While most viewers are rightly focused on this new addition to the General Surgery dept, Dr. Na Dae IL, and his name-branding of his patient’s liver, I think they missed another great reveal in Episode 3.

Did you see it?

I’ll write about it after our Sunday brunch. 🙂

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I’m back.

As promised, here’s the other great reveal.

The Intern Park TaeGyeong is the “son of the great director who started with a plastic surgery clinic in Busan, and grew it into the biggest medical center of the region.”

SuJeong’s know-it-all manager, Ms. Jang, was able to ferret this info out of the intern when she sent SuJeong (SJ) to get a drink for her.

And it tracks.

In Episode 1, the Intern was playing pool with his buddies. They were speculating about the specialty he’d take up at the hospital.

Friend 1: Hey, you should go into plastic surgery or dermatology. Why general surgery? Oh, ophthalmology could work.
Friend 2: Leave him alone. Having a surgeon we know will come in handy when we’re older. You think you would like orthopedics?
Friend 1: By that logic, wouldn’t internal medicine be better?
Intern: Ugh! I didn’t go to med school just to care for you guys.
Friend 2: I understand. It was to be able to inherit the hospital.
Intern: Ugh! Just focus on the ball, gaesaekki-ya.

In Episode 2, the Intern had no problem buying her all the desserts she craved. He obviously had more than enough money on his debit card.

Then, in Episode 3, Ms Jang demonstrated that she could sniff out his privileged background. That’s why she immediately stopped nagging SJ when she noticed him. Wanting alone time with him, she sent SJ on an errand to the vending machine. Then, she turned the heat on the Intern, saying, “Just be looking at your face, Doctor, I can tell that there are other great doctors in your family, aren’t there?”

I think the Intern’s senior resident, Dr. Ma, might have an inkling about his privileged nepobaby-hood. Hence, when he apologized to the Intern about losing his cool, he gave the Intern a piece of advice about his future.

Ma: Uhhh, but [if I were in your shoes] as an intern, I’d just quietly finish a month with us, and then go on your way. I really don’t want to see any more interns doing a rotation in surgery, pretending to be doctors with some great sense of duty only to go to an easier department somewhere. You won’t be a surgeon anyway.

I interpreted his comment to mean two things: either he expected the Intern to take the easier route like the others or he expected the Intern to eventually take over the family business as an administrator or director.

Also, in Episode 4, when the surgeons found the Intern asleep at his desk, with a cup of cold ramyeon wasted, Dr. Ma brought up the price of ramyeon.

Intern: (sighing) This was the last bowl of ramyeon.
Ma: We spent a third of our budget just on wasted ramyeon.

To my ears, he was apprising the Intern of the typical tight budgets of underpaid (and overworked) interns and residents like them. He wasn’t to know that the Intern had bribed SJ with desserts and offered to treat her out to jjajangmyeon without regard for his spending budget.

New surgeon Na: Then, I’ll make a donation to the budget for you, TaeGyeong.
Bae: Oh, no surprise there. Nice!

Indeed, no surprise there. Dr. Na acts like a generous an ingratiating doctor that he is. Yuck.

I do wonder why the secrecy about the intern’s background. Lol. I hope the screenwriters won’t do anything utterly ridiculous like make the Chairman of Magnolia turned out to be the Intern’s father.

Moving on…

What are the social commentaries on bad doctors in these two episodes?

Like in the first two episodes, the show exposes the few bad apples that spoil the barrel.

1. In Episode 3, it’s the holier-than-thou doctors. And we have several of them in this episode.

a. First came Drs Hwang and Jang.

They’re the only two neurosurgeons in the hospital board-certified to perform craniotomy. They called the meeting at Director Bu’s office to complain that Dr. Gye (SJ) performed the craniotomy. They were panicking because if the surgery had been completed incorrectly or if the aneurysm still ruptured after the surgery, then they’d be held accountable for the fall-out. They were so sure that SJ’s surgery would fail that they bet their white coats off their backs.

So Director Bu yelled at them.

