A Surgeon Who Uses Martial Arts [EN]: Chapter 78

The Future (3)

“The patient is suffering from… acute compartment syndrome.”

Jun-hoo began his explanation calmly.

Acute compartment syndrome.

It was one of the few emergency conditions in orthopedics where time was of the essence.

There are compartments in the leg. [These are spaces that divide muscle groups.]

A compartment is a kind of empty space that divides the muscle layers.

If the pressure inside the compartment increases due to edema (swelling), it can compress the arteries, hindering blood circulation.

If surgery is not performed in time.

Necrosis [tissue death] and nerve damage can occur in the muscles and nearby tissues, potentially requiring amputation of the affected area.

In severe cases, the patient could even die.

The patient and guardian’s faces turned even paler at Jun-hoo’s explanation.

They had expected simple bone fracture pain.

Receiving a diagnosis of an unexpectedly serious illness came as a great shock.

“Doctor… why does my son have to suffer from such a disease?”

The guardian continued, sounding aggrieved.

“Other people are fine even when they have fractures, so why only my child…”

“In my opinion… it seems that the cast, the full cast, is constricting your son’s leg too much.”

“…….”

“Earlier, while he had the cast on, your son couldn’t move his foot well.”

“…….”

“He also felt pain when he moved it.”

“Then what’s going to happen to me?”

The patient chimed into the conversation with a frightened expression.

“You need to have emergency surgery. I’ll explain the details while getting your consent form signed.”

“…….”

“Just a moment before that.”

Jun-hoo placed his hand on the patient’s tightly swollen left shin.

He mentally visualized the anatomical location of the area and infused it with internal energy.

The place where the internal energy was directed was the border of the lower leg compartment.

He temporarily prevented the pressure inside the compartment from expanding outward with his internal energy.

It was a kind of protective barrier.

If the internal energy held, the pressure on the artery would be reduced even a little.

It wasn’t a fundamental cure, but it was the best option for now.

Time is of the essence in emergency surgery.

He could buy time with internal energy before the patient’s symptoms worsened.

“Strangely, my foot feels a little more comfortable since the doctor touched it.”

“If that’s a coincidence, it’s a really good one.”

“I’m sorry, doctor.”

Jun-hoo tilted his head at the patient’s sudden apology.

“Why the sudden apology…”

“To be honest, I thought you were exaggerating my pain on purpose so you could take CTs or MRIs.”

“I can understand why you might think that. There are quite a few doctors who see patients as a source of money.”

Jun-hoo smiled bitterly.

It seemed the patient had experience with overdiagnosis at a local clinic.

Indeed, there were plenty of orthopedic and neurosurgery clinics that recommended 100,000 won nerve injections [approximately $75 USD, a significant expense] even if the patient only complained of a little back pain.

After finishing the conversation, Jun-hoo headed straight to the station.

He printed out the consent form for the fasciotomy [surgical procedure to relieve pressure in a compartment].

He had diagnosed the patient’s acute compartment syndrome with a thorough examination, but the war was just beginning.

Surgery was essential to reduce the patient’s high compartment pressure.

Chun-woon.

Although I couldn’t save you.

I’m working hard to prevent others from experiencing the same tragedy as you in this world.

Please forgive me with this.

* * *

“Ha… this is driving me crazy.”

Hyun-jin ran his hands through his hair after receiving the emergency room call.

He had been notified that the patient Jun-hoo was examining had acute compartment syndrome.

With a mix of disbelief and suspicion, he checked the EMR (Electronic Medical Record).

The patient did indeed have acute compartment syndrome.

The reading from the compartment pressure monitor was a whopping 50mmHg [millimeters of mercury].

Normally, acute compartment syndrome is suspected if it exceeds 30mmHg, but at the patient’s level, surgery was needed immediately.

Jun-hoo is really amazing.

If it were me, I would have just given him painkillers and sent him away.

He even took off the cast to examine him.

However, the admiration for Jun-hoo didn’t last long.

He had a fire to put out right away.

Hyun-jin contacted the anesthesiology department to call an anesthesiologist for emergency and contacted the operating room to secure an operating room.

The problem arose when contacting the attending physician.

“Ha… what are they even doing?”

Hyun-jin paced anxiously.

He had contacted them via the call phone.

He had also contacted them via their personal cell phone, but the on-call fellow wasn’t answering.

Where are they holed up sleeping?

Or did they go out for a while?

Even if there are few emergency patients in orthopedics at night, this is too much!

Hyun-jin searched every corner near the orthopedic ward, blaming the on-call fellow.

Unfortunately, the on-call fellow was nowhere to be seen.

And they hadn’t contacted him in the meantime.

“Professor, I’m sorry to bother you while you’re resting. We have an urgent emergency patient.”

Hyun-jin had no choice but to contact Professor Sung Jae-yoon.

He notified him about the acute compartment syndrome patient.

Hoping that Jae-yoon, who was usually gentle, would come to the hospital right away.

But his expectations were shattered in an instant.

-Oh… this is really messed up. Kyung-woo is with me right now.

“Yes? The on-call fellow is with you?”

-Yes. Kyung-woo said he wanted to quit the fellowship, so he came to my house to talk for a bit.

It was like a bolt from the blue.

Things couldn’t be more twisted.

He never imagined the two would be tied together like this.

“Then… what should we do with the patient? Should we send them to another hospital?”

-When was the cast put on the patient?

“About 5 hours ago.”

Hyun-jin bit his lip and replied.

The golden time for fasciotomy is 6 hours, and after 6 hours, even if the surgery is successful, the patient is likely to have permanent disabilities.

-It’s a close call even if we operate now. Transfer is absolutely out of the question.”

“…….”

-First, ask Myung-ho to perform the surgery. He’s assisted with fasciotomies and even performed one last week.

“…….”

-It’ll take us about 40 minutes to leave now. We haven’t had any alcohol, so we can handle the key procedures.

“Okay, Professor.”

Hyun-jin hung up and sighed deeply.

It was clear that today was not his day.

How could things get so twisted?

It was almost pretzel-like.

It was fortunate that the chief, Myung-ho, could perform the fasciotomy.

Even if something happened in the middle, there wouldn’t be a big problem if the professor and fellow joined.

“Chief, I have something to tell you. It’s urgent.”

Hyun-jin went to the conference room and notified Myung-ho, who was studying, of the situation.

Myung-ho showed a resigned look, though he was annoyed.

“What can I do? I’ll have to operate. Who’s going to scrub in?”

“The chief can decide.”

“Is Dong-seok still in bad shape?”

“Yes. I don’t know why, but he’s still passed out in the on-call room.”

“Hmm… then let’s have Tae-woong as the first assist… and Jun-hoo as the second. I heard Jun-hoo diagnosed the acute compartment syndrome.”

“Yes. I’ll contact them now.”

Hyun-jin took out his call phone from his gown and quickly called Jun-hoo.

“Jun-hoo, I’m really sorry, but I need you to suffer a little more while you’re suffering.”

* * *

Thump, thump.

Thump, thump.

Jun-hoo was pulling the bed with the patient on it towards the second-floor operating room.

The surgery schedule had been set.

Jun-hoo was going to participate in the surgery as the second assist.

Other interns would have hated having more work, but not Jun-hoo.

Jun-hoo, who dreamed of becoming a surgeon, loved surgery.

The solemnity and tension that could only be felt in the operating room.

The pleasure of completing difficult procedures and surgeries.

He loved the sense of accomplishment of saving a patient.

If he participated directly in the surgery of the patient he had diagnosed, he would be able to achieve a satisfactory conclusion.

Arriving at the operating room by elevator.

Hyun-jin was waiting in front of the door.

“Hey, I’m really sorry. You had to go down to the emergency room because of me, and now you’re scrubbing in.”

“I said I’d go. Well. Haven’t the chief and Tae-woong sunbae [senior colleague] come down yet?”

“They’re on their way now. They’re checking the chart and doing a quick briefing, so they’re late. Did you print out the consent form?”

“Yes, here it is.”

Jun-hoo handed the consent form, which was at the patient’s head, to Hyun-jin.

Interns receive examination consent forms.

Residents were supposed to receive surgery consent forms.

“Guardian, would you like to talk to me for a moment?”

Hyun-jin spoke with the guardian in the waiting room, and Jun-hoo passed them and entered the operating room.

The second act for the patient’s recovery had begun.

“Doctor. Am I going to die during the surgery?”

The guardian suddenly looked up at Jun-hoo with anxious eyes.

It seemed they were scared and nervous because it was their first proper surgery.

In fact, fasciotomy was not a dangerous surgery.

The surgery time is generally between 1-2 hours.

However, as with all surgeries, there was no guarantee that the patient would not die.

Anything could happen in the operating room.

Miracles and misfortunes.

“That won’t happen. Don’t worry. The staff will do their best for you.”

Jun-hoo replied in a kind voice.

“I lose consciousness completely under general anesthesia. I’m worried that I’ll close my eyes like that and never open them again.”

