Chapter 56

Chapter 56

Im Gain called the Education and Training Department at Hanguk University Second Campus.

"Hello. This is Im Gain, graduate class sixty-two."

"I'm scheduled to observe Professor Kim Dohyeon's first surgery next Wednesday."

"Yes, one moment."

Gain heard clicking and typing through the phone.

"Yes. Dr. Im Gain is on the observer list."

"Administration told me I had to submit the application with my adjunct-professor appointment number, so I called to confirm."

"Administration?"

The person sounded confused.

"That has nothing to do with them."

A brief silence followed.

"Professor Kim Dohyeon submitted the surgery schedule and observer list before leaving for his conference."

"All you need to do is sign the surgical observation consent and confidentiality agreement."

"I'll fax them to you."

Gain remained silent for a moment, still holding the receiver.

Kim Dohyeon had prepared everything before leaving the country.

She had never even asked him to.

He had simply taken care of it.

Han Seongyeon deliberately sent it to administration.

Administration did not handle such documents, so they had simply tried to process what they received.

A petty little trick.

Han Seongyeon had often done things like this when they were students too.

We're not students anymore.

"Dr. Han Seongyeon must have gotten confused."

Gain politely gave the staff member's name and ended the call.

The fax machine beeped.

The consent form and confidentiality agreement printed out.

In the affiliation section, Gain wrote:

[Director, Hyundai OB-GYN Clinic]

She signed both pages and faxed them back.

***

At the same time, in the OB-GYN department office at Hanguk University Second Campus.

Lunch had just ended.

The department phone rang.

A first-year resident sitting by the door answered.

"Yes, OB-GYN department."

"Administration? Yes. Yes. One moment."

The resident covered the receiver with one hand and looked around.

Han Seongyeon was at a desk by the window organizing operative records.

Two third-year residents beside her had just opened their lunch boxes.

"Dr. Han Seongyeon, it's administration."

"They said the Education and Training Department contacted them."

"Apparently surgical-observation paperwork isn't handled by administration."

"They're asking why OB-GYN sent it there."

The chopsticks of both third-year residents stopped.

"The surgery next Wednesday, Professor Kim Dohyeon's case."

Han Seongyeon nearly bit her pen.

"I must've gotten confused."

"Tell them it's fine."

"Okay."

The first-year resident turned back toward the phone.

One of the third-years whispered to the other,

"Isn't the observer list always handled by Education and Training?"

"Shh."

Both lowered their heads.

Han Seongyeon's face turned bright red.

She left the room.

***

Jeong Inhwa came in for an appointment that afternoon.

She was the pregnant patient who had developed preeclampsia, with a blood pressure of 160/105 and proteinuria.

She had been the patient Gain worried most about while attending the infertility course.

During Gain's absence, locum Pyo Jinwoo had twice urged her to go to a major hospital.

She refused both times.

Only after speaking to Gain on the phone did she finally go to Hanguk University Hospital.

"Ms. Jeong Inhwa, come in."

Jeong Inhwa entered with her mother.

Her mother was holding the baby.

"Doctor, thank you so much for calling me that day."

"I'm glad you're here."

"Sit down."

Gain pulled up the records on the monitor.

The notes written by locum physician Pyo Jinwoo appeared.

Blood pressure and urine protein values.

Transfer to a tertiary hospital recommended.

Patient refused.

Returned that evening.

Transfer recommended again.

Refused again.

Everything had been documented cleanly.

Then Gain read the discharge summary from Hanguk University Hospital that Jeong Inhwa had brought.

[36 weeks + 2 days: induced labor, vaginal delivery.]

[Maximum intrapartum blood pressure: 168/110 mmHg.]

[Magnesium sulfate administered for 24 hours.]

[Newborn weight: 2.4 kg.]

[Nursery admission: 3 days.]

"How is the baby?"

"Good."

"Last week at pediatrics, she weighed 3.5 kilograms."

The five-week-old baby was growing very well.

Her mother pulled the swaddle down slightly to show Gain the baby's face.

The cheeks had not completely filled out yet, so the little chin still looked pointed.

"She's grown well."

"Let's check your blood pressure first."

Lee Seyoung wrapped the cuff around Jeong Inhwa's arm.

"136 over 88."

"Do you measure it at home too?"

"Yes. Morning and evening."

Jeong Inhwa took out a notebook.

She had been recording her blood pressure diligently.

The first week after discharge, systolic values were in the 150s.

The second week, mid-140s.

Since last week, high 130s.

"Are you taking blood-pressure medication?"

"I stopped last week."

"The hospital told me to try stopping."

"Any headaches or flashing lights in your vision?"

"No."

The protein section of the urine test was clear.

No protein detected.

Gain also performed a pelvic examination and ultrasound.

The uterus had involuted appropriately for five weeks postpartum.

