Dr. Shin Seonhan: The Doctor Who Sees The Future [EN]: Chapter 125

#125 The Heart Beats (9)

Crack—

Doctor Pung split the left side of the chest in half.

The incision was so bold that it made the onlookers flinch.

It was the biggest incision I had ever seen.

“Bovie!”

Clang—

Doