A Surgeon Who Uses Martial Arts [EN]: Chapter 79

The Surgeon Who Uses Martial Arts – Chapter 79

Chapter 13: Future (4)

While the anesthesiologist administered general anesthesia, Myung-ho stared intently at Jun-hoo.

Two months into his internship, six days into his orthopedic rotation.

Compared to his limited work experience, Jun-hoo’s skills were outstanding.

*Let’s put everything else aside and just focus on today.*

First, he diagnosed a patient with acute compartment syndrome [a painful condition that occurs when pressure within the muscles builds to dangerous levels], which is easy to miss.

Wasn’t the patient with the cast already diagnosed and treated at another hospital?

It’s easy to relax during the examination in such cases, but Jun-hoo even removed the cast and examined the patient meticulously.

Thanks to him, the patient had a chance to save his leg.

Second, the speed and accuracy of setting up the operating room were unmatched.

According to the circulating nurse.

She even said Jun-hoo did the setup alone…

Thanks to him, Myung-ho saved 15 minutes of golden time [the critical period during which treatment is most effective].

What would have happened if Jun-hoo hadn’t been there?

Wouldn’t the patient have permanent damage to his leg?

He might have faced a medical lawsuit later due to a missed diagnosis.

Looking back, it was a truly terrifying moment.

Jun-hoo had emerged as a beacon of hope in the department.

“Chief, is there something you want to say?”

Jun-hoo, aware of Myung-ho’s gaze, asked.

“I think I’ve only been surprised and haven’t given you any compliments. From the examination to the setup, you were excellent.”

“Thank you. But Chief, I have a question.”

“Yeah? What is it?”

“Isn’t the attending fellow supposed to perform the surgery? Why is the Chief doing it…?”

“Things got a bit twisted. It seems the fellow and the professor met outside.”

Myung-ho explained the inside story that Jun-hoo didn’t know.

He added that the two were on their way to the operating room.

“Why? Are you scared that I’m doing the surgery?”

“No. It’s not that, it’s just different from the usual situation.”

“Well, no one expected this to happen.”

“Chief.”

While talking to Jun-hoo.

Tae-woong, who was assisting, returned to the operating table.

He was returning after receiving a call to the operating room.

“The professor and the fellow are going to be a little late?”

The shocking news caused the atmosphere in the operating room to freeze rapidly.

A reliable support team arriving late? What other misfortune is this?

Myung-ho suddenly felt a throbbing in his temples.

“What happened?”

“They said they had a traffic accident on the way. The road is so congested that movement is slow…”

“Ha… Is this an unlucky day? When can they arrive?”

“It depends on how quickly the scene is cleared, but it will take at least 90 minutes…”

Tae-woong said, watching Myung-ho’s expression. Tae-woong, who was delivering the bad news, was also uneasy.

“So, we’re stuck dealing with this on our own…”

Myung-ho looked back and forth between Tae-woong and Jun-hoo.

Unlike before, Myung-ho’s expression was grim.

“Both of you, stay focused. This surgery won’t be easy.”

* * *

With the general anesthesia successfully administered, the patient’s body slumped helplessly.

*Thank goodness.*

*We’ve avoided the worst-case scenario.*

Jun-hoo checked the wall clock and nodded.

The medical team still had a precious 10 minutes left. Enough time to perform the initial decompression.

Although the news that the professor and his team were delayed was unfortunate.

If the Chief had surgical experience, they could complete the surgery with just the three of them.

“I’ll prepare for the surgery.”

*Swoosh.*

*Swoosh.*

Jun-hoo widely disinfected the area around the patient’s left shin with a povidone-iodine-soaked cotton ball.

He covered it with a white surgical drape.

Having succeeded in the first goal of setting up the surgery, it was now time to move on to the second goal.

To assist Myung-ho and Tae-woong in every way possible so they could focus solely on the surgery.

The outcome of the surgery could change depending on Jun-hoo’s capabilities.

Jun-hoo wasn’t an ordinary intern.

“#10 blade.”

Myung-ho, receiving the scalpel from the scrub nurse, began the skin incision.

He made a vertical incision with the scalpel.

The skin split like paper along the path of the scalpel.

Usually, the incision is no more than 2-5 centimeters, but the incision for a fasciotomy [surgical procedure to relieve pressure] is a whopping 17 centimeters.

A wide incision was necessary to decompress the pressure within the compartment.

Although he seemed nervous, Myung-ho’s incision was surprisingly clean.

There was no hand tremor.

The incision was as clean as if it had been made with a ruler.

Perhaps that’s why.

Jun-hoo expected that the surgery might go smoothly.

As the incision was completed, blood oozed out from the split skin.

Jun-hoo wiped the blood with gauze as if he had been waiting for it.

He used retractors to widen the incision from side to side.

The whitish subcutaneous fascia layer appeared with Jun-hoo’s quick action.

“Jun-hoo, retract well, and Tae-woong, cut the fascia with me. We don’t have time, so we’ll proceed quickly.”

“Yes, Chief.”

“Yes, Chief.”

The patient’s progress depended on the speed of the primary decompression, so from now on, it was a race against time.

“Mayo scissors.”

Myung-ho, with the help of Tae-woong and Jun-hoo, began to cut through the subcutaneous fat and fascia.

*Snip. Snip.*

Each time the scissors moved, thick fat and tough fascia were cut away.

At first glance, Myung-ho’s scissor work seemed clumsy, but upon closer inspection, that wasn’t the case.

