A Surgeon Who Uses Martial Arts [EN]: Chapter 433

Chapter 84: Illusion and Derangement (4)

The goal of debridement was singular:

To remove necrotic tissue and prevent further contamination!

For the patient on the operating table, debridement was essential because…

…he had suffered a gunshot wound.

As the bullet passed through his head, foreign substances like gunpowder and soot remained.

If left unattended, various inflammations were sure to occur.

But was debridement the most pressing issue right now?

If someone were to ask Min-seok that, he would have to shake his head.

What was important now was to stop the bleeding.

Reduce the intracranial pressure.

And repair the damaged parietal lobe.

‘At least, that’s what I thought three minutes ago.’

Min-seok clicked his tongue and muttered inwardly.

Just three minutes ago.

In the blink of an eye.

Jun-hoo had successfully completed the debridement with a No. 11 scalpel, sharper and more pointed than a No. 10.

Just in three minutes, as promised.

Even 30 minutes was a generous reduction, considering Jun-hoo was a renowned doctor.

But he had shortened it tenfold.

As soon as he started the debridement, his hands and arms moved, the scalpel flashing like lightning.

All Min-seok could see were the silvery trails left by the scalpel, shimmering like scales.

Maybe it was just his imagination.

But every time the scalpel flashed, it felt like a breeze stirred in the operating room.

A light ruffle of his bangs.

The mask he was wearing fluttered in the wind.

Scratch!

Wherever Jun-hoo’s hand passed, blackened, dead skin tissue was invariably cut away.

The speed was terrifying, but the accuracy was even more so.

Differentiating between necrotic and contaminated tissue from normal tissue and excising it was no easy task.

If the surgeon was too aggressive, a tragedy could occur where normal tissue was also excised.

Conversely.

Contaminated tissue that should have been removed could remain and cause inflammation later.

But Jun-hoo walked that line exquisitely.

In short, he only excised what needed to be excised.

After three minutes.

The silver tray was piled high with black, dead tissue, forming a mound.

“Were you a psychic in your past life, Doctor? How is this even possible?”

Min-seok asked in amazement after the debridement was finished.

Even though he had witnessed Jun-hoo’s performance with his own eyes, it felt as hazy as if it had happened in a dream.

He felt no sense of reality whatsoever.

If they weren’t in the operating room.

He would have pinched his cheek.

“I sometimes have dreams where a world of martial arts unfolds. I must have been a martial artist in my past life.”

“Like Mook-hyang from martial arts novels?”

“Yes, something like that.”

“I’d believe you even if you said you came from a real martial arts world.”

Min-seok nodded vigorously.

Jun-hoo smiled with crescent eyes.

Min-seok would probably never know.

That what he had said jokingly was actually all true.

‘So far, so good….’

During a brief lull in the conversation, Jun-hoo looked down at the patient’s head.

The patient’s temple was covered with a blue surgical drape.

With the debridement finished, the gunshot wound on the temple, where the bullet had first entered, was clean.

Logically, Min-seok’s judgment was correct. Debridement was the last surgery to be performed.

But Jun-hoo had pushed ahead with the debridement.

Firstly, because he was confident he could shorten the time.

Secondly, to increase the patient’s chances of survival.

As critical as the patient was, any post-operative contamination would be fatal.

So he nipped the potential cause of contamination in the bud.

“Doctor, what’s the surgical plan from here on out?”

Min-seok asked as Jun-hoo gathered his thoughts.

“From now on, we’ll proceed by the book. Just keep up with the speed.”

“Then how long will it take you to finish the craniotomy [surgical removal of part of the skull] and the dural incision [incision into the dura mater, the outermost membrane covering the brain and spinal cord]?”

“Well, about 15 minutes should do it.”

The staff was speechless at Jun-hoo’s answer.

This was also an absurd speed.

These procedures usually took 90 minutes.

But having just witnessed the debridement, no one could argue.

No one could accuse Jun-hoo’s statement of being a bluff.

“Alright, let’s resume the surgery.”

Jun-hoo’s voice rang out clearly.

Using the Howling Moon Twelve Hands, both hands blazed.

Since the accuracy of both hands was the same.

The accuracy of the procedures was also the same.

Doing with two hands what could be done with one, the already fast procedure speed was doubled.

Wee-ing. Wee-ing.

Jun-hoo held a medical drill in each hand and drilled holes in the skull. Finely ground bone powder, like slush, flowed out of the drilled holes.

Ssssh!

Min-seok sucked up the bone powder with a suction device. The piled-up bone powder vanished in an instant.

Chee-ik. Chee-ik.

Min-seok also occasionally sprayed saline solution to keep the surface of the incision from drying out.

It was his first time assisting with a gunshot wound patient, he was flustered, and he was nervous because the patient’s life was in danger.

It was also overwhelming to keep up with Jun-hoo’s procedures, but Min-seok kept his wits about him and provided flawless assistance.

He had the potential to become an excellent surgeon in the future.

While Jun-hoo was active as a shadow surgeon.

If Min-seok learned from Jun-hoo.

He would level up tremendously.

After drilling four holes in the skull.

Jun-hoo also held scalpels in both hands and connected the four holes with lines.

A rectangular shape appeared on the patient’s temple.

Then Min-seok hooked the skull and lifted it.

The dura mater, hidden beneath the skull, peeked out.

The dura mater formed a rounded curve.

It looked like a hill was rising on the head.

This meant only one thing.

The intracranial pressure on the patient’s brain was immense.

If Jun-hoo had not performed the surgery at a dazzling speed, if another surgeon had performed it.

The patient might have died before reaching the surgical site.

“Wow… I’ve never seen the dura mater protrude like this, even in textbooks.”

