Sunday, 2/15/2015
Oh god, this is the post many of you have been waiting for, but that I've been sitting on for a while because of the subject matter and because there's just no way I'll have a better story to tell while I'm here.
Sometimes, the swirling currents of chance and eventuality conspire in such a way as to produce an event so unimaginably absurd and unlikely that after it happens, you need to take a step back to simply absorb the stark (this is a play on words that you'll get later) reality of what just happened. Granted, copious amounts of alcohol are generally on board to help facilitate such headlong dives down these rabbit holes of unfathomably elaborate, usually self-induced (always hilarious to everyone else) injury to one's own pride or person. However, the following scene is rare in that no such substances were involved; nevertheless, I think I can confidently say that this story deserves to join the canon ranks of the likes of Milk Goggles, FritFrat Is Cool, The Darkness The Darkness, Patrick Tu Le, and The Great Everclear Incident of 2010.
So as many of you know, and as I mentioned in my third post, Peter is one of my closest friends and PIC (see? now you know what that is!). Between recruiting him to UMMS, co-directing the Auscultations a cappella group, considering bro-couples matching for residency, and leading Team Korea to two consecutive championships in the Thirsty Games Drinking Olympics--our bromance is considered peerless by our med school friends. Well, through a combination of unfortunate misunderstanding and debatable intentional deceit, that friendship just reached a new level.
Swag.
A disclaimer is in order. After the surprisingly recent and borderline idiotic realization that my largely uncensored and often profane blog was being diligently read by my parents, sister, teachers, mentors, girls I like, parents of friends, etc., I have become acutely more cognizant of my audience (though on a related note and to my credit, I think I did a very good job of passing up perfectly good that's-what-she-said jokes around Sophie and the kids). However after some thought, I don't plan on/don't have the ability to alter the stream-of-consciousness that produces these posts, and this story is too good by far not to tell--so I will continue to write how I write and instead just feel significantly more awkward about it. Turn back, all ye who enter here (and don't want to hear a potentially awkward story about your son/brother/former student/kid who used to come over to your house and eat all the cheese and salami).
Your call.
Seriously though.
Still here?
Okay then...
Ahem.
The following story is based on real events that transpired at the 시리리 찜질방 Sea La La Bath House (yup, real name); names unfortunately have not been changed to protect the innocent.
Jjimjilbangs are Korean bath houses--establishments which are actually quite a prominent part of modern (and historic) Korean culture as families will often go together and spend the better part of a Saturday or Sunday there just chilling. The layout of these large complexes is generally two gender segregated wings called 목욕탕 (mogyoktang) with locker rooms, showers, baths, saunas, and massage (not "massage", this isn't Thailand) rooms with common unisex spaces in the middle that house a large social area with heated floors for lounging and sleeping, a food court, and more traditional Korean kiln saunas of varying temperatures. They are generally open 24 hours a day and have sleeping quarters which are frequented by commuting corporate slaves, savvy travelers (they only cost about ₩6,000-10,000 Korean won, about $6-10, per night), and drunk asses that can't make it home, but did at least avoid this fate:
(Not an uncommon sight in Seoul after, meh, 8:00 PM; please note the guilty-looking bottle of soju and the delicious-looking ice cream shake)Regarding jjimjilbangs:
- I had heard about them before and was interested in checking one out.
- Peter was a bit lukewarm on the idea and kind of gave a noncommittal nod and "sure" whenever it came up.
- Grace was a big proponent of them and repeatedly tried to get us to go.
These attitudes are somewhat telling and play into a conspiracy theory that I'll introduce shortly.
Well we didn't have any definite plans for Sunday, so at Grace and Sophie's suggestion, we headed out for a jjimjilbang that they had been to before. After paying the cashier, we removed our shoes, parted ways with the girls with plans to meet up in the common area, and headed for the changing rooms.
Now I had never been to a bathhouse before, but in my head, I was picturing this:
(If you don't get it, watch Spirited Away, you'll thank me later, though you should question the strength of our friendship if I haven't already forced you to watch it with me.)What it actually looked like was this.
It's an interesting psychological phenomenon that it feels distinctly less weird to be naked in front of strangers than it does in front of people you know. Well, Grace assured us that the latter wouldn't be an issue as "you only need to do the naked communal shower thing if you want to stay in the mogyoktang gender-specific bath area." This was an odious lie. Whether innocently ignorant of the strict and complex naked rules set forth by the management of Sea La La Jjimjilbang or malevolently deceptive in order to trick friends into seeing one another naked, we may never know. What we do know, is that one short conversation with the men's mogyoktang attendant relayed in English later, and it was off to the showers. Some intense initial awkwardness quickly passed however, and a new height of friendship was in the books. We high-fived, grabbed our jjimjilbang baggy t-shirt and shorts from the attendant and headed to the common lounge area.
