A Surgeon Who Uses Martial Arts [EN]: Chapter 68

The Lingering Attachment (1)

“Doctor! He needs immediate treatment! If we continue like this…”

“…”

“Everyone, focus! The patient needs treatment!”

It might have been a delusion, but it sounded like a tiger roaring.

A voice like thunder shook the operating room.

By Jun-hoo’s loud shout, Byung-gu snapped out of it.

He felt his mind, which had been overwhelmed by the situation, focusing sharply around Jun-hoo’s voice.

His lost consciousness had returned.

‘Did this guy learn elocution in his childhood? The resonance is no joke?’

Byung-gu wasn’t the only one who regained his composure thanks to Jun-hoo.

Won-seok also looked as if he had just woken up from a deep sleep.

“Jun-hoo is right. Let’s start with what we can do.”

“Should we use a vasopressor [medication to raise blood pressure] first?”

“No. Using a vasopressor recklessly could cause greater side effects.”

Byung-gu shook his head and continued.

“Mix one ampule of Midodrine [vasoconstrictor] IV for me.”

After giving instructions to Won-seok, Byung-gu began to examine the surgical site.

Hypotension and increased pulse.

These were typical signs of bleeding.

‘Ha… I really don’t understand.’

‘There shouldn’t have been any problems.’

Byung-gu’s forehead furrowed.

Byung-gu had watched Won-seok’s surgery from start to finish.

He swore he had never taken his eyes off it, never let his mind wander elsewhere.

‘But why! But where! Did the bleeding occur?’

There was no clear bleeding at the surgical site.

Byung-gu searched every inch around the surgical site. But the location of the bleeding was still a mystery.

It was truly a frustrating situation.

During a discectomy [surgical removal of part of an intervertebral disc].

It was the first time he had experienced such bizarre bleeding.

“Doctor, what are the patient’s vitals?”

Byung-gu’s gaze turned to the anesthesiologist.

“They are not dropping further and are maintaining. I will report immediately if there are any unusual findings.”

“Yes, please.”

“What should we do now?”

Byung-gu couldn’t easily answer Won-seok’s question.

Because Byung-gu was also wondering the same thing.

“It’s certain that bleeding occurred, but I don’t know where.”

“…”

“It’s not a typical case, so I need to think more about it.”

Byung-gu looked down at the patient and pondered.

He meticulously searched through the papers he had read.

He thoroughly searched the papers stored in his head.

The staff had no one to rely on but Byung-gu, a second-year fellow.

Byung-gu had obtained his specialist qualification and was undergoing fellowship training, but that fact was not very important.

In any case, Byung-gu was the captain of this surgery.

He had the heavy responsibility of leading the staff well and sending the patient safely and healthily to the recovery room.

“…”

The operating room was quiet and still.

As all procedures were stopped, the staff could only stand by, looking alternately at the patient and Byung-gu.

The frustrating situation showed no signs of improving.

“Doctor! C.A. [Cardiac Arrest]! We need CPR!”

The anesthesiologist shouted urgently.

Beeeep.

The patient monitoring device also sounded an urgent alarm.

When Byung-gu checked the electrocardiogram monitor, the ECG graph was completely flat.

‘God. Why are you giving me this trial…’

Even with his eyes open, Byung-gu saw everything only darkly.

“Uh… what should we do? Doctor, the patient is lying down, so we can’t do CPR, can we?”

Won-seok asked in a terrified voice.

That was right.

The patient was in a prone position because he was undergoing disc surgery.

But to perform chest compressions, the patient had to be repositioned to lie supine (face up).

The problem was that changing the position was not so simple.

Didn’t the patient have an incision in his lower back?

If the incision touched the floor of the operating table, there was a high risk of secondary infection.

There was also a risk of secondary injury while performing chest compressions.

“First, give 1 ampule of epinephrine and 1 ampule of lidocaine IV (intravenously), and prepare the defibrillator.”