He was cutting while avoiding blood vessels and nerves.

Jun-hoo, who had delved into anatomy under an anatomy professor in medical school, could see that.

*Should I be more proactive?*

*One hand is free?*

*The surgery time is also tight.*

Since the Ambidextrous skill wasn’t fully developed yet, Jun-hoo switched his retracting right hand to his left hand.

He grabbed the Adson forceps [surgical instrument used to grasp tissue] with his freed right hand.

“I’ll help you.”

Jun-hoo pulled the tissue next to the fascia taut so that Myung-ho could cut the fascia easily.

“Can you retract and assist at the same time? Won’t it be distracting?”

Myung-ho expressed his concern.

He was worried about trying to catch two rabbits and ending up missing both.

“I can do it. If I make even a slight mistake, I’ll just retract then.”

“Well, it’s not the time to be picky. Do your best.”

With Myung-ho’s confirmation, Jun-hoo actively used his right hand.

He moved around the surgical area, busily.

If there was blood flowing, he wiped it with gauze to secure the surgical field.

He assisted with the fasciotomy.

In the meantime, he prevented Myung-ho’s surgical tools and movements from colliding with each other.

Jun-hoo, who had been a swordsman, knew not only how to cross swords but also how to avoid them.

He applied that principle to the surgery.

Jun-hoo felt joy in his first active assistance.

Until now, he had been helping with surgeries as an intern, feeling like a spectator, but today was different.

He felt like he was participating in the surgery as a full-fledged staff member.

This was the feeling Jun-hoo had been searching for.

Treating patients directly with his own hands.

The path of a life-saving sword, not a killing sword.

“Were you a doctor in your past life? Why are your hands so skilled?”

Myung-ho said in admiration.

Jun-hoo’s performance was remarkable not only in setting up but also in assisting.

Thanks to Jun-hoo, the fasciotomy became easier and faster.

At this pace, it seemed that the primary decompression could be completed before the golden time.

* * *

“Phew~ Everyone worked hard. I’m relieved now.”

Myung-ho let out a sigh of relief and straightened his back.

The fasciotomy was successfully completed, leaving 5 minutes of golden time.

As a result of visual confirmation.

There was no necrotic tissue visible.

The principle of fasciotomy could be compared to a balloon.

Doesn’t a balloon burst when it’s full of air?

Fasciotomy, in this case, was a surgery that created space on the surface of the balloon for air to escape.

Cutting the fascia reduced the pressure within the compartment, preventing blood vessel necrosis.

*This is excellent?*

Jun-hoo also reassured himself and muttered inwardly.

The staff accurately cut only the fascia without damaging nerves or blood vessels.

The amount of bleeding was also approximately 400cc [cubic centimeters, a unit of volume].

Except for the blood shed during the skin incision.

Or unavoidable bleeding in certain areas, the bleeding was minimal.

To bring the surgery this far with a resident and intern combination…

It was definitely a great achievement.

“Everyone worked hard.”

“Jun-hoo, you did the most work. You’re the top contributor to today’s surgery.”

“Chief is right. Diagnosis, setup, and assistance were all perfect.”

Jun-hoo smiled awkwardly at Myung-ho and Tae-woong’s compliments.

“I just helped with what you two were doing. Shall I bring the compartment pressure monitor?”

“Of course, you should. If you took the exam, you have to check the results.”

Jun-hoo went to the supply room with light steps.

Since the surgery was successful, the compartment pressure should be much lower by now.

-Doctor. Am I going to die during the surgery?

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

Before entering the operating room.

I had this conversation with the patient.

Jun-hoo was happy that he could keep that promise.

The patient was safe, and there would be no aftereffects on his leg.

Jun-hoo, who had returned with the compartment pressure monitor, inserted the needle of the monitor into the surgical area.

*Thump.*

Over time, the needle of the measuring instrument began to move from left to right.

Everyone’s eyes followed the measuring needle.

“…”

“…”

The moment the needle stopped, the atmosphere in the operating room changed subtly.

The result was unexpected.

“What? The decompression isn’t as good as I thought? This can’t be happening?”

Myung-ho said with a dissatisfied voice.

The patient’s current compartment pressure was 35mmHg [millimeters of mercury, a unit of pressure].

Considering that the compartment pressure before surgery was 50mmHg, it had decreased significantly.

It was no different from escaping an emergency situation.

However, the reduced compartment pressure was disappointing.

The normal range was below 30mmHg.

Usually, it fell below 20mmHg after surgery.

“Chief. You have to calculate the rate at which the compartment pressure is falling.”

Tae-woong continued, as if to reassure him.

“Isn’t it high because it’s right after the surgery? If we wait a little longer, it will definitely drop.”

“I hope so. I have a bad feeling about this. Why does everything keep going wrong today?”

“Surely it won’t be that unlucky.”

Tae-woong shook his head.

10 minutes had passed since the fasciotomy was completed.

Amid the tense atmosphere.

The staff looked at the measuring instrument again.

“Ah… Damn it, I’m going crazy. What am I supposed to do?”

Rough words poured out of Myung-ho’s mouth, who had been calmly leading the surgery.

Unable to contain his temper, he stomped his feet.

“It’s a ghostly thing? This can’t be happening?”

Tae-woong blinked and tapped the measuring instrument.

He seemed to think there was something wrong with the measuring instrument.

Jun-hoo was also shaken.

Without realizing it, Jun-hoo bit his lip tightly. The patient’s compartment pressure was still 35mmHg.