Chapter 54 - Acupuncture Study
“Then I won’t proceed with the treatment. Instead…”
“?”
“How about I check the condition of your knee with an ultrasound?”
Emma’s expression softened a bit at my suggestion.
It’s likely that she’s hesitant to go to the hospital but is curious about her knee’s condition.
As expected, she conveyed her agreement through the translator.
“She says she wants to be checked in a place without other people around.”
So, we moved back to the treatment room.
The most common injury in the knee is an anterior cruciate ligament (ACL) injury.
To examine the ACL, I asked Emma to bend her knee as much as possible.
Then, I placed the probe along the direction of the ligament’s path on the front of her knee.
‘This way, I can observe the ligament above the tibia.’
With a first-degree injury, the ligament would appear tense with some fluid visible.
A second-degree injury would show swelling of the ligament along with fluid and some unclear partial tears.
A third-degree injury would indicate complete rupture of the ligament fibers, with observable bleeding and fluid.
I carefully observed the ultrasound screen. Given what I saw…
“Have you heard a ‘pop’ sound from your knee recently? It must have hurt to walk, and your knee probably hasn’t been extending properly since then.”
“I think that happened about two weeks ago.”
“It appears you have a second-degree injury to your anterior cruciate ligament, meaning a partial tear. To see more accurately, you’d need an MRI. If it progresses to a third-degree injury, meaning a complete tear, surgery would be required. The rehabilitation after surgery would take six months to a year.”
Emma’s brow furrowed more with each translation.
“What’s more concerning is that the anterior cruciate ligament and the meniscus often get damaged together. The mechanisms of injury are similar. This could lead to complications such as degenerative knee arthritis.”
Her response didn’t need translation.
Emma’s mouth and eyes were wide open. I could read the shock on her face.
Seeing it firsthand, it would be hard for her to deny it any longer.
“I’ll arrange for additional tests.”
I performed physical examinations such as the Drawer test, Apley compression test, and McMurray’s test.
(In simple terms, these tests involve positioning the knee in ways that could induce pain or instability to observe the response.)
The results were somewhat ambiguous.
“Fortunately, there isn’t significant knee instability, so surgery isn’t immediately necessary. However, as you feared, it appears there’s damage to the meniscus as well. Healing the knee ligaments and cartilage will take at least a month, so we need to start treatment promptly.”
I looked into Emma’s eyes and spoke slowly.
“In Korea, acupuncture is frequently used for knee injuries like this. It’s a safe and effective treatment method, so I hope you won’t hold any biases against it. Please think it over carefully.”
Bringing the ultrasound machine today was a great decision in many ways.
Showing her the injury directly would have a greater impact than just relying on physical tests.
‘And asking Professor Yeon for a lecture on ultrasound for shoulders and knees while borrowing the equipment was also a smart choice.’
However, it seems I should be satisfied with the treatment of Ho-jeong today and step back for now.
—
The schedule for the July interns is “pongdang pongdang,” meaning it’s alternating shifts.
Initially, I would be on duty almost every day right after joining, but over time, the number of off days gradually increases.
You might think that the “Resident Law” restricts work hours to 80 hours a week, but interestingly, that law only applies to Western medicine and does not cover traditional medicine.
So, after just a few shifts, I often found myself exceeding the 80-hour work week easily.
Anyway, these days my evening schedule consists of either going to the volleyball team after work or being on duty—one or the other.
Since I visited the Blue Whales yesterday, that means I’m on duty today.
Having many duties is no big deal.
‘It doesn’t matter since I don’t have anything special to do after work except study.’
However, I feel a bit guilty about not having visited my grandmother in a long time.
Thanks to Min-hwa, I managed to get tickets for the Nahoonha concert, which eased my mind a little.
In that sense, I plan to have a productive study session with Min-hwa during my duty today.
But first, I need to finish my tasks.
At 5 PM, I pulled the now-familiar heavy cart to find Jin+ah’s hospital room.
Today, I had something special prepared.
“Jin-ah.”
“Uh? What’s this?”
After her treatment today, as I pulled something out from the last compartment of the cart, the patient’s eyes widened.
