The Doctor With a Diagnosis System

CHAPTER 6: Surgeon's Refusal

Dr. Si Jae stood in the doorway, an iced coffee in his hand. He took one look at the shattered vials on the floor, the pool of dark blood near my sneakers, and me, standing over his patient in a gray hoodie with a massive needle buried in the man's chest.

The plastic cup slipped from Si Jae's grip, hitting the floor and exploding brown liquid and ice cubes everywhere.

"Are you insane?!" Si Jae shrieked, his voice cracking an octave higher than normal. His face went completely pale. "What the hell are you doing to my patient? Security! Get security in here!"

"Your patient is bleeding to death from a ruptured aorta!" I yelled back, not daring to move my hands. "It wasn't gastric reflux! He dissected!"

"That's impossible! His EKG was clean!" Si Jae stammered, stepping into the room but keeping his distance, looking at the blood like it was radioactive. "His troponin was negative!"

"An EKG doesn't show an ascending dissection until it tears into the coronary arteries or the pericardium, you incompetent hack!" I shot back, the exhaustion finally boiling over into pure rage. "He told you it felt like tearing in his back. That is textbook! And you gave him antacids and told him to sleep!"

Si Jae’s mouth opened and closed like a fish. He knew I was right. The realization that his laziness had just caused a fatal medical error washed over his face, turning his pale skin a sickly shade of green. But instead of jumping in to help, his eyes darted to the hallway. He was already thinking about how to cover his tracks.

"You're suspended," Si Jae said, his voice dropping to a harsh, panicked whisper. "You aren't even supposed to be in the building. You stabbed him. If he dies, it's on you. You killed him."

"Shut up and help me maintain the airway!" I demanded.

Before Si Jae could respond, a new figure stepped into the cramped room.

Dr. Chae Daewon, the on-call Cardiothoracic Attending Surgeon.

Daewon was a tall, imposing man in his late thirties. He wore tailored navy scrubs and wire-rimmed glasses that caught the light. He carried an aura of absolute, chilling authority. He didn't yell. He didn't panic. He just observed.

He looked at the puddle of blood on the floor. He looked at the weak, thready rhythm on the monitor. And finally, he looked at me, an intern holding a decompression needle.

"Dr. Chae," Si Jae practically whimpered, stepping out of the surgeon's way. "This suspended intern just assaulted my patient. He performed an unauthorized pericardiocentesis—"

Daewon ignored him. He stepped up to the bed, pulling a small penlight from his pocket. He flashed it into Mr. Han's eyes. Sluggish, barely reactive pupils.

"What is the output?" Daewon asked, his voice a low, smooth baritone.

"I pulled a hundred cc's of dark, non-clotting blood from the sac," I said quickly, trying to keep my voice steady. "The rhythm returned, but his blood pressure is still tanking. Sixty over forty. The tear in the ascending aorta is massive. It's actively leaking. He needs an emergency sternotomy and a synthetic graft right now, or the sac will just fill up again."

Daewon reached out and placed two fingers on Mr. Han’s carotid artery. He felt the weak pulse for exactly five seconds.

Then, he pulled his hand away and wiped his fingers on a piece of clean gauze.

"No," Daewon said simply.

The word hit me like a physical blow to the chest.

"What?" I choked out.

"The mortality rate for a ruptured type-A dissection that has already progressed to cardiac tamponade and clinical arrest is over ninety percent," Daewon said, his tone entirely conversational, as if he were discussing the weather. "Even if I crack his chest right now, the tissue will be like wet tissue paper. He will bleed out on my table. And given that he was down for at least two minutes, his brain has already suffered hypoxic damage."

"He's fifty-two years old!" I yelled, my grip tightening on the syringe. "He has a chance! You can clamp the aorta and put him on bypass!"

Daewon adjusted his glasses, looking at me with cold, dead eyes. "And who is going to take the blame when he dies on the table? Me? Hanseong Central Hospital? No. You are a suspended intern who performed an invasive, unsterile procedure in a dirty observation room without authorization. If I take him to the OR, I assume liability for your butchery. I am not ruining my surgical statistics or dragging my department into a massive malpractice lawsuit for a dead man."

He turned to Nurse Mi-Sun. "Pull the needle. Push five milligrams of morphine. Make him comfortable. Let him go."

"You can't do this!" I screamed, the sound tearing my throat. "You're a doctor! You take the risk!"

Daewon didn't even look back. He walked out of the room, his perfectly polished shoes leaving a single, bloody footprint on the linoleum. Si Jae immediately scrambled out after him, desperate to distance himself from the dying man.

I stood there, completely alone with the nurse and the dying patient.

My arms were shaking so violently I could barely hold the needle steady. The blood pressure on the monitor ticked down. Fifty-five over thirty. His heart was failing again. The sac was refilling.

The blue screen flared to life in front of my face, the light harsher than before.

[Patient Death Imminent in 00:04:30]

[Attending Surgeon has abandoned the patient.]

[System Override Activated]

The text deleted itself, replaced by a single, terrifying prompt that made my blood run cold.

[Mission Update: Perform Emergency Thoracotomy.]

[Objective: Open the chest cavity. Cross-clamp the aorta to halt hemorrhage.]

[Penalty for Failure or Inaction: Patient Death. Permanent Psychological Trauma (+100).]

[Legal Warning: Performing this surgery will result in severe criminal prosecution.]

I stared at the screen. Open the chest. Crack the sternum open right here, in a dirty room, with no anesthesia, no surgical team, and no bypass machine. It was madness. It was physically impossible for an intern.

[Reward: Unlock Skill - Master Surgeon's Hands (Temporary)]

I looked down at the crash cart. My eyes landed on a sterile surgical tray, sealed in plastic. Inside was a heavy, stainless-steel #10 scalpel.

I looked at Mr. Han’s gray face. I looked at the scalpel.

"Intern Ryeong..." Mi-Sun whispered, stepping forward with trembling hands. "Please. Let go of the needle. It's over."

I didn't let go. I reached out with my left hand and grabbed the scalpel.