A Surgeon Who Uses Martial Arts [EN]: Chapter 218

Chapter 41: Crossroads of Choice (3)

By successfully harvesting the artery from the chicken wing, Jun-hoo proved his capabilities.

He demonstrated his readiness to participate in the Moyamoya disease surgery.

Chul-woo repeatedly expressed admiration at Jun-hoo’s success, but Min-seok remained reserved, offering no particular praise.

He seemed to have a naturally taciturn personality.

Regardless of others’ evaluations, Jun-hoo was pleased to have successfully performed the challenging graft procedure.

He had succeeded at a procedure he had never done before, all in one go.

He had succeeded cleanly.

Jun-hoo was happiest when he realized his skills had improved.

It was the same in the Murim world [a world of martial arts and cultivation, often depicted in fantasy stories].

And it was the same in the modern world.

He knew better than anyone that the stronger he became, the more choices he had.

“Chul-woo, let’s start the briefing soon.”

“Yes, Professor.”

“Jun-hoo, clean up your desk.”

“Yes, I understand.”

After the table was cleared, the full-scale surgical briefing began.

The patient was Jae-eun, whom Jun-hoo had briefly met in the pediatric surgery ward.

Chul-woo quickly summarized Jae-eun’s admission process, pre-existing conditions, family history, and so on.

Soon after, the beam projector illuminated the screen.

Jae-eun’s brain MRI scan, taken before admission, appeared on the screen.

‘It’s serious… it’s serious indeed,’ Jun-hoo thought.

Jun-hoo frowned as he examined the image.

The area of constricted blood vessels was exceptionally wide.

It was almost twice that of a typical Moyamoya disease patient.

While a healthy person’s brain blood vessels branch out vigorously like tree branches, Jae-eun’s were concentrated in one spot, like wisps of rising smoke.

Tok!

Jun-hoo poked his ear with his index finger.

It was a nerve stimulation method using acupressure.

The internal energy [a concept in martial arts referring to vital energy within the body] extending from his fingertip reached the hippocampus.

As soon as the internal energy touched it, the hippocampus, the center of long-term memory, began to activate intensely.

It felt like a bomb had exploded in his head.

Various medical knowledge transformed into fragments and scattered in all directions.

Jun-hoo quickly examined those fragments.

Unfortunately, Jae-eun’s case wasn’t found even in his teacher Jae-hyun’s secret manual.

Jun-hoo had a strong feeling that this surgery would not be easy.

“Jae-eun is a very special case among Moyamoya disease patients. This is because the pattern of blood vessel narrowing extends throughout the middle cerebral artery and anterior cerebral artery.”

“…….”

“In the Moyamoya disease stages, which range from stage 1 to stage 6, Jae-eun is in stage 5. The surgical method is…….”

“Wait a minute.”

Min-seok raised his hand to stop Chul-woo’s explanation.

“Jun-hoo, do you know the Moyamoya disease surgical procedures?”

Min-seok’s gaze rested on Jun-hoo, as if he still had more to test.

“There’s indirect bypass surgery, which involves implanting human tissue to encourage brain blood vessel growth, and direct bypass surgery, which directly connects the blood vessels.”

“…….”

“The former is mainly performed on children, while the latter is performed on adults. Recently, hybrid surgery, which combines both direct and indirect bypass surgery, is becoming more common.”

Jun-hoo answered clearly.

This much was a piece of cake.

Since his surgical skills were already top-notch, he had put a lot of effort into building up his medical knowledge.

So much so that he had memorized his teacher’s secret manual entirely.

“It’s coming out smoothly. You must have studied separately?”

“Yes. Because in the medical profession, knowledge is power.”

“Okay. You’re doing well.”

When Min-seok gave the signal, Chul-woo started the briefing again.

He mentioned a specific surgical method.

The surgery that would be performed on Jae-eun was direct bypass surgery.

In other words, they would directly connect a healthy blood vessel to the blocked one in the brain.

‘Do we really have to do direct bypass surgery?’ Jun-hoo wondered.

‘This is too risky.’

‘It feels like we’re deliberately choosing a difficult path when there’s an easier one.’

From Jun-hoo’s perspective, it was a questionable decision.

It was generally accepted that direct bypass surgery should not be performed on children.

