Chapter 6 — The White Coat Oath

Bui Trong Nghia agreed to help as soon as Khoa presented the problem, although his face could not hide the tension when he knew the sensitivity of the request. The three — Yen, Khoa, and Nghia — arranged to meet at a quiet coffee shop far from the hospital, where no colleagues could stumble upon them.

"I did a preliminary review of the electronic records system data," Nghia said, opening his laptop to the table, his voice whispering even though no one around was paying attention. "Over the past eighteen months, there have been seven cases of patients who had surgery by Dr. Phat having to be readmitted to the hospital with unusual symptoms of infection between two and six months after the initial surgery."

Yen and Khoa looked at each other, both unable to hide their shock at that number. "Seven cases?" Yen asked again, her voice trembling slightly, unable to hide her shock. "That can't be a coincidence."

"I think so too," Nghia nodded, turning the laptop screen for both of them to see the detailed list. "But I've only seen the summary on the electronic system, I don't know the full details about each case. If you want to verify for sure, you need to look at the original paper records of each case, like the way you two did with Ms. Tam's case."

"Seven files is a big number," Khoa said, his voice low, "we can't check them all in a short time without attracting attention."

"We don't need to check everything right away," Yen said, thinking quickly. "Let's start with the two or three cases with symptoms most similar to Ms. Tam's — persistent abdominal infection after surgery. If a common denominator is found, that will be strong enough evidence to proceed with an official report."

Nghia filtered the list according to that criteria, quickly typed a few search commands on the system, narrowing it down to the three most suitable cases. "Here, these three patients have the most similar symptoms — all had abdominal surgery, all were re-hospitalized with infections of unknown cause within half a year."

"I will help get the original paper records of these three cases," Nghia added, "but be careful. If someone discovers that I accessed many records related to the same surgeon in a short period of time, questions may arise."

The plan was agreed upon: Nghia would slowly, scattered over a few days, borrow each file one by one under the pretext of normal scientific research — a common activity for resident doctors preparing a thesis topic. Yen and Khoa will carefully review each file in the rare free time between shifts.

"I have a thesis topic on the effectiveness of digitizing medical records in progress," Nghia said, smiling wryly. "At least this excuse isn't completely fabricated, it's just that I'll focus on collecting the right documents I need a little more."

"Thank you for being willing to help with this," Khoa said, squeezing his best friend's shoulder. "I know this is not an easy request."

"Don't be polite," Nghia waved his hand. "I entered the medical field because I wanted to help patients, not to protect anyone's reputation by turning a blind eye to errors. If it is true that there is a systemic problem like you two suspect, this is something that needs to be clarified, there can be no hesitation."

Yen looked at Nghia with grateful eyes. "Thank you, Nghia. Having a trustworthy companion like you makes us feel much more secure."

Three days later, the group met again, this time in a quiet corner of the hospital's medical library — where the three residents sitting together reading documents did not raise any suspicions.

"I found this," Nghia said, his voice more serious than last time, pointing to a profile page. "All three cases have the same thing in common - the counting of post-operative surgical instruments lacks a full confirmation signature, identical to Ms. Tam's records."

Yen flipped through each page carefully, her heart beating faster when she recognized the clear repeating pattern. "All three of these shifts occurred at very late hours — near morning, after long shifts."

The department remained silent, reviewing the doctor's duty schedule. During the period of time corresponding to each surgery, their faces gradually turned pale. "This all happened after Dr. Phat was on duty for more than twenty-four hours without a break."

Silence enveloped the group for a moment, with only the gentle sound of the ceiling fan spinning overhead. The bigger picture gradually emerged — not a single mistake, but likely a recurring pattern, stemming from chronic work overload that severely affected concentration and precision during the final operations of each long shift.

“This changes everything,” Yen said, her voice serious. "This is no longer just an individual problem, but a systemic one — overcrowding is directly threatening patient safety."

She remembered her own long shifts, the times she had to try her best to stay awake after more than twenty hours without sleep. If even an experienced doctor like Dr. Phat can make serious mistakes under such overwhelming pressure, the risks for younger, less experienced doctors like herself and Khoa are probably much higher.

"I think," Yen continued, her voice thoughtful, "perhaps the real problem lies not only in the handling of Dr. Phat's errors, but also in changing the entire duty schedule system that is pushing doctors into such a state of exhaustion. If not resolved at the root, the same errors may continue to occur, no matter who it is."

Nghia nodded in agreement. "That is an important perspective. Perhaps our report should not only focus on assigning personal responsibility, but also propose solutions to reform working regimes, so that this does not happen again in the future."

"But that does not alleviate the responsibility of concealing errors," Khoa said, his voice still shaking, but having regained the necessary steadfastness. "Regardless of the root cause, editing records and delaying proper treatment of patients is unacceptable in medicine, no matter the reason."

Nghia nodded in agreement. "I think, you two need to present this discovery to the official channel as soon as possible. This is no longer something that you can quietly handle on your own, especially when it involves the safety of many other patients."

Yen looked at Khoa and saw a clear conflict in his eyes - between loyalty to the teacher who had guided him for many years, and professional ethical responsibility that could not be avoided. She understood that, for Khoa, this was not simply a professional decision, but also an internal battle between gratitude and professional conscience - two things that normally always go hand in hand, but now put him in a position of having to choose.

"I need a little more time," Khoa said softly, his voice filled with fatigue. "Not to delay justice, but so that I can prepare myself to face you directly before things reach a point of no return. I owe you at least a chance to explain yourself, before anyone else knows about this."

Yen nodded, understanding and respecting that time, although in her heart she worried about other patients who might still be silently suffering the same consequences without being discovered in time.

"I propose this," Nghia said, trying to offer a concrete direction to ease the tension that was engulfing the group. "While waiting for the department to mentally prepare, we can review these three files more closely, confirm every detail, and prepare a complete and coherent set of documents. That way, when the right time comes, we won't waste time collecting them from the beginning."

"Good idea," Yen nodded in agreement. "Just have time to prepare mentally and not waste precious time."

Khoa looked at both companions, a warmth mixed with gratitude rising in his heart. "Thank you both. I don't think I could have faced this without both of your support."

"That's what friends should do," Nghia replied, closing his laptop when he saw a library staff passing by to check the upcoming closing time. "We have more work to do, but at least now there is a clearer direction."

The three left the library in silence, each carrying a heavy but determined mood, ready to face the next steps of the challenging journey to find the truth ahead.