A Surgeon Who Uses Martial Arts [EN]: Chapter 372

Chapter 72. Faith (2)

Woo-oong. Woo-oong.

A massive vibration echoed through the operating room.

It was the portable CT scanner next to the operating table.

The portable CT, shaped like a rectangle with a hole in the middle, was a minimized version of the existing CT scanner, allowing CT scans to be performed even in the operating room.

Beeep. Beeep.

The examination table, with the patient lying on it, passed through the circular X-ray tube and returned to its original position.

Jun-hoo and Maxwell carefully lifted the patient and laid him back on the operating table.

“Of all times, why now… What do you think? Why did the bleeding occur?”

Maxwell’s gaze turned to Jun-hoo.

“I don’t know.”

“Isn’t ‘I don’t know’ a bit irresponsible?”

Maxwell frowned, displeased with Jun-hoo’s answer.

“During brain aneurysm surgery, various blood vessels become hemodynamically unstable. Even if there were no mistakes in the surgical area.”

“…….”

“Maxwell, what do you think?”

“Could it be because the surgery took too long? If Professor had performed the surgery, it would be over by now.”

“I don’t think so.”

Jun-hoo shook his head firmly.

“Oliver failed his first solo surgery, didn’t he? Aren’t you going to factor in that time?”

“I made up for it by quickly harvesting the radial artery. It’s only about 10 minutes different compared to the professors’ surgeries, right?”

“Tsk. I disagree.”

Maxwell still didn’t agree with Jun-hoo’s opinion.

Perhaps it wasn’t the actual time.

Jun-hoo thought that maybe he felt the psychological time was longer.

Jun-hoo also felt that surgeries with many twists and turns seemed to take longer.

After finishing his chat with Maxwell.

Jun-hoo stared at the monitor unfolded next to the operating table.

Oliver was standing in front of the desk, looking at the CT images with a serious expression.

“Are the results out?”

Oliver nodded weakly.

Jun-hoo also checked the images.

A 40ml hematoma [a localized collection of blood outside blood vessels] was clustered in the patient’s temporal lobe.

The amount of hematoma was quite threatening, about the size of a thumbnail.

There was a reason why the patient’s intracranial pressure had risen so sharply.

“It never ends. A giant hematoma when the direct surgery isn’t even finished?”

Maxwell shook his head as if he was fed up.

The atmosphere in the operating room instantly turned heavy.

If bleeding occurred in the surgical area.

The hematoma could be removed by suction or aspiration with a syringe.

But the location of the hematoma was terrible.

It was in the temporal lobe where no incision had been made.

That meant…….

The complex and arduous process from craniotomy [surgical opening of the skull] to dural incision [incision into the dura mater, the outermost membrane covering the brain and spinal cord] had to be repeated once again.

“If things are going to go wrong, they really go wrong. Haa…….”

Unable to bear the frustration, Oliver finally sighed.

Jun-hoo didn’t answer and checked the patient’s intracranial pressure first.

The patient’s current intracranial pressure was 28mmHg [millimeters of mercury, a unit of pressure].

It was somewhat lower than the initial intracranial pressure of 35mmHg. It was still higher than the normal intracranial pressure of 0-15mmHg.

It was thanks to the administration of antihypertensive drugs and antihypertensive agents.

Controlling the blood flow caused by the bleeding could somewhat reduce the intracranial pressure.

Jun-hoo shifted his gaze to the patient.

Suddenly, the melody of Baby Shark that Maxi had hummed before the surgery vividly replayed in his ears.

He wanted to hear that melody again.

There may be countless Baby Sharks in the world, but only Maxi could sing the Baby Shark that Maxi sang.

What choice should he make for the patient?

Should he open the temporal lobe according to the textbook and perform hematoma removal?

Or is there a third way?

His worries deepened.

It wasn’t a situation where he could make a carefree choice, like ‘if it works, great, if not, oh well.’

The method of removing the hematoma…….

Would have a decisive impact on the patient’s life and treatment.

The crossroads in front of Jun-hoo were that important.

“Oliver, what do you want to do?”

Maxwell asked Oliver.

“What choice do we have? Of course, we have to open the temporal lobe and remove the hematoma. What if the intracranial pressure rises further and brain herniation [a life-threatening condition where brain tissue shifts out of its normal location] occurs? Then we really can’t do anything.”

“We’re on the same page this time. I agree too. Jun-hoo, are you okay with removal surgery?”

“…….”

“Jun-hoo, why aren’t you answering?”

Maxwell urged Jun-hoo, but even after that, Jun-hoo remained silent for a long time.

Oliver was performing the surgery.

But in fact, Jun-hoo was the leader of the team.

Everyone’s attention was focused on Jun-hoo. They waited for a decision to fall from Jun-hoo’s lips.

“Let’s just go.”

“Go where?”

“Let’s proceed with the existing surgery without doing hematoma removal.”

The staff was shocked by Jun-hoo’s shocking statement.

Oliver and Maxwell were speechless, and even the anesthesiologist behind the curtain coughed as if he had choked.

“Open your eyes wide and look at the CT images again. You’re just going to ignore that thing in the patient’s head?”

Maxwell pointed to the monitor with a dumbfounded expression.

“Jun-hoo. I don’t think that’s right either. The intracranial pressure has dropped with medication, but that’s just a temporary result. There must be a fundamental treatment. It’s like peeing on a cold foot [a temporary and ultimately ineffective solution].”

Oliver also came to support Maxwell.

Jun-hoo was suddenly fighting a 2-on-1 battle.

The clashing gazes between the three were tense.

Neither side seemed willing to back down easily.

A desperate atmosphere swept through the operating room, as if they were fighting a life-or-death battle on a single log bridge with a cliff below.