Children’s blood vessels are not as developed as adults’ blood vessels, making them shorter and thinner.

There was a high risk of the blood vessels bursting during the anastomosis [surgical connection] process.

“Professor, is there a reason why you chose direct bypass surgery?” Jun-hoo asked, raising his hand.

“Because the potential outcome of a successful direct bypass surgery is better than that of indirect bypass surgery.”

“The potential is high, but doesn’t that also increase the risk?”

“We have to take that risk.”

“So, you mean you’re only going to do direct bypass surgery, not hybrid surgery?”

“Yes. But, can you stop asking so many questions? Jun-hoo, you’re here to assist with the surgery, not to judge whether it’s a good one. Just listen quietly.”

Chul-woo silenced Jun-hoo’s questions, asserting his seniority.

Although it was unpleasant, Jun-hoo endured it.

The hospital was a place where the hierarchy was as strict as the military.

Regardless of who was right, questioning a superior’s opinion would inevitably create an unpleasant atmosphere.

‘Is this why they say you need to get ahead to avoid being wronged?’ Jun-hoo thought.

‘I need to become a fellow and a professor quickly.’

‘I’m so frustrated.’

Hiding his inner thoughts, Jun-hoo focused on the briefing.

The more he listened to the detailed explanation, the more he worried about the surgery.

Jae-eun had five blocked brain blood vessels, and all of them had to be connected with direct bypass surgery.

Even if just one blood vessel burst, a major disaster seemed likely.

Another 10 minutes passed.

Min-seok instructed Jun-hoo to take meticulous care of Jae-eun, repeatedly urging him to bring Jae-eun’s condition to its peak before the surgery.

Jun-hoo said he understood.

As Min-seok and Chul-woo left, only Jun-hoo remained in the on-call room.

Jun-hoo took a picture of the MRI image on the screen and immediately sent it in a text message to his teacher, Jae-hyun.

Beeeee.

Unexpectedly, the phone vibrated quickly.

His teacher called three minutes after he started cleaning up.

“Yes, Teacher. This is Jun-hoo.”

“Yes. I just saw the text message you sent and checked the picture.”

“I hope I’m not causing trouble for you when you’re busy.”

“It’s okay. I was just taking a break anyway.”

“What do you think of this surgery, Teacher?”

Jun-hoo sought advice from Jae-hyun.

Why were they insisting on direct bypass surgery for Jae-eun?

Was that really the best option?

Jun-hoo had a hard time shaking off those doubts and suspicions.

Jae-hyun, the best neurosurgeon in Korea, would be able to give him a satisfactory answer.

“In my opinion, it seems like that professor is pushing himself too hard,” Jae-hyun said.

“I contacted you because I thought so too.”

“If it were me, I would have performed hybrid surgery on the patient. I would have only done direct bypass surgery in two places and performed indirect bypass surgery on the rest.”

Jun-hoo nodded in satisfaction at Jae-hyun’s explanation.

He couldn’t come up with a detailed surgical plan like his teacher, but he agreed that hybrid surgery was the best option.

“Then why are they insisting on taking the difficult path?”

“It must be because of the thesis. There’s the fall Korean Neurosurgical Society meeting this fall. If you present a thesis at the meeting and get a good response, you could become a rising star.”

“So he wants to show off how great he is by doing this difficult surgery.”

A bitter smile touched Jun-hoo’s lips.

There were two main types of surgery: surgery solely for the patient and surgery for the doctor’s own reputation and fame.

It seemed that this surgery was the latter for Min-seok.

‘How can a person be like that?’ Jun-hoo wondered.

‘Doesn’t Jae-eun’s future, who is only six years old, matter at all?’

Jun-hoo shuddered at Min-seok’s self-serving decision.

Min-seok was a professor who deserved to be called medical waste.

“You’ve seen through it exactly. This kind of surgery is also called surgery of greed or desire,” Jae-hyun said.

“…….”

“Don’t you feel unpleasant because it seems like you’re being used?”

“Yes. I even feel disgusted and skeptical about humanity.”

Jun-hoo conveyed his honest feelings.

It was a sentiment he could express because he was talking to his teacher, whom he could trust and rely on.

“Remember your current feelings well. It’s also good to take them out whenever you need them and solidify your determination not to become like that person.”

