Chapter 3 — The White Coat Oath

Three weeks after the first shift, Yen and Khoa had become a familiar pair in the eyes of their colleagues whenever there was a complicated case that required inter-departmental coordination. There were no longer fierce arguments like in the beginning; instead, there was a harmonious working rhythm, although occasionally there were still small disagreements about approach.

On Monday morning, a middle-aged female patient named Nguyen Thi Tam was admitted to the hospital with symptoms of severe abdominal pain and high fever. Yen was the first person admitted to the Emergency Department and quickly recognized signs of a serious abdominal infection.

"The patient has a history of appendectomy four months ago," Yen quickly read through old records brought by her family, frowning at some unclear notes. "But why are there signs of such a serious infection now?"

She immediately called the Department of Surgery for consultation, and was not surprised when the person who came down was Khoa.

"Late infectious complications after surgery are not rare," Khoa said after a preliminary examination, "but four months is quite a long time for this symptom to appear. An abdominal CT scan is needed to clearly determine the cause."

CT results showed a large abscess in the abdomen, requiring urgent surgical drainage. During the process of preparing documents to transfer the patient to the operating room, Khoa looked more closely at the old appendectomy case file and frowned.

"Is something wrong?" Yen asked, noticing the strange expression on his face.

"No, it's just..." Khoa hesitated, pointing to a page of post-operative notes. "The description of the number of surgical instruments and gauze counted after the surgery is a bit sketchy compared to normal standards. Usually, there must be full confirmation signatures of both the surgeon and the instrument nurse."

"Maybe it's just a mistake in the notes," Yen said, although she was also a little worried. "The most important thing now is to treat her abscess first."

"You're right," Khoa nodded, folded the old file, and temporarily put it aside. "The top priority is still the health of the patient at hand. But..." he paused for a moment, his eyes still lingering with concern, "I think after this surgery is finished, I will ask for permission to review all the old records more closely, just to make sure nothing is missed."

"Good idea," Yen agreed. "It's better to be safe, especially when it comes to the patient's long-term health."

The two quickly completed the necessary procedures, transferred Ms. Tam to the operating room according to emergency procedures, temporarily putting aside unanswered questions to focus all their attention on the surgery at hand.

Before entering the operating room, Khoa stopped by Dr. Phat's office to report the situation and seek guidance. The small room was flooded with table-lamp light, and Dr. Phat sat there, his face more haggard than usual, the wrinkles around his eyes showing traces of many sleepless nights.

"Are you okay, teacher?" Khoa asked, unable to hide his concern when he saw his teacher looking unusually tired.

"I'm fine," Dr. Phat replied, gently rubbing his temples. "It's just that my duty schedule is too busy these days, and I'm in the process of preparing documents for approval to be submitted to the Deputy Director of Specialization, so there's a lot of paperwork to complete."

The team quickly presented Ms. Tam's condition, asking for advice on how to handle the abscess drainage surgery. Dr. Phat listened and nodded in agreement with Khoa's proposed plan, but when Khoa mentioned that he would be directly in charge of the surgery because his teacher was busy, an unpredictable expression flashed across his face - so fast that Khoa almost didn't have time to recognize it.

"Okay, just proactively handle it," Dr. Phat said, his voice returned to normal. "I trust you."

Khoa bowed his head in thanks and left the office without realizing that behind him, Dr. Phat sat silently for a long time, his eyes glued to the computer screen where Ms. Tam's old surgery file was still open, his fingers clenched tightly on the armrest of the chair.

The abscess drainage surgery went smoothly, performed by Khoa himself and another doctor in the Surgery Department under the remote supervision of Dr. Phat, who was busy with another surgery at the time and could not directly participate. After the surgery, Ms. Tam was transferred to the recovery room and her condition gradually stabilized.

Ms. Tam's daughter, a young woman named Hoa, stood by her mother's side throughout the following days, her face always full of worry, her eyes dark circles from sleepless nights in the hospital waiting room. Yen often stopped by to check on the patient's condition whenever she has free time, gradually becoming close to this family.

"Doctor," Hoa asked during one of Yen's visits, her voice filled with concern, "my mother had appendicitis surgery a few months ago, why are complications so serious now? Was there a problem with the previous surgery?"

Yen paused for a second before that question, remembering Khoa's strange expression when looking at the old file. "Post-operative complications can occur for many different reasons," she answered carefully, not wanting to draw hasty conclusions without enough evidence. "The important thing now is to focus on treating my mother for the best recovery."

Hoa nodded, although her eyes were still filled with worry. "I just hope my mother gets better. My father passed away early, and my mother is my only support."

Those words made Yen suddenly remember her own family situation, and a deep sympathy arose in her heart. "I promise to monitor your mother's condition carefully," she said, gently holding Hoa's hand to comfort her.

"Thank you very much, doctor," Hoa said, her voice choked up. "Since my mother had her last appendix surgery, I kept seeing her complaining of fatigue and losing her appetite, but when I went back for a check-up, the doctor said she was normal and probably just needed more rest. I didn't expect complications to be this serious."

Yen paused at that detail, remembering it carefully in her mind. "Did your mother have regular follow-up visits after the surgery?"

"Yes, exactly once according to the appointment," Hoa replied, "but that time the doctor only did a cursory examination, saying everything was fine, no additional scans were needed."

That information made Yen even more worried. A cursory follow-up examination, without a thorough examination, for a patient who had undergone abdominal surgery, was somewhat unusual compared to the standard procedure she had been trained for.

That evening, when her shift ended, Yen happened to meet Khoa in the hospital cafeteria, and they both sat down for a late dinner after a long day.

"Are you still thinking about Mrs. Tam's old surgery records?" Yen asked, noticing the unusual pensive look on Khoa's face.

"Maybe I'm thinking too much," Khoa admitted, gently pushing the unfinished plate of rice. "But there was something wrong with the way the records were written. As a medical resident, I was trained to always pay attention to the smallest details, and this detail kept bothering me."

"Then why don't you check more closely?" Yen suggested.

"That is the file prepared by Dr. Phat himself," Khoa said, his voice somewhat hesitant. "I don't want to doubt the teacher I always respect just because of a few imperfect notes."

Yen remained silent, not pressing further, but in her heart, a vague premonition began to form - a premonition that, behind Mrs. Tam's health incident, there might be something much more complicated than a common medical complication hidden.

"Anyway," Yen said, trying to dispel the heavy atmosphere, "Mrs. Tam is recovering well now. Maybe we shouldn't speculate too much without concrete evidence."

"You're right," Khoa nodded, trying to clear away the idle thoughts, although his eyes were still a little gloomy. "I just hope I'm being too sensitive about the little details."

The two finished the rest of their rice in silence, each pursuing their own thoughts. Before saying goodbye and leaving, Khoa suddenly asked one more question, making Yen a bit surprised.

"Hey, are you scheduled to be on duty this weekend? I think if we're both free, we could visit the archives and look back a little more closely, just for peace of mind. Not out of suspicion of anyone."

Yen looked at him, clearly realizing the contradiction in Khoa's heart - both wanting to trust absolutely in the teacher he respected, while also being unable to ignore his professional intuition that was telling him something was wrong.

"Okay," she nodded. "I also want to feel more secure about this."

The two parted ways in the quiet late night of the hospital, no one expected that the seemingly simple decision would begin a challenging journey ahead, forcing both of them to face the most difficult choices in their young medical careers, choices that would test not only their expertise, but also their professional conscience.