A Surgeon Who Uses Martial Arts [EN]: Chapter 382

Chapter 74: Spring (2)

Observation room overlooking the operating room.

Austin, arms crossed, stared intently at the monitor displaying the surgery.

The surgeon was Jun-hoo.

The first assistant was Maxwell.

The surgery in progress was for a pediatric arteriovenous malformation (AVM) [an abnormal tangle of blood vessels connecting arteries and veins in the brain].

Blood vessels can be broadly divided into arteries, veins, and capillaries.

In patients with brain AVMs,

blood flow bypassed the normal capillary circulation, flowing directly from artery to vein instead of artery → capillary → vein.

This shortcut created a blood pressure difference.

The blood pressure difference could lead to a cerebral hemorrhage (bleeding in the brain).

Fortunately (?), the patient had a seizure before the hemorrhage occurred.

Thanks to losing consciousness due to the seizure, they visited Mayhew, underwent a detailed examination, and were diagnosed with a brain AVM.

“The more I see it, the more amazing it is. At that level, it’s almost insulting to call him a trainee,” Bruce remarked, clicking his tongue while seated next to Austin.

Jun-hoo was meticulously removing the malformed blood vessels located near the anterior cerebral artery.

Holding forceps in one hand,

and a Bovie (electrocautery) [a device using heat to cut or seal tissue] in the other.

Jun-hoo used the forceps to gently lift the malformed blood vessels attached to the cerebral cortex.

Then, he cauterized the left end of the blood vessel with the electrocautery.

Sizzle.

White smoke billowed as the blood vessel burned.

The blood vessel, exposed to high heat, shriveled up like dried filefish before snapping off cleanly.

There was no bleeding.

Austin widened his eyes, carefully examining the patient’s cerebral cortex.

The Bovie had precisely cauterized only the blood vessel.

There were no burn marks on the surrounding cerebral cortex.

The patient’s delicate nerves and brain area, the most vulnerable part of the surgery, were being handled with remarkable precision.

Even though he was using both hands simultaneously, Jun-hoo’s movements were incredibly delicate.

There was no tremor, not even the slightest unwanted movement.

As Jun-hoo’s hands worked with focused precision, the tangled and clumped blood vessels were removed one by one.

Blood vessels, resembling earthworms, piled up on the silver curved tray.

“To think he could handle a Grade 4 surgery. Honestly, I ordered it hoping he would fail halfway through.”

“Are you serious? What if something happened to the patient?” Bruce asked, his eyes wide with concern.

“Of course, I was planning to step in myself. Otherwise, why would I be here observing when I’m so busy?”

“I see.”

After their brief exchange, Austin refocused his gaze on Jun-hoo, whose image was reflected on the monitor.

Spetzler-Martin grade [a grading system for AVMs].

This was an index that divided adult and pediatric brain AVM patients into a total of five grades, based on size, location, and venous drainage.

The patient Jun-hoo was operating on was Grade 4.

It was the grade right below Grade 5, which had the worst prognosis, but in practice, it was considered the highest grade that could be surgically addressed.

Grade 5 was generally considered impossible to operate on directly.

A Gamma Knife surgery [a type of stereotactic radiosurgery], which didn’t involve incisions, was the preferred treatment.

“Is there a reason why you want Jun-hoo to fail?” Bruce asked after a long pause.

“He hasn’t faced any real setbacks. A surgeon is supposed to grow by experiencing bitter tastes.”

“Come to think of it… Jun-hoo is the only one among the trainees who hasn’t had a single patient die or develop any significant aftereffects.”

Bruce’s voice was filled with a mix of admiration and disbelief.

What Jun-hoo lacked was, in fact, only experience.

The delicate hand movements required for surgery, the comprehensive medical knowledge from basic principles to the latest research papers, and a bold and decisive judgment – Jun-hoo was already ahead of Bruce in almost every aspect.

Austin knew this.

Bruce himself knew it.

And another professor, Hector, knew it.

Even Jun-hoo probably knew it. People tend to see as much as they know.

“No matter how skilled you are, you can’t save every patient, can you?”

“……”

“I’m sure there will be inevitable trials as time passes.”

“That’s true, but… I’d prefer it if he stumbled while he was under my guidance. I’m originally good at helping people who have fallen, you know?” Austin smiled slyly.