Bu: Stop! Aren’t you ashamed? You love taking credit for simple cases, but when you get a patient who’s about to die, you jump and run for the hills. Unfettered cowardice. Spineless fools.

Ha! He’s one to talk. He’s only marginally better than these Drs. Hwang and Jang.

b. Director Bu

When they had the pre-surgery briefing and discussed the lack of neurosurgeon, the ER doctor, Dr. Kim, reminded the room that Director Bu could do it himself.

Kim: There’s a doctor who can handle the operation.
HR Lady: And who is that?
Kim: I would call on Director Bu SeungGwon. I’ve studied a lot of material about your great skills and about your past operations. Please, I beg of you.
Do (the 2nd in command): I wouldn’t throw this on Director Bu. He’s not ready to go into surgery.

Judging by the look he gave Dir. Bu, he’s probably aware of Bu’s eyesight problem.

Kim: Since when do doctors need to get ready to save someone from dying?
Bu: It’s just that it’s been such a long while now since I last operated.

Hmph! He’s trying to weasel out. He’s out of practice, just like that Dinosaur ex-Director Kim whom he ousted by blackmail.

Bae: (raising his hand) Allow me to assist you, please. You’ve completed over 300 craniotomies to date.
Do: (trying to signal him to drop it)
Bu: Well, first, I’ll need to look at the materials. We don’t have any other option.
Kim: No. You’re the only one who can do this within a 30 minute radius of this place with the skill this operation will take.

Everybody waits for Dir. Bu’s reply. Dr. Do stepped in to give his boss an out.

Do: (decisively) Listen us, people. This patient is going to be transferred.

See that? Who’s he to call Drs. Hwang and Jang, “Unfettered cowardice. Spineless fools.”

Pot, meet kettle.

c. The Intern Park

His disapproving tone when he spoke to his chief resident, Dr. Ma, was classic example of holier-than-thou.

Park: When you say the chances were low that the surgery would work, what’s your rationale? That he was destined to die no matter what they tried on him? Basically, it’s the patient’s fault? Is that it? That isn’t the type of thing a doctor should be saying.

Oh dear. I dislike it when Intern Park put words in Dr. Ma’s mouth. Dr. Ma wasn’t saying that; he wasn’t victim-blaming at all. He was just saying that patients and doctors are both humans and there are limits to what is humanly possible as a patient and as a doctor.

Ma: Then, what am I supposed to say? “Sorry, I couldn’t save the patient. Please haul me to prison, so sorry about that.” That what you want? Doctors have our limits. We’re only human.

Good. You tell him, Dr. Ma!

Park: Had there been one other doctor who could do a craniotomy clipping, I would’ve taken every chance on that possibility….
Ma: (interrupting him) Hippocrates really got to you, huh?

Then, he started to explain what he meant like Intern Park was a 10-year-old kid.

Ma: Years ago, if a doctor did that surgery, people would go, “Wow, he’s got God’s hands, doesn’t he?” Going four hours at least, bent over, staring through a tine little microscope, and poking around a patient’s bloody brain.

He’s saying that craniotomy clipping is a difficult procedure. It entails opening the skull, seeking the aneurysm (or balloon/bulge) on the artery wall of the brain putting a clip at the base of the aneurysm to block the blood from entering, then closing up everything.

Ma: (continuing) Fine. Let’s say you muscle through it all. And the surgery is a success. Do you know what the shitty part really is? That clip could slip off at any time.

Meaning, when the clip slips off, the blood will enter then the aneurysm (or balloon) and the aneurysm will burst.

Ma: (continuing) If the aneurysm ruptures, the patient’s either dead, or disabled for life. Who takes the blame? Do you know how many medical lawsuits come from this surgery? And those clips are pricy to get. You know the reimbursement rate on a six-person surgery barely covers the overhead. Get it?

Now, he’s summarizing the four points why craniotomy is “dreaded” by surgeons. According to him, these are: a) exposure to lawsuits, b) expensive material, c) high cost of the procedure, and d) no 100% guarantee that patient will live.

