A Surgeon Who Uses Martial Arts [EN]: Chapter 358

무공 쓰는 외과 의사 358화

제69장 첫 수술(3)

The Great Surgeon 69 – First Surgery (3)

A suffocating silence gripped the operating room.

Hector had thrown the ball, and it was up to Jun-hoo to decide whether to catch it or hit it away.

The staff’s attention was entirely focused on Jun-hoo.

‘Judging by how long he’s hesitating, he’s probably going to give up. Well, he can’t push it any further. Especially since he’s not getting any hints.’

Maxwell expected Jun-hoo to readily concede the lead surgeon position to Hector.

Whether it was ramming Raymond in the Boost Up program test.

Or stepping up to perform the Pipsy Glioma surgery.

Jun-hoo was assertive and confident.

For such a Jun-hoo to hesitate meant he lacked confidence in himself.

“You’ve done well enough so far. You should be proud of yourself.”

Maxwell encouraged Jun-hoo.

However, Jun-hoo stared down at the patient without any response.

Then, he uttered a masterpiece.

“Huh? What did you say?”

“Didn’t you hear me? I said you’ve done well so far. So don’t be disappointed if you give up here.”

“What are you talking about?”

Jun-hoo shrugged, as if he couldn’t understand, and looked straight at Hector.

“Professor. I don’t need any help. I’ll continue the surgery as is.”

Jun-hoo’s statement turned the operating room upside down.

Startled, Maxwell’s eyes widened.

The anesthesiologist behind the curtain coughed, as if choking, and the scrub nurse nervously darted her eyes from side to side.

“Do as you please. But know that I’ll accept your declaration of surrender at any time.”

“Yes, Professor.”

In the overturned operating room, only Hector and Jun-hoo remained calm.

Jun-hoo, who insisted on pushing forward with the surgery, was crazy.

And Hector, who readily accepted it, was also crazy.

This surgery was insane.

“Jun-hoo, don’t be stubborn and leave it to the professor. What if the patient dies… no, what if something happens to the patient?”

“…….”

“Do you want to see a lawyer as soon as you come to Mayo [referring to the Mayo Clinic, a prestigious medical center]?”

Maxwell asked sternly.

It couldn’t be helped.

He had to say it like this for Junhoo to listen even a little bit.

“I know what you’re saying, but let’s focus on the surgery now. We’ve wasted too much time arguing.”

“Do you have a way to stop the bleeding?”

“I’ll have to find one.”

“Isn’t that too irresponsible?”

“Creating a path where there is none is also a virtue a surgeon must possess. Overcoming this crisis will allow me to grow once more. Electrocautery.”

Jun-hoo received the electrocautery from Hector.

He began to incise the dura mater [the outermost of the three layers of membrane protecting the brain and spinal cord] 1cm below the point where the bleeding had occurred.

“Ah…….”

Maxwell reflexively groaned.

Bleeding erupted again.

It wasn’t as much as before, but it was still a significant amount.

‘This is driving me crazy.’

‘Why is this happening?’

It wasn’t like Jun-hoo was making mistakes.

Maxwell frowned, suctioning the red blood that soaked the dura mater.

It was even more maddening because Hector, who knew the answer, kept his mouth shut.

“We’re going to be here all day just cutting the dura mater.”

“No. I think I know what’s going on.”

“Suddenly?”

Jun-hoo nodded instead of answering.

This time, he placed the electrocautery a full 5 centimeters away from the foramen magnum [the large opening in the base of the skull through which the spinal cord passes].

“Isn’t that too far from the tumor?”

“It’s okay. We can retract and widen it.”

“Alright. Try it for now.”

Maxwell’s voice was somber.

Would simply changing the incision site stop the bleeding?

It was unlikely.

In Maxwell’s eyes.

The patient clearly had an unusual cerebrovascular disease.

Whether they were an adult or a child.

There was no way this much bleeding could occur from a dural incision.

Zzzzzz.

Following the blade of the electrocautery, the dura mater slowly opened.

