After sending off the myocardial infarction patient, a brief peace settled over the emergency room.
I sat in an empty chair, staring into space with a completely hollow expression.

I got praised by both cardiology and cardiothoracic surgery.

Heh heh.

Oh right, I think shop points came in again earlier.
I was just about to check how much this time.

That was when the peace shattered.

“Male patient in his thirties, continuous vomiting!”

With the paramedic’s loud shout, the automatic ER doors flew open again.

The stretcher wheels screeched as they raced down the hallway.
On top lay a man who looked to be in his thirties, curled on his side, clutching his abdomen and groaning.

I reflexively stood up and moved alongside the stretcher.

“Are you conscious?
What’s bothering you?”

The patient seemed too exhausted to answer.
He glanced at me once, then immediately buried his face back into a plastic bag and started violently retching.

“Uwaeerrgh!”

The paramedic standing beside him answered for him with an awkward expression.

“He says that earlier this evening… um, he ate an entire bag of dried seaweed.”

My brain froze.

“…”

Did I hear that wrong?
Dried seaweed?
The kind you soak in water to make soup?

I doubted my ears and asked again.

“You ate dried seaweed?”

“Yes… uwaeerrgh….”

The paramedic added apologetically.

“He said it was crunchy, so he just ate the whole bag.”

It was a chief complaint I’d never heard in my life.

Dried seaweed gastronomy.

Is this guy out of his mind?

“What were his vitals?”

“On scene, BP was 140 over 90, pulse 110, respiratory rate 24.
He was alert.
It took about 15 minutes to reach him, and he kept vomiting during transport.
It’s been about 25 minutes total since arrival.”

Blood pressure slightly elevated, pulse and respiration fast.

If you think of it as pain and dehydration, it made sense.

He wasn’t dying right this second, but it wasn’t something I could just ignore either.

“Alright… let’s put him in A zone.”

Persistent vomiting like that could cause severe dehydration and electrolyte imbalance.

So I decided to place him in an A-zone bed.

The moment the patient was transferred, he curled up like a shrimp and started vomiting again.

I put on latex gloves and palpated his abdomen.
It was bloated overall, and he winced every time I pressed.

‘Is this a bowel obstruction?’

The worst-case scenario flashed through my mind.

Dried seaweed expands dozens of times its size when it absorbs water.
That massive amount of seaweed could have passed the stomach and clogged the narrow small intestine.

If that was the case, this wasn’t a simple incident but a surgical emergency requiring immediate intervention.

“Get two IV lines on this patient.
I’ll put in fluids.
Order abdominal X-rays, both supine and upright.
And send basic labs right away.”

A short while later, the X-ray results appeared on the monitor.

I scanned the screen with wide eyes, searching for the classic signs of bowel obstruction.

“There’s nothing?”

The X-ray was clean.

No, more precisely, aside from gastric distension, there were no findings suggestive of bowel obstruction at all.

The blood tests were also all within normal limits, except for mild dehydration.

The radiology read that arrived shortly after said the same thing.
No evidence of bowel obstruction.

Ah.

This isn’t bowel obstruction.

This is just…

The seaweed has massively swollen in his stomach.

It didn’t get stuck in the intestines.
The stomach itself is already completely overloaded.

The seaweed expanded dozens of times inside his stomach, compressing the gastric wall, and his brain is ordering his body to vomit to expel the foreign material.

I looked at the patient, still gagging and clutching his plastic bag, with a hollow expression.

Damn it.

Bowel obstruction, my ass.

Honestly, this was a relief.
If it were an obstruction, I’d have to call surgery and raise all kinds of hell, and the patient would suffer that much more.

“Doctor… am I going to die…?”

The patient asked between ragged breaths.

I looked at him with pity.

Why would you die?

You’re just hosting a seaweed party in your stomach.

The problem was how to end that party.

The first thing that came to mind was a Levin tube.
A thick tube shoved through the nose down into the stomach, hooked up to suction to drain the contents.
Crude, but effective.

‘Would that even work?’

I imagined it.

Me pushing a Levin tube into his nostril with my own hands.

The tube reaches the stomach, suction starts, but what comes up won’t be watery gastric fluid.

It would be swollen, sticky, slippery, unrecognizable green masses of seaweed.
The moment that mass clogged the tube opening, the suction machine would scream and stop.

It could injure the gastric mucosa.
It could cause GI bleeding.

The result would be disastrous.

The patient would suffer, and I’d be standing there holding a tube covered in seaweed sludge, staring into space.

This was beyond my level.

Still, just in case, I stared into the air for a moment to get confirmation for my judgment.

Title: Hey, patient came in after eating dried seaweed, can we do gastric lavage with an L-tube?
Author: HellJoseonSlave1

The gallery exploded with mockery and veered into a completely unexpected direction.