At that time, Jun-hoo was thinking.

About the advice the Murim Lord [a martial arts master] had given him in the past.

[The best swordsman is the one who subdues his opponent without using a sword.]

“Do you two trust me?”

Jun-hoo broke the silence first.

“If you trust me, let’s go my way.”

* * *

The surgical observation room.

Austin was watching the monitor showing the operating room with his arms crossed.

With the occurrence of a hematoma in the temporal lobe.

The surgery was temporarily suspended.

There was quite a long debate among the staff about the differences in treatment.

“Things were going well, but things got complicated at the last minute. A hematoma in the temporal lobe of all places…….”

Bruce clicked his tongue as if he was sorry.

“This is an unexpected situation, should I give them some advice? Otherwise, they’ll probably do hematoma removal. Hematoma removal will only lengthen the surgery time and put the patient at risk.”

“Let’s watch for now.”

“Still, they’re just trainees, aren’t you being too stingy with advice?”

“You’re too hasty.”

Austin shook his head and continued.

“Even if you give advice, you should give them time to think for themselves first.”

“It’s because the result is too obvious. How many surgeons wouldn’t fall for that trap?”

Bruce’s voice was full of disbelief.

In fact, Bruce’s point wasn’t wrong either.

There was no fish that wouldn’t bite a delicious bait wiggling its tail in front of its eyes.

But Austin focused on the fact that the conflict between the staff was prolonged.

The prolonged conflict meant that the opinions were not unified.

Not unified opinions meant that there was a fish that didn’t bite the bait.

The fish that didn’t bite the bait was probably Jun-hoo.

‘I thought he was the type to do anything for surgery, but I guess that’s not the case?’

Austin was newly impressed with Jun-hoo.

The temporal lobe hematoma that occurred in the patient.

It was certainly threatening, but it wasn’t enough to affect the main surgery.

If you knew ‘that method’ in advance.

Come to think of it, Austin belatedly realized that he had forgotten to include ‘that method’ in the textbook.

So, he instinctively figured out ‘that method’?

He’s a much more amazing friend than I thought.

“I’ll prepare in advance.”

Bruce got up from his seat and headed to the table by the window.

It seemed he was planning to give advice as soon as the trainees chose hematoma removal.

About five minutes passed.

The staff returned to their positions and began surgery again.

Surprisingly, hematoma removal was not performed.

* * *

“Everyone, you’ve worked hard.”

“You’ve worked hard.”

The staff said a word each in a hurry.

Total surgery time: 6 hours and 20 minutes.

The curtain finally fell on the direct and indirect revascularization surgery for pediatric moyamoya disease [a rare, progressive cerebrovascular disorder].

A new blood vessel was connected to the middle cerebral artery M1 segment [a major artery in the brain].

And blood vessels from the scalp were implanted around the existing blood vessels that were thin and unable to properly carry blood.

As the patient grows, the transplanted blood vessels will grow like sprouts.

It will be responsible for normal blood flow.

“I feel uneasy because I finished the surgery without removing the hematoma.”

Oliver clicked his tongue and muttered to himself.

“Yeah. It’s like not wiping your butt in the bathroom. Jun-hoo, are you sure there won’t be any problems?”

Maxwell’s disapproving gaze turned to Jun-hoo.

“If it goes according to my plan.”

“Wasn’t it too dangerous to just trust the plan and go?”

“It’s important to trust your colleagues, and it’s also important to trust yourself. I trust my decision.”

Jun-hoo answered calmly.

In fact, Jun-hoo didn’t oppose hematoma removal because he knew something accurate about medical knowledge.

What is best for the patient?

As he persistently clung to that question, this question suddenly popped into his head.

What if the hematoma is removed on its own even if hematoma removal is not performed?

He knew it was nonsense.

He also knew it was absurd.

Isn’t there hematoma removal because the hematoma can’t be removed?

But Jun-hoo knew that there were exceptional cases where hematomas were naturally removed.

Jun-hoo believed that this exceptional case could be this case.

He was not without fear that he might be barking up the wrong tree [pursuing a mistaken or misguided approach], but he fought it off with all his might.

If I don’t trust myself.

Who would trust me?

“What about the patient’s vitals and intracranial pressure?”

“Vitals are all normal and intracranial pressure is 20mmHg. It’s a little higher than normal.”

“Let’s take another CT scan before sending the patient to the intensive care unit.”

“Of course, we should.”

Maxwell nodded vigorously.

The examination table with the patient lying on it advanced towards the X-ray tube.

In Jun-hoo’s eyes, that scene looked slow, as if it were in slow motion.

The test questions were solved.

Finally, the scoring results were about to come out.

If Jun-hoo’s judgment was correct, the size of the hematoma should have decreased somewhat.

If the hematoma size remained the same.

Jun-hoo would have done something unforgivable to the patient, Oliver, and Maxwell.

Because hematoma removal would have to be performed additionally.

A short but long time passed.

The CT equipment spat out the patient.

The patient was transferred to the bed, and the three were huddled together in front of the monitor next to the operating table.

“Shall we check then?”

Jun-hoo and Maxwell nodded at Oliver’s words.

Click!

CT images appeared on each of the dual monitors with a mouse click.

The existing CT image on the left.

The freshly taken image on the right was located.

Oliver moved the mouse pointer and dragged the hematoma existing in the CT image just taken.

The size and width of the hematoma were calculated, and the amount of blood in the hematoma floated above it.

The amount of hematoma, which was previously 40ml, was drastically reduced to 25ml.

All the staff did was steadily administer thrombolytic agents [medications used to dissolve blood clots].

“What? The hematoma really got smaller? Why is that?”

Oliver stared at Jun-hoo with eyes so big they looked like they would pop out any minute now.