A Surgeon Who Uses Martial Arts [EN]: Chapter 178

Chapter 33: Parabola (3)

The surgery observation room was usually empty.

Most people who observed surgeries were surgeons themselves, and surgeons were too busy with their own schedules to watch others’ surgeries.

Their days were filled with their own surgeries, outpatient care,

writing papers, and research.

But today, for once, a middle-aged man occupied a seat in the observation room.

It was Park Jaehyun.

Jaehyun sat in the frontmost, center seat out of the total 20 seats.

He alternated between looking at the large monitor showing the overall view of the operating room

and the large monitor showing the surgical site directly.

Jaehyun’s gaze was sharp.

Like a soccer coach analyzing a game.

“So far, so good.”

Jaehyun nodded, muttering to himself like a typical middle-aged man.

Donghoon’s awake surgery team was well-coordinated.

They didn’t seem to exchange opinions or

give instructions, yet they were proceeding smoothly with the surgery.

The process from scalp incision to dura mater [the tough outer membrane covering the brain and spinal cord] resection was seamless.

Just like popular ball sports such as soccer, basketball, and baseball,

harmony among the staff is crucial in surgery as well.

And Donghoon’s team already had that harmony.

If there were no variables, the surgery would likely end without incident.

If there were no variables…

* * *

“Oh my, Dr. Park, it’s been a while!”

Pyo Seongdeok, who had entered the observation room, made a fuss and sat next to Jaehyun.

Pyo Seongdeok was the head of the Department of Neurosurgery at Shinwon University Hospital.

With his graying hair,

unusually large nose, and large, wide earlobes like Buddha’s,

Seongdeok appeared kind and warm on the outside, but he wasn’t on the inside.

He was the embodiment of greed itself.

If he weren’t close to Junhoo or Donghoon, he wouldn’t have even considered coming to observe.

“Dr. Pyo, how have you been? It’s been a while.”

“Indeed. It’s been a year since I saw you at the neurosurgery seminar last year. Good to see you, good to see you.”

Seongdeok offered a handshake, and Jaehyun shook hands with Seongdeok.

“What brings such a precious person like you to observe surgery at our hospital?”

“It’s an interesting surgery.”

“Well, the patient has to be a VIP. None other than Korea’s top pianist.”

Seongdeok said proudly.

While Jaehyun was interested in the surgery itself,

Seongdeok was interested in the patient’s influence.

Seongdeok was originally this kind of person.

A person who calculated everything and weighed the pros and cons.

Donghoon’s surgery team, who was currently performing the surgery, must have been under great pressure from Seongdeok.

He wouldn’t let them off easy if the surgery failed.

Jaehyun suddenly felt sorry for Junhoo and Donghoon, who were working under such a narrow-minded boss.

“What do you think of this surgery?”

“Awake surgery has so many variables that I’m hesitant to say anything rashly.”

“Come on, don’t be so reserved. A surgeon of your caliber wouldn’t be watching the surgery without any thoughts, would you?”

“My personal opinion may act as a prejudice to you, Doctor.”

“Professor Park’s opinion wouldn’t be a prejudice, but a correct theory.”

Seongdeok stubbornly pressed.

He showed no signs of backing down without an answer.

Jaehyun sighed softly.

“Then I’ll be honest with you. I’d say about 70 percent.”

“Oh. That’s good enough. Reassuring.”

“Not the success rate, but the failure rate.”

“Huh? Are you serious?”

Seongdeok’s smile, which had been wide open, crumpled.

“Yes. I heard from Professor Donghoon yesterday that they belatedly confirmed that the patient suffers from panic disorder.”

“I heard too. But is that such a big deal? We can calm him down with psychiatric medication.”

“Using medication lowers the success rate of awake surgery. The patient’s response becomes dull, and sometimes they say things that contradict nerve stimulation.”

“…….”

“If it were me, I probably wouldn’t have performed awake surgery on this patient.”

Jaehyun revealed his conviction.

In order to perform a perfect surgery, one must first have perfect conditions.

But this surgery had a fundamental weakness.

That was the patient’s mental state was too weak.

A sensitive and delicate.

Even a pianist suffering from panic disorder.

Could he really handle the weight of awake surgery?

Frankly, Jaehyun was skeptical.

“Haha. I didn’t want to hear this kind of answer…”

“Still, let’s watch until the end. I’m not always right.”

Silence fell after the small talk.

Jaehyun crossed his arms and focused on the monitor.

He earnestly hoped that Donghoon’s surgery team would prove his judgment wrong.

* * *

After the injection of the arousal-inducing agent.

