[Medical Human Story: Episode 61]-At the Brink of Breath, Unseen Pressure_4

 

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A medical human story centered on supine tension pneumothorax, detailing the emergency management, diagnostic process (CT, PET-CT, biopsy), surgical treatment (VATS, lobectomy), and recovery of a patient with COPD and lung cancer, combining emotional storytelling with in-depth medical insight.  

Part III: Collapsing Boundaries

Waiting Always Feels Longer Than It Is

I sat in a chair outside the ICU.

The clock was moving at its usual pace,
yet somehow, time felt stretched in this place.

Biopsy results usually take two to three days.

But that time—

for the patient, for the family, and even for me as a physician—
is an unbearable void.

 Think Within That Void

We deal with life.

But we do not always have the answers.

Sometimes, waiting itself becomes part of the treatment.

But that waiting
is cruelly silent.

Kim Doyoon Had Not Yet Awakened

Twenty-four hours after surgery.

He was still dependent on the ventilator.

FiO₂: 40%

PEEP: 5 cmH₂O

SpO₂: 96%

The numbers were stable.

But the problem was elsewhere.

“The lungs are more damaged than we expected.”

The ICU resident said.

“Spontaneous breathing is still insufficient.”

I nodded.

It was expected.

The lungs of a COPD patient
cannot be explained simply by the concept of “recovery.”

What It Means to Regain Breath

Normal lungs recover.

But damaged lungs
can only adapt.

The difference is profound.

Recovery means returning to the original state.
Adaptation means accepting a new one.

And now—

Kim Doyoon was learning how to breathe again.

[Medical Insight]

And Then, the Call Came

Pathology.

I paused for a moment, holding my breath.

“The results are in.”

That single sentence is always heavy.

I spoke quietly.

“Please, go ahead.”

In That Moment, Every Boundary Collapsed

“Non-small cell lung carcinoma.”

I closed my eyes.

I had expected it—
but the moment it becomes confirmed is different.

Lung cancer. Non-small cell type

The most common form of lung cancer.

And yet, still a deadly disease.

I asked,

“What stage?”

A brief silence.

“Further evaluation is needed… but it appears to be an early stage.”

Hope and Despair Arrive Together

Early-stage lung cancer.

That means—

There is a possibility of treatment

And at the same time, it has already begun

I took a deep breath.

The Battle Had Changed

We were no longer dealing with a simple pneumothorax patient.

Now he was:

A COPD patient

A survivor of tension pneumothorax

And a lung cancer patient

I Called in the Family

The consultation room.

A small space—

but within it,
a person’s life can change completely.

“The test results are back.”

I spoke as calmly as possible.

Their eyes were fixed on me.

The Truth Is Always Simple, But Hard to Accept

“It’s lung cancer.”

The words cut through the air.

His wife’s hand trembled.

His son said nothing.

“But it’s an early stage,”

I added immediately.

“There is a chance for treatment.”

It was hope—

but not complete comfort.

A Doctor Must Speak of Hope

But never lies.

That balance is difficult.

“It appears to be surgically resectable.”

I explained while showing the CT images.

“After additional tests, we will establish a treatment plan.”

They Nodded

But I knew—

their understanding was not complete.

In the presence of the word cancer,

emotion always comes before logic.


[Medical Insight]

I Returned to the Intensive Care Unit

Kim Doyoon was still asleep.

I looked at his chart.

A Life Written on Paper

COPD

Pneumothorax

Lung cancer

Three words.

But behind them—

were decades of life.

I Looked at His Hands for a Moment

Rough, calloused hands.

He was a man who had worked his entire life.

And now—

those hands could do nothing.

Doctors Always Meet Patients Too Late

While people are living with and worsening their illnesses,
we do not see them.

And when they finally collapse—

that is when we meet them.

But This Is Not the End

He is still alive.

And there is still something we can do.

I Made a Decision

I would see this patient through to the end.

Breath Will Begin Again

In a different way,
with a different meaning.

And the Process Will Not Be Easy

Rehabilitation
Surgery
Treatment
Pain
Anxiety

All of it awaits.

But This Is Medicine

We may not be able to stop death.

But—

we can change the time of life.

I Looked at the Clock Again

Time was still moving forward.

This time, it felt a little faster.

And I Prepared for the Next Step

PET-CT
Pulmonary function test
Surgical planning

[Medical Insight]

Breath Continues

Because that is what it means to be human.


To be continued. Part IV: Learning to Breathe Again



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