A Surgeon Who Uses Martial Arts [EN]: Chapter 284

Chapter 54: Dispatch (4)

While Jun-hoo and Hyuk-jae were engaged in a tense battle of wills, the phone in the on-call room rang.

Jun-hoo answered it.

“Yes.”

-…….

“I’ll check the chart and head down right away.”

Jun-hoo hung up and sat at his desk, moving the mouse. It seemed like a call from the emergency room.

“What kind of patient is it?”

Hyuk-jae asked gruffly.

“It’s a T.A. (Traffic Accident) patient. They’re reporting a skull fracture and subarachnoid hemorrhage [bleeding in the space surrounding the brain]. I’ll review the emergency records and brain CT scan before going down.”

“Is that so?”

Hyuk-jae pretended not to be interested but meticulously scanned the patient’s information on the monitor.

A chill ran down his spine; he had a bad feeling about this.

Emergency surgery seemed likely.

“I’ll come down with you.”

“Shouldn’t one person stay in the on-call room? Or do you not trust my judgment?”

“It’s not that I don’t trust you, but…”

Hyuk-jae hesitated before continuing. “I’ve heard rumors that you’re quite the hotshot from Seoul. I just want to see your skills firsthand. We can have an intern cover the on-call duty for a bit.”

“Do as you please.”

Jun-hoo said with an indifferent expression.

Jun-hoo’s almost too-polished appearance.

His irritating tone.

His attitude of looking down on him bothered Hyuk-jae.

So, Hyuk-jae planned to use this opportunity to put Jun-hoo in his place.

*No matter how good you are.*

*Have you treated and cared for as many neurosurgical trauma patients as I have?*

…That was his conviction.

“If you’ve reviewed the chart, let’s go.”

Hyuk-jae put his hand on Jun-hoo’s shoulder, a smile spreading across his face.

* * *

*This guy is a real piece of work, isn’t he?*

*I’ll have to find something to get him on soon.*

While going down to the emergency room, Jun-hoo finished his assessment of Hyuk-jae.

Hyuk-jae was the type of person who was used to ignoring his juniors like servants and bossing them around.

His overbearing tone and actions.

Above all, the half-broken mop handle was undeniable proof.

The more someone is like Hyuk-jae, the better their evaluation is from superiors.

Because…

They squeeze their juniors to produce results no matter what.

But Jun-hoo hated Hyuk-jae’s type. Exploiting and using subordinates was no different from the Demonic Sect [a common antagonist group in martial arts stories, known for ruthless tactics].

The two soon arrived at the emergency room.

They stood in front of a bed near the wall in the A-10 zone, which was designated for patients requiring emergency surgery.

The patient’s name was Yang Jae-woong.

He was 32 years old.

He was hit by a car that suddenly jumped the curb.

Because the car wasn’t going fast, other parts of his body weren’t seriously injured, but he hit his head hard when he fell.

The patient was leaning against the back of the bed.

He stared blankly at the IV drip connected to his arm.

In other words, he had a spaced-out expression.

A bandage was wrapped around the patient’s head.

A guardian, who appeared to be his mother, held the patient’s hand.

“Hello. I’m Seo Jun-hoo from neurosurgery.”

“Yes, hello, doctor.”

The patient greeted him readily.

His blank eyes quickly regained their vitality.

The guardian also belatedly noticed Jun-hoo and bowed her head in greeting.

“What’s the most uncomfortable thing you’re experiencing right now?”

“My head is buzzing. I also feel nauseous.”

“How do you see my fingers?”

Jun-hoo extended his index finger and held it out to the patient.

“Isn’t that just your finger?”

“Do you see two fingers, afterimages of the finger, or does the finger appear to be shaking?”

“No. Everything’s fine.”

Jun-hoo calmly questioned the patient.

No prior history related to the head.

No family history related to the head.

The patient had no other medical history or surgical records.

Click!

He turned on the penlight and shone it into the patient’s pupils. There were no abnormalities in the size or shape of the left and right pupils.

The GCS (Glasgow Coma Scale) score [a neurological scale used to assess level of consciousness] was also 15 out of 15.

