A Surgeon Who Uses Martial Arts [EN]: Chapter 121

The Resident (1)

“You have a phone call, sunbae [senior colleague]. It’s Jun-hoo.”

“Who is it?”

“Jun-hoo.”

Kyung-soo nonchalantly handed over the receiver, and Min-kyung took it.

She had been wondering about Jun-hoo’s recent activities since he went down to the emergency room.

His return was delayed as if he was creating patients out of thin air.

Given Jun-hoo’s personality, he wouldn’t be slacking off.

Jun-hoo would even use the smallest scraps of time to read neurosurgery books.

However, what Min-kyung was curious about was the condition of the patients Jun-hoo was seeing.

“Oh, Jun-hoo. You’re taking a long time. Is the situation serious?”

-Yes, sunbae. I took a head CT scan, and it showed a subdural hematoma [a collection of blood outside the brain]. It seems the patient is also doing drugs.

“Huh? A subdural hematoma and drugs? Aren’t you taking the joke too far?”

The notification was so shocking that Min-kyung couldn’t easily believe it.

However, the laughter was completely gone from Jun-hoo’s voice that followed.

-I confirmed pinpoint pupils in the pupillary reflex, and I also smelled weed. It seems like long-term drug use has caused damage to the cerebral blood vessels.

Jun-hoo poured out a storm of notifications for 2 minutes.

Min-kyung just listened.

Jun-hoo’s examination and tests were impeccable.

You could feel that he had meticulously observed the patient.

Jun-hoo’s notification was also clean.

He only conveyed the necessary information without any unnecessary details.

So Min-kyung felt reassured.

The fact that Jun-hoo had entered neurosurgery as a first-year resident… Wasn’t Jun-hoo a talent coveted by all surgical departments?

“Wait a moment, let me check the images.”

Min-kyung displayed the CT images on the monitor and carefully examined them.

The hematoma was located in the temporal lobe [area of the brain responsible for memory and language]. And the current length was about 3 centimeters.

“Hmm… There’s no need to admit him to the ward, we can just admit him to the emergency room, right?”

-……

“Let’s monitor the progress while treating with medication. Elevate the patient’s head to 45 degrees and administer mannitol (diuretic) and glycerol (hyperosmotic agent).”

-Sunbae. Shouldn’t we consider ICP monitoring (Intracranial Pressure monitoring) [a procedure to measure the pressure inside the skull]?

“ICP? Medication is enough.”

Min-kyung shook her head.

Jun-hoo’s order was excessive.

ICP monitoring was a procedure to open a part of the patient’s head and insert a tube.

It was a procedure to lower the patient’s brain pressure and measure the brain pressure.

It was not a necessary procedure for the patient Jun-hoo was currently treating, unless the hematoma was larger, or there was a head injury, or there was damage to the cerebral blood vessels.

“Jun-hoo, you’re good at everything, but you tend to look at patients too deeply. In other words, you worry too much.”

-……

“Sometimes it’s necessary to keep a proper distance from the patient and observe them calmly.”

-I’m very calm right now. If you take my temperature now, it might be around 34 degrees [Celsius, indicating extreme calmness or even coldness].

“Anyway, you’re full of wit. Put in the medication order and come up quickly.”

-Sunbae. No matter how I think about it, I think it’s right to do ICP monitoring.

Jun-hoo showed no signs of backing down.

So Min-kyung got a little angry.

If he made a notification, shouldn’t he listen to his senior?

Why is he talking back so much today?

“Jun-hoo, let’s not cross the line. You have to follow the order if your senior gives it.”

-I don’t want to fight with you either, sunbae.

“Come on. Not listening to me means you want to fight with me, right?”

Min-kyung raised her voice without realizing it.

-I’m saying this because the patient’s condition is getting worse and worse with medication alone.

Jun-hoo continued calmly.

-I’m seeing the patient directly in the emergency room.

“……”

-Please don’t hang up. I’ll evaluate the GCS (patient’s level of consciousness) [Glasgow Coma Scale, a neurological scale used to assess the level of consciousness] and notify you right away.

Jun-hoo’s voice was heard over the receiver.

Jun-hoo kept asking the patient something.