The staff were looking into Myunghan’s brain with a micro microscope.

It’s not easy.

Because the tumor is so large, it spans the parietal, frontal, and temporal lobes [regions of the brain responsible for sensory perception, higher-level thinking, and auditory processing, respectively].

Junhoo clicked his tongue while staring at the 4cm x 4cm meningioma [a type of tumor that arises from the meninges, the membranes surrounding the brain and spinal cord].

The tumor seen on the MRI scan and the tumor seen with his own eyes had a completely different presence.

There was a clear difference, like seeing a world-famous landmark in a photo versus seeing it in person.

Junhoo, who had been overwhelmed by the tumor, quickly regained his composure.

He displayed the MRI and CT images with pre-surgical brain mapping on the monitor, away from the operating table.

He also set up the nerve stimulator.

The nerve stimulator was a metal rod that looked just like a radio antenna.

“Hmm…”

Soon, Myunghan blinked his eyes with a groan.

The curtain of awake surgery had risen.

“Professor, let’s begin.”

“Alright.”

Junhoo turned up the volume of the pre-installed speakers and played a piano piece.

The majestic piano piece instantly swallowed up the minor noises of the operating room.

A piano performance in the operating room…

Junhoo felt awkward and unfamiliar with this combination, which he was experiencing for the first time.

“Are you feeling a little more awake? Where are you?”

“Is this… the operating room?”

Myunghan looked around and answered Donghoon’s question.

“Yes. That’s right. How are you feeling?”

“Not so good. My body feels heavy like cotton soaked in water. My head is throbbing too.”

“You don’t have to worry too much. It’s just a side effect of waking up from anesthesia.”

“Ah, yes. But I think I hear a piano performance. Is it a hallucination?”

“No. You heard correctly. We turned it on for the patient’s comfort.”

“Who chose the song?”

“I did.”

Junhoo, who had returned to the operating table, answered.

“I had a feeling it was you. I guess you studied something other than music too.”

The piece currently playing was Beethoven’s Piano Concerto No. 5, Emperor.

It was the song that Myunghan had revealed in various interviews as his favorite.

Perhaps thanks to Junhoo’s meticulous consideration for him.

Perhaps because he was with his favorite song.

Myunghan’s mind calmed down. He was able to overcome the unfamiliar sensation and tension of the operating room.

“I have a question.”

“Yes. Please tell me.”

“Is my head open right now?”

“Yes. Sometimes we use the expression ‘your head is open,’ right? That’s exactly the situation. How do you feel?”

Junhoo used the joke that his teacher Jaehyun had made.

Then Myunghan chuckled.

Indeed, Jaehyun’s jokes had a good batting average. He would probably use them often in the future.

“It’s not as bad as I thought. What should I do now?”

“Just relax and play the piano as you are now.”

“Play the piano? But there’s nothing here?”

“Please wait a moment.”

Junhoo took out the sterilized electronic keyboard that he had placed on the supply shelf and placed it on Myunghan’s lap.

It was a Bluetooth-enabled product.

And since it had been pre-charged, there was no problem using it right away.

This was Junhoo’s second trump card prepared for awake surgery.

Click.

When Junhoo turned on the switch, the power light on the top of the keyboard lit up.

“Wow. You’ve prepared a lot. I didn’t expect this.”

“We didn’t expect it either. It’s all thanks to Junhoo, who thought about the patient and pondered everything from start to finish.”

Donghoon, who had been silent, praised Junhoo.

Chanyeol was also looking at Junhoo with a pleased expression.

Junhoo just smiled awkwardly at the praise and attention pouring in from those around him.

It wasn’t an action done to receive praise or

recognition.

Junhoo had simply been faithful to his duty as an attending physician.

Anyway, it’s a relief.

Things are going smoother than I thought?

No signs of panic attacks, and the atmosphere in the operating room is friendly.

If Myunghan maintains his mental state, it might end smoothly.

Junhoo was filled with a bit of hope.

The current situation was that good.

Having a moment of leisure, Junhoo looked up at the observation room and nodded lightly.

It was a thank you to Jaehyun, who was watching the surgery.

The basis of Junhoo’s performance was what he had gained from observing Jaehyun’s surgery a few days ago, so he expressed his respect.

“Can I play one song before the surgery starts?”

“Of course. As much as you want.”

Donghoon nodded at Myunghan’s request.

Soon, Myunghan’s performance began.

The intense and powerful piece was Spring from Vivaldi’s Four Seasons.

Even if you don’t know the name of the song, it was a song that everyone had heard at least once.