The reason why Austin was so highly regarded was not only because he was exceptionally skilled at surgery.

He was also famous for instilling a steel mentality in his students, preparing them for the harsh realities of the profession.

“I’m going to orchestrate an interesting scenario soon.”

“The scenarios you orchestrate are only interesting to you, aren’t they? The people watching are usually anxious,” Bruce said, shaking his head.

“Please exclude me from that scenario. Even as a background character.”

“Lucky you. You’re excluded.”

“Oh. God. Then who are the poor sacrifices?”

“Jun-hoo and Hector.”

“The main characters are all formidable. Did you approve that surgery?”

“Of course. Avoiding surgery is a surgeon’s shame,” Austin said triumphantly.

Normally, Bruce would have felt reassured by Austin, the foremost authority in pediatric neurosurgery, but this time he couldn’t shake off a feeling of unease.

The surgery he was about to undertake was incredibly challenging.

The patient had been rejected for surgery by almost every major university hospital and had finally come to Mayhew as a last resort.

Even though he wasn’t selected as staff for the surgery, Bruce was anxious.

It felt like a typhoon was brewing within the department.

* * *

4th floor lounge.

Jun-hoo, having just finished the pediatric brain AVM surgery, leaned back on the sofa, a sense of accomplishment washing over him.

Click!

He opened a can of coffee and took a sip. The sweet and bitter taste filled his mouth.

“I never thought you’d be able to handle a Grade 4 surgery. Are you even human?” Maxwell asked, genuinely impressed.

“Maybe he’s a Reptilian?” another trainee joked.

Reptilians were reptilian aliens who could supposedly transform into humans, a popular conspiracy theory.

“That’s plausible. That’s why he’s not afraid of any surgery. His skills are far superior to humans,” Maxwell said, playing along with Jun-hoo’s joke and chuckling.

“I think the department head secretly wanted you to fail the surgery?” Maxwell changed the subject, his tone turning serious.

“Did you notice that too?”

“Honestly, it wasn’t a surgery that a trainee could reasonably handle. It seemed like the department head was planning to step in if you messed up,” Maxwell explained.

“Our Maxwell. You’re so perceptive,” Jun-hoo said, smiling.

At Jun-hoo’s words, Maxwell playfully turned his head 90 degrees to the left and right, respectively, as if acknowledging the compliment.

Maxwell had been particularly cheerful and excited lately.

There was good reason to be so…

Over the past 8 months, Maxwell was the trainee whose hand skills had improved the most significantly.

The reason for this rapid improvement was, of course, thanks to the Finger Locking Skill that Jun-hoo had taught him.

The Finger Locking Skill was inspired by one of the 72 arts of Shaolin [a reference to martial arts techniques].

The training method was deceptively simple.

All you had to do was sequentially attach the tips of your other four fingers to your thumb.

This exercise helped develop the trick of distributing power to the back of your hand, fingers, and wrist, improving fine motor control.

In the meantime, Maxwell stubbornly practiced the Finger Locking Skill, even while being teased by his colleagues for looking like an idiot.

And he was only recently revealing the fruits of his labor, silencing the doubters.

Today, Maxwell’s surgical assist was simply outstanding.

He fixed the blood vessels with forceps with unwavering precision.

There were several places in the middle cerebral artery that needed to be sutured, and he did a remarkable job of suturing in Jun-hoo’s stead.

It would be beneficial to continue training Maxwell diligently until he graduates from the Boost Up program.

And then apply that data later when teaching future students.

“Did you say the next subject to train is hand surgery?” Jun-hoo muttered, leaning back on the sofa.

“That’s right, hand surgery. I’m worried that hand surgery will be even more difficult than pediatric neurosurgery,” Maxwell groaned, his brow furrowed.

“I can tolerate cutting off severed fingers for replantation, but I don’t think I can watch patients with severed wrists, forearms, or legs. It’s terrible,” he added, expressing his squeamishness.

“You’ll get used to it if you keep watching?”

“You’re a Reptilian, aren’t you?” Maxwell joked.

“In my experience, people eventually adapt to everything,” Jun-hoo said, a hint of melancholy in his voice.

Jun-hoo smiled bitterly, recalling the countless corpses he had witnessed in the Murim [a world of martial arts and cultivation].