“…….”

“I’m being silly, right?”

“No. Everyone who has surgery for the first time is like that. It’s definitely not strange for you.”

Jun-hoo raised the bed because the patient seemed very nervous.

He rubbed the blood point located below the patient’s right middle finger in a circular motion with his thumb.

Infusing it with an appropriate amount of internal energy.

The Shimjung blood point was located at that location. [Acupressure point believed to calm the heart.]

Stimulating the Shimjung blood point when feeling nervous, anxious, or restless could help regain stability.

“How do you feel now?”

“Hmm… I feel a little more at ease? You were like that in the emergency room too, doctor. Do you have healing hands?”

“I guess so. Please wait here for a moment. I’ll see you in the operating room.”

Jun-hoo left the patient in the anesthesia waiting room and went to the changing room.

He put on a surgical gown, scrubbed in (pre-operative disinfection), and put on gloves and a mask with the help of a nurse.

Whoosh.

Whoosh.

Jun-hoo entered the operating room, taking in the sterilizing smoke pouring from the ceiling.

Today’s goal as an assistant was speed.

The golden time for fasciotomy was 6 hours.

The staff had about 30 minutes left.

The first incision had to be made within those 30 minutes.

This was because simply incising the skin and fascia greatly reduces the pressure within the compartment.

First, complete the surgical setup quickly and perfectly.

Second, help the surgeon and first assist in every way possible so they can operate comfortably.

Having prioritized, Jun-hoo began to digest the first goal at a crazy speed.

Suture at the top of the supply cabinet.

Consumables such as gauze, cotton balls, and bandages in the lower drawer of the supply cabinet.

Surgical tools such as forceps, needle holders, clamps, and Kellys in the middle of the basket cabinet.

Jun-hoo had memorized the locations of all the main items while assisting in the operating room several times.

It was the memorization skills that came from managing the armory of the Murim Alliance back in his Murim days.

Not only that.

Based on the locations of the items he had memorized in advance, Jun-hoo took out only the necessary items and placed them on the dressing cart.

In Murim, Jun-hoo could tell the purpose and use of a weapon at a glance just by looking at it.

For example, not all swords were the same.

Some swords were specialized for stabbing.

Some swords were specialized for cutting.

Some swords were long, giving them a long range, but also had the disadvantage of being difficult to balance.

That ability to recognize the use of weapons was also usefully applied to preparing surgical tools.

There were dozens of types of forceps alone.

Jun-hoo had no difficulty picking out the forceps needed for the surgery.

He could immediately tell the purpose of the forceps by looking at their shape.

Jun-hoo swept up the necessary treatment items like a person at a bargain market.

His hands were invisible.

Because he mixed in the technique of the Geumna hand, which snatches the enemy’s arm, he never missed or fumbled the items.

“Doctor. They said to set up quickly because it’s an emergency surgery. Let’s work together.”

The circulating nurse, who joined late, came into the supply room and spoke to Jun-hoo.

“The item setup is already done?”

“Yes? What do you mean? Didn’t you just come in, doctor?”

The circulating nurse blinked her eyes and asked.

She knew the time Jun-hoo had entered the operating room.

“I just came in, and I just finished.”

“It takes 20 minutes to prepare together, and you finished it alone in 3 minutes?”

“Yes. If you don’t believe me, check it yourself.”

Jun-hoo answered nonchalantly and returned to the operating room.

He connected the patient monitoring device to the patient, whose tension had been relieved by the blood point, turned on the surgical light, and adjusted the height of the operating table.

He had completed the setup at the speed of light.

Jun-hoo felt comfortable only after completing the first goal.

This saved 15 minutes needed for the fasciotomy.

The patient’s recovery was one step closer.

“Doctor. You really finished preparing alone? And nothing’s out of place?”

“I’m a little fast, aren’t I?”

“There’s a limit to how fast you can be. At this rate, you’re like a superhuman…”

Whoosh.

The operating room door opened while the circulating nurse was admiring Jun-hoo.

Chief Myung-ho, the surgeon.

Tae-woong, the first assist, hurriedly approached Jun-hoo.

“Are you busy setting up? We’ll help too.”

“No. I think you can just start operating right away.”

“What are you talking about? You just came up from the emergency room. Did a house elf set it up for you instead?”

Myung-ho clicked his tongue and asked.

Considering Jun-hoo’s entry time, it was absurd to have already completed the surgical setup.

But why?

The reason why the operating room, which he glanced around, seemed perfectly organized.

“That house elf, I think it’s me.”

Jun-hoo smiled brightly.