Byung-gu replied, trying to hold onto his shaking mentality.

Even though nightmarish events were happening one after another, he couldn’t collapse here.

‘Patient dies of cardiac arrest during disc surgery?’

He couldn’t allow it, even if the sky were to split in two.

“What about chest compressions?”

“What choice do we have? Turn the patient supine with Jun-hoo. Repositioning comes before chest compressions.”

“What about contamination or additional injuries…?”

“Restoring the heart rhythm is the top priority. What good is a normal back if the heart stops?”

Byung-gu said rapidly.

But it was at that moment.

Jun-hoo, who had been quietly observing the situation, looked straight at Byung-gu and said.

“Doctor, I’ll do CPR on this patient.”

“I’m already frustrated to death, are you going to say something infuriating? Who said not to do CPR? Start with repositioning!”

“No. I want to try CPR without changing the position.”

Jun-hoo’s eyes were calm, and his voice was subdued.

“I’ll try Prone CPR. I can do it.”

* * *

Jun-hoo, who had been observing the situation, suddenly thought of Prone CPR.

Prone CPR.

This was a chest compression method performed on patients in the prone position (lying face down).

So, if Prone CPR was used, there was no need to change the patient’s position.

There was no concern about contamination or additional injuries due to repositioning.

The time when Jun-hoo learned about Prone CPR was earlier than expected.

It was back in high school.

While preparing for the CPR competition, his curiosity about CPR grew.

That’s when he happened to come across Prone CPR.

“You can do Prone CPR? You?”

Byung-gu looked incredulous.

This is because there are usually no cases where Prone CPR is performed.

How often in reality, in movies, or in dramas would there be a need to perform CPR on a patient lying face down?

“Yes, I can. I’ll do it right now.”

Jun-hoo continued rapidly.

“I’ve done it while working in the emergency department. I did it on a construction worker who fell from a height.”

Of course, it was a lie.

Jun-hoo had never done Prone CPR.

But if he didn’t lie, he didn’t think he would be given the opportunity.

If he didn’t seize the opportunity, he thought the patient would die due to delayed treatment.

And lastly.

Although Prone CPR was his first time, Jun-hoo was confident that he could do it successfully.

“Ha… I have to entrust Prone CPR to an intern.”

“…”

“Won-seok, have you ever done Prone CPR?”

“No, I haven’t.”

“I haven’t either… Damn it, then it’s all or nothing. Seo Jun-hoo, I’m counting on you.”

“…”

“Do well as much as I trust you. The patient’s life is in your hands.”

“Yes, Doctor. I will never disappoint you.”

After permission was granted, Jun-hoo moved to the patient’s right flank.

He placed his clasped hands between the patient’s right thoracic vertebrae 7-10 [the 7th to 10th vertebrae in the upper back].

In a vertical line, this spot was right above the heart.

‘No need to be nervous just because it’s the first time.’

‘The principle itself is no different from general chest compressions.’

‘Pour everything you’ve honed in the Murim world [a world of martial arts and cultivation] into your physical.’

‘Save the patient.’

‘Repay those who believed in me.’

‘You can’t watch someone die in front of you again, can you?’

‘That’s not why you became a doctor, is it?’

Jun-hoo’s eyes, full of determination, shone with clarity.

Thump! Thump! Thump!

Jun-hoo’s palms began to compress the area near the patient’s right scapula [shoulder blade].

Each time, the patient’s body leaped up.

‘Stronger than usual!’

‘Even stronger!’

Jun-hoo increased the intensity of the compression by putting strength into both hands.

‘[General chest compressions easily cause damage to the costochondral joint, so there is a limit to increasing the intensity of the compression.]’

‘[However, if compressed from the back of the rib cage, like in Prone CPR, the possibility of rib cage damage is low even when compressed with greater force, so the compressive force can be increased.]’

Since he decided to do Prone CPR, shouldn’t he maximize its advantages?

Jun-hoo performed chest compressions with higher intensity than usual.