We relaxed on the heated floors with Grace and Sophie, checked out the different sauna rooms--there were 7*C, 35*C, 50*C, and 75*C ones (American readers, multiply by 9/5 and add 32)--all of which were quite nice, and grabbed some mediocre food from the food court.
This post will be pretty devoid of photos from here on out; I'm sure you understand.
It was a very relaxing experience, and though it's a fairly foreign concept to Americans, I can see why so many people frequent these places to veg out on the weekends. That being said, after several hours, we were ready to move onto the next thing, so we headed back to our respective mogyoktangs to check out the saunas and baths there for a bit (because really after the initial encounter, it's not much of an issue anymore) before heading out.
Well I had just climbed into the 50*C (122*F, which is fucking hot) bath when we heard a rather loud, dull thud somewhere close by. I didn't really think much of it right away, so I continued to cook myself alive for another several minutes, trying to convince myself--amidst thoughts of ring worm, Pseudomonas skin infections, and reduced sperm counts (#medstudentproblems)--that this was a comfortable and relaxing endeavor.
Well, that didn't work out, so I got up to go, but as I did, I saw that there was a young man in his early teens (Tanner stage 3) slumped against the tiled wall in the corner. His eyes were closed though he was stirring a bit, and when we asked if he was all right, he said yes and stood up to leave the mogyoktang area. Something was still very not right about him though, as he staggered across the room, stopping to center his balance several times, and once we saw him lie back down on a bench in the towel area, Peter and I decided to go check on him. In the better lit room, he appeared quite flushed, sweaty, and disoriented, and he felt rather too warm to the touch.
In the medical world, first things are first to assess for any immediately life-threatening issues: the ABCs. A: airway, he was talking and didn't look like he aspirated any water (fine). B: breathing, he was breathing well though maybe a bit quickly, and both lungs looked to be moving equally (fine). C: circulation, his pulses were strong and regular--less concern for something heart-related causing his collapse (fine).
With Peter translating, we then attempted to get a history from him: he didn't remember slipping and falling or losing consciousness, but he also couldn't recall how he ended up on the floor. He was only answering questions with short sentences in somewhat slurred Korean and he wasn't keeping his eyes open, so we were starting to get pretty worried about him. I asked the attendant to get him a towel to dry him off and he also came back with a portable oxygen mask. In the meantime though, the boy began to retch, so I grabbed a garbage can and he vomited into it.
Since he wasn't communicating well, we had to do our best to find out by other means if anything gravely serious was going on. Unfortunately, no one else in the area seemed to witness what happened to him, if he fell or if he convulsed, and no one there knew who he was. So while I grabbed my phone to check his pupil reflexes with the flashlight (they were normal), Peter checked the vertebrae in his neck for any step-offs suggesting a fracture (none) and we looked over his scalp for any large hematoma (collection of blood under the skin) suggesting that he fell and hit it (maybe, hard to tell). As we continued the exam, he seemed to be improving, sitting up better and interacting more. There were no other obvious injuries to his head, face, or the rest of his body, he could move all four of his extremities with good strength, decent coordination, and sensation, and his cranial nerves (special nerves in the head that are easily tested and can indicate if something is wrong in the brain) all seemed to be normal.
By this time, he was able to tell us his name, where he was, what day it was, that he was here with his mother who was in the women's mogyoktang, and that he didn't think he had ever had a seizure before (something that could have caused his fall and confusion), but that he had fainted in the past. He remembered feeling dizzy and thought he then fell down and hit the back of his head.
While the staff tried to find his mother, Peter and I talked through what could have happened. The most likely scenario was that he was in one of the hot baths and had a vasovagal reaction--a fainting spell--causing him to fall and hit his head. It could also have been a seizure, but that's less likely since he hadn't had a history of them before and no one saw him shaking or convulsing before or after the fall; a heart condition causing the fall was even less likely given his age and normal pulses.
