A Surgeon Who Uses Martial Arts [EN]: Chapter 304

Chapter 58: Golf (4)

‘This is getting complicated.’

Orthopedic surgery attending physician, Namgung Hyuk, sighed as he headed to the operating room.

Ten minutes prior to this moment.

He received a call from Sideok, the head of neurosurgery and his classmate from medical school, asking him to perform surgery on a spinal arteriovenous malformation [an abnormal tangle of blood vessels on, in, or near the spinal cord] patient in place of the neurosurgery department.

At first, Namgung Hyuk thought Sideok was joking.

The cervical and lumbar spine areas were where neurosurgery and orthopedic surgery overlapped.

This could easily lead to disputes.

They had firmly adhered to the principle of alternating days for cervical and lumbar spine cases, with orthopedic surgery handling it one day and neurosurgery the next.

But now, Sideok was saying he would break that principle.

His surprise was short-lived, however, as he was dumbfounded upon hearing the full story.

The attending physician on duty had left his post to play golf.

The attending physician in question was Hunsik, notorious within the hospital for shirking his duties.

“Professor, is something wrong?”

Yungi asked, hearing Namgung Hyuk’s sigh.

Yungi’s eyes, as he looked at Namgung Hyuk, were innocent and clueless.

Yungi was a first-year resident who knew nothing.

The third and fourth-year residents were all at seminars, and the second-year residents were stuck guarding the ward.

“The surgery is quite challenging. Emergency spinal arteriovenous malformation cases are difficult to operate on. Moreover, by now, several blood vessels might have already ruptured.”

“Ah… Then, if something goes wrong during the surgery, won’t the neurosurgery department blame us?”

Yungi asked, worried.

“That can’t be considered blame. Yungi, you need to change your way of thinking.”

“……”

“Once you enter the operating room, that surgery becomes your surgery. You need to take responsibility.”

“I’m sorry, Professor. I was short-sighted…”

“That’s how you learn.”

Even after saying that, Namgung Hyuk stared at Yungi for a long time.

Namgung Hyuk’s eyes wavered for a moment.

He was considering whether to replace him with a second-year resident as an assistant, even now.

He wasn’t thrilled with the second-year resident either, but they would at least be better than Yungi.

However, bringing the second-year resident to the operating room would leave no one to handle the issues that might arise in the ward.

To use a gaming analogy, it would be like going to help an ally only to have your own base destroyed.

“Still, I’m a bit relieved.”

“Relieved? How can you say something so foolish in this situation?”

Namgung Hyuk reacted sensitively to the rash word that came out of Yungi’s mouth.

“Well… I heard that Senior Junhoo is assisting with this surgery.”

“Junhoo? Who is that?”

“He’s a second-year neurosurgery resident.”

“As a first-year, you might think a second-year is amazing, but second-years don’t know that much either.”

“I think Senior Junhoo is a bit different.”

“Why is that?”

“He was called a legend since his days in medical school. He never missed being the top student and treated a lot of patients.”

Yungi replied confidently.

Come to think of it, he seemed to have heard the name ‘Junhoo’ a few times during faculty meetings.

Junhoo was also the one who recognized the spinal arteriovenous malformation, which had a top-tier diagnostic difficulty.

However, Namgung Hyuk didn’t trust Junhoo.

“Rumors tend to be exaggerated. Don’t be swayed by such things.”

“…Yes.”

Yungi’s voice clearly indicated that he was answering reluctantly.

Having chatted, they arrived at the operating room.

Namgung Hyuk moved to the sink and began scrubbing with Yungi.

Though he didn’t show it, he felt rushed, as if someone was chasing him.

If the patient’s life was a season,

It felt like early winter now.

With the help of the scrub nurse, he put on a surgical cap, surgical gloves, and a surgical gown.

Namgung Hyuk entered the operating room with quick, short steps.

The scene in the operating room, which he arrived at with half worry and half anxiety, was well-organized.

The patient was lying on the operating table.

The patient monitoring device was connected, and a central venous catheter [a thin, flexible tube inserted into a large vein] was also connected.

Two dressing carts were placed on either side of the operating table.

The patient’s emergency CT scan was displayed on the monitor.