His condition was quite good considering the accident he had.

But then, it happened.

The moment he was about to relax.

A clear liquid flowed from the patient’s ear.

Like water from a spring.

Drip. Drip. Drip.

“Huh? What is this?”

“Wait! Don’t touch it.”

Jun-hoo urgently stopped the patient.

He took gauze from the gauze container and held it under the patient’s ear.

The gauze quickly became damp.

The cerebrospinal fluid flowed for about a minute before stopping.

But as the unexpected situation unfolded, the atmosphere in the room became heavy.

In particular, Hyuk-jae, who had been watching the patient, shook his head from side to side without a word.

“Doctor… Doctor! Why is this happening to Jae-woong? Why is water coming out of his ear…?”

The guardian asked, tapping her feet anxiously.

She was greatly surprised to see water suddenly flowing from her son’s ear.

The patient’s eyes also widened like an owl’s.

“It’s a symptom called Cerebrospinal Fluid Leak. Due to the trauma, the ventricles in the brain swell, preventing the cerebrospinal fluid from escaping the head…”

“…….”

“It’s a symptom where it leaks out through the ears or nose.”

Jun-hoo solemnly conveyed the prohibitions to the patient.

No coughing and no blowing the nose.

Both were actions that increased pressure on the head.

Jun-hoo also helped ensure that the patient’s head was kept at a 30-degree angle.

“So, the water inside his head came out through his ear? Isn’t that a very serious illness?”

The guardian asked with a pale face.

“It depends on the situation. In your son’s case, it can be treated naturally.”

“Really? Then he doesn’t need surgery?”

“Yes. Not at the moment.”

Jun-hoo reassured the guardian.

Jun-hoo was not at all flustered by the occurrence of cerebrospinal fluid leak in the patient.

It was because he had witnessed countless horrific scenes of colleagues’ arms and legs being cut off, heads rolling, and intestines spilling out of the abdomen when he was active in the Murim [martial arts world].

The composure he developed at that time became an invisible foundation for Jun-hoo’s training as a surgeon.

“I’ll check your head. Don’t move.”

Jun-hoo took the bandage scissors from the dressing cart.

Snip. Snip. Snip.

He cut the bandage that was wrapped around the patient’s head.

As he did so, Jun-hoo gently placed his hand on the back of the patient’s head.

He was using Internal Energy Cerebral Angiography.

Woo Woong. Woo Woong.

The internal energy drawn from his dantian [energy center in the body, according to traditional Chinese medicine] was transmitted to his palm, and from his palm to the skull.

As he converted the internal energy into medical qi [vital energy], the internal energy smoothly passed through the skull and spread throughout the brain.

As if injecting a contrast agent.

Through the internal energy that rapidly spread to the patient’s brain.

Jun-hoo was able to touch, scan, and probe the patient’s brain.

And the time it took to perform the procedure and confirm the results was only 15 seconds.

As always, he felt that…

Internal Energy Cerebral Angiography was a cheat.

“There’s an abrasion on the temporal area, but it doesn’t need to be stitched. Medication will be enough.”

Jun-hoo reassured the patient and the guardian, taking his hand off the back of the patient’s head.

But then, it happened.

An unexpected uninvited guest suddenly interrupted the examination.

“Wait a minute. Seo Jun-hoo, let me talk to you.”

Hyuk-jae put his right hand on Jun-hoo’s shoulder.

He pointed behind him with his left thumb.

Jun-hoo faced Hyuk-jae in a place quite far from the bed. Hyuk-jae’s attitude with his arms crossed was very poor.

“Are you out of your mind? You’re going to treat that patient with medication?”

“Yes. Mannitol (diuretic) and nimodipine (calcium channel blocker) should be enough for him to recover.”

“That patient has a skull fracture, subarachnoid hemorrhage, and even a cerebrospinal fluid leak. Medication alone won’t be enough!”

“…….”

“And from the start, if surgery wasn’t necessary, why would the emergency department have notified us? They would have notified neurology.”

Hyuk-jae asked accusingly.

