A Surgeon Who Uses Martial Arts [EN]: Chapter 165

Chapter 30: Courage (5)

Before the awake surgery on the pianist patient.

The brain mapping, where we discussed the distribution of nerves and the extent of resection, concluded in an hour.

It was just the initial planning stage.

A lengthy discussion wasn’t necessary.

“Everyone worked hard. I’ll let you know if there are any changes.”

“Thank you for your hard work, Professor.”

“Thank you for your hard work.”

As Dong-hoon left first, only Jun-hoo and Chan-young remained in the conference room.

The tense atmosphere finally eased. To residents, professors were always a source of stress.

“Professor, you’re being surprisingly conservative? The resection area isn’t that large?”

Chan-young looked at Jun-hoo and continued.

“Is it because the patient is a celebrity and the head of the department is pressuring you? I thought the resection would be more extensive.”

“…….”

“To be satisfied with reducing a 4cm x 4cm tumor to 1.4cm x 1.4cm.”

“Could it be that he’s relying on the Gamma Knife [a type of stereotactic radiosurgery]?”

“Well, Gamma Knife is effective for small tumors, but… it’s not a cure-all, is it?”

“That’s true.”

Jun-hoo agreed.

Gamma Knife was effective for brain tumors smaller than 3cm x 3cm.

However, it didn’t always completely eliminate the tumor.

“But I think the professor is operating as he usually does.”

“Huh? As usual?”

“He may seem assertive in appearance and speech, but his surgical technique is delicate, isn’t it?”

“Surgical technique… well, you could see it that way.”

Chan-young nodded.

“If you were the surgeon, what would you do? How would you decide on the resection area?”

At Chan-young’s probing question, Jun-hoo hesitated for a moment.

It wasn’t an easy question to answer.

It was also a problem he would inevitably face in a few years.

It was also a fundamental question about how to develop his own surgical style as a surgeon.

Chan-young’s question was layered with meaning.

“If it were me…….”

“If it were you?”

“I think I would have resected as much as possible. I’d aim to leave about 0.5cm x 0.5cm of the tumor, wouldn’t I?”

“I knew it. Whether it’s treatment or assisting, you’re naturally aggressive.”

“What about you, Chief?”

“I’m not specializing in brain tumors.”

“Wow. Is it okay to weasel out of it so unfairly?”

“Didn’t you know? My real specialty is being unfair.”

Chan-young chuckled and stood up. He approached Jun-hoo and gently placed his hand on Jun-hoo’s shoulder.

“Anyway, please take care of me. Let’s try not to get on the head of the department’s bad side. It’ll be really tough if you do.”

“I’m the one who should be asking you to take care of me.”

“Alright. Good work.”

After Chan-young left.

Jun-hoo savored the silence that lingered in the conference room.

Jun-hoo had been merciless to the evil heretics in the Murim [a fictional martial arts world].

Maybe that’s why.

Jun-hoo didn’t want to show mercy to brain tumors either.

He wanted to remove as much of the brain tumor as possible within the limits of avoiding nerve damage.

The patient will be fine.

There’s surgery and Gamma Knife.

And if necessary, I can use my Mind Sword to perform internal energy tumor resection [a metaphorical technique referring to his mental focus and skill].

If I can control the variables.

Wouldn’t this surgery be successful?

Jun-hoo was inwardly optimistic about the progress of the awake surgery.

For reference, brain tumor surgery had a lower rate of chemotherapy compared to other surgeries.

There was a barrier between the brain’s blood vessels and the brain itself, called the blood-brain barrier.

The disadvantage was that chemotherapy drugs didn’t pass through it effectively.

Recently, next-generation chemotherapy drugs that overcame these shortcomings were being developed and used, but they weren’t yet widely adopted.

Awake surgery is four days away…

Jun-hoo’s gaze lingered on the calendar hanging on the wall for a long time.

* * *

That evening.

The neurosurgery resident room was bustling for the first time in a while.

Residents and fellows alike gathered to hold a welcome back party for Shi-ho.

A table was placed in the center of the resident room.

Various delivery foods such as cakes, pizzas, and chicken were laid out on the table.

The aroma of food filled the resident room.

The people gathered.

Whether they were acquaintances of Shi-ho or not, they all offered words of blessing or jokes to Shi-ho.

“I thought you’d be a little taller after being dispatched. You’re still the same.”

“You worked hard in Busan where there’s no T.O [Training Opportunity]. Now you can walk the flower path [a Korean idiom for a bright future] since two first-year students have joined.”

“Welcome back, Senior.”

“Now that the original ace has returned, our surgery schedule will be more relaxed.”

The evaluation of Shi-ho was overwhelmingly positive.

Everyone liked Shi-ho, and everyone showed trust in Shi-ho.

“Thank you all. I don’t know why you’re taking care of me like this.”

The main attraction of the welcome party, Shi-ho, smiled awkwardly and said a few words.

In a friendly atmosphere.

There was one person who was isolated, and that was Jun-hoo.

Jun-hoo couldn’t easily blend into this environment.

It wasn’t that he lacked social skills, but Jun-hoo was simply suspicious of Shi-ho.

When the phone call came from the Busan branch informing him of the death of the patient Shi-ho had operated on.

The eerie smile that Shi-ho had shown for a moment.

The act of trying to completely remove the lumbar structure of the Mami-chong syndrome patient he operated on today (Of course, he himself answered that it was to test Jun-hoo).

Those things kept coming to mind.

Jun-hoo couldn’t trust Shi-ho.

It seemed like Shi-ho was wearing a hypocritical mask.

“Loosen up your expression. Anyone would think you’re at a funeral.”

Kyung-soo, who was next to him, commented to Jun-hoo.

“Why? Does my expression look that bad?”

“Why don’t you look in the mirror?”

“It’s not like I need to look in the mirror.”

“Is the current ace nervous because the old ace has returned?”

“You’re misinterpreting it. It’s nothing.”

Jun-hoo shrugged his shoulders with a nonchalant expression.

Was there a need to compare who was better or worse among the members of the department?

The reason Jun-hoo was wary of Shi-ho was simply because he sensed the dangerous aura unique to heretics from Shi-ho.

“Ah, Kyung-soo, let me ask you something.”

“What is it?”

“The Mami-chong syndrome patient who came to the emergency room.”

“You’re talking about the patient you saw today and assisted with, right?”

“Yeah. Why didn’t you call the orthopedic department? Wouldn’t it have been better to call the orthopedic department? You said there was no one in our department available to operate.”

“Shi-ho must have overheard me talking on the phone. As soon as I hung up, he said he would operate himself.”

Voluntarily taking on emergency surgery on the first day of his return…

Even at the point when he heard the news that the patient he had operated on had died…

What’s the reason?

Jun-hoo’s suspicion of Shi-ho intensified.

Shi-ho’s welcome party ended in 30 minutes.

Residents and fellows with more than two years of experience dispersed, and Jun-hoo and Kyung-soo were responsible for cleaning up.

Since he had finished entering orders and writing charts in advance, Jun-hoo was able to have some personal time.

So, he first looked at his teacher’s secret book on awake surgery.

Jun-hoo’s eyes were serious as he scanned the secret book.

Jae-hyun had performed a total of 100 awake surgeries so far, and the success rate was a whopping 90 percent.

The nerve damage rate was also extremely low.

Like teacher, like student…

Jae-hyun also showed an aggressive approach toward tumor removal like Jun-hoo.

The number of Gamma Knife surgeries performed after surgery was less than 10.

As if he didn’t want to rely on Gamma Knife.

[The foundation of brain tumor surgery is to remove the tumor through surgical intervention. The limitations of chemotherapy and radiation therapy are clear. Therefore, you have to take a bold gamble when you open the patient’s head.]

His teacher’s secret book also contained phrases like martial arts secrets.

Jun-hoo also strongly agreed.

Jun-hoo had long believed that it was a virtue to move forward fearlessly, even at the risk of crisis.

After analyzing about ten successful surgery cases.

Jun-hoo began to look at the failed cases.

In fact, this was more interesting.

Even the best neurosurgeon in Korea had failed surgeries?

What on earth had frustrated his teacher?

He couldn’t help but be curious.

Jun-hoo carefully scanned the thesis.

Unexpectedly.

He thought it would be caused by acute cerebral hemorrhage or C.A (Cardiac arrest, heart attack).

The teacher’s failed awake surgery cases completely deviated from Jun-hoo’s expectations.

