A Surgeon Who Uses Martial Arts [EN]: Chapter 220

Thump. Thump.

Jun-hoo walked down the obstetrics and gynecology ward hallway.

He looked around as he walked, noticing that the ward was smaller than the neurosurgery ward.

The number of hospitalized patients was also not very high.

It must be because the birth rate has recently decreased.

Jun-hoo’s thoughts naturally turned to the birth rate.

He had once seen a news report that South Korea’s birth rate was 0.92, the lowest among OECD [Organisation for Economic Co-operation and Development] countries.

When he first heard the news, he didn’t think much of it, but…

Seeing that cold reality in the hospital made his mouth bitter.

What was even more unfortunate was that there was no hope for the situation in obstetrics and gynecology to improve in the future.

People will give birth to fewer and fewer children.

The role of obstetrics and gynecology will gradually shrink.

“Oh, Jun-hoo, why are you here?”

Seo-rae, a medical school classmate he ran into, spoke to him.

“Why else would I be here? I’m here for a consult.”

“Isn’t the consult usually done by the 4th-year chief resident? Is the neurosurgery system different?”

“It’s not like that. The chief resident went into the operating room and couldn’t do the consult. I’m going to see the patient first and then notify the chief.”

“Well, I guess it’s okay for you to see the patient. I requested the consult just in case.”

Seo-rae nodded as if in agreement.

She joined him, saying she had nothing to do.

Jun-hoo found the 6-bed room close to Seo-rae.

The pregnant patient was lying in the left bed near the entrance.

The patient’s name was Kang Mi-rae.

She was 30 years old and in her 27th week of the third trimester.

She had been hospitalized five days ago with pre-eclampsia, a hypertensive disorder related to pregnancy.

The patient was stroking her bulging belly and talking to her husband, who was sitting in the guardian’s bed.

Seeing him at the hospital at this hour, it seemed like her husband was on paternity leave.

“Hello. I’m from neurosurgery.”

“Yes, hello, doctor.”

“Hello, doctor.”

The patient and her husband greeted Jun-hoo.

“I heard you’ve had severe headaches for the past two days. And the headache doesn’t improve even with painkillers?”

“Yes. My right temple is throbbing.”

The patient frowned and pointed to her temple with her index finger.

“When is the pain the worst? Morning, afternoon, or night?”

“It doesn’t seem to be specific to a time. It’s very erratic.”

“How much does the pain decrease when you take medication?”

“I think it decreases by about half.”

“Have you ever bumped your head on a hard object?”

“No. Not at all.”

Jun-hoo continued the thorough questioning.

Had she experienced similar headaches before, was there a family history of headaches, did she smoke, and so on.

The more questions asked of the patient, the better.

Unexpected information often became a clue.

A similar case was scrub typhus.

In the case of scrub typhus, which is caused by infection with the larvae of trombiculid mites, causing fever and chills.

By asking about the patient’s movements.

If they had visited a grave or done weeding, it was a disease that could be suspected.

This case is ambiguous.

There’s nothing particularly concerning.

Jun-hoo frowned after a long Q&A session without getting anything out of it.

A headache was a symptom with too broad a range. It was difficult to pinpoint just one cause.

“Doctor, why do I keep having headaches?”

The patient looked at Jun-hoo with a frustrated expression.

The husband’s eyes also lit up as if he was curious.

Now it was Jun-hoo’s turn to answer.

“I heard that your body temperature is normal. Assuming it’s not an infectious disease… pregnancy-related headaches or tension headaches seem more likely.”

“It’s not serious, is it?”

“I think we need to do a detailed examination first.”

“Hey, what kind of examination are you talking about for a normal headache?”

Seo-rae, who had been watching Jun-hoo’s examination, whispered in his ear.

Her voice was sharp, as if she didn’t like Jun-hoo’s judgment.

“Just do a moderate examination and finish it. Don’t make things too big.”

“The patient is pregnant. It’s right to examine her as defensively as possible. And the only painkiller you can give to pregnant women is A.A.P (acetaminophen). That’s what your department has been prescribing P.O (per os, by mouth) until now.”

Even with Jun-hoo’s explanation, Seo-rae shook her head.

She began to argue in a small voice.