There was a rustling sound from behind the curtain, slightly away from the operating table.

The anesthesiologist seemed to have arrived already.

Namgung Hyuk was in a state where he only needed to pick up his spoon on a fully prepared table [everything was prepared for him].

“Did you set up the surgery by yourself?”

Namgung Hyuk, standing in the surgeon’s position, asked the resident across from him.

The resident had a handsome build and sparkling clear eyes.

“Yes, Professor. I’m Seo Junhoo from neurosurgery.”

Namgung Hyuk nodded instead of answering. He meticulously examined the surgical tools that were set up, pretending to be nonchalant.

Micro forceps needed for vascular surgery, vascular clamps, a spine-specific retractor, a navigation system, various consumables, and so on.

It was a perfect setup with nothing to add or subtract.

Considering that the surgery preparation time was not long, it was a setup with unbelievable accuracy and speed.

Soon, Namgung Hyuk’s gaze, having finished exploring, rested on Junhoo.

“You’re quite something.”

* * *

Junhoo felt a sense of relief at Namgung Hyuk’s arrival.

Without the help of the orthopedic surgery department, he would have had to transfer the patient to another hospital.

“You’re quite something.”

Namgung Hyuk praised Junhoo after examining the surgical setup.

“Being a second-year resident… and from neurosurgery, you wouldn’t have had much experience assisting with lumbar spine surgeries.”

“I’ve been studying in my spare time. Patients don’t wait for me.”

“Anyone would think you’re already a famous doctor.”

His tone seemed sarcastic, but Namgung Hyuk’s eyes were curved in a gentle arc.

He seemed pleased with Junhoo’s answer.

“How much do you know about spinal arteriovenous malformations?”

Namgung Hyuk’s voice was stern as he asked the question.

“Enough to assist you without any issues, Professor.”

“If you want to save the patient, you need to do well. Briefly recite the surgical procedure.”

“After exposing the surgical area, we perform a laminectomy [surgical procedure to remove a portion of a vertebra]. After removing all the structures blocking the blood vessels, we clamp the blood vessels with vascular clamps above and below the malformed blood vessels.”

“……”

“We excise the malformed blood vessels and restore the surgical area.”

Junhoo’s answer was concise.

Junhoo had memorized all of Jaehyun Park, the master of neurosurgery’s, surgical know-how in just 10 minutes.

Explaining the surgical overview was a piece of cake.

“I’m glad you’re not a simpleton. Let’s start the surgery right away.”

Staff members became busy at Namgung Hyuk’s direction.

Yungi, the first-year orthopedic resident, stuck close to Junhoo.

The scrub nurse, who had joined late due to circumstances, stood beside Namgung Hyuk.

All the pieces needed for the surgery were gathered.

Before the full-scale surgery, Junhoo checked the patient’s vitals one more time.

Body temperature 36.7.

Respiratory rate 15 breaths per minute.

Pulse 145.

Blood pressure 160mmHg/120mmHg.

The pulse and blood pressure had risen slightly more than what was measured in the emergency room.

It was a sign of blood vessel bleeding.

To compensate for the blood already lost, the body increases the pulse and blood pressure when a blood vessel ruptures.

Junhoo sensed that there wasn’t much time left.

This surgery would be a race against time.

“Yungi, administer a beta-blocker and an antihypertensive, and add an albumin IV.”

“Yes, Professor.”

“Junhoo, you’ll assist me and go straight into the surgery.”

Namgung Hyuk’s orders were clear and refreshing.

It was a world of difference from someone who went to play golf.

Junhoo thought that if Namgung Hyuk was the surgeon,

There was a good chance of success in this surgery.

Soon, Junhoo’s hands became busy.

First, Junhoo drew a vertical line with a marking pen on the patient’s lumbar vertebrae 2-3 area, who was lying face down.

It was the skin incision line.

Swoosh. Swoosh.

Following Junhoo’s touch, red disinfectant was applied to the patient’s waist.

Flap!

A white surgical drape was placed over the disinfected area.

The surgical drape looked coldly white because of the light from the operating light illuminating the operating table.

“#10 blade.”

As soon as the preparations were complete, Namgung Hyuk held the scalpel.

