A Surgeon Who Uses Martial Arts [EN]: Chapter 380

Infectious Disease Department, on-call room.

Clara stared intently at Justin’s nursing chart.

Her brow furrowed, and her eyes narrowed.

Tock. Tock. Tock.

Her fingers tapped rhythmically on the desk.

Despite the heavy doses of antibiotics and fluids, the child’s condition showed no signs of improvement.

His vitals were precarious, as if teetering on the edge of a cliff.

‘If only he can hold on until the culture results come back.’

Clara fidgeted with the crucifix necklace around her neck.

Neurosurgery patients.

Pediatric neurosurgery patients, in particular, had a notably high mortality rate from sepsis [a life-threatening complication of an infection].

Their young bodies, having endured major surgeries lasting at least 4-6 hours, often experienced a significant drop in physical strength and immunity.

Modern medicine was advancing daily, yet sepsis remained a difficult challenge to overcome.

There was no rapid diagnostic method or accurate treatment in sight.

As an infectious disease specialist, she found it disheartening.

‘In the worst-case scenario, we can try ECMO (Extracorporeal Membrane Oxygenation) [a life support machine that replaces the function of the lungs and heart]. Or switch antibiotics.’

As Clara prepared for the worst, a knock sounded.

Knock, knock, knock.

When she said to come in, an unexpected person appeared.

It was Jun-hoo from neurosurgery.

“Hello, doctor.”

“Yes, hello. But what brings you to the on-call room…”

Clara tilted her head.

Justin was now an infectious disease patient. There was no need for Jun-hoo to be concerned.

“Are you busy, perhaps?”

“No, it’s not that. Have a seat there.”

Jun-hoo sat in the chair Clara indicated.

Clara stared at Jun-hoo for a while. More than anything, she liked how clear and bright Jun-hoo’s eyes were.

Clara tended to believe that people with clear eyes also had clear souls.

“You’re an applicant for the Boost-Up Program, right?”

Clara broached the subject first.

“Yes. I came from Korea to receive training.”

“How’s the program going?”

“Everyone else seems to be struggling, but I’m managing. I came with a determined mindset from the start.”

“Do you have a story to tell?”

“Doesn’t everyone have a story? Isn’t it the same for you, Clara?”

At Jun-hoo’s counter-question, Clara smiled bitterly.

Of course, she did.

A painful wound in her heart that she had never shared with her colleagues. And that wound had led Clara to infectious diseases.

“How is the infectious disease on-call duty?”

“It feels like I’m slowly dying? Surgeons tend to become somewhat lax in patient management after surgery.”

“That tends to be the case.”

“For internal medicine, there’s nothing quite like a surgery to mark the end. I have to constantly look at the nursing charts and change medications and injections.”

“What are the chances of Justin improving, in your opinion?”

Jun-hoo changed the subject.

She could have given a sugar-coated answer or a stern, whip-like response.

Clara’s choice was the latter.

“I’ll be blunt.”

“That’s what I was hoping for.”

“I’ve treated similar patients many times, and I’d say the survival rate is around 50 percent.”

“Has a technology been discovered yet that can detect sepsis-causing bacteria early?”

“I wish someone would discover it already, before my lifespan is drastically reduced while waiting for the culture results.”

Clara complained to Jun-hoo, running a hand over her face as if in distress.

“Doctor, may I ask one more question?”

“Go ahead.”

“Do sepsis-causing bacteria have unique characteristics for each type of bacteria?”

“Of course, they do. It’s similar to how you surgeons operate. Not all scalpels are the same, right? There are scalpels for cutting skin and scalpels specifically for cutting nerves or blood vessels.”

“…”

“We match antibiotics according to the characteristics of the bacteria. We perform culture tests to identify those characteristics.”

Jun-hoo nodded at Clara’s answer.

He crossed his arms and fell into silence.

Suddenly, Clara wondered why Jun-hoo was so interested in sepsis.

It wasn’t even his specialty…

“You have a knack for leading conversations comfortably. Thanks to you, I almost forgot.”

“Forgot what?”

“You didn’t come all the way to the on-call room just to chat with me. You have a reason, right?”

“Yes. That’s right. I have a reason.”

Jun-hoo’s voice was firm.

“If it’s not too much trouble, I’d like to receive a list of sepsis patients. I’d also like to take a quick look at the patient rooms.”

* * *

Swoosh.

Jun-hoo left the infectious disease on-call room.

In Jun-hoo’s hand was a warm stack of A4 papers [standard-sized paper].

Jun-hoo glanced down at the first page.

The first page listed patients being treated for Streptococcus, one of the sepsis-causing bacteria.

Tock. Tock. Tock.

He knocked on a nearby patient room and entered.

The guardian was temporarily away, and only the patient was lying in the room.

The patient was fast asleep.

His breathing was even and regular.

A drip was connected to the patient’s arm.

Jun-hoo carefully placed his palm on the patient’s chest.

He channeled internal energy drawn from his dantian [an energy center in the body, according to traditional Chinese medicine].

The internal energy became a thin, fine thread, traveling through every corner of the patient’s blood vessels.

But that time was only about a minute.

It coincided with the time it took for the blood vessels, ejected by the heartbeat, to circulate throughout the body and return.

The internal energy, having fulfilled its role, dissolved into the blood and disappeared.

‘Haa… it’s difficult after all.’

Jun-hoo clenched his teeth at the challenging task. The sound of grinding echoed in the room.

Rewind to 30 minutes ago.

Jun-hoo did not use Internal Energy Cardiac Technique on Justin.

The greater good?

The majority?

No matter how important those things were, they could not infringe upon the dignity of one person.

Justin did not exist in the past.

He was a unique human being who would not exist in the future either.

Jun-hoo did not want to harm that uniqueness.

