Chapter 4 — The White Coat Oath

On weekends, when the hospital was more deserted than usual, Yen and Khoa met at the medical records storage room - a small room deep in the basement, filled with old paper filing cabinets that had not yet been fully digitized, even though the hospital had applied an electronic system several years ago.

"The original paper records of Ms. Tam's surgery are probably still saved here," Khoa said, flipping through the list arranged by patient code. "Electronic systems sometimes only save a summary, which is not as complete as the original."

After nearly half an hour of searching, Khoa finally found the file he was looking for and brought it to the table to read under the dim fluorescent light of the storage room. They both sat down, turning each page carefully.

"Here," Yen pointed to a page of post-operative notes, her voice somewhat tense. "The surgical instrument count section says 'sufficient quantity as prescribed', but there is no specific confirmation signature of the instrument nurse directly participating in the surgery that day. Normally there must be two full signatures — the surgeon and the instrument nurse."

Khoa frowned and compared it with a few other surgery records from the same time period for comparison. "You're right. All the other documents I checked have two signatures, only this one is missing."

"It could have been a simple mistake," Yen said, although her voice was not very convincing. "But combined with the serious complications Ms. Tam encountered four months later, and a cursory follow-up without a thorough scan..."

"Do you think there is a possibility of a foreign object remaining in the abdomen?" Khoa asked directly, his voice low, as if he himself was hesitant to say that possibility.

"I can't confirm," Yen replied carefully. "But it's a possibility that needs to be ruled out. Prolonged abdominal infection, recurrence after surgery, combined with incomplete instrument inventory records — those are classic signs of missing surgical instruments or gauze."

Khoa was silent for a long time, his hands clasped tightly on the edge of the table. "If that's true, it would be a serious medical mistake. And I can't believe that Dr. Phat could make such a mistake."

"Everyone can make mistakes, Khoa," Yen said gently, placing her hand on his shoulder to comfort him. "Even the best doctors. It's important that we verify clearly, not to accuse anyone, but to make sure Ms. Tam gets proper treatment."

Khoa nodded, even though his face was still heavy, his fingers unconsciously tapping on the old wooden table of the storage room, a habit he often did when he had to think about a difficult problem. "So what should we do next?"

"I think," Yen said after a moment of thinking, "we need to ask for an X-ray of Mrs. Tam's abdomen to be re-checked to see if there are any radiopaque foreign objects left in the abdomen. That is the most objective way to verify, not dependent on speculation."

"But if we request a scan without a clear clinical reason, it might make others ask questions," Khoa said, his voice cautious. "Especially if someone in the department notices we're going through old files."

"Are you worried about Dr. Phat knowing about this?" Yen asked directly, wanting to better understand the real concern in his heart.

"Partly," Khoa admitted, his voice slow. "But I'm more worried that, if rumors spread before we have enough solid evidence, it could cause unnecessary confusion for patients, or worse, give the person actually involved the opportunity to cover their tracks before the truth is clear."

Yen nodded, realizing the thoroughness of Khoa's way of thinking. "You're right. We need to act discreetly and carefully, until we have enough clear evidence."

"Then we need a legitimate clinical reason," Yen said, her eyes flashing with familiar determination. "Ms. Tam is currently still recovering from surgery to drain the abscess. The request for a general examination of the abdomen by X-ray before leaving the hospital is completely reasonable in terms of expertise, no one can question its necessity."

Khoa nodded, impressed by Yen's quickness in finding a direction that was both reasonable and did not cause unnecessary suspicion. "Okay. I will suggest this order during the medical examination tomorrow morning, right at the start of my shift."

Before leaving the storage room, Khoa carefully took a photo of the problematic profile page with his phone and saved it in a separate password-protected folder. "Just in case you need it later," he explained when he saw Yen looking at him questioningly.

"You're thinking too far ahead," Yen said, although in her heart she also secretly agreed with that caution.

"If this is really as serious as we suspect," Khoa replied, his tone serious, "we'll need hard evidence, not just memory or accounts. I've learned that from my own work — every medical conclusion needs to have a concrete basis, it can't just be based on feelings."

Before leaving the storage room, the two carefully rearranged the files back to their original positions, leaving no trace that anyone had looked through them. Yen locked the storage room door according to regulations and returned the key to its original position on the key board in the administrative room.

"I still hope I'm guessing wrong," Khoa said as the two walked out of the administrative area, the late afternoon sunlight streaming through the long windows of the hospital hallway.

"Me too," Yen nodded. "But if it is true that there was a mistake, early detection is still much better than letting Ms. Tam continue to suffer complications without knowing the real cause."

Leaving the basement, the two walked slowly through the deserted hallways of the weekend hospital, the atmosphere between the two became much quieter than the cheerfulness of the previous days.

"Are you okay?" Yen asked, noticing the heaviness in Khoa's eyes.

"I just... didn't think I'd have to face this situation," Khoa admitted, sounding somewhat tired. "Dr. Phat is the person who taught me almost everything I know about surgery. If what we suspect is true, I don't know how I will face him."

Yen gently held Khoa's hand, a sincere gesture of encouragement, looking straight into his eyes full of trust. "No matter the outcome, I believe you will do the right thing, Khoa. That's the reason why I respected you from the first days, even though at that time we still argued fiercely with each other."

Khoa looked at her, a gentle smile, although still a little worried, appeared on his lips. "Thank you, Yen. With you accompanying me in this matter, I feel much more confident than having to face all these doubts alone."

The two parted ways in front of the hospital gate, carrying with them a new worry and determination - determined to find the truth, even though that truth could bring consequences that neither of them had fully anticipated.

Returning to her small motel room, Yen couldn't sleep, she kept tossing and turning thinking about what she discovered that afternoon. She opened her laptop, re-read some medical documents about the complications of surgical foreign body retention, trying to better understand the severity of the situation if her suspicions were correct.

According to the documents she found, complications of surgical gauze remaining in the abdomen, although rare, can cause prolonged infection, abscess formation, and even be life-threatening if not detected and treated promptly. Reading that, Yen became even more worried about Ms. Tam's condition, and at the same time felt more clearly the heavy responsibility that was placed on her and Khoa's shoulders.

She texted Khoa, even though it was late: "Are you sleeping yet? I just read more about this complication, it seems more serious than I thought if it was true that a foreign object was left behind."

A few minutes later, Khoa replied: "I'm also reading the same document. Can't sleep. But no matter what, tomorrow we will have the X-ray results, all doubts will be clarified."

"Yes," Yen typed back, "thank you very much for facing this difficult matter with me."

"We're teammates," Khoa replied, followed by a gentle exclamation point. "Go to bed early, there's still a lot to do tomorrow, you need to be as alert as possible."

Yen put down the phone, looked up at the ceiling, her heart mixed between worry for the patient and a strange warm feeling knowing she was not alone in facing the difficult challenge ahead, a feeling that she realized, more and more clearly each day, was probably far beyond the boundaries of a normal colleague.