The scalpel moved indifferently along the skin incision line.

The incision line drawn by Junhoo and the incision line drawn by the scalpel matched exactly as if they were one.

It was a scene that revealed Namgung Hyuk’s skill.

As the skin split, blood trickled out from the sides, so Junhoo wiped the blood with gauze.

Holding the retractors in both hands, he widened the incision to the left and right.

The surgical view became as clear as a plain.

Junhoo and Namgung Hyuk began to expose the surgical area, taking turns.

The two people’s teamwork fit together perfectly like puzzle pieces every time.

They understood each other without speaking.

And because they understood each other, they didn’t need to speak.

The subcutaneous layer split.

The fascia layer split.

A fixation retractor was installed, and so on.

All the processes proceeded smoothly and quickly.

Junhoo and Namgung Hyuk were both aware that the key point of this surgery was speed.

The two were looking at the same place.

The forefront of the spine.

So, as the veil was lifted, the internal structure of the waist was finally revealed.

The first thing that caught the eye was, of course, the patient’s lumbar vertebrae.

The alignment of the lumbar vertebrae was straight.

It wasn’t a bone problem, but a blood vessel problem.

“I expected it because the blood pressure and pulse are high… but as expected, several blood vessels have ruptured.”

Namgung Hyuk, with his eyes close to the microscope, clicked his tongue and said.

Some blood vessels extending from the ASA (Anterior Spine Artery) of lumbar vertebrae 2-3 had ruptured.

A dark red dot was hanging at the end of the blood vessels.

It was a thrombus [blood clot] caused by blood clotting.

“The arteriovenous malformation of the spine also seems more complicated than expected.”

Junhoo added a word.

“Yes. Even the location is the worst. It’s on the lateral artery, and there’s even a nerve passing nearby.”

Namgung Hyuk’s eyebrows furrowed.

“Shall we try a laminectomy first?”

“We have to. To access the blood vessels.”

“Can I try the laminectomy? I think it would be better for you to conserve your energy, Professor.”

“I appreciate the thought… but can you do it well? You need to be fast and accurate.”

“I’ve done it at least 10 times.”

“Still, you’ve never done it on an emergency patient, have you? You’ll be in big trouble if you think of it as leisurely as a regular surgery.”

“How about I try it first, and if you don’t like the way I’m doing it, you can take over?”

“That’s not a bad suggestion.”

Namgung Hyuk nodded as if to allow it.

In response, Junhoo held a diamond drill in both hands.

Namgung Hyuk’s eyes widened in surprise at the sight.

“You’re going to use both hands?”

“Yes. I’m good at using both hands. And using both hands will be much faster than using one hand.”

The ambidextrous skill he learned while being called ‘fool’ during his internship was about to come into play again.

“Yungi, do the suction and irrigation (saline wash) well. You can’t fall behind my speed.”

“Ah. Yes, Senior.”

After giving Yungi a firm warning, Junhoo performed the laminectomy.

Wee-ing.

Wee-ing.

Two drills rotated simultaneously.

The subtle yet noisy rotation sound devoured all the sounds in the operating room.

Junhoo’s world began from then on.

The drills in both hands dug into the lateral side of the triangular pyramid-shaped lamina [part of the vertebral arch].

Junhoo already had a blueprint in his head for perfectly resecting the lamina.

A blueprint that his teacher, Jaehyun Park, had drawn for decades.

And Junhoo had the skills to complete that blueprint with martial arts.

Mistakes?

Variables?

Such things could never occur.

Right now, Junhoo’s hands were simply falling flowers on flowing water [effortless and natural action].

While using the ambidextrous technique, he even incorporated the principles of martial arts moves.

As the name of the move suggested, Junhoo’s wrist and finger movements were as flexible as flowing water.

The two drills were unobstructed, unresisted, and uncollided.

Thanks to this, the hard lamina bone was delicately and quickly ground away.

The desperation to save the patient.

When combined with the wondrous martial arts, Junhoo’s performance was dazzling.

Finally, the laminectomy came to an end.

The cut surface was as clean as if it had been measured with a ruler, and there was no damage to nearby nerves and blood vessels.

It all happened in just 3 minutes.