The cavity was clean.

The perineum had healed well.

The lochia was decreasing normally.

"Your body is recovering well."

"Your blood pressure is just taking a little longer to come down."

"Is that very bad?"

"No."

Gain reassured her.

"Preeclampsia usually improves within one or two weeks after delivery."

"But you're at five weeks and still in the high 130s."

"Let's watch it until three months postpartum."

Jeong Inhwa tilted her head.

"What if it stays like this after that?"

"Then it would be good to have internal medicine follow you and treat the blood pressure if necessary."

Her mother adjusted the baby in her arms.

"She used to have a little high blood pressure anyway."

"What were you, twenty-five?"

"Her company health exam said it was high once."

"Mom, why are you telling her that?"

Gain immediately entered the information into the chart.

"That's important."

"The treatment is different for someone who already had elevated blood pressure before pregnancy."

"Next time, bring that old health-checkup report."

"I thought it was nothing."

"They didn't even tell me to take medicine back then."

Gain looked at Jeong Inhwa.

"If you're thinking about having a second child, come in as soon as the pregnancy is confirmed."

"If you've had preeclampsia once, it can happen again."

"What do I do then?"

"We'll start low-dose aspirin from twelve weeks."

"That can reduce the risk of preeclampsia."

Jeong Inhwa nodded.

Her mother looked relieved as she gently patted the baby.

"That's a relief."

"Such a relief."

"Continue checking your blood pressure twice a day, morning and evening."

"Okay."

At the end of the appointment, Jeong Inhwa stopped at the door and turned back.

"Doctor, is that male doctor here?"

"The one with glasses?"

"Dr. Pyo Jinwoo?"

"He's in Examination Room Two."

"Could I say hello to him?"

"Back then, I refused to believe him."

"I kept insisting I wasn't going to the hospital."

Gain's eyes widened slightly.

"He's seeing a patient right now."

"Wait just a little."

"I'll let him know so you can greet him before his next appointment."

Gain looked at Lee Seyoung.

Seyoung nodded.

"I'll tell Nurse Oh Dayoung."

Oh Dayoung was assigned to Pyo Jinwoo's examination room.

***

That evening, after the clinic closed and the staff went home, Kim Misuk came upstairs.

"Director, I'm here for my medicine."

"You said you'd give it to me today."

"Yes. Sit down."

Gain began with questions.

"Are you sleeping well these days?"

"About five hours."

"I wake once around dawn, but fall asleep again pretty quickly."

"Before, if I woke up, I'd start thinking about the real-estate ledger and stay awake until morning."

Five hours was not generally a good amount of sleep.

But this patient was different.

Gain pulled up the previous record.

Last month, she was sleeping about four hours.

An increase of one hour was a very positive improvement for her.

"The medication suits you."

"I'll prescribe the same thing for another month."

Gain printed the prescription herself and handed it to Misuk.

Misuk carefully placed the paper inside an inner pocket of her bag.

"Then let's go see the house."

"It's right in front."

Gain left the clinic with Kim Misuk.

"I still need to take overnight calls at the hospital."

"So somewhere far away would be difficult."

Misuk had recommended many houses before, saying she would find Gain good lodging.

Most were outside Gain's budget.

Others were too far away.

This one matched the budget, so Gain had agreed to look.

"This place is really close, Doctor."

Misuk sounded confident.

"You'll regret it if you don't at least see it."

Just as she promised, the house was directly across from the clinic.

They barely walked a few steps before arriving.

"Here?"

Gain looked surprised.

"Of course."

"I told you you'd like it."

The green-painted gate was peeling in several places.

A small garden sat in the yard of the detached house.

It had been made by leaving a strip of earth along the edge of the cement and building a low border around it.

Rows of moss roses and balsam flowers planted by the previous tenant were still growing there.

A concrete wash basin stood beneath an outdoor faucet.

A bamboo pole supported a tightly stretched clothesline.

Beyond the wall, which was slightly taller than an adult, Gain could see the third-floor window of the clinic building.

The very duty room where she currently lived.

She could even see the towel she had hung out before leaving.

That's my room.

It really was close.

The entrance had an old sliding door fitted with cloudy glass.

Misuk used a key and opened it.

"This way."

Gain murmured,

"It must get good sunlight during the day."

The living room was spacious and open.

A large south-facing window overlooked the yard, letting pale moonlight brighten the room.

In the center of the ceiling hung an old-fashioned wooden ceiling fan with a light fixture beneath it.

A thick layer of dust was clearly visible from below.

The house strangely resembled the one Gain had lived in long ago.

It felt nostalgic.

And a little sad.

Her old house had been demolished years ago.

This one still remained.

Misuk took her time explaining each room.

"There are two bathrooms."

"In the old days, the maid used this small room."