“Okay. Let’s say we do an examination as you said. Then what kind of examination are you going to do? The patient is pregnant. You can’t do X-rays, CT scans, or contrast-enhanced MRIs.”

“Doctor, could you please see patient Lee Ho-yeon in room 701? She seems to be having labor pains…”

Drrr-

The hospital room door opened, and a nurse peeked her head in and asked.

“Yes. I understand. Jun-hoo, take care of yourself.”

Seo-rae threw a warning comment and disappeared.

Jun-hoo fully understood why Seo-rae was overreacting.

It was rare to do a head-related examination for a mild headache.

The fact that the patient was pregnant was also a stumbling block.

If they performed radiation and contrast-enhanced examinations, the fetus could be born with deformities.

However, Jun-hoo was no ordinary neurosurgeon.

He was a specialist who had experienced the world of martial arts and created a miraculous examination.

And that examination was also useful for pregnant women.

“Doctor, is my headache serious enough to warrant an examination?”

The patient asked with a frightened face, sensing the atmosphere of Jun-hoo and Seo-rae’s argument.

“As I said before, I think we need to check to know that. Excuse me for a moment, I’m going to check your head.”

“…”

“I’m just checking in case there’s a lump or something.”

Jun-hoo made an excuse and placed his hand on the patient’s head.

He pulled the internal energy from his dantian [energy center in the body, according to traditional Chinese medicine] up to his palm.

And then he shot the internal energy from his palm back into the patient’s head.

It was internal energy cerebral angiography, one of Jun-hoo’s trademarks.

Since internal energy was used instead of contrast agents, internal energy cerebral angiography was also safe for pregnant women.

As if ripples were rising on a calm lake.

The internal energy rippled, passing through the skull, passing through the meninges, and beginning to embrace the walnut-shaped brain.

The internal energy he had accumulated was abundant, and he had a lot of experience with examinations, so Jun-hoo was able to scan all of the patient’s cerebral blood vessels in less than a minute.

It was a level that far surpassed the speed, convenience, and accuracy of cerebral angiography performed in hospitals.

While checking the cerebral blood vessels and brain structure that the internal energy had embraced and groped, Jun-hoo frowned.

The patient’s condition was not normal.

* * *

Beep, beep, beep-

The phone rang in operating room number 3.

Chief Chan-young, who was performing a cerebral shunt, had deep wrinkles on his forehead.

“Tae-jin, go answer the phone.”

“Yes, Chief.”

Intern Tae-jin answered the phone next to the operating room entrance and returned.

“Chief, it’s a call from Senior Jun-hoo. He said you have to take it.”

“Jun-hoo? He knows I’m in surgery. Geez.”

Feeling annoyed, Chan-young headed to the operating room entrance. He picked up the receiver, which was still ringing.

“I’m busy, what’s going on?”

-I’m sorry, Chief. It’s a situation where I have to notify you. I have something to tell you about the pregnant patient who seemed to have a consult instead of the Chief.

“Wasn’t it just a headache?”

-It seems more serious than I thought. I think we should take an MRI.

“An MRI for a headache patient? Aren’t you crossing the line?”

Chan-young couldn’t say nice things. It was because Jun-hoo’s judgment was too extreme.

This was overdiagnosis like no other.

-She is taking A.A.P, but it is not very effective.

“Isn’t that because of pre-eclampsia?”

-I looked at the nursing records and her blood pressure is well controlled. It has been normal since she was hospitalized.

“What about the possibility of a tension headache (stress, fatigue, lack of sleep)?”

-The patient says she sleeps well and doesn’t have any particular discomfort. It seems like it would be good to do an examination to find out the cause.

Jun-hoo gave a sharp answer to Chan-young’s question.

So there was nothing more to argue about.

In principle, it was right to do an examination to find the cause of the headache.

Chan-young couldn’t shake the feeling that he was unnecessarily making things bigger.

A headache usually comes and goes.

“What kind of examination are you going to do?”

-It’s an MRI without contrast. That’s the only option right now.

“I don’t know if it’ll be okay. The accuracy of the examination will be reduced if you don’t use contrast.”

-Unfortunately, there’s no other way.

“Are you confident that you can persuade the patient?”

-Yes. I’m confident.