He had made a decision, but that did not mean the remaining task would be automatically solved.

If he couldn’t use Internal Energy Cardiac Technique to treat sepsis, he had to find another way.

The gates of hell opened at that moment.

If not for treatment purposes, what could he use internal energy for?

Pressure point strikes had no particular use.

And swordsmanship was even more out of the question.

Jun-hoo felt as if he were trapped in a dark cave.

In that place, it was the same whether he opened his eyes or closed them. Even if he walked, he couldn’t tell if he was going in the right direction.

There wasn’t even a single ray of light to guide Jun-hoo.

Is this the end after all?

Even with internal energy and martial arts.

Because there are things that are impossible even with strong will alone.

Perhaps he had a vague premonition of this, which is why he hadn’t been able to tackle sepsis treatment all along.

Once he gave up on treatment, plausible excuses and justifications sprang up like weeds.

He even began to feel that his previous determination to treat sepsis was foolish.

But it was right then.

The very moment he was about to take his hand off Justin’s chest!

Something flashed through his mind.

A shift in perspective, so to speak, had occurred.

Did he necessarily have to treat with internal energy?

Couldn’t he use internal energy to identify the causative bacteria of sepsis and treat it with antibiotics?

That was the thought that came to him.

‘It may seem absurd, but let’s give it a try for now.’

Jun-hoo channeled only a very small amount of internal energy into Justin’s heart.

He repeated the same process nearly 20 times.

Then he realized something.

Justin’s systemic inflammatory response was particularly severe in the abdomen.

He found that the inflammatory response was occurring as intensely as if an explosive had detonated.

Based on this, Jun-hoo hastily formulated a hypothesis.

1) There are various types of sepsis-causing bacteria.

2) The effects on the body vary as much as the types.

3) If the unique inflammatory response caused by each causative agent in the body can be read with internal energy, the causative agent can be identified before the blood culture results are available.

Once he had formulated a hypothesis, he needed to verify it. Jun-hoo immediately went to see Clara.

He obtained a list of patients who had already undergone blood culture tests and were receiving appropriate antibiotics.

‘From now on, I’ll find out one by one how the systemic inflammatory response appears according to the sepsis-causing bacteria.’

Having finished his recollection, Jun-hoo continued to emit a small amount of internal energy to the patient.

It was a painful task.

He had to maximize the sensitivity of his internal energy.

His concentration could not be scattered even for a moment.

Cold sweat broke out, and his face and fingertips turned cold as it dried.

Still, Jun-hoo did not give up.

He knew that trials that could be overcome would help him grow to the next level.

“Hoo.”

Jun-hoo sighed and took his hand off the patient’s chest.

A patient receiving Iperacillin / Tazobactam antibiotic treatment for Streptococcus.

His inflammatory response was strongest in the skin layer of his waist.

The form of the inflammatory response was like a torrential rain.

Bacteria like raindrops were striking the systemic blood vessels.

Having finished the experiment, Jun-hoo moved to the next patient room.

In the same way, he explored the systemic inflammatory response of sepsis patients.

Because there were many sepsis-causing bacteria.

The inflammation patterns were diverse.

For some, the inflammatory response was concentrated in the lungs, for others in the urinary system, and for others in the liver system.

The inflammation patterns were also subtly different, such as bombs, torrential rain, whirlwinds, and fountains.

After going around the patient rooms for nearly 3 hours, Jun-hoo also got the hang of it.

The patterns of systemic inflammation were visible at a glance.

Streptococcus, Staphylococcus, Pseudomonas aeruginosa, Pneumococcus, Fungi, etc.

He could easily capture the characteristics of various bacteria that cause sepsis.

At the end of that long and arduous journey.

Jun-hoo was able to find out even the sepsis-causing bacteria that Justin was suffering from.

The beginning was absurd, but the end was brilliant.

The main cause of death from sepsis.

That is, during the few days it takes to identify the causative bacteria through blood culture tests, somewhat inaccurate treatment must be given.

Jun-hoo overcame this with internal energy.

He was able to identify the inflammation patterns of each causative agent in advance with internal energy.

From now on, he wouldn’t have to watch the tragedy of neurosurgery patients dying from sepsis.

Swoosh.

Jun-hoo left the last patient room.

He crumpled the printout in his hand and put it in his gown pocket.

He hurried to the intensive care unit where Justin was.

All that was left was treatment.

* * *

At the same time, in the intensive care unit.

Clara stood looking down at Justin with her hands in the pockets of her doctor’s gown.

The worst thing she had feared had happened.

The broad-spectrum antibiotic was not having much effect.

The vitals, which had been quiet for a while, were falling again.

Beep. Beep.

The electronic sound flowing from the patient monitoring device was ominous.

“Doctor. We must save Justin. Please.”

The person complaining next to Clara was not a guardian.

Raymond, having received a call from somewhere, had arrived at the intensive care unit before her.

“Is this child perhaps a relative of yours?”

“No, it’s not that, but I performed the surgery, and he’s the son of a VIP [very important person].”

“Ah. I see.”

Clara clicked her tongue at Raymond’s snobbish answer.

Although she had only met him for the first time today.

It felt like she had seen the complete true colors of the human being Raymond with just that answer.

“Doctor. The antibiotic doesn’t seem to be working. Shouldn’t we change it?”

“It’s not good to change it often in a short period of time… but it doesn’t seem like there’s much choice right now.”

Clara bit her lip tightly.

The problem was which antibiotic to use.

There were many types of broad-spectrum antibiotics.

And if she changed the antibiotic this time, it would be even more difficult to change it again next time.

Because resistance may develop.

While Clara was racking her brains over the antibiotic change.

A third person suddenly approached Clara.

“Doctor. Has Justin’s condition worsened?”