The fall itself was a separate and more pressing issue, regardless of whether he lost consciousness and fell or fell first and then lost consciousness. A fall, even from just standing height, onto a hard tile floor could cause a concussion, basically a hard collision of the brain against the inside of the skull--caused by a very fast acceleration or deceleration--basically bruising the brain. This can cause confusion, loss of consciousness, nausea, vomiting, dizziness (all symptoms he had), and even cognitive and emotional changes. Less likely, but a serious enough complication that it always needs to be evaluated for is something called an epidural hematoma, a bleed, caused by trauma, that builds up in the space between the skull and the outermost covering of the brain--the dura mater. This collection of blood can grow rapidly over time, even in people who feel and act completely normally for minutes to hours after the injury, and eventually cause so much pressure on the brain that it herniates out through the base of the skull into the spinal canal, causing death (it's what killed Liam Neeson's wife after a skiing collision--she felt fine and didn't seek medical care and never woke up from her nap). Since he was young, improving, and had a normal exam, this was unlikely. The most likely scenario was that he had a vasovagal reaction to a hot bath causing a fall from standing height onto the back of his head, causing a concussion, and he should probably go to the ER to be observed or worked up there to be safe.
In a serious situation, it's interesting how peripheral details evaporate away in their irrelevance as the task at hand dominates one's primary focus.
It was around this point that I remembered that I was completely butt ass naked.
The patient was butt ass naked.
My friend was translating and examining the patient butt ass naked and about a dozen concerned Korean men of varying age, fitness, and assertiveness were crowded around the bench offering help and asking questions in Korean. Butt. Ass. Naked. The only asshole who wasn't naked was the fucking attendant who made me strip down in front of all these people in the first place.
In that moment, the inundation of so much reality at once was just too much and I needed a moment to not only accept that I could simultaneously add and cross off "work up a trauma patient while completely nude" off my bucket list, but also properly react to the experience by, much to the bewilderment of all the naked Korean dudes in the changing room, laughing hysterically to myself.
Shortly thereafter, the kid's mother arrived and Peter went to go tell her what had happened and what would be most important to tell the doctors at the ER.
I put my clothes on and we went home.
No bullshit,
Mark
We relaxed on the heated floors with Grace and Sophie, checked out the different sauna rooms--there were 7*C, 35*C, 50*C, and 75*C ones (American readers, multiply by 9/5 and add 32)--all of which were quite nice, and grabbed some mediocre food from the food court.
People hanging out in the lounge area.
The cold sauna room--being from Michigan, neither a foreign sensation nor a pleasurable one.
This post will be pretty devoid of photos from here on out; I'm sure you understand.
It was a very relaxing experience, and though it's a fairly foreign concept to Americans, I can see why so many people frequent these places to veg out on the weekends. That being said, after several hours, we were ready to move onto the next thing, so we headed back to our respective mogyoktangs to check out the saunas and baths there for a bit (because really after the initial encounter, it's not much of an issue anymore) before heading out.
Well I had just climbed into the 50*C (122*F, which is fucking hot) bath when we heard a rather loud, dull thud somewhere close by. I didn't really think much of it right away, so I continued to cook myself alive for another several minutes, trying to convince myself--amidst thoughts of ring worm, Pseudomonas skin infections, and reduced sperm counts (#medstudentproblems)--that this was a comfortable and relaxing endeavor.
Well, that didn't work out, so I got up to go, but as I did, I saw that there was a young man in his early teens (Tanner stage 3) slumped against the tiled wall in the corner. His eyes were closed though he was stirring a bit, and when we asked if he was all right, he said yes and stood up to leave the mogyoktang area. Something was still very not right about him though, as he staggered across the room, stopping to center his balance several times, and once we saw him lie back down on a bench in the towel area, Peter and I decided to go check on him. In the better lit room, he appeared quite flushed, sweaty, and disoriented, and he felt rather too warm to the touch.
In the medical world, first things are first to assess for any immediately life-threatening issues: the ABCs. A: airway, he was talking and didn't look like he aspirated any water (fine). B: breathing, he was breathing well though maybe a bit quickly, and both lungs looked to be moving equally (fine). C: circulation, his pulses were strong and regular--less concern for something heart-related causing his collapse (fine).
With Peter translating, we then attempted to get a history from him: he didn't remember slipping and falling or losing consciousness, but he also couldn't recall how he ended up on the floor. He was only answering questions with short sentences in somewhat slurred Korean and he wasn't keeping his eyes open, so we were starting to get pretty worried about him. I asked the attendant to get him a towel to dry him off and he also came back with a portable oxygen mask. In the meantime though, the boy began to retch, so I grabbed a garbage can and he vomited into it.
Since he wasn't communicating well, we had to do our best to find out by other means if anything gravely serious was going on. Unfortunately, no one else in the area seemed to witness what happened to him, if he fell or if he convulsed, and no one there knew who he was. So while I grabbed my phone to check his pupil reflexes with the flashlight (they were normal), Peter checked the vertebrae in his neck for any step-offs suggesting a fracture (none) and we looked over his scalp for any large hematoma (collection of blood under the skin) suggesting that he fell and hit it (maybe, hard to tell). As we continued the exam, he seemed to be improving, sitting up better and interacting more. There were no other obvious injuries to his head, face, or the rest of his body, he could move all four of his extremities with good strength, decent coordination, and sensation, and his cranial nerves (special nerves in the head that are easily tested and can indicate if something is wrong in the brain) all seemed to be normal.
