't it a given that we would care more about our Orthopedics than the Trauma team?

This is concerning the number of staff on the trauma team.

Please send interns as fixed staffs, not as supporting manpower,

and add more paramedics and nurses so that they can take shifts.

And please increase the positions of coordinator to two.

A new semester has to start for the interns in order to assign them to a fixed T.O.

For the rest of the manpower issue, it seems simple but it's actually the most difficult.

In the end, money is the issue.

Yes, that's correct.

If we get a penalty from this audit, it will be several millions to 10 millions dollars.

Rather than using it like that, I think this will be less of a waste.

If we don't get any penalty,

maybe we will have the budget to do so,

but if we get any penalty,

more investment would be impossible in reality.

I'm sorry.

Then, what about the location of the ICU?

It's not a matter of space.

It's the fact that we have to place those expensive 1 million won ventilators in each dept.

And the bed cost about millions of dollars.

Including the nurse manpower to take shifts,

it will be 1 million dollars for total 5 beds, 200 thousand per bed.

But,

Once those trauma patients come in, they can't go up for several days at a time.

So, it'll be difficult with just 5 beds.

Aren't you going home?

Did my Grandpa also work with such strong resistance?

Since he has charisma...

Just because I'm the Chairwoman,

There's no way that a 10 year system would change.

Anyway,

It's a system that won't change even if the President of South Korea came.

Let's go. I have to sleep so I can work tomorrow.

Interrogation, reprimand, punishment, discipline, torture!

Are you prepared to receive all these bad things?

Yes.

Exactly why?!

While "Sir Me" was gone,

I don't understand why you guys caused such a big problem.

Just 3 days in a year,

Were you that jealous of my 3 day vacation?

I'll take responsibility.

What?!

Are you saying that because the hearts of the mother and the baby are still beating?

For troublesome interns,

How many, many, many... times did I tell you guys not to do anything that you have to take responsibility for?!

You guys,

See you later, okay!

See you later.

Are you the accused of today?

Hey, what the accused?

Does an intern even have the right to become the accused?

That's right, how come a mere intern can be the accused or have the right or what-not?

Anyway, today, let's stay low and beg them.

Hyungnim, frankly speaking, we didn't do anything wrong, did we?

Wow, you're out of your mind, crazy.

As you had opened the abdomen once, your liver is pooped out of your abdomen!

You also did laparotomy with us!

I didn't do anything else but CPR!

Aigo, that's something you can brag about!

Hyung, shouldn't we really go and beg their forgiveness?

33 year old patient, Jo Young Hee. It's a female patient.

During her 35th week of pregnancy,

Due to a car accident,

She was transported here through 119.

Dr. Lee Min Woo.

Yes.

Did you only think about the stopped heart?

Without any preparation, you just cut open the abdomen.

If you open up the uterus, the bleeding will worsen.

Then, it'll be more harmful to the patient.

I did take that into consideration.

But if I just left her alone, I decided that it would be harder for the patient's heart to come back to normal.

You just opened it without any thinking? Without any situation or circumstance?

No, that's not the case.

Since she was pregnant, her stomach was bloated.

we couldn't distinguish if it's because of pregnancy or hemorrhage.

Did you check the condition of the baby?

If the baby is already dead, what is the medical ground to perform a laparotomy within 5 minutes?

I confirmed it by stethoscope.

Even though it sounded weak,

I could hear the baby's heart beats.

After hearing the baby's heart beats,

after hearing it...

I couldn't not take the baby out.

Dr. Lee Min Woo. Dr. Lee Min Woo!

It's a mess in the ICU right now!

The mother's BP is not good and the oxygen saturation is dropping now!

Hurry, hurry!

I'm sorry.

I'm sorry, but I'll be leaving!

I'm sorry.

Hey, Lee Min Woo!