Min-seok shook his head in disbelief.

“Can we really save this patient?”

“I’m getting a little scared now.”

The resident and scrub nurse, who had been silent, also spoke up.

The patient’s critical condition was enough to dampen the staff’s spirits.

It was only natural.

They probably had no experience operating on gunshot wound patients.

“It’s okay. It’s not too late.”

Jun-hoo encouraged the staff with a look of conviction.

Boosting the staff’s morale was also one of the duties of the chief surgeon.

“There is no failure or abandonment in my dictionary. The patient will recover, certainly and safely.”

Controlling the staff with charisma was also one of the duties of the chief surgeon.

Before the main surgery, Jun-hoo lightly tilted his head from side to side.

Unlike other surgeries.

There was one more reason why this surgery had to succeed.

That reason was….

The patient’s honor.

At least, as far as Jun-hoo could tell, the patient had not committed suicide.

If he had pulled the trigger himself.

Traces of gunpowder that should have been found on his hand were not found.

But what if the patient died like this?

In that case.

The patient might be ‘forced’ to commit suicide, in colloquial terms.

Because if the patient ended his life by suicide, the storm that would hit the upper echelons would be weakened.

‘I must save him. I must.’

Jun-hoo gritted his teeth and brought his eyes close to the microscope.

* * *

‘Crazy. He’s crazy.’

Min-seok muttered inwardly.

The only crazy person Min-seok had ever seen was the singer Son Nam-bi.

But Jun-hoo was also a madman.

Min-seok’s dazed gaze lingered on the patient monitoring device.

40 minutes into the surgery.

The patient’s vitals had almost returned to normal levels.

Blood pressure was 160mmHg/100mmHg.

The pulse was 120 beats per minute.

The body temperature was 36.7 degrees Celsius.

Respiration was 20 breaths per minute, and the high concentration of oxygen that had been administered before the surgery had been discontinued.

The electrocardiogram rhythm was also even and regular, like a lullaby.

Most notably, the value that had dropped significantly was….

Intracranial pressure.

Normal intracranial pressure is below 15mmHg, but at one point, the patient’s intracranial pressure was close to 50mmHg.

It was like a balloon about to burst.

But by incising the skull and dura mater at a divine speed.

And removing even the massive hematoma [a collection of blood outside blood vessels] in an instant.

The intracranial pressure dropped to 20mmHg.

Thanks to this, the brain, which had been shrunken by the hematoma and cerebrospinal fluid in the head, regained its space.

You never know what will happen in life, but.

Still, at this point, the patient’s survival seemed certain.

“Doctor, why do you look so gloomy?”

Min-seok asked, tilting his head.

The surgery was on the verge of success.

But somehow, Jun-hoo’s expression looked dark.

“I’m contemplating the extent of the lobectomy [surgical removal of a lobe of the brain].”

“Ah….”

“The bullet grazed the frontal lobe and the upper part of the parietal lobe.”

Jun-hoo pointed to the patient’s brain with his index finger.

Min-seok looked down at the brain.

Fortunately, the bullet had not penetrated the brain.

If it had, the patient would have been pronounced DOA (Dead On Arrival).

Whether the gun barrel was slightly raised when the pistol trigger was pulled, the bullet penetrated the head diagonally.

“Is a lobectomy really necessary?”

“Yes. It’s the same principle as debridement. If left unattended, it will become contaminated and cause fatal encephalitis [inflammation of the brain].”

“I’ve never experienced a lobectomy either… it’s already horrifying.”

Min-seok shuddered.

Lobectomy.

The name alone could only feel barbaric and violent.

To cut out the brain, of all things.

In fact, lobotomies performed in the past were crude and were abused as a means of treating mental illness.

But the lobotomies performed in modern times were different from the past.

It had become much more sophisticated and precise.

It was only performed on those who needed it among patients with cerebral infarction [stroke] or brain tumors.

“Then… you must be worried about the extent of the resection [surgical removal of tissue].”

“Yes.”

Jun-hoo answered with a sigh.

“Do you have a range in mind?”

“I do.”

“What’s the range?”

“Up to 1mm away from the contaminated area.”

If the lobe is cut out.

The function of that area is permanently damaged. There was no way to reverse it.

In the patient’s case.

He would inevitably experience motor deficits [impairment of motor function].

The map of brain functions has not yet been fully drawn, so I can’t be sure, but he will probably have trouble moving his arms and legs.

He was unfairly shot.

And now he has a disability in his arms and legs?

If Jun-hoo were the patient, he would feel frustrated.

“A 1mm resection, is that even possible?”

The resident, who had been silent, asked in a shrill voice.

Jun-hoo nodded instead of answering. It was challenging for Jun-hoo, but it wasn’t impossible.

“Let’s refocus and finish strong. Number 11.”

Jun-hoo took the scalpel handed to him by the scrub nurse and brought his eyes close to the microscope.

At the same time, he drew up the inner energy from his dantian [energy center in the body, according to traditional Chinese medicine] and put it in his eyes.

The inner energy amplified the field of vision that the microscope had magnified 25 times.

The movement of microvessels and wriggling blood flow.

Each and every nerve fiber distributed in a radial pattern like a spider web was captured in his eyes.

This was a miracle that only Jun-hoo among the surgeons in the world could perform.

With the amplified vision, Jun-hoo drew a virtual line.

He drew a ‘∪’ shaped virtual border in the middle of the frontal lobe and parietal lobe where the bullet had grazed.

There is no second chance.

I have to go in one go.

Holding his breath for a moment, Jun-hoo swung the scalpel decisively.

霹靂閃電! [Pili shandian – literally “thunder and lightning,” often used to describe something extremely fast or powerful]

The scalpel flashed like thunder and lightning.