Chapter 5 — The White Coat Oath

On Monday morning, Khoa came to see Ms. Tam at the beginning of the hour, carefully explaining the reason why more X-rays were needed before discharging the patient. Mrs. Tam and Hoa both agreed immediately, believing absolutely in what the doctor proposed.

"Don't worry," Khoa said, his voice gentle and reassuring. "This is just a routine check to make sure everything is okay before you go home."

The X-ray room was located on the second floor. Khoa personally took Ms. Tam down, while Yen took advantage of the break between shifts to be there. Both could not hide their excitement as they waited for the results.

The film technician, a middle-aged man named Mr. Hung, performed familiar steps expertly. "Done, the doctor can see the results on the system in a few minutes."

Yen and Khoa waited outside the movie reading room, a tense atmosphere prevailed even though they both tried to keep a calm face in front of the patient. When the screen displayed the results, they both stared at the X-ray image that appeared.

In the lower right corner of the abdomen, a small, characteristic long band-shaped radiopaque image — the typical sign of surgical gauze with radiopaque fibers, is clearly visible on the radiograph.

Yen took a deep breath, feeling both shocked and as if her previous fears had been confirmed. "Just as we suspected all along."

Khoa stood silently, his hands clasped tightly on the table, his face pale. "So... after the appendectomy four months ago, a piece of gauze was left in Ms. Tam's abdomen."

The two looked at each other, with an indescribable heaviness in their eyes. This is no longer a vague suspicion, but has become a fact confirmed by clear, irrefutable medical images.

"We need to report this right away," Yen said, her voice firm though also filled with worry. "Mrs. Tam needs surgery to remove the foreign object as soon as possible. This is the direct cause of prolonged infection."

"I agree about Ms. Tam's treatment," Khoa said, his voice still shaking slightly. "But about reporting... we need to think carefully about how to do it. This is a serious medical error, directly related to Dr. Phat."

"I understand how difficult it is for you," Yen said, her voice softening, placing a comforting hand on Khoa's shoulder. "But the top priority must still be the patient's health. We cannot delay her need for proper treatment because of personal feelings."

Khoa nodded, tried to regain composure, took a deep breath to calm his mind. "You're right. First, we need to report to the Head of the Emergency Department and ask for advice on emergency surgery to remove the foreign object for Ms. Tam. Regarding the investigation of the root cause, we will handle it later, according to the correct procedure, without haste."

The two quickly reported the situation to Dr. Hoang Anh Dung, who presented the X-ray results objectively, only focusing on the clinical aspects that need to be handled immediately without mentioning the doubts about old surgery records.

"This is a case that requires urgent foreign body removal surgery," Dr. Dung said after seeing the results, his face was serious, his eyes glanced over the two young resident doctors standing in front of him. "I will schedule the surgery today."

Before the surgery began, Dr. Dung asked Khoa a question in private that made him startled. "Do you know who performed Ms. Tam's previous appendectomy?"

Khoa paused for a second, considering his answer. "Yes, the records say it's Dr. Phat."

Dr. Dung nodded and did not comment further, but his eyes flashed with an unpredictable contemplation before turning away to prepare for the surgery. Khoa stood there, wondering if Dr. Dung suspected something similar to what he and Yen had discovered, but he did not dare to ask further while all attention needed to be focused on the urgent surgery ahead.

The surgery to remove the foreign body took place in the afternoon, performed by another surgeon not related to the previous surgery, in accordance with regulations on avoiding conflicts of interest when detecting potential medical errors. The surgical gauze, which had been causing infection for months, was successfully removed, and the abdomen was thoroughly cleaned.

Yen and Khoa stood together to observe the surgery through the area for resident doctors. Both were speechless when they saw with their own eyes the gauze - discolored and stuck to the surrounding tissues due to the prolonged inflammatory process - being removed from the patient's abdomen. That was concrete, irrefutable proof of what both of them had suspected all these days.

After the surgery, Ms. Tam gradually recovered. Infection indicators began to decrease significantly after only a few days of intensive antibiotic treatment, and her face gradually regained its original rosy appearance. Hoa, upon hearing the news, could not hold back her emotional tears, hugged Yen and thanked her profusely.

"Thank you doctor, thank you very much," Hoa said, her voice choked up. "If it weren't for the doctors' care, I don't know how long my mother would have suffered."

Yen smiled, even though her heart was still heavy at what she had to face next. "That is our responsibility. The most important thing is that your mother is recovering well."

"Doctor," Hoa added, her voice still shaking with emotion, "I really don't know how to thank you enough. If I hadn't found out in time, I don't know what would have happened to my mother."

Yen looked at the young girl, her heart filled with a stronger determination than ever. She thought of herself at twelve years old, standing helplessly as the boat carrying her father left the dock, and told herself that she would not let anyone else go through the same pain of medical delays or cover-ups — even if that meant facing the hardest truths.

That evening, after the shift ended, Yen and Khoa sat together at a small cafe near the hospital, both in a heavy mood even though the patient had been treated promptly.

"Now we have to decide on the next step," Yen said, gently stirring the cooled coffee. "We have enough evidence of missing records and X-ray images confirming the foreign object. But to officially report to the medical ethics council, it is necessary to follow the correct process, carefully every step."

Khoa nodded, his eyes filled with concern. "I need time to think about how to approach Dr. Phat first, giving him a chance to explain before we go to the official reporting step. I believe, no matter the outcome, he deserves to be treated fairly, not hastily accused."

"I respect that," Yen said, gently holding Khoa's hand across the table. "But we can't delay too long. If this was truly a deliberately hidden error, there may be many other patients at similar risk that we don't know about."

Khoa squeezed Yen's hand, his eyes firmly returning. "I know. Together we will find the best way to handle it — ensuring fairness and protecting patient safety. Thank you for always being by my side in this matter, Yen, even when I was hesitant."

The two looked at each other in the warm yellow light of the coffee shop, realizing that the road ahead would have many more difficult challenges, but at least they would not have to face it alone.

"I have a suggestion," Yen said after a moment of silent thought. "Before we decide on any formal steps, it might be a good idea to find out if there are any other patients who have experienced similar situations at the hands of Dr. Phat. If this is just an isolated mistake, the way it is handled may be different than if this is a systemic problem."

Khoa nodded, realizing the reasonableness of that proposal. "I can ask Nghia to help review electronic record data and find cases of patients being readmitted to the hospital with symptoms of infection after surgery in recent times. He is quite good at medical information technology."

"But make sure Nghia understands the sensitivity of this," Yen reminded. "We don't want information to leak out before there is an official conclusion."

"I trust Nghia," Khoa affirmed. "He's a private person, and I know he takes patient safety as seriously as we do."

Yen nodded, feeling relieved to have a more specific plan to proceed with. "So we start from there. Step by step, carefully but without delay."