A Surgeon Who Uses Martial Arts [EN]: Chapter 221

Chapter 42: A Surge in Fortune (1)

6 PM.

The outpatient clinic on the first floor of the main building was deserted.

With outpatient hours over, the stream of patients and their families had ceased.

The outpatient nurses had all gone home, and the electronic board displaying the order of consultations was blank.

However, in the silent outpatient clinic, only one professor remained at his post.

It was Professor Jo Minseok, from the neurovascular department.

Minseok was in his office, chin in hand, staring at the monitor.

“Good grief, a brain aneurysm in a pregnant woman?”

How long has it been?

Minseok chuckled to himself as he reviewed the brain MRI results.

This afternoon, he had received shocking news from his chief resident, Chanyeong.

A patient had been referred from the obstetrics and gynecology ward for a consultation.

She had complained of a common headache, but an MRI revealed an unruptured brain aneurysm.

According to Chanyeong,

the person who strongly pushed for the brain MRI was Junhoo.

What on earth was Junhoo thinking, insisting on an MRI for a headache patient?

If Junhoo hadn’t pushed for the MRI,

what would have happened to the patient?

Wouldn’t she have suffered a brain hemorrhage due to a ruptured aneurysm during childbirth?

Minseok was both amazed and intrigued by Junhoo’s actions.

But one thing was certain.

It was thanks to Junhoo that the neurosurgery department had saved face.

“The more I see of him, the more I like him.”

Even though it was a chicken wing, he succeeded in the vascular graft.

And he diagnosed a brain aneurysm in a pregnant woman.

For a first-year resident, that’s genius level.

Minseok was gradually falling for Junhoo’s charms.

If he nurtured Junhoo well,

or rather, if he could bring Junhoo onto his side, Junhoo would surely become an invaluable asset.

Knock. Knock. Knock.

The sound of knocking broke his train of thought.

He told them to come in, and Professor Seongeun from obstetrics and gynecology entered the office.

Seongeun was Minseok’s classmate from medical school.

They were the same age and close friends, so they were comfortable with each other.

“Did you hear about what happened this afternoon?”

Seongeun sat down next to Minseok and broached the subject.

“I can’t even go home because of it.”

“You’re having a hard time. The god of early *toegeun* [leaving work on time] can’t even *toegeun* early.”

“Are you comforting me? Or teasing me?”

“Both.”

Seongeun chuckled and changed the subject.

“What are you going to do about the patient? Surgery before delivery? Or after?”

“Before delivery, of course.”

Minseok answered as if he had been waiting for the question. He answered without a moment’s hesitation.

It was a conclusion he had reached after much deliberation.

“Isn’t it common to perform brain surgery on pregnant women right after or after delivery? Wouldn’t it be better to wait a little longer?”

Seongeun calmly voiced her opposition.

“I’m concerned about the patient’s pre-eclampsia. And the aneurysm hasn’t ruptured, has it? Is there any reason to take the risk?”

“I can see why you might think that way. But in my opinion, the situation is much more serious.”

“In what way?”

“Unruptured aneurysms usually don’t have symptoms, but the patient is complaining of headaches. Symptomatic unruptured aneurysms should be operated on as soon as possible.”

Minseok gave four more reasons why surgery was necessary.

He mentioned the location and size of the aneurysm,

its saccular [sac-like] shape,

and the fact that pregnant women are more likely to experience aneurysm rupture than the general population.

“If it were okay to postpone the surgery, I would have done so already. I don’t want to operate on pregnant women if I can help it. If something goes wrong with the fetus…”

Minseok trailed off.

The mere thought of the worst-case scenario sent a chill down his spine.

“Have you ever performed aneurysm surgery on a pregnant woman before?”

“Of course, I have. But it was always right after or after delivery.”

“So, this is your first time operating before delivery.”

“That’s right. It’s a very rare case.”

“Aren’t you scared?”

“Scared? Me?”

Minseok scoffed.

Every surgeon has a different style of operating.

Minseok preferred aggressive surgeries.

He liked surgeries with good patient outcomes and high difficulty.