ㅇㅇ (210.94): Damn, first time in my life seeing someone eat seaweed and get hauled into the ER lol.
Oh right, I’m dead.

GodOfTheScalpel: The seaweed chunks are probably bigger than the tube diameter, yeah.

HippocratesDescendant: Seaweed?
What is that?
Why would one eat such a thing.
Truly incomprehensible, these Koreans.

– HematomaIsHell: Hey you foreign bastard, what do you know.
Seaweed and laver are delicious and healthy.
Packed with iodine and iron, cleans your blood.

– HippocratesDescendant: Such profound benefits!
Then this patient must be a martyr who nearly lost his life pursuing health through seaweed consumption!

– LatteIsLife: Martyr my ass.
He’s just an idiot.

My prediction that the Levin tube would clog was confirmed, and at the same time a wave of existential emptiness hit me from watching these otherworldly doctors argue about nonsense.

…Sigh.
Should I call gastroenterology?

Yeah.
This is the GI specialists’ territory.

They have endoscopes.
They can go in directly, see the seaweed field with their own eyes, and extract it with all kinds of bizarre tools.

But a first-year resident calling the GI fellow and saying, “The patient ate dried seaweed like a snack and is vomiting,” without even trying an L-tube first?

If I didn’t get cursed out over the phone, I’d be lucky.

In the end, I chose the most traditional and safest option.

‘Senior SOS.’

I left A zone and scanned the station.

Just then, fourth-year Yoo Seonghoon was stretching his stiff neck while charting.

I approached him with my most pitiful, serious, and urgent expression equipped.

“Doctor.”

“What.”

Yoo Seonghoon replied in his usual chronically exhausted voice.

“There’s a male patient in his thirties in A-3 with nausea and vomiting.
The case is a bit unusual, so I wanted to report it.”

“How unusual can it be.
Another drunk who blacked out?”

“No, it’s not that…
The patient says he ate an entire bag of dried seaweed like a snack.”

“…”

Yoo Seonghoon stopped moving.

Then he slowly turned his head to look at me.
In his eyes flickered a faint emotion that said, “What did I just hear?”

“What?”

“Dried seaweed.
The dried kind.
He ate a whole bag, and since then he’s been vomiting continuously and complaining of abdominal distension.
At first I suspected bowel obstruction and got X-rays, but there are no remarkable findings.”

I reported as calmly and clinically as possible.

When I finished, Yoo Seonghoon stayed silent for a moment.

Then he let out a short snort of disbelief and stood up.

“Let’s go.”

He headed toward A zone to see the patient himself.

I followed behind him.

Yoo Seonghoon pressed on the patient’s abdomen a few times, listened with a stethoscope, then turned to me with a resigned expression.

“What about a Levin tube?”

“I held off because it seemed like it would just clog.”

“Good call.”

After leaving that brief praise, he returned to the station and picked up the phone.

He was calling the on-call gastroenterology fellow.

I stood beside him, holding my breath and listening in.

“Hello, doctor.
This is Yoo Seonghoon, fourth-year emergency medicine.
Are you the GI on call?”

“…”

“Yes, doctor.
I’m calling because we have a patient in the ER with a rather absurd case that I think you’ll need to see.”

“…”

When the fellow asked something, Yoo Seonghoon hesitated briefly, then confessed.

“The patient ate a bag of dried seaweed raw.”

“…”

“Yes, doctor.
Not soaked, just like a snack.
The whole bag.”

Yoo Seonghoon’s brow furrowed slightly.

“Yes, I know it sounds ridiculous.
But he really came in like this and keeps vomiting.
No bowel obstruction on X-ray, but the stomach seems completely blocked.
We were wondering if this could be resolved endoscopically.”

After a long call, Yoo Seonghoon said, “Yes, doctor.
Understood.
We’ll be waiting,” and hung up.

Then, lowering the receiver, he said to me,

“Ha… all kinds of weird people out there.
GI is coming down.
When they do the scope, you should tag along and take a look.
You’ll probably never see something like this twice in your life.”

Of course, he probably didn’t literally mean for me to observe the endoscopy.
It was just that absurd.

A short while later, a gastroenterology fellow came down, his face twisted in irritation.

He gave the patient a quick glance and said, with the same resigned expression I’d seen on Yoo Seonghoon earlier,

“Let’s prep for endoscopy.
Gastric lavage won’t cut it.
We’ll have to go in and pull it out.”

In the end, the patient was taken to the endoscopy suite under the unprecedented diagnosis of
“suspected upper gastrointestinal obstruction due to acute dried seaweed ingestion.”

Watching him go, I thought to myself.

The emergency room really does get every kind of human imaginable.

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