Only two cases matched Jun-hoo’s expectations.

The real reason the surgery failed was different.

It was the patient’s mentality.

Awake surgery is performed with the patient awake at a certain point.

The patient couldn’t withstand the pressure.

Just because the brain doesn’t feel pain.

It didn’t mean that the patient wasn’t afraid of surgery.

The tense and solemn atmosphere unique to the operating room.

The urgent surgery performed out of the patient’s sight, etc.

As a result, patients who felt tremendous pressure requested that the surgery be stopped.

From Jun-hoo’s point of view, he could fully understand the patients.

In a state of consciousness.

How many people would be able to maintain a sound mind if someone opened their head and performed brain surgery?

Then, shouldn’t we stabilize the patient with psychiatric drugs?

Jun-hoo tilted his head.

Jun-hoo’s question was quickly resolved.

The teacher also tried to calm the patient while administering tranquilizers.

But the results were mostly not good.

The patient became too drowsy.

He couldn’t answer the doctors’ questions properly.

For example, it was like this.

The surgeon stimulates a part of the patient’s brain area with nerve stimulation and asks, ‘Where do you feel the stimulation now?’

At this time, the patient who received the tranquilizer often showed a reaction that he didn’t know well.

Sometimes he answered that he felt stimulation in a completely different area.

In this case, awake surgery could lead to results that were worse than not doing it.

Maybe that’s why.

The teacher included this phrase at the very end of the failed awake surgery case.

[Awake surgery patients should be selected carefully. The key to awake surgery is the patient’s mentality first, the patient’s mentality second, and the patient’s mentality third.]

According to the teacher’s unexpected insight.

The key point of awake surgery was the patient’s mentality, not the resection area.

I’m in trouble.

If it were my teacher, he wouldn’t have accepted Myung-han at all.

Jun-hoo smiled bitterly.

Could Myung-han, who was delicate and sensitive, really withstand awake surgery?

Jun-hoo didn’t think so.

The operating room would be like hell for a free-spirited pianist.

Even if Jun-hoo tried to stop him, the surgery schedule that had already been set wouldn’t be canceled, so he was frustrated.

If the key is to stabilize the patient, I need a different method.

Jun-hoo, who had gained enlightenment, hurriedly closed his teacher’s secret document.

He plugged earphones into the speaker and searched for classical music played by Myung-han and listened to it.

Studying music.

Talking to the patient about music.

Through this, he builds rapport (trust and bond) with the patient.

Jun-hoo immediately realized that narrowing the distance with the patient was the top priority rather than awake surgery knowledge.

The success or failure of this surgery will be determined by whether or not the patient’s mentality can be managed.

“What music are you listening to?”

A familiar voice was heard from behind. When he turned his head, Shi-ho was smiling brightly.

“There’s a pianist among the hospitalized patients. I’m listening to his music to get closer to him.”

“You’re talking about Myung-han?”

“Yes. But Senior, do you smoke?”

Jun-hoo smelled cigarette smoke from Shi-ho’s gown and asked.

“No, I don’t smoke. I just came back from the rooftop with the chief.”

“I see.”

“Myung-han played Mozart’s Requiem [a mass for the dead], listen to it. It’s my favorite song.”

“What kind of song is Requiem?”

“A funeral song. It’s music that commemorates the spirits of the dead.”

A slight smile appeared on Shi-ho’s lips as he recommended the music. It was that eerie smile that Jun-hoo had seen in the morning.

“I’m going to listen to it before I go to bed today too. Huhu, you know why, right?”

“Ah. Yes.”

“By the way, you’re even listening to music to get close to the patient. Jun-hoo, you’re pretty cool?”

“I hear that often.”

“You rascal, you’re cheeky. You’re on duty today, right? Good work.”

“Yes. Senior, go in and get some rest.”

After Shi-ho left the resident room.

Jun-hoo listened to Mozart’s Requiem (the version played by Myung-han on the piano) that Shi-ho had recommended.

A heavy and somber melody.

A bleak melody as if cast into a deep darkness where the light has disappeared.

Because of its uniquely despairing atmosphere.

Jun-hoo listened to the song for only 1 minute and stopped the playback.

If he kept listening to the music.

It seemed like the Requiem played by Myung-han would become a Requiem for Myung-han.