“I remembered you mentioned being sad that fresh flowers can’t be brought in.”
“Wow! Thank you, doctor!”
What I presented was a small rosemary plant.
The green, needle-like leaves were densely packed along the twisted branches.
“I checked the hospital regulations, and while fresh flowers aren’t allowed due to pollen allergies, this is fine.”
Since the flowers bloom in winter or spring, it’s perfect for July when only the leaves can be enjoyed.
…That’s what I was told at the flower shop.
“This is creeping rosemary! I’m so touched. Thank you! I’ll take good care of it.”
Jin-ah looked almost teary-eyed with joy.
The caregiver and family member nearby were in disbelief, wondering where on earth you could find a doctor like this.
‘…Is this really something to be so happy about?’
I just thought about how boring it must be to lie in bed all day.
I won’t deny that I personally felt a sense of camaraderie due to the car accident.
While I was somewhat bewildered, Jin-ah asked in surprise, “Did you know the flower language of creeping rosemary before giving it to me?”
Huh? This plant has a flower language too?
“…I just got recommended something easy to grow that could be brought into the ward.”
“Ah, I see. Its flower language is ‘regeneration.’ I’ll try to recover well while looking at it.”
Seeing my flustered expression seemed to amuse Jin-ah, and she burst into laughter.
Hmm. I didn’t intend it, but it’s an appropriate flower language.
‘Unfortunately, the chart shows no significant changes even a week later.’
I had prepared myself for a tough journey from the start, so I want to continue with consistent treatment.
Wishing for Jin-ah’s regeneration, just like the flower language.
* * *
After finishing Jin-ah’s treatment, my work was done, and it was time for my duty.
Today, I decided to practice acupuncture on the shoulder and upper back.
Since acupuncture practice requires removing the upper clothing, I chose the male duty room instead of the intern training room as the study location.
“I need to demonstrate the acupuncture, so Min-hwa, you’ll have to change.”
“Okay…!”
“By the way, have you been doing well with ABGA (arterial blood gas sampling) lately?”
While waiting for Min-hwa to change, I suddenly remembered the advice I had given him when he kept failing at blood draws and asked.
“Ah, yes…! Since then, I’ve practiced a lot on my own, and I think I understand it a bit better now.”
“Good to hear. You’re going to be a great acupuncturist.”
“Huh? Why do you say that all of a sudden…?”
Min-hwa looked at me wide-eyed, surprised by my casual remark.
“Well, I don’t know? You’re diligent, your physical condition is good for Chuna therapy, and you have a lot of consideration for others, so I think you’ll catch on to things patients don’t even say.”
At that, his face turned bright red, and he waved his hands around.
“No, not at all! I may be big, but I can’t use my strength well… I’m not particularly considerate either… I’m so timid that I worry about whether being an acupuncturist is really for me…”
“Min-hwa.”
“Yes…?”
“You can just accept compliments as they are. You already know how to do ABGA; you just needed experience and confidence. You’ll do well in the future.”
“Ah….”
Min-hwa rolled his eyes and trailed off, seemingly lost in thought.
At that moment, the duty room door swung open.
Min-hwa let out a strange noise and quickly covered himself with her clothes.
“Oh, Seon-joon! Traitor! How can you have a study session without me?!”
With his curly hair and bright eyes, it was Ye Wonil who entered.
“I’m really hurt! I took care of you when you started your internship late in May!”
“Are you interested in the study session?”
“No, Hyung. What do you take me for…?”
What do you mean “What do you take me for”? You’re such a social butterfly.
Did you think I wouldn’t notice you have plans every day that aren’t duty days?
When I shot him a knowing look, he stumbled over his words.
“Well, of course, I prefer hanging out over studying! But starting in October, I’m planning to take on a job as a primary doctor, so I thought I should study a bit to keep up.”
So, the three of us ended up practicing acupuncture together.
Min-hwa showed curiosity about my relationship with Wonil.
“How did you two become friends in the first place?”
“We were in the same medical volunteer club at school.”