“By the way, aren’t you pushing yourself too hard? There are still 3 months left of training,” Maxwell pointed out.

“That’s true, but… I’m feeling a little bored,” Jun-hoo admitted, revealing his honest feelings.

The moment he succeeded in the brain AVM surgery today, he felt a shift.

Unless it’s a very unusual case, he was confident he wouldn’t fail another surgery.

As the training entered its 8th month,

one of the reasons why he felt bored was that he was repeating surgeries he had already performed, rather than encountering new challenges.

“You’re talking like you’re already at the top. I’m just keeping quiet because it’s me you’re talking to. Don’t say that anywhere else. You’ll get slapped,” Maxwell warned, half-jokingly.

“Maybe.”

Jun-hoo got up from the sofa, and Maxwell looked up at him.

“Where are you going?”

“I have an afternoon appointment. See you tonight.”

Even at this moment, Jun-hoo had no idea that the boredom he felt would be completely overturned in just 10 minutes.

* * *

1st floor, pediatric neurosurgery outpatient clinic.

Jun-hoo was diligently seeing patients.

The Boost Up program was primarily focused on surgery, but he also dedicated at least 4 hours twice a week to seeing patients in the outpatient clinic.

This allowed him to significantly improve his clinical skills.

Perhaps it was unique to Mayhew,

outpatient clinic hours were relatively relaxed.

Anyone who has experienced outpatient treatment at a Korean university hospital would likely agree that the experience was quite different.

In Korean outpatient treatment, the doctor typically took the lead.

When the doctor asked a question, the patient answered.

When the patient tried to ask about something they were curious about, the consultation time was often already over.

The consultation time was often limited to about 3-4 minutes.

There were many factors that contributed to the short consultation times in Korean outpatient clinics, such as the concentration of patients in university hospitals, the pressure to increase hospital profits, and patient complaints due to long waits, leading to a general sense of dissatisfaction among patients.

However, at Mayhew, Jun-hoo was able to provide meticulous care to each patient.

There were many cases where the consultation time exceeded 10 minutes.

“Phew.”

Jun-hoo, who had just finished seeing a patient, picked up the water bottle on his desk and took a refreshing drink.

His mouth was parched, likely from talking so much.

“Doctor. Shall I let the next patient in?” the nurse’s voice was heard from outside the door.

Jun-hoo told her to do so.

Squeak.

The clinic door opened, and a middle-aged man wearing glasses entered the clinic.

He didn’t come further inside, holding the door open with one hand.

The wristwatch the man was wearing was particularly eye-catching.

It was a Rolex.

The watch shimmered with golden waves from head to toe. Sparkling jewels were studded on the dial.

If someone didn’t know what luxury meant,

you could simply show them that watch.

Apart from the exorbitant price, even Jun-hoo’s eyes were drawn to the watch’s ostentatious display.

The stroller passed through the door opened by the man. It was a wagon-type stroller with a rectangular shape and a wide width.

The person pushing the stroller was a blonde woman.

The man and woman, who appeared to be a couple, sat in the examination chairs.

The stroller was parked vertically between the two.

The child’s face was not yet visible because the canopy was closed.

“Hello. Doctor,” the man said in a polite tone.

“Yes. Hello. Thank you for coming. Let’s check the chart first?” Jun-hoo replied, quickly scanning the referral form.

He realized he had been distracted by the man’s Rolex and had neglected to read the chart in advance.

‘Huh?’

Jun-hoo’s eyes narrowed as he examined the chart.

The space between his eyebrows furrowed, and worry lines appeared on his forehead.

The hospitals from which the guardian had received the referral form were all top-tier institutions.

Cleveland Clinic.

Massachusetts General Hospital, etc.

In addition, Jun-hoo had never seen CT and MRI images quite like these since becoming a neurosurgeon.

“It seems you didn’t receive prior notice. You must be very surprised?” the man asked in a soft voice, observing Jun-hoo’s reaction.

“Ah, yes.”

“It would be faster to see our child directly than to look at the monitor,” the man suggested.

The man got up from his seat and carefully opened the canopy of the stroller.

The moment he saw the child,

Jun-hoo’s body froze, as if turned to stone.

The patient was not one but two. And the crowns of their heads were fused together.

The patients were conjoined twins.