But Min-kyung’s expression was indifferent as she waited for the results.

Min-kyung had already told him the best treatment.

What’s the point of measuring GCS now?

He’s still turning his eyes on the patient.

Why do you assume the worst situation for every patient?

You can watch the situation step by step.

“Jun-hoo. Are you done?”

-Yes. I just finished.

Jun-hoo immediately announced the patient’s GCS score.

Eye opening: 2 points.

Verbal response: 3 points.

Motor response: 3 points.

The patient’s GCS score was quite low at 8 points.

Certainly, the patient’s condition had deteriorated compared to when the emergency medicine department first examined him.

The patient only opened his eyes to painful stimuli.

He only uttered words without completing sentences.

And he showed a flexion response to pain.

-Sunbae. If the GCS score is below 8, isn’t it right to monitor ICP?

“Oh, it’s right, but…”

Min-kyung scratched her cheek and continued.

“The hematoma is small, so I think it will be absorbed naturally enough, right?”

-Shouldn’t GCS take precedence over hematoma size? That’s what I learned in the textbook.

“Textbooks are not always right. You have to interpret them differently depending on the situation.”

Drrrrr.

As she was trying to persuade Jun-hoo again, Hee-joon, a 3rd year, came in as the on-duty room door opened.

“Jun-hoo. Wait a minute. Sunbae, I have a question.”

“What is it?”

“I’m trying to notify you about an emergency room patient. There’s a bit of friction between me and Jun-hoo in the treatment plan.”

“Friction? Isn’t it over if Jun-hoo listens to you?”

Hee-joon raised his head as if he didn’t understand.

A first-year resident was still a baby.

It wasn’t the time to judge something on his own.

Usually, if a problem arose, he would notify his superiors and follow orders.

“That’s what I’m saying. But Jun-hoo won’t listen to me. But I thought he might listen if Sunbae told him.”

Min-kyung notified Hee-joon of the current situation with a mix of complaints.

Hee-joon, who was listening to the notification with his arms crossed, shook his head.

“Min-kyung, you were wrong this time.”

* * *

Drrrrr.

Jun-hoo was pulling the bed to the operating room.

He was following Min-kyung’s order, after talking with Hee-joon, a 3rd year.

Min-kyung suddenly changed her decision to do ICP monitoring.

In fact, Jun-hoo didn’t think Min-kyung’s decision to treat with medication was wrong.

The patient’s hematoma was not that big.

It was worth expecting natural absorption with medication.

But still, no matter what anyone said, the best treatment now was ICP monitoring, because it can immediately lower the patient’s brain pressure and monitor the patient’s brain pressure.

But is there any need to choose the next best thing when you can do the best treatment?

Jun-hoo couldn’t understand that point.

Just like wanting to give only good things to his family, Jun-hoo wanted to give only good things to the patient.

And he was sure that maintaining this mindset consistently would make him the best neurosurgeon.

That way, he believed he would not be ashamed of Sung-ho in heaven.

Jun-hoo, who got on the elevator, looked down at the patient.

The patient, who had been swaggering just 30 minutes ago, was now lying still like a dead mouse.

“Doctor. Giwoo, you’re not going to die, are you?”

The guardian looked at Jun-hoo with anxious eyes.

“Don’t worry. As I said before, it’s not a deadly disease. You’ll get better if you get neurosurgical treatment and are hospitalized for a few days.”

“Then that’s a relief, but…”

“It’s a relief, but it’s only half a relief,” Jun-hoo took over the guardian’s words.

“What do you mean?”

“I’m seriously warning you, quit drugs if you want to live healthy.”

“Drugs? We’ve never done anything like that!”

The guardian jumped up when Jun-hoo subtly pointed out whether he had inhaled drugs.

“What basis do you have for saying that? Aren’t you being too harsh?”

“Do you know what kind of drug I’m talking about and get so excited? Do you have anything to feel guilty about?”

“That… that’s…”

The guardian, caught in the leading question, avoided Jun-hoo’s gaze.

Jun-hoo closed his mouth because he didn’t think he would understand even if he said more.

Now that Jun-hoo had identified whether the two had inhaled drugs, anyway, the two could not avoid punishment.

[Ding-dong~ 4th floor.]

