Chapter 8 — The White Coat Oath

Saturday morning, Khoa went to Dr. Phat's office as arranged, saying that he wanted advice on a research topic. The familiar small room, where Khoa had learned so many valuable things during his two years of residency, now suddenly felt strangely unfamiliar.

"What do you want to talk about?" Dr. Phat asked, smiling friendly as usual, motioning for Khoa to sit in the chair opposite.

Khoa sat down, tightened his grip on the documents he was holding, trying to keep his voice as calm as possible. "Teacher, I want to ask you about patient Nguyen Thi Tam's appendectomy, performed about five months ago."

Smile on BS's face. Phat stopped for a brief moment, but enough for Khoa to notice the change. "What about that surgery?"

"Mrs. Tam had to be readmitted to the hospital because of a serious abdominal infection," Khoa said, trying to keep his voice even and nonjudgmental. "When we performed surgery again, we discovered a piece of surgical gauze was left in her abdomen."

The room fell into a heavy silence. Dr. Phat sat motionless, his face gradually changing to an unpredictable expression — not surprise, but something close to resignation.

"Have you checked carefully?" he asked, his voice losing its usual warmth.

"I saw the X-ray results, and the original surgery records," Khoa replied, mustering up the courage to put the documents on the table. "The counting of post-operative surgical instruments did not have enough confirmation signatures. I also discovered six other cases with similar symptoms, all related to surgeries you performed after long shifts."

Dr. Phat closed his eyes, his hands clasped together on the table. A long silence passed, so long that Khoa felt like every second lasted forever.

"You're right," Dr. Phat finally spoke, his voice lowered, carrying a deep fatigue that Khoa had never heard from the always calm and steady teacher. "That night, I was on duty for nearly thirty hours without stopping. Ms. Tam's appendectomy was the last in a series of consecutive emergency cases. I... I was too tired and lost focus during the final count."

Khoa was speechless. Even though he had prepared himself for this possibility, hearing his teacher admit it from his own mouth still made him shocked.

"So why didn't you handle it as soon as you discovered the problem?" Khoa asked, his voice shaking with both emotion and disappointment. "Why edit the records, delaying her proper treatment?"

Dr. Phat opened his eyes and looked straight at Khoa, his eyes filled with torment. "I was panicking, Khoa. At that time, I was in the process of applying for the position of Deputy Director of Specialization, which was about to be approved. Such a serious mistake, if discovered, would not only ruin my chances of promotion, but could completely end the twenty-year career I have worked so hard to build."

"But it's the patient's life, teacher," Khoa said, his voice choking. "I can't believe you - the person who always taught me that the patient should always come first - could make such a choice."

Dr. Phat bowed his head, no longer daring to look directly into his student's eyes. "You're right. There is no reason that can justify what I did. I let my personal fear override my professional conscience, which I have proudly maintained throughout my career."

Silence enveloped the room once again, with only the sound of the wall clock ticking steadily, a cold reminder of the time passing between the two people who once had a deeply attached teacher-student relationship.

"Did you tell this story to anyone else?" Dr. Phat asked, his voice cautious, not to blame but to understand the seriousness of the situation he was facing.

"I asked Yen - a resident doctor in the Emergency Department - and Nghia, my classmate, to help verify the information," Khoa answered frankly, not wanting to hide anything anymore. "But none of them have officially reported to anyone else. We wanted to give you a chance to speak for yourself first."

Dr. Phat nodded, a trace of gratitude flashing through his tired eyes, his hand shaking slightly as he raised it to rub his temple. "Thank you for that, kids. At least I can be treated with a little humanity while everything is falling apart."

"That's the least you deserve, after everything you've devoted to this hospital," Khoa said, his voice sincere although still heavy, standing up to prepare to leave the office as the most difficult conversation of his life gradually came to an end.

"What are you going to do next?" Khoa asked, trying to regain composure.

"I don't know," Dr. Phat admitted, his voice filled with despair. "I know I need to take responsibility, but I'm also afraid... afraid that everything I've built will completely collapse."

Khoa looked at the teacher he once absolutely admired, now broken down by his own mistakes, a feeling of sympathy mixed with a complex disappointment that was hard to name arose in his heart. This is not the image of the powerful, steady teacher he has always known, but a normal person, with the same fears and weaknesses as anyone else.

He recalled the dedicated guidance Dr. Phat had given him over the past two years - the times he patiently explained a surgical suturing technique until Khoa really mastered it, the sincere words of encouragement every time he was discouraged by work pressure, and the late evenings when he volunteered to stay and give extra instructions even though his shift had ended long ago. All those memories were now intricately intertwined with the painful truth that had just been revealed, making Khoa not know how to properly view his teacher.

"I still respect you, teacher," Khoa said softly, his voice full of inner conflict. "But I also can't ignore what happened. I hope you understand, this is not a betrayal, but my way of showing true respect for what you taught me about professional ethics."

Dr. Phat nodded, his eyes red with emotion. "I understand, Khoa. And I'm proud that you've become exactly the type of doctor I always wanted to train — one who isn't afraid to speak up for what's right, even when it's hardest."

"I think," Khoa said after a moment of thought, his voice calmer, "you need to voluntarily report to the hospital's medical ethics board. Not to be punished, but so that Ms. Tam and the other patients receive proper recognition for what happened, and so that the system has a chance to correct the flaws that led to this error. I believe, if you proactively admitted before being discovered, that would be considered a significant mitigating factor."

Dr. Phat looked up at Khoa, a faint ray of hope flashed in his eyes, his shoulders that were previously stiff with tension now sagged a bit. "Do you think they'll give me a chance to explain?"

"I don't know for sure," Khoa replied honestly. "But believe me, honestly admitting your mistakes is always the best first step, no matter what the outcome may be."

Dr. Phat was silent for a long time, his eyes looking far away out the small window of his office, where he could see a corner of the hospital yard bustling with people passing by. "You know, when I was a young resident doctor like you are now, I also witnessed a hidden medical error. At that time, I promised myself that, if in the future I was in a position to make the same choice, I would always choose the truth, choosing the patient first."

He smiled bitterly and shook his head. "And yet, when actually faced with that situation, he did the opposite of everything he had vowed. Perhaps, people easily make noble promises when they are on the outside, but when they are faced with the risk of losing everything, their weakness truly shows."

"You're not the only one who has had moments of weakness like that," Khoa said, his voice softening somewhat. "But what's important now is what you choose to do next, not what happened in the past."

Dr. Phat nodded slowly, as if trying to absorb every word his student said. "You're right. I need time to prepare, but I promise to do the right thing, Khoa. I owe you, Mrs. Tam, and my own professional conscience a sincere apology, along with the responsibility to bear."