His plan to perform direct bypass surgery on a child with Moyamoya disease was in the same vein.

And this was not so much for the sake of the patient as it was because Minseok wanted to be noticed.

Minseok wanted to become a star surgeon.

Like Professor Lee Gukjong, the trauma surgeon whose name was known to the entire nation.

“I do admire your confidence. Anyway, if you say surgery is necessary, then it has to be done. When are you going to schedule it?”

“Two days from now. Keep a close eye on her vitals. Don’t let the schedule get pushed back.”

“I’ll take care of it.”

“And just in case, come into the operating room too. You’re the expert in pregnant women’s vital care.”

“I was planning to come in even if you didn’t ask.”

Seongeun crossed her arms and continued.

“But have you decided on the surgical method? Coil embolization? Or clip ligation?”

“I think…”

Minseok told Seongeun his detailed surgical plan.

Two days passed.

* * *

A faint blue light of dawn streamed through the crack in the duty room window.

The current time was 4 AM.

Minkyeong, who was on duty, was nodding off like a sleepy chicken.

Next to her, Junhoo was reviewing the nursing records of the pregnant woman who was scheduled to undergo aneurysm surgery today.

It was natural for Junhoo to stay up all night, even when he wasn’t on duty.

*The OB/GYN department must have been paying close attention. The patient’s vitals have been consistently normal.*

Junhoo was inwardly impressed.

Maintaining a normal blood pressure for a patient hospitalized with pre-eclampsia was no easy feat.

But the OB/GYN department had managed to do it.

This meant that the surgery was that much more important.

Since the patient’s condition was good,

today’s surgery would proceed as planned.

Junhoo, who had been chosen as the second assistant, closed his eyes.

He mentally rehearsed today’s surgery.

There were two main surgical methods for unruptured brain aneurysms.

One was coil embolization.

This involved using a catheter to fill the aneurysm with platinum coils.

As the coils were inserted into the bulging blood vessel, they displaced the blood that had pooled there.

The coils also served to hold the shape firmly, preventing the blood vessel from rupturing.

The second was clip ligation.

This involved clamping the bulging blood vessel with a surgical clip.

The principle was to block blood flow, thereby preventing the vessel from rupturing.

The surgery that would be performed on the pregnant patient was the latter.

It was clip ligation.

Although it was a major surgery that required opening the skull and accessing the surgical site, Junhoo believed that the professor’s decision was correct.

Junhoo would have chosen clip ligation even if he were Minseok.

This was because the location, size, and shape of the aneurysm were beyond what could be handled with coil embolization.

*I am worried, though.*

To open the head of a pregnant woman with pre-eclampsia before delivery.

The thought of the surgery that would take place this morning already made him feel overwhelmed.

Unfortunately, this case was not found even in his master Jaehyun’s secret manual.

This meant that it was a surgery that even his highly skilled master had never performed.

There were only ten cases of brain surgery performed on pregnant women before delivery.

There were no cases that matched the specific keywords of unruptured giant aneurysm and pre-eclampsia.

Shaking off his tension and fear,

Junhoo began his mental training with his eyes closed.

This was a training method that Junhoo had enjoyed since his martial arts days, and in modern terms, it was image training.

He closed his eyes, and in the black darkness,

a surgical table appeared.

A pregnant patient with a bulging belly appeared.

The staff who would be joining him in today’s surgery also began to appear one by one.

The surgery proceeded under the bright light of the surgical lamp.

Although it was virtual, the senses of sight, hearing, touch, taste, and smell were vivid.

The patient’s head was opened, the walnut-like brain was exposed, the bulging blood vessel appeared, and so on.

In his imagination, Junhoo also experienced various cases.

A case where the aneurysm suddenly ruptured.

A case where the patient’s intracranial pressure increased.

A case where cardiac arrest occurred.

In the imagined reality, Junhoo struggled to save the patient.

After nearly an hour of training,

his entire body was drenched in cold sweat.

Junhoo was that immersed in the virtual training, and he was able to test his knowledge and skills in a practical way.

*I can do this.*

I will save both the patient and the fetus.

I can do it.

Having regained his confidence, Junhoo also practiced the Howling Moon Twelve Hand Techniques to loosen up his arms.

Swift hand movements like a swallow.

Soft hand movements like silk.

Powerful hand movements like lightning.

As Junhoo followed the stances of the Howling Moon Twelve Hand Techniques, his fingers, knuckles, elbows, shoulders, and so on.

Various parts related to his arms became more flexible.

The range of motion of his joints increased, his control over his strength became more delicate, and his movements became more precise.

“Junhoo, what are you doing?”

Junhoo suddenly snapped out of it at the sound of Minkyeong’s voice.

He had been so focused on the Howling Moon Twelve Hand Techniques that he had forgotten that Minkyeong had woken up.

Turning around, he saw Minkyeong staring at him with a look of pity.

From Minkyeong’s perspective, it was understandable.

“You haven’t been able to sleep, so you’ve gone crazy, haven’t you?”

“Of course not. I was just… doing some midnight exercise? Or stretching, you could say?”

Junhoo gave an awkward laugh.

* * *

7:30 AM.

The neurosurgery morning conference began.

By that time, Junhoo’s condition had completely recovered.

This was thanks to the *Cheonsanhwan* pills [traditional herbal medicine] and fatigue recovery supplements that were constantly delivered from the Korean medicine clinic, and the 30 minutes of energy circulation in the bathroom.

To be able to barely sleep.

To be able to use that time to build up medical knowledge.

To be able to use that time to learn martial arts.

The combination of supplements and energy circulation was still a cheat.

The biggest topic of the conference was the aneurysm surgery on the pregnant patient that would take place today.

“Professor Kwak. Aren’t you just stirring up trouble for no reason?”

The head of the department stared at Minseok and expressed his concern.

“If it’s an unruptured aneurysm, isn’t it better to monitor it? Do you really have to be so aggressive with the surgery?”

“Because it’s a giant aneurysm, we can’t guarantee the patient’s outcome if it ruptures. I think it’s right to treat it preemptively.”

“The media is scaring people by calling it a time bomb in the head, but aneurysms don’t rupture as easily as people think, do they?”

The head of the department retorted.

The head of the department was also a neurovascular specialist like Minseok, so he was speaking from experience.

“If she weren’t pregnant, I would have taken a more relaxed approach and monitored her. But in the case of pregnant women, there are many hemodynamic risk factors before and after childbirth…”

“Well, I respect Professor Kwak’s opinion.”

The head of the department surprisingly backed down quickly.

But what he said next was even scarier.

“I don’t care if you operate on a brain-dead patient or a vegetative state patient. As long as the result is good. Only the result.”

The head of the department emphasized the result.

It was an unspoken pressure to succeed in the surgery at all costs.

Minseok’s face stiffened as if he felt the pressure.

*That guy is such a jerk.*

When will I stop seeing our department head’s face?

I wish we had a proper department head.

With Junhoo’s wishful thinking, the conference and rounds came to an end.

Junhoo printed out the surgical consent form and moved to the obstetrics and gynecology ward to find the pregnant patient’s room where the surgery would take place today.

“Hello.”

“Yes, hello, doctor.”

“Hello.”

Junhoo approached the bedside and greeted the patient and her guardian, who returned the greeting.

Perhaps it was because the surgery was imminent.

Both of them looked very nervous. Their expressions were unnatural, and their movements were stiff.

Junhoo could understand how they felt.

If the patient were Ahyeong and he were her husband, the anxiety would have been unimaginable.

“You must be very nervous.”

“Yes. I just thought it was a headache, and I thought it would get better if I just took medicine. I never thought I would have to undergo surgery that requires opening my head.”

The patient bit her lip.

“I’m so sorry. You’re already suffering from pre-eclampsia, and now you have this burden…”

“Will I be able to have surgery safely? Will my baby be safe too?”

“What is the success rate of the surgery?”

The patient asked, and the guardian asked again.

How should he answer these difficult questions?

Junhoo paused for a moment before parting his lips.