By this time, he was able to tell us his name, where he was, what day it was, that he was here with his mother who was in the women's mogyoktang, and that he didn't think he had ever had a seizure before (something that could have caused his fall and confusion), but that he had fainted in the past. He remembered feeling dizzy and thought he then fell down and hit the back of his head.
While the staff tried to find his mother, Peter and I talked through what could have happened. The most likely scenario was that he was in one of the hot baths and had a vasovagal reaction--a fainting spell--causing him to fall and hit his head. It could also have been a seizure, but that's less likely since he hadn't had a history of them before and no one saw him shaking or convulsing before or after the fall; a heart condition causing the fall was even less likely given his age and normal pulses.
The fall itself was a separate and more pressing issue, regardless of whether he lost consciousness and fell or fell first and then lost consciousness. A fall, even from just standing height, onto a hard tile floor could cause a concussion, basically a hard collision of the brain against the inside of the skull--caused by a very fast acceleration or deceleration--basically bruising the brain. This can cause confusion, loss of consciousness, nausea, vomiting, dizziness (all symptoms he had), and even cognitive and emotional changes. Less likely, but a serious enough complication that it always needs to be evaluated for is something called an epidural hematoma, a bleed, caused by trauma, that builds up in the space between the skull and the outermost covering of the brain--the dura mater. This collection of blood can grow rapidly over time, even in people who feel and act completely normally for minutes to hours after the injury, and eventually cause so much pressure on the brain that it herniates out through the base of the skull into the spinal canal, causing death (it's what killed Liam Neeson's wife after a skiing collision--she felt fine and didn't seek medical care and never woke up from her nap). Since he was young, improving, and had a normal exam, this was unlikely. The most likely scenario was that he had a vasovagal reaction to a hot bath causing a fall from standing height onto the back of his head, causing a concussion, and he should probably go to the ER to be observed or worked up there to be safe.
In a serious situation, it's interesting how peripheral details evaporate away in their irrelevance as the task at hand dominates one's primary focus.
It was around this point that I remembered that I was completely butt ass naked.
The patient was butt ass naked.
My friend was translating and examining the patient butt ass naked and about a dozen concerned Korean men of varying age, fitness, and assertiveness were crowded around the bench offering help and asking questions in Korean. Butt. Ass. Naked. The only asshole who wasn't naked was the fucking attendant who made me strip down in front of all these people in the first place.
In that moment, the inundation of so much reality at once was just too much and I needed a moment to not only accept that I could simultaneously add and cross off "work up a trauma patient while completely nude" off my bucket list, but also properly react to the experience by, much to the bewilderment of all the naked Korean dudes in the changing room, laughing hysterically to myself.
Shortly thereafter, the kid's mother arrived and Peter went to go tell her what had happened and what would be most important to tell the doctors at the ER.
I put my clothes on and we went home.
No bullshit,
Mark
Updates and Things:
Minook and Minsoo know American swear words (2/15): Who knew? I was playing a videogame in the common room--it wasn't going very well--and a few choice expletives escaped my lips. The kids started giggling, Grace hit me, and I learned something new about Minook and Minsoo's English vocabulary.
Rank list (2/25): My rank list for residency programs is officially submitted (unless I did it wrong and now I'm not going to match because the deadline's passed), so now it's just a waiting game until March 20th to find out where I'll be doing my Internal Medicine & Pediatrics training!
More housemate changes (2/27): Mina and Mohammed moved out, which is sad, but they were both so quiet that it hasn't changed things too much around here. Megan, another American student (from Minnesota) moved in and is adapting well. She is a bit shy, which belies her formidable drinking abilities, studies Korean and Social Sciences or something at Yonsei, and excels at getting hit on by married Korean men at the club.
Taiwan (3/2): I have a couple other medical school friends who are doing away rotations in Taipei this month, so I'm going to go over there tomorrow for a few days to see a bit of Taiwan. I'm really excited to see another Asian country, especially one that's subtropical, but that means no blog posts for a while and I may be incommunicado if my Korean SIM card doesn't work there--I should be able to get wifi though so I'll have access to my gmail, iMessage, Whatsapp, and KakaoTalk.
Reading the words "milk goggles" made me weep a little just now, Markus.
ReplyDeleteThank you.