“Yes. I will keep that in mind. I feel energized thanks to you, Teacher.”

“It’s okay. Anyone grows while shaking and breaking. The important thing is that you do your best in the position you are in now.”

“Yes, Teacher.”

The call ended.

Jun-hoo finished cleaning up and left the conference room.

It was a week before the Moyamoya disease surgery.

* * *

That evening, basement level 1 cafe.

Chul-woo was chatting with Min-seok over coffee.

“That Jun-hoo guy is better than I expected. I can’t believe a first-year resident would succeed in a vascular graft in one go.”

“Wasn’t it just luck?”

“Is graft a procedure that can be successful with luck?”

“Didn’t he do the graft with a chicken wing instead of in a real operation? I think he was able to be bold because he thought it wouldn’t matter if he failed.”

Chul-woo was busy downplaying Jun-hoo’s success.

When he was with Jun-hoo earlier, Chul-woo had experienced a range of negative emotions, including self-disgust.

Jun-hoo had succeeded in the vascular graft procedure, which Chul-woo had practiced relentlessly for a month, in one try.

He couldn’t help but feel a sense of inadequacy.

Chul-woo also felt jealousy towards Jun-hoo and a sense of foreboding that Jun-hoo might surpass him someday.

“Are you already trying to keep Jun-hoo in check?” Min-seok asked with a strange smile.

“Hey, Professor, what do you mean by keeping him in check? It’s just that you only see the good side of Jun-hoo, so I’m just giving you a balanced opinion.”

Chul-woo took a sip of coffee and continued, “Professor, you saw Jun-hoo dissecting blood vessels, right? How can anyone dissect blood vessels like tearing off tape?”

“…….”

“It was like, ‘it would be nice if it worked, but it doesn’t matter if it doesn’t,’ wasn’t it?”

“There was some of that. What kind of person is Jun-hoo?”

“From what I’ve heard, his reputation is good. He’s kind to patients and their families, and he’s very popular among the nurses.”

“In the medical resident office?”

“Everyone in the medical resident office likes him because he’s so good at his job. Are you also interested in Jun-hoo, Professor?”

“I can’t help but be interested, looking at what he did today.”

Chul-woo felt jealous once again that the professor’s attention, which should have been directed at him, was focused on Jun-hoo.

An even more unpleasant fact was that his competitor was not a 3rd or 4th year resident, but a fresh 1st year resident.

“Let’s get up now.”

“Yes, Professor.”

Min-seok moved to the research building, and Chul-woo returned to the neurosurgery ward.

He went to the conference room to prepare for the chicken wing graft procedure, intending to try the mysterious dissection method that Jun-hoo had demonstrated.

‘I can’t be outdone by a first-year resident,’ he thought.

After setting up, Chul-woo started working quickly.

He incised the skin and muscles of the chicken wing and exposed the blue artery.

The real challenge was about to begin.

Chul-woo lifted the flesh attached to the artery with his left hand and held the blood vessel firmly with the forceps in his right hand.

‘I’ll just do it quickly in one go, right?’

Chul-woo moved his hand to the right boldly and quickly.

“Ah…….”

A sigh escaped his lips. The blood vessel had broken in the middle.

Since it was not a living chicken, blood did not splatter.

Instead, something like bluish sawdust flowed out between the severed blood vessels – hardened blood clots with oxygen removed from the blood.

Chul-woo tried to reapply Jun-hoo’s method to the remaining artery.

Thud!

This time, the blood vessel burst in vain. Had he put too much force on the forceps holding the blood vessel?

The blood vessel burst before he could even dissect it.

For the next 20 minutes, Chul-woo continued to practice until all the thawed chicken wings were used up.

‘Didn’t he do the graft with a chicken wing instead of in a real operation? I think he was able to be bold because he thought it wouldn’t matter if he failed,’ Chul-woo had said to Min-seok.

After finishing the practice, Chul-woo had no choice but to retract his statement.

Even though he followed Jun-hoo’s method, he had not succeeded in dissecting even once.

The blood vessels kept bursting.

‘This f*cking…’!

Clang!

Chul-woo, overcome with inferiority, threw the forceps he was holding on the floor.

Frustratingly, Jun-hoo was an insurmountable wall.