As expected, world-renowned pianist Myunghan’s performance was different.

The vitality of the sprouts breaking through the barren and hard earth of winter was felt directly in the performance.

Myunghan’s performance briefly turned the operating room into a concert hall.

The season in the operating room became spring.

Myunghan’s hand movements were flamboyant yet disciplined, and disciplined yet soft.

He freely crossed the white and black keys.

Junhoo was also mesmerized by Myunghan’s performance.

At the same time, he had a thought.

That piano was everything to Myunghan.

If this surgery failed, Myunghan’s life might fall into an uncontrollable quagmire.

“Then, are you ready?”

“Yes.”

Myunghan showed confidence in Donghoon’s question.

“Then, please continue with a simple performance. We’ll start the surgery too. Everyone to your positions.”

“Yes. Professor.”

“Yes. Professor.”

At Donghoon’s order, the staff scattered.

The full-scale practical brain mapping had begun.

Junhoo took his place in front of the monitor and keyboard, slightly away from the operating table.

Junhoo’s role was mapping.

Donghoon and Chanyeong would stimulate the patient’s brain with a nerve stimulator to find out the function of that area.

He was in charge of recording that function.

“Okay. What do you feel now?”

Donghoon stimulated the uppermost part of the patient’s brain tumor with a nerve stimulator and asked.

“Ugh… my left leg is tingling?”

“Uppermost part of the brain tumor, left lower extremity motor nerve.”

“Confirmed.”

Junhoo dragged the area with the mouse and wrote down what Donghoon said.

The uppermost part of the brain tumor was an area that had nothing to do with piano performance.

Therefore, it would be resected after mapping.

Myunghan might have some difficulty walking after the surgery, but unfortunately, there was no other way.

Brain tumor resection that completely preserves all nerves was just a wishful thinking.

Especially when the size of the brain tumor is large like Myunghan’s.

And when the brain tumor invades various areas.

“Okay, how is it now?”

“My right wrist doesn’t move well.”

“It was an area that was originally planned to be resected, but it almost became dangerous.”

“Yes. Professor. It seems that the sensory nerves related to the arms and hands are wide, probably because he is a pianist.”

Donghoon whispered softly so that only Chanyeong could hear, and Chanyeong also answered in a voice as cautious as Donghoon’s.

This was the very reason for the existence of awake surgery.

Depending on the environment in which they grew up and what they have learned, the nerve distribution of people is subtly different.

But awake surgery was able to capture that subtle part.

If the tumor had been resected following the general nerve distribution.

Myunghan would not have been able to use his right wrist properly after the surgery.

“Junhoo, exclude the brain tumor LUQ (left upper quadrant) [a specific region or section of the brain tumor] .”

“Yes. Professor.”

The following mapping was smooth.

Out of the total 30 minutes of the process, up to the first 10 minutes.

During that time, Junhoo mapped and checked Myunghan’s condition.

But, ominously, Myunghan’s condition seemed to be getting worse.

First of all, Myunghan’s expression was gradually hardening.

He thought it was just his imagination, but when he checked the patient’s monitoring device, it wasn’t just that.

The pulse, which had been maintained in the 80s, soared to 130.

The blood pressure, which had been maintained at 120mmHg/80mmHg, rose to 150mmHg/100mmHg.

There was no way that bleeding had occurred.

This had to be taken as a sign that Myunghan was severely nervous.

In other words, Myunghan’s mental state was slowly collapsing.

The fact that the initially bright piece was gradually becoming gloomy was enough to increase Junhoo’s anxiety.

He must have become anxious because they started nerve stimulation.

Even though the brain cannot feel pain, nerve stimulation causes pain in the area connected to the nerve.

The atmosphere in the operating room must be unfamiliar and scary.

Mr. Myunghan.

Just hold on for 20 more minutes, no more, no less. If you hold on for 20 minutes, you can play for 20 more years.

While mapping under Donghoon’s instructions.

Junhoo kept a close eye on Myunghan again.

While Donghoon and Chanyeong were busy exchanging opinions, Myunghan suddenly made an unexpected move.

He suddenly stopped playing.

He was about to bring the hand that had stopped playing to his head.

If his hand or fingernails touched his brain.

It was a critical situation where infection and even abrasions could occur in the brain.

Oh… crazy!

Junhoo, who was startled, stepped on the movement technique and ran to the operating table.

Using the technique of Geumna-soo [likely a martial arts or medical technique involving swift hand movements].

He snatched Myunghan’s wrist, which was about to touch his head.

“What are you doing?”

Junhoo’s thunderous roar erupted.