“You’re good at talking. But you should also know this. If you do the examination and there’s nothing wrong, the patient will curse you out, saying that you induced an expensive examination to get money.”

-If that happens, I’ll have to take responsibility.

“It’s not just your responsibility. What will the obstetrics and gynecology department think of our neurosurgery department?”

Chan-young was still negative about Jun-hoo’s diagnosis.

He fully understood his desire to help the patient, but would the patient understand that desire?

This was a completely different area of ​​concern.

-I will persuade her so that our department is not harmed. Please trust me.

“Oh, I don’t know. Do whatever you want. I’m sure it’ll work out somehow.”

-Thank you. Chief.

After hanging up, Chan-young returned to the operating table. He changed his surgical gloves and continued the surgery.

What kind of news will the phone call he receives again in 30 minutes contain?

He was already nervous.

* * *

Obstetrics and gynecology ward hallway.

Jun-hoo was talking to Seo-rae, who had her hands on her hips.

“Real? Really? Your chief allowed an MRI too?”

Seo-rae glared at Jun-hoo with an absurd expression.

“Would I lie by selling the chief’s name? It’s a consult case, how would I handle the aftermath if I deceived you later?”

“I still think it’s an overreaction. Why don’t you think about it again?”

“A conclusion has been reached, what’s the point of thinking about it again? This is the area of ​​neurosurgery, so accept it.”

“Did the patient and guardian willingly agree to the examination?”

“The persuasion is over. All you have to do is give the order.”

Jun-hoo shrugged his shoulders.

The patient’s headache may be nothing, but it may be serious.

Jun-hoo persuaded the patient and guardian that an examination was necessary to confirm.

Was it thanks to his sincerity?

The patient and guardian did not resist much.

“Hoo. Anyway, you have to recognize that Seo Jun-hoo is a troublemaker.”

“It’s true that I’m a troublemaker, but I’m also amazing at solving troubles.”

“You’re so great. Really. I’ll let you know when the test results come out.”

“Okay. Thanks for your hard work.”

Jun-hoo returned to the neurosurgery ward with heavy steps.

He didn’t have an MRI, but.

Jun-hoo already knew the test results.

The patient had a cerebral aneurysm in the posterior communicating artery located in the temporal lobe.

A cerebral aneurysm.

This disease is a disease in which blood vessels swell like balloons due to various causes.

It was also called a time bomb in the head because it was not known when the blood vessels would burst.

In the patient’s case, the cerebral aneurysm had not yet ruptured.

It was an unruptured cerebral aneurysm.

The volume of the cerebral aneurysm was about 11mm, and it had a pouch-like shape called a daughter sac.

There was no mistake because he had checked it several times with internal energy.

I think I need to have surgery.

I don’t know what the obstetrics and gynecology professor and our department professor will decide.

Jun-hoo stroked his chin quietly.

Considering that the patient was pregnant, it seemed right to have cerebral aneurysm surgery after delivery.

However, Jun-hoo had the opinion that it would be better to have surgery before delivery.

Because of the location, size, and shape of the cerebral aneurysm.

In addition, it was an unruptured cerebral aneurysm with symptoms that could not be resolved with painkillers.

In fact, surgery under general anesthesia was not completely avoided just because the patient was pregnant.

High-level heart valve surgery for pregnant women, or high-level stroke surgery was performed.

Of course, surgery on pregnant women was much more difficult and challenging than surgery on general patients.

This was because they had to take care of both the patient and the fetus.

Worrying about the patient’s future, Jun-hoo arrived at the neurosurgery on-call room.

Of course, he couldn’t focus on his work.

He was diligently entering orders, but his head was full of the obstetrics and gynecology patient.

Beep, beep, beep~

The phone on the on-call room desk rang loudly.

Finally, what was coming had come.

Jun-hoo answered the phone.

“Yes. This is neurosurgery.”

-Jun-hoo, it’s a jackpot! The patient has a cerebral aneurysm in her temporal lobe. It was so clear that you could see it even without contrast?

Seo-rae excitedly announced the test results in a burst of speed.

Jun-hoo was not greatly shaken because he already knew everything.

He was just curious about whether or not he would have surgery.

“Did you notify the professor? What did he say?”