Jun-hoo pulled the bed and headed to the operating room with the guardian.

In the guardian waiting area, guardians who had sent their loved ones to the operating room were already sitting with anxious expressions.

“Wait here. The procedure will be over in 30-40 minutes.”

“Yes.”

Jun-hoo pulled the bed alone and headed to the operating room entrance.

Min-kyung was standing in front of the entrance.

“Go in and talk to me.”

* * *

Jun-hoo changed clothes in the changing room and scrubbed (disinfected before surgery) in front of the sink.

Buck. Buck. Buck.

The disinfectant-soaked brush mercilessly rubbed Jun-hoo’s fingers, finger gaps, palms, and forearms.

Min-kyung was also scrubbing next to Jun-hoo.

“I was sorry earlier.”

Min-kyung first offered an open-hearted apology.

“Did Sunbae have anything to be sorry about? I should apologize. I’m the one who made a different noise after receiving the order.”

“Because you said the right thing and I said the wrong thing. I’m a senior.”

Min-kyung continued calmly.

“I should have thought about GCS first, but I insisted on drug treatment, right?”

“It was worth judging that way.”

“No. It’s my fault.”

“……”

“When I thought about it, I think I was too lazy to do ICP monitoring. It was a kind of laziness.”

“……”

“Also, I think I had a desire to control you as a 2nd year.”

“……”

“I wasn’t fit to be a senior in many ways. I apologize for that.”

Jun-hoo was impressed by Min-kyung’s honest confession.

Looking straight at the inside and confessing the inside to others requires great courage.

Min-kyung did both at the same time.

That alone was a necessary and sufficient condition for Min-kyung to become a good senior.

Is that why? Jun-hoo rather felt attracted to Min-kyung.

“Sunbae, that was cool just now. It was like a drama line.”

“I know.”

Min-kyung joked.

The two burst into laughter at the same time.

After wearing surgical gloves, masks, and surgical caps, the two entered the operating room.

The air in the operating room was cool.

The operating room was kept at a colder temperature than the outside to prevent infection and prevent the spread of germs.

Jun-hoo loved this coolness.

The cold air sharply sharpened Jun-hoo’s mental strength and concentration.

“Doctor. Did the anesthesia just end? Can I go up first?”

“Yes. Thank you for your hard work.”

“You two have a hard time too.”

The anesthesiologist, who arrived first and finished general anesthesia, left the operating room.

ICP monitoring was tricky, but it was an area of treatment, not surgery.

There was no need for an anesthesiologist to stay in the operating room to monitor vitals.

Thump. Thump.

Jun-hoo and Min-kyung approached the operating table.

Whether an intern had come and gone, a dressing cart with treatment tools was neatly placed next to the operating table.

“I’ll do the ICP, so Jun-hoo, would you like to do the shaving?”

“Yes.”

Jun-hoo picked up a razor from the dressing cart.

Shaving was literally cutting the patient’s hair. This was done to prevent contamination or infection of the patient’s head incision due to hair.

Shave. Shave.

Jun-hoo cut the patient’s hair with a razor.

There was no hesitation in the hand movements.

The hand movements were precise.

Jun-hoo’s hand never went awry and accurately cut the hair.

There were no skin injuries either.

It was natural.

In Murim [martial arts world], Jun-hoo was a swordsman, and the razor was also an extension of the sword when interpreted broadly.

If it was about using a sword, Jun-hoo was confident that he would not be behind anyone in modern times.

“The shaving is always art. Even the chief can’t do this.”

Min-kyung, who was watching Jun-hoo’s shaving, continued in an admiring tone.

“Are you going to open a barbershop later?”

“I’ll think about it when I retire later.”

After finishing the shaving, Jun-hoo collected the patient’s hair separately and put it in a plastic bag.

Min-kyung, who thought the sight was strange, tilted her head.

“Why do you keep your hair? You have to throw it away as waste. You don’t have any strange hobbies, do you?”

Jun-hoo answered as if he had been waiting.

“I don’t have any strange hobbies. This patient did drugs. I have to keep my hair and report it. Treatment is separate.”

Min-kyung shook her head at Jun-hoo’s clear answer.

All right. I lost. I lost.