“Hyung, now that I think about it, it’ll be August soon, and others will be going for volunteer work. Are you going too?”
“If nothing comes up, I’ll go.”
Almost all students in the Korean Medicine program join a medical volunteer club. They learn a lot by going to rural areas for volunteer work during breaks.
At this time, senior acupuncturists visit to help the students study and guide them to prevent medical accidents.
“Hyung, can you include Haet-nim in the next study session?”
Min-hwa, who was taking off his clothes, panicked and shook his head.
That was a surprisingly clear expression of opinion from him.
“Oh, what I meant was, since acupuncture might be a bit much for her, maybe when we’re doing the herbal study.”
“Why can’t you talk to someone you’ve never met before for advice, but you can with her?”
“Wow, Hyung! That’s a direct hit.”
At my words, Ye Wonil scratched his head and admitted, “It’s just really awkward to approach someone I’m interested in. I don’t even know what I’m saying.”
Interesting… I didn’t know he had this side to him.
Seeing me look at him curiously, he smiled shyly.
“But still, hyung, I didn’t even mention I bought new shoes, and Haet-nim said they looked great, right? Doesn’t that mean she might have a crush on me? She was even looking at my shoes!”
“…….”
“Let’s just focus on studying.”
“Sure.”
Min-hwa and I lightly dismissed Wonil’s happy thoughts and refocused on our acupuncture practice.
“When practicing acupuncture on the upper back and shoulders, we need to be careful about pneumothorax (a hole in the lung). To prevent pneumothorax, everyone knows to pinch the muscle while inserting the needle horizontally or at an angle. But what about when inserting into the supraspinatus?”
“After palpating the scapular spine, you should insert the needle from top to bottom for bone touch.”
“That’s right. But we shouldn’t just locate the scapular spine; we should also get into the habit of palpating the medial and inferior angles of the scapula.”
“Uh? Why?”
I grabbed Min-hwa’s arm and moved it to show the change in the position of the scapula.
“The position of the scapula changes a lot depending on arm movement. When your arms are down, it’s here, but when you lift your arms, it goes up like this. So, when inserting needles into the scapula, it’s better to have the arms down. On the other hand, the subscapularis (the muscle connecting the scapula and humerus) is best palpated when the arm is raised above 90 degrees. This area has the axillary nerve passing through, so make sure to check for any tingling sensations while needling.”
“Oh, I see…!”
“How do you know all this, Hyung? Even among interns, your level is different.”
I shrugged my shoulders.
“There are so many good books and lectures these days. You can learn a lot just by watching the professors during rounds.”
“Wow, I was just thinking about when the rounds would end.”
While nodding in admiration, Wonil suddenly lowered his voice.
“Oh, by the way. Are you learning anything specific from Professor Yeon Jae-wook these days?”
“…Word travels fast.”
“Really? So you have one-on-one classes with the professor? I’d probably faint from fear.”
I looked at Wonil incredulously as he pretended to shiver.
“What do you even think of the professor?”
“A king. A king. An intern like me wouldn’t even dare to make eye contact or say a word.”
I chuckled at that.
“You’re exaggerating.”
“No, you’re being way too nonchalant about it!”
“Then if the professor is a king, what are residents?”
“Nobles. Interns are commoners… or maybe slaves?”
I muttered as I listened to Wonil seriously discuss the hierarchy in the hospital.
“Then I, as a slave, ended up fighting with a noble.”
“Excuse me??”
“I had a fight with Shim Ji-seob.”
“What? You fought with a second-year? Are you out of your mind?”
Wonil’s voice shot up in pitch.
Min-hwa, who was getting needled, turned to me in surprise.
I shrugged at my younger siblings.
“If someone talks nonsense, you have to fight back.”
“Wow… If it were me, I’d probably just hold it in and endure it.”
At the mention of “Shim Ji-seob,” Min-hwa suddenly spoke up.
“Oh, right…! Hyung Joon, I looked into what you mentioned before. It’s more complicated than I thought.”
“What is it?”
“That… the natural medicine patent. The research team at Ho Yeon University is apparently preparing for a lawsuit.”