The bathroom beside the small room contained only a toilet, sink, and faucet.

The main bathroom had a large bathtub, toilet, and sink.

Three bedrooms.

Two bathrooms.

A large kitchen and living room.

"This is too good."

Gain looked from room to room.

"I was actually trying to find space where the on-call doctors could stay."

She pointed.

"I'll use this room."

"We can put a table in the living room and use it as a meeting area."

"Then the other two rooms can be rotated between whoever is on call."

After saying it, Gain paused.

During internship and residency, she had practically lived in hospital duty rooms for five years.

After opening her clinic, she had lived in the duty room directly above it.

Now she was finally renting a real house.

And she was immediately planning to turn it into another duty room.

I only need one bedroom anyway.

The thought made her laugh.

"My goodness."

Misuk covered her mouth.

"Our doctor kept rejecting house after house."

"So this time you're finally taking one because you're thinking about the on-call doctors too."

"I tried to show you eight houses."

"I should've realized sooner."

"You rejected them without even asking the floor area or price."

"It was because you hated being more than ten minutes away from the hospital."

Misuk became serious.

"Somang City is lucky to have a doctor like you."

"Who lives upstairs?"

Gain asked.

"There are two two-bedroom units upstairs."

"Each has two rooms and one bathroom."

"Both leases expire at the end of this year."

"Are you thinking of renting those too?"

"Maybe later, if we have enough room in the budget."

Gain looked upward.

"I thought we could use them as staff housing."

Misuk blinked.

"Staff housing?"

"You've got the delivery banner up."

"You're starting infertility treatment."

"You're hiring more nurses."

"And now staff housing?"

She smiled broadly.

"The hospital really is getting bigger."

Gain almost responded, then stopped.

As the number of deliveries increased, they would need more staff.

Some of them would probably want to stay close to the clinic.

"Let me know before the tenants move out."

"Of course."

***

After parting with Misuk, Gain returned to the clinic.

She entered through the back door and climbed the stairs.

At the end of the second-floor hallway, light spilled through the crack beneath Examination Room Two.

Gain knocked twice.

"Come in."

Pyo Jinwoo was sitting in front of the monitor.

Two chart windows were open side by side.

On the left was his record from the day he had worked as a locum.

[142/88 mmHg]

[160/105 mmHg]

[Proteinuria 3+]

[Transfer recommended]

[Patient refused]

[Recommendation repeated]

[Refused again]

On the right was Gain's note from that day.

[136/88 mmHg]

[Borderline hypertension noted during workplace health exam at age 25]

The two windows split the screen exactly in half.

"You're still here?"

"Jeong Inhwa came by to thank me earlier."

"She brought the baby too."

"Apparently the baby went from 2.4 kilograms to 3.5."

"Yes. I saw them too."

"She said you told her on the phone that my judgment had been correct."

"That you would have transferred her too."

Gain answered simply.

"Because that was true."

Pyo Jinwoo did not respond.

Instead, he pointed to the final line in the right-hand chart.

"How did you learn this?"

"When I mentioned internal medicine follow-up in three months, her mother brought it up."

"She never told me."

Pyo Jinwoo frowned.

"I definitely took a proper history."

[History taking] meant reviewing a patient's past medical history.

Pyo Jinwoo closed both windows.

The desktop returned.

Then he opened a card holder in his drawer and removed a business card.

"If you eventually refer her to internal medicine, this doctor is good."

Gain accepted it.

[Hangyeol Internal Medicine Clinic]

[Central Road, Somang City]

"He used to specifically manage pregnant patients with hypertension when we were at university."

"Tell him I sent you."

"It's nearby."

"That patient won't go if it's far."

Pyo Jinwoo returned the card holder to his drawer.

"Go home, Director."

"You have twenty-two outpatients tomorrow morning."

Gain stepped into the hallway and climbed upstairs.

When she touched the third-floor duty-room doorknob, the divine spring inside her chest filled with a cool surge.

Pyo Jinwoo had acknowledged her.

Through the window, she could see the yard of number eighty-five.

The clothesline stretched horizontally through the darkness.

Gain took off her white coat and was about to hang it over a chair when the duty-room phone rang.

It was 9:40 p.m.

"Hyundai OB-GYN? Is this the director?"

A woman's voice trembled.

"I'm Moon Hyejin. I have a delivery booked there..."

The moment Gain heard the name, the face came to mind.

The pregnant woman who had taken a two-hour intercity bus to visit and repeatedly said she absolutely wanted to deliver there.

"Yes, Hyejin. What's wrong?"

"My water... I think my water broke."

Gain looked at the calendar on the wall.

The expected completion date for the delivery-room construction was circled in red.

Next Monday.

"I'm in a taxi right now."

"It'll take about two hours to get there."

Her voice shook.

"I can come to you, right?"