1. "A Place Where Night Feels Like Day": Extreme 64-Hour Shift
"At this rate, everyone will die." This was an expression included in presentation materials presented on June 28 by Professor Kim, who had been solely responsible for the Neonatal Intensive Care Unit (NICU) at Chonbuk National University Hospital, when announcing his resignation. Professor Kim said, "If I endure, I feel the system will collapse even further," pointing to the staffing reality where high-risk patients are increasing due to more late-age pregnancies, while applications from medical residents to specialize in pediatrics—and specifically neonatal subspecialties—have virtually dried up. Coincidentally, less than a week after Professor Kim left, a newborn baby in Jeonju, where Chonbuk National University Hospital is located, struggled overnight to find a hospital transfer and was barely moved to an NICU in another region, but ultimately passed away. To examine the working reality of NICUs outside the capital area, the reporting team accompanied Professor Lee Byung-guk of the NICU at Sejong Chungnam National University Hospital, who treats critically ill newborns in the Sejong and Chungbuk regions, during his night shift. Even before 6 p.m., when his night shift began, Professor Lee had already been working for 40 hours.
[Lee Byung-guk / Professor of NICU at Sejong Chungnam National University Hospital: "A baby was in critical condition during the early morning hours between Sunday and Monday, so I came to work at 2 a.m. and will be working until 6 p.m. on Tuesday and Wednesday."]
In other words, it was a continuous shift totaling 64 hours. Continuous shifts of dozens of hours are said to be routine in NICUs across the country, because 24-hour monitoring and immediate necessary care are essential.
[Lee Byung-guk / Professor of NICU at Sejong Chungnam National University Hospital: "In a brief moment, a baby's respiratory rate could drop to zero, or their blood pressure could plunge, which could cause a brain hemorrhage. We have to administer treatment as quickly as possible to prepare for such situations."]
On this day as well, all 20 beds in the NICU were full. Most of the patients were premature babies born before completing 37 weeks, and several were extremely low birthweight infants weighing less than 1 kg.
[Lee Byung-guk / Professor of NICU at Sejong Chungnam National University Hospital: "For babies born weighing less than 1 kg, many severe, critical situations frequently arise within the first week. So even if it doesn't show on the surface right now..."]
Due to these characteristics, experienced specialist medical personnel are essential in the NICU.
[Lee Byung-guk / Professor of NICU at Sejong Chungnam National University Hospital: "When newborns experience even a slight change in condition, they cannot express it, and visible symptoms are extremely subtle. If these are not caught as early as possible, in most cases it leads to lifelong complications. For example, if a premature baby remains in poor condition for an extended period, it can lead to a brain hemorrhage, which as they grow can result in cerebral palsy or nerve paralysis, making normal social life difficult. To detect these things as quickly as possible and treat them as effectively as possible, experienced personnel are needed..."]
The night shift also runs frantically without a moment to catch one's breath. The professor frequently checks the condition of a premature baby with a weak heart in an incubator who was admitted to the ICU immediately after birth, and performs procedures inside the ICU such as inserting a catheter into an artery to measure blood pressure for a baby whose blood pressure has dropped—where even finding the artery is no easy task.
[Lee Byung-guk / Professor of NICU at Sejong Chungnam National University Hospital: "If you look at the wrists of these babies, they are this small, and the radial artery inside is tiny. You have no choice but to locate it by feeling the pulse directly, because it's not visible to the eye. While placing an arterial catheter in such small blood vessels, complications can also arise. There is the risk of bleeding, the risk of infection, and if a blood clot forms because of this, tissue necrosis in the surrounding area can certainly occur."]
Even past midnight, checking on "Teunteun-i" (a fetus nickname meaning "Healthy"), a baby weighing less than 600 grams, continues repeatedly.
[It has been seven hours since we arrived here, and it is past midnight. As you can see, it does not look like night; it looks like day.]
2. Eating, Sleeping... Everything Is a Struggle
Because they must monitor the situation 24 hours a day and deliver continuous necessary treatments, even getting a proper meal is difficult. Professor Lee skipped dinner the previous evening, and on this day, he made a moment to visit a convenience store inside the hospital to buy dinner.
[Lee Byung-guk / Professor of NICU at Sejong Chungnam National University Hospital: "A sandwich, plain milk, and a protein drink."]
[Lee Byung-guk / Professor of NICU at Sejong Chungnam National University Hospital: (Days without emergencies are the best, right?) "That is my hope. Actually, because we never know when a baby will be born, we need to always be on standby. But my biggest hope is to remain on standby with no work and no urgent patients. That would mean the babies aren't sick. That is my biggest hope."]
During a brief lull, while eating his meal in his lab right next to the ICU, he also had to prepare for his medical school lecture scheduled for the next morning.
[Lee Byung-guk / Professor of NICU at Sejong Chungnam National University Hospital: "Tomorrow, I have to give a four-hour lecture to medical students all at once. Time is tight because of the patients, but I am trying my best to get tomorrow's lecture ready."]
After stealing a quick nap past 1 a.m., he woke up an hour later to attend to patients once again. Nurses working three shifts are equally busy day and night. Taking care of two or three babies each, they feed them milk formula every three hours and check for any abnormalities.