Ma: The next time you want to tell me what a doctor’s supposed to say, learn how to do a craniotomy first. You do those. I’m going to learn coiling from Dr. Bae. It comes with lower risk, takes less staff because it’s non-surgical, and there’s actual money in doing it. That’s where I draw my line: stick to what I know I can handle.

Compared to brain aneurysm clipping, coiling is less invasive. It entails inserting a long and small catheter through the wrist or groin area, navigating up to the vessels in the brain, and entering the aneurysm (or balloon). Then, coil is released from the catheter into aneurysm to fill it up. Blood clots around the coil, sealing the aneurysm and blocking blood from getting into it/rupturing it. With aneurysm coiling, the patient can go home after two days.

Note: I’m not a doctor. This is how I understood the difference between clipping and coiling.

Ma: (continuing) So, am I not a doctor because of that? What do you think?

Me? I get why Dr. Ma’s risk averse. Years of medical school have trained him to a) follow safety protocols always, b) avoid ambiguity in diagnosis and patient care, c) avoid committing errors at all costs, d) fear malpractice lawsuits and financial penalties, and e) take the tried-and-tested/conventional route and heed counsel from experienced veterans.

I can’t blame him if he wants to go the “easier” route. However, if coiling is going to be his specialty, then I’d like him to improve the methodology and technology over time.

Anyway, the good thing about Intern Park is that he’s young enough to learn from his mistake.

In Episode 4, the bad apples are those doctors who undermine public trust in their physicians.

a. First, the doctors who fraternize with the pharmaceutical representatives

Obviously, there’s a conflict of interest here. The patients trust their doctors to give medical advice with their best interest in mind. But when these pharma reps give incentives (in the form of freebies, perks, and/or research assistance like with Dr. Do) to the doctors to prescribe their drugs, then the doctors may be unintentionally influenced to compromise patient care.

I also pity the Pharma Rep because it seems like he needed to work another job (as chauffeur to plastic surgeon Dr. Jo’s son) just to make ends meet. He must have spent his own money on Drs Bae and Do’s entertainment and hotel expenses. No doubt the constant “drinking service” he performed for the doctors contributed to his liver cirrhosis.

b. Second, drunk surgeons

Glad that Director Bu called out that Dr. Mun for drinking.

Mun: I mean, it’s not like it’s ever affected any of my surgeries.
Bu: You could face disciplinary action.

c. Dr Na Dae Il

Holding SJ’s hand during the surgery not only shows that he’s a sexual predator (i.e., exploiting the situation to touch her), but that he also has no fundamental respect for the sanctity of body. Be it SJ’s hand which he groped during the surgery or the body of his unconscious patient, he violates their bodies without their permission.

Hence, I wasn’t shocked when SJ’s discovered his initials (ND) on the liver of the Pharma Rep.

There was ample foreshadowing when SJ was studying the imaging from the Pharma Rep’s MRI. She noticed something abnormal and then the camera flashed back to the time Dr. Na was alone operating on his fellow soldier during their enlistment days.

Later, when Dr. Na invited her to eat dinner with him, she doggedly brought it up.

SJ: Did you see the imaging? On the liver?
Na: That’s most likely just a minor adhesion that formed due to his surgery years ago.

According to google, internal tissues and organs have slippery surfaces so they can shift when the body moves. However, after surgery, scar-like tissues called adhesions may develop which cause the tissues and organs to stick together. Dr. Na is saying what SJ saw on the imaging is just bands of scar tissue.

SJ: You never know.
Na: Well, I doubt that it’s a tumor.
SJ: You’ll have to open him up to find out.

This told me that she was suspicious of him already.

Moreover, there was an infamous 2013 case of a British doctor, Simon Bramhall, burning his initials onto the livers of his unconscious patients. He autographed his patients during the liver transplant.

Fiction is simply copying reality.

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On a lighter note, I’m happy that SJ is finally forming her own team. She has the Intern Park, Dr. Jo, and Dr. Kim on her side.

Also, while I don’t think there’s going to be romantic storyline between Intern Park and SJ, I won’t disapprove of it, despite their age gap.