Despite being in a major crisis.

Jun-hoo’s eyes and gestures were calm itself.

“Huh?”

Maxwell, who had been preparing for suction with great tension, was greatly taken aback.

It was hard to believe even though he was seeing it with his own eyes.

There wasn’t much bleeding at the third location Jun-hoo had chosen.

What on earth was going on?

* * *

‘I don’t know exactly, but did I succeed?’

After fully incising the dura mater, Jun-hoo let out a sigh of relief.

1) Should I incise the dura mater at the shortest distance from the surgical site?

2) Or should I incise the dura mater that seems safe, even if it takes longer?

Jun-hoo narrowed down the cause of this situation to just two options before choosing the latter.

If it were his usual personality, he would have definitely pushed for the former.

Jun-hoo preferred things to be fast and accurate. Usually, that was more beneficial for the patient’s treatment and recovery.

Administering diuretics.

Administering antihypertensive agents.

Elevating the patient’s head.

He could have lowered the patient’s intracranial pressure and continued the dural incision while accepting the bleeding.

But today, he changed his mind.

He chose a path he doesn’t usually take.

[Doing the same thing every day and expecting a different future is an early sign of mental illness.]

He remembered it as something Einstein had said.

If he was right.

A new problem should be solved in a new way, a feeling flashed through his mind.

And Jun-hoo’s judgment was spot on.

“Professor. Now can you tell me why the bleeding occurred?”

Jun-hoo’s gaze turned to Hector.

Maxwell’s eyes twinkled as if he was also curious about the reason.

“Well, now that the problem is solved, I guess it’s okay to tell you. Where were the first and second dural incisions made?”

“Near the foramen magnum.”

“In pediatric patients, veins are concentrated around the foramen magnum.”

Hector’s voice was calm as he explained.

“Because the brain and cerebral blood vessels are still actively being created and growing.”

“…….”

“Do you know that the brain is completed at 25 years old?”

“Isn’t that a false statement? There’s neuroplasticity, so new circuits can be created and developed in the brain even in old age, right?”

Jun-hoo tilted his head and asked.

“That’s also true. But it’s also true that the brain is ‘structurally’ completed at 25.”

“Structural aspects.”

“Yes. You picked up on the key word well. The reason why people’s personalities don’t change easily is also because the brain is structurally completed at 25.”

After finishing the long explanation, Hector met Jun-hoo’s eyes.

He didn’t show it, but he was sure that Jun-hoo would fail in this surgery.

Judging by how stubborn he was.

He was confident that Jun-hoo would continue to incise the dura mater with developed venous sinuses [channels that drain blood from the brain], taste the heat, and hand over the scalpel.

But an unexpected variable occurred.

Jun-hoo chose a detour instead of a head-on collision.

“Why did you change your mind in the middle? I thought you would steadily incise the venous sinus.”

“That’s…….”

Jun-hoo smiled awkwardly and continued his answer.

“There’s a Korean proverb that says a tree that is too straight will break. It’s okay if I break, but it’s a problem if the patient breaks. So I gave up my stubbornness.”

“You have a surprisingly flexible side. Good job.”

Hector praised Jun-hoo for the first time in a while.

If it weren’t for the operating room, he would have patted Jun-hoo on the shoulder.

Jun-hoo demonstrated excellent strategy in solving the problem without even studying pediatric neurosurgery textbooks.

The other trainees probably…….

Wouldn’t have been able to make the same judgment as Jun-hoo even if they died and came back to life.

No, would they have even taken on the surgery in the first place?

The surgery continued as the incised dura mater was widened.

The arachnoid [the middle layer of the three membranes (meninges) that surround the brain and spinal cord] and pia mater [the innermost delicate membrane closely attached to the brain and spinal cord] were incised in turn, revealing the walnut-shaped brain.

Weighing around 1.4 kilograms to 1.6 kilograms.

Yet, it consumes 20 percent of the body’s energy and controls the entire body.