But it didn’t end there.

Jun-hoo also sent internal energy along with the chest compressions.

In simple terms, he was simultaneously performing the roles of chest compressions and a defibrillator.

This was a hybrid CPR that only Jun-hoo, who had experienced the Murim world, could perform.

Thump! Thump! Thump!

Jun-hoo attempted two chest compressions per second, sending materialized internal energy into the patient’s heart to shock it.

Doing two procedures at the same time was overwhelming even for Jun-hoo.

But he didn’t want to give up.

He didn’t want to collapse.

In the Murim world, he couldn’t save people because he didn’t know how, but it wasn’t the same now.

Armed with modern medical knowledge, Jun-hoo knew how to save people.

‘If you know, shouldn’t you act?’

‘Shouldn’t you go down the difficult path?’

“Seo Jun-hoo, come out! Turn the patient slightly to the side and fix them with the immobilizer.”

“Yes, senior.”

As Jun-hoo tilted and secured the patient, Won-seok prepared for defibrillation.

Swoosh.

Won-seok placed the paddles of the defibrillator, smeared with gel, below the patient’s right collarbone and below the left chest, respectively, and performed defibrillation.

“100J clear!”

As the electric shock occurred, the patient’s body trembled and heaved.

“I’m sorry, Jun-hoo. I’d love to switch with you, but I’m not confident in Prone CPR.”

Won-seok said with an apologetic expression.

“It’s okay. It’s better for someone who’s done it even once to do it.”

“I appreciate you saying that. Charging 100J.”

Jun-hoo laid the patient face down again and continued Prone CPR.

Although it was a short time, Jun-hoo quickly became accustomed to Prone CPR.

Emitting internal energy while performing chest compressions also became natural.

He was getting stronger as he overcame the crisis.

It was the opposite of when he got stronger each time he cut down a villain in the Murim world.

In modern times, Jun-hoo was getting stronger each time he saved someone.

‘It’s definitely working.’

‘There’s hope for recovery.’

Jun-hoo even had the余裕 [leeway/composure] to check the patient monitoring device while performing chest compressions.

Blood pressure and pulse were gradually rising towards the normal range.

The electrocardiogram, which had been flat, was also slowly regaining its energy. It was moving up and down, regaining its rhythm.

Seven minutes into performing CPR.

The patient, who had been close to the afterlife, returned to this world.

The patient’s heart began to beat again.

There were no problems with vital signs.

The tense atmosphere in the operating room loosened slightly.

Jun-hoo was overjoyed with the sense of accomplishment that he had revived the patient.

He didn’t need any other reward.

Not money, not fame, not power.

Not having to helplessly watch a dying patient.

Being able to do something.

That he had saved the patient with his own hands.

That itself was a reward that Jun-hoo couldn’t trade for anything.

Jun-hoo was simply happy at this moment.

“Hoo. I almost died. Really.”

Byung-gu said with a sigh of relief.

“Seo Jun-hoo.”

“Yes, Doctor.”

“This cardiopulmonary resuscitation is largely thanks to you. If we hadn’t done Prone CPR, CPR would have been much delayed. I wouldn’t have been able to guarantee the patient’s recovery either.”

Byung-gu continued calmly.

“Even if we had done CPR, there would have been a high probability of contamination or additional injuries.”

“No, I just did what I had to do.”

“The key is that the work you did was something that an ordinary intern couldn’t have done.”

“The fellow doctor is right. Jun-hoo, you really worked hard. You did chest compressions alone for several minutes without switching.”

“Thank you. Dr. Seo.”

Jun-hoo didn’t know what to do with the praise pouring in from those around him.

He never got used to hearing praise, even though he heard it often.

Jun-hoo avoided his colleagues’ gazes and suddenly looked down at the patient.

The thought that it was too early to be relieved suddenly struck him.

Perhaps the real game was just beginning.

“Doctor, I think we need to find out why C.A. (Cardiac Arrest) occurred now.”