A Little Heartbroken
Monday was rather bland as I only spent the time doing research and trying to find a way to put together my presentation.
Tuesday was interesting. During rounds, we went down to the emergency room. It's about the same size as the one in St. Joseph's, however its structure is, again, different. In St. Joseph's, the rooms are seperated by walls rather than simply curtains. It's also a very open space so that you can see everything by standing in one spot. Again, this might go back to their belief of collectivism. Aftewards, I met with the patient I mentioned earlier this month for the first time. (The one who's been in the hospital for about 2 years) She's a very sweet girl and her English is very good, so I can properly communicate with her. We were both very shy so our conversation dawdled here and there, but once it got going, we talked quite a bit. We then had dinner with the rest of the residents and Dr. Hong at night.
On Wednesday, I didn't go in for morning rounds, but I did head over to see the patient.
Thursday was a bit busier as, after rounds, Dr. Hong showed me one of her trauma patients as well as hand over some data. The trauma patient was in his mid-thirties and had been in a car accident. Now, here is where the problem lies in the Korean healthcare system. While he was in the first hospital he was sent to, nothing was done to help his condition. No one scanned him, gave him any oxygen, etc. It wasn't until he was transferred into Asan Medical Center a few days later that he was finally properly treated. They hadn't expected him to fully heal, but due to his young age, his progress was very fast. Personally, I think this guy was extremely lucky. The car accident seemed to have been very severe and he wasn't immediately treated, yet he still managed to pull through.
Afterwards, I was sent some data. I sat down with a resident and she translated it for me. (I owe you many thanks and I couldn't have done it without you) It went by pretty quickly and, before I knew it, I was sitting at the trauma conference. It was in Korean, so I didn't understand everything. However, as far as I could tell, they were talking about different procedures that the professor had in his book. I believe he was trying to show off new ways to approach a specific type of patient to improve care. I wish I understood exactly what he was saying, but it was still interesting to see the pictures. I was sent away after the conference to do more research.
Now, Friday was, to say the least, a bit heartbreaking. I went in for rounds and was informed that they would be transferring a brain dead patient to the hospital. (A brain dead patient is someone that has no brain activity whatsoever) They didn't know what time so I had to stay in the office so that I could quickly rush over when the ambulance got the call.
We received the call at 2:30 p.m. and I rushed over to the ICU. Three of her residents and I made our way to the ambulance. It was going to be an hour and a half trip so one of the workers grabbed us some coffee. One of the first things that stuck out to me during the trip was the ambulance. It was, in my opinion, fairly small; or at least it's not as big as the ones that we have in America. However, it seemed to have all of the proper equipment, I sat in the back with the other residents and the ride over was pretty quiet. But let me tell you something about Korean drivers. I was pushed and shaken around in the ambulance and the amount of people that wouldn't move even though the siren was on frustrated me. It wasn't to the point of blowing up because we didn't have the patient yet. (But oh, don't get me started on what happened on the way back. We'll talk about that more when I get there.)
Back on track, we arrived at Konkuk University Hospital at around 4:30. I still didn't quite grasp the situation as the doctors were busy, so the only thing I knew was that the patient was brain dead. If you were in my position, you would be wondering why they would be transferring a brain dead patient. To put it bluntly, there's really nothing you can do. The patient is "breathing", but he/she will never wake up.
I watched as they switched the equipment around. But then the family members came in and I started tearing up. I've seen brain dead patients before with family, so I know I don't typically cry at these things. But the two kids had such blank expressions and didn't fully grasp what was going on and it broke my heart just a tiny bit. I couldn't help but wonder why they were transferring the patient because I thought it brought more pain to keep the patient like that compared to letting go. While we were moving the patient to the ambulance, I teared up even more because, as I looked outside the window, they were looking straight at me and I had to look away. And I couldn't help but watch as one of them cried as she momentarily tried to chase the ambulance. Overall, I ended up being mentally exhausted.
And now we're back to Korean drivers. At this point, after dealing with the patient and having her inside the actual ambulance, I was enfuriated with the amount of people that simply wouldn't move or even sped along with the ambulance. I'm sure the paramedic agreed as he seemed to be muttering angrily as he honked at the cars. We finally made it back at around 6:30 p.m. and the patient was taken to get scans done. I was sent off to change because we were going to have a big dinner with the rest of the medical staff. Once I met with Dr. Hong, I asked the question that kept running through my head. Why were we transferring a brain dead patient? She told me simply that she was here for organ transplant. The two kids flashed through my mind again and it made me realize that perhaps they didn't understand that their parent was really going now and not just being transferred. (Now that I've looked more into it, brain dead patients are typically taken for organ transplantation as all their organs are typically still very healthy and fully functional)
I couldn't help but think about it until we got to the restaurant. My mind finally drifted off and I relaxed a bit. Again, I ate bbq with them and watched them drink. It was very interesting as they were attempting to get me to say "Arizona" and "Cincinnati" and repeating it after me Let me just say that I found it extremely hilarious and wish that I had recorded their voices. (It's okay, they can get me back because my Korean accent is so bad) At around 10 p.m., one of her residents went back to the dorms with me. He was very kind and, as much as he said that his English was bad, it was actually very good. (Personally, I think anybody who can speak more English than I can Korean is very good)
And so, I ended my week there. I went off to Myeongdong over the weekend and relaxed a bit. I also went cafe hopping, which I truly enjoyed. The Starbucks here has Cherry Blossom drinks and I am absolutely in love with it.
As of now, I officially have about three more days until I go back to the States. I am a bit sad to be leaving, but happy to be coming back home to my family. My friend asked me if I could see myself living here in the future and, honestly, I could. The atmosphere is very nice, the food is amazing, and it's very safe. Unfortunately, I can't take my soon to be medical degree over here. But I guess I'll figure all that out when the time comes.
Now, let's get down to business.
Just now, I had a thought. Perhaps ambulances are cheaper here because they're much smaller and a bit less advanced. But at the same time, I feel like they should be small because of the amount of space they have to get through when having to drive long distances.
Also, back to driving. In America, it's a rule that drivers must move to the right lane so that ambulances can get by and everybody takes that seriously. I feel like people in Korea don't take it as seriously and that bothers me a bit. One of the biggest problems with medical care here is the transportation of patients and I can definitely see why. With that, the transferring of patients from hospital to hospital seems to be a big problem too. The trauma patient I had mentioned earlier had severe injuries and it took him way too long of a time to get treated. I believe that these problems will be solved in the near future as the trauma system progresses. Just looking at the data, I can already see a lot of improvement and hope to see more in the future.
I don't want to spill everything about the data as I want to keep some of if as a surprise during my presentation, but I will say something about preventable death rates. Now, this is the most important point of the data because it shows off the overall improvement. I believe I've mentioned this on another blog post, but preventable death rates show off the deaths that could have been prevented if another procedure had been done. Asan Medical Center had a preventable death rate of 22% in 2014. That's significantly higher compared to some of the states, such as Utah, who has a 7% preventable death rate. Good news is, they managed to get it down to 11.1% in 2015. That's about a 50% decrease and that's a great amount of change within one year. They're looking forward to watching that number continue to drop as the system improves.
Interesting Fact of the Day
Asan Medical Center is known for being number one, especially in intensive care. Its trauma center is funded by Hyundae and not the government.
*Fact obtained from Dr. Hong