An organ still full of mysteries like the universe.

Hector became a pediatric neurosurgeon because he was fascinated by the brain.

Perhaps because he wanted to see a microcosm rather than the universe.

‘The ordeal is not over yet. I wonder if you can make it that far?’

Hector muttered inwardly, glancing sideways at Jun-hoo.

* * *

‘The highlight is from now on!’

Jun-hoo stared at the Pipsy Glioma [a type of brain tumor] through the surgical microscope.

The Pipsy Glioma was located 5 centimeters below the crown of the head.

As Jun-hoo remembered, this was where the motor and sensory nerves were distributed.

So, if Jun-hoo’s scalpel went astray, Amy would have difficulty moving her body or feeling sensations.

In the worst case…….

She could lose some motor and sensory abilities.

But Jun-hoo, who held the electrocautery in his hand, was rather full of confidence.

Although it wasn’t a real sword.

The confidence he had when he held the scalpel seemed to pierce the sky.

In the Murim world [a genre of Korean fantasy fiction], Jun-hoo lived and died by the sword.

Of course, back then it was no different from a sword of revenge, but now Jun-hoo’s sword was a sword of healing.

“Are you really okay?”

Maxwell asked with a worried voice.

“Even if you make a mistake with the skull or meninges [the membranes that surround the brain and spinal cord], you can somehow restore them, but not the brain. If you make a mistake…….”

“If you have the strength to worry about me, focus more on assisting with that strength.”

“Sigh. How can I stop you? Alright.”

Maxwell said as if he had given up.

Hector had been silent since earlier and hadn’t said a word.

Jun-hoo had no way of knowing what he was thinking.

‘Could it be that he still doesn’t trust me?’

“I will continue with the Pipsy Glioma removal surgery.”

Jun-hoo’s electrocautery approached the brain tumor.

The scalpel began to cut out the 4-centimeter brain tumor in a circular motion from the edge.

During the resection, Jun-hoo paused his breathing for a moment.

Even in the subtle moment of inhaling and exhaling, his hand could be disturbed.

If the electrocautery went even 0.1mm beyond the tumor, the nerves distributed in the cerebral cortex could die.

It was necessary to be as careful as possible.

While resecting the tumor.

Jun-hoo infused the mysteries of one of the martial arts techniques, Wind Celestial Moon Illumination (風天月朗) [Pungcheon Wolrang – a fictional martial arts technique], into the scalpel.

Wind Celestial Moon Illumination (風天月朗).

A martial art that embodies a clear wind and a bright moon, characterized by smooth and gentle movements.

Jun-hoo intentionally took the strength out of his wrist.

So much so that others would mistake his wrist for being limp.

Instead, he put enough strength into his fingers.

Was it thanks to mastering the Lunar Sword Twelve Forms [another fictional martial arts technique]?

His hand was Jun-hoo.

The scalpel was Jun-hoo.

Jun-hoo’s tumor removal technique was like water, with nothing to resist.

Rather, the more he used the scalpel.

Concentration and delicacy were gaining momentum and acceleration.

It was a synergy created when a fish meets water.

Jun-hoo had already entered a state of ecstasy. In the place where the ego disappeared, he felt everything.

‘Crazy. Is he even human?’

Maxwell was busy admiring inwardly as he watched the tumor removal surgery.

Jun-hoo’s hand movements were amazing.

A steady hand.

A wrist that was so flexible.

A tumor outline that was as precise as if it had been measured with a ruler.

Jun-hoo was easily peeling off the tumor’s edges as if a child was tracing a picture.

If someone saw this scene.

They would misunderstand, thinking, ‘Is tumor resection this easy? I can do it too.’

Jun-hoo, who had completely peeled off the edges of the tumor, soon pushed the electrocautery deep inside as if he was slicing sashimi.

It seemed he was determined to completely remove the tumor.

But why was it.

Even in the eyes of a third party watching.

There wasn’t even a strand of hair’s worth of worry that Jun-hoo would fail.