[Yoon Ye-rin / Nurse at NICU, Sejong Chungnam National University Hospital: "When an alarm rings, we have to run right over, so we always have to stay attentive. (Is it uncomfortable even going to the restroom?) Yes. So I have to ask a colleague nearby, 'I'm going to the restroom, could you watch over for a moment?' before I can go."]
3. "If Something Happens to Me Tomorrow, This Place Will Be Empty..."
Caring for patients in all 20 beds alone is overwhelming, but even when full, the hospital quite frequently receives requests for transfers due to external emergency situations.
[Lee Byung-guk / Professor of NICU at Sejong Chungnam National University Hospital: "We almost never turn away emergency patients nearby just because we are tired. We only refuse when it is physically impossible. If we were truly unable to accept a patient, we stay on edge listening for news afterward. If a problem occurred, I suffer from a sense of guilt, thinking, 'Should I have accepted one more patient then?' or 'Should we have pushed ourselves to take them in?'"]
According to a recent complete enumeration survey by the Korean Society of Neonatology, there are currently 65 open NICUs nationwide, with a total of 199 neonatologists. Sixty-five percent of neonatologists were concentrated in the Seoul metropolitan area, while Sejong, Jeonbuk, and Jeju had only two each, and Gyeongbuk and Chungbuk had only one each. Specialists like Professor Lee who handle both daytime treatment and night shifts account for 78%, or 154 doctors. Over the past three years through June this year, 98 specialists resigned or transferred from NICUs nationwide, and 30 specialists plan to resign or expressed an intention to resign within the next year, pushing staff attrition beyond alarming levels. The crisis is now reality. Seventeen NICUs—27%—responded that if even one specialist leaves from their current staff, "operation would become impossible and closure would have to be considered."
[Lee Byung-guk / Professor of NICU at Sejong Chungnam National University Hospital: "My neck is giving me a lot of trouble due to a herniated disc, but I am holding on. I hope it recovers, but if it worsens, or if something happens to my personal health tomorrow, this place will become empty. That shouldn't happen, but..."]
4. "I Respect You, Professor, But...": A Resident's Confession
With low compensation despite intense workloads and the potential for legal liability if something goes wrong with a baby, the NICU at Sejong Chungnam National University Hospital has had zero medical residents for seven consecutive years. In 2018, following the deaths of four newborns late the previous year at the Ewha Womans University Mookdong Hospital NICU, three medical staff members—including two professors and a head nurse—were arrested during the investigation. Although courts from the first instance to the Supreme Court eventually acquitted them, NICUs became a prime area to avoid.
[Lee Byung-guk / Professor of NICU at Sejong Chungnam National University Hospital: "Among the patients we see, in terms of premature baby survival rates, 10 out of 100 actually die. Among those, for babies weighing under 1.5 kg or under 1 kg, the mortality rate increases even further. No matter how hard we try and give our best, some of the patients we see inevitably face tragic outcomes, and a portion of surviving babies inevitably suffer complications. I believe fear (of potential legal burdens) felt in advance is a major reason pediatric residents refrain from applying for neonatal subspecialties."]
Professor Lee cannot forget the words left by the last resident who worked with him in the past.
[Lee Byung-guk / Professor of NICU at Sejong Chungnam National University Hospital: "When I suggested, 'You work so hard, how about working together in this field?', that resident replied, 'I respect you tremendously, Professor, and I think the work you do is truly wonderful. But I and my family cannot do it. It is far too difficult a job for us to handle.'"]
5. A Night in the NICU: His Final Request
Nevertheless, Professor Lee spoke about the driving force that keeps him fighting every day as follows:
[Lee Byung-guk / Professor of NICU at Sejong Chungnam National University Hospital: "The primary reward is when babies grow well here and are discharged, when parents hold them in their arms, seeing the parents happy—and the babies are actually happy too. Others might not know, but I feel I can sense it. Also, when they occasionally write letters or draw pictures like that... and that over there is drip coffee a mother made with her newborn's face printed on it; I haven't opened it because it feels too precious."]
After completing a 14-hour night shift, with 10 hours still remaining until he could go home, Professor Lee hurried off in the morning for his medical school lecture.
[Lee Byung-guk / Professor of NICU at Sejong Chungnam National University Hospital: "After finishing class at the medical school, I have to rush back, make afternoon rounds, check on the babies, stay on standby, and if anything special happens, administer treatment again..."]
Before the sun rose, during a particularly heavy night in the NICU, Professor Lee left these words of appeal:
[Lee Byung-guk / Professor of NICU at Sejong Chungnam National University Hospital: "It would be wonderful if we could save 100% of the babies and 100% of the mothers, but we are not gods capable of that. Although there may be shortcomings, everyone is truly doing their best in their respective places. When problems occur, if people try to help fix them and offer support rather than blame, I think we will be able to find a bit more strength."]
Reported by Han Sung-hee | Written by Shin Hee-sook | Video by Lee Byung-joo | Video Editing by Jang Yu-jin | Design by Lee Soo-min | Produced by SBS Digital News
※
Copying, redistribution, and unauthorized use in AI training are strictly prohibited.