Neurology was internal medicine, and neurosurgery was surgery.

To use heart disease as an analogy.

Cardiology (circulatory medicine) is internal medicine, and thoracic surgery is surgery.

“Emergency physicians have limitations in examining the head, right? They might have mistakenly thought surgery was necessary.”

“Mistaken my ass.”

Hyuk-jae sneered and continued.

“Stop talking nonsense and schedule surgery right away. A hematoma [a collection of blood outside the blood vessels] will soon form due to the subarachnoid hemorrhage. And if a hematoma forms, the intracranial pressure [pressure inside the skull] will skyrocket.”

“No. I can’t do that.”

“What… what did you say?”

“Why would I operate on a patient who doesn’t need surgery?”

Jun-hoo didn’t back down an inch.

He didn’t think that his medical knowledge was inferior to Hyuk-jae’s even by a fingernail.

Jae-hyun, the self-proclaimed and publicly recognized best neurosurgeon in the country.

Jun-hoo was the one who memorized his training notes entirely.

From that point of view.

Hyuk-jae discussing medical knowledge in front of Jun-hoo was as unsightly as a novice boasting about his martial arts in front of the Murim Alliance Leader [leader of the martial arts world, a position of great authority].

“Look at this punk? A senior tells you to do something, and you just do it. Why are you arguing so much?”

“…….”

“Have you seen more trauma patients than I have? Or… are you perhaps not confident in surgery?”

A sneer appeared on Hyuk-jae’s face.

He had the expression of someone who had caught something.

“Don’t talk nonsense, senior. Don’t make a perfectly healthy patient suffer by opening up their head.”

“Did you just say nonsense?”

“Did I say something wrong? If a doctor talks about ‘catching’ a patient [meaning unnecessarily operating on them for personal gain], isn’t that nonsense?”

Jun-hoo once again mentioned the reasons why surgery was not necessary.

The first reason was a linear skull fracture without a scalp laceration.

This meant that the impact on the patient’s head was not as great as feared.

The second reason was, surprisingly, the subarachnoid hemorrhage. As confirmed by the CT scan, the amount of bleeding was not significant.

This was evidence that it was not a ruptured cerebral aneurysm but a ruptured microvessel due to trauma.

Also, the amount of bleeding was about 50CC [cubic centimeters].

At this rate, even if a hematoma formed, it could be naturally absorbed by the cerebrospinal fluid.

“Skull fracture, subarachnoid hemorrhage, cerebrospinal fluid leak. If you put all three together, the patient’s condition may seem very bad.”

“…….”

“But let’s take a closer look. Are those three things really as serious as we’re worried about?”

“…….”

“You saw that the patient’s consciousness is clear, right? You remember that there was nothing wrong with the pupillary reflex, right?”

Jun-hoo beat Hyuk-jae with data-based arguments.

He used his three-inch tongue to perform fist techniques, palm techniques, leg techniques, and hand techniques [a metaphor for arguing skillfully and persuasively].

Hyuk-jae had become speechless.

No, more than that, he was battered.

He had an expression of injustice, but he couldn’t even make a single proper rebuttal.

Eeeeeek.

*That annoying bastard!*

Hyuk-jae was suppressing his anger inside.

He couldn’t handle Jun-hoo’s flamboyant mouth at all.

“W-Well, anyway!”

Hyuk-jae’s voice rose.

“Anyway, what?”

“It’s hard to express in words, but that patient needs surgery. My gut feeling from seeing trauma patients tells me so!”

“Seriously, do surgeons operate based on gut feeling these days? Were you a shaman instead of a senior doctor?”

“You little punk, all you do is argue back. Someone as arrogant as you needs to be taught a lesson.”

Hyuk-jae, unable to overcome his anger, punched Jun-hoo.

Whoo Woong.

But Jun-hoo simply blocked Hyuk-jae’s fist with his palm.

It was a fantastic defense that was hard to believe even when seen.

As Hyuk-jae was in shock, Jun-hoo’s even more shocking statement followed in his ear.

“Hey, from this moment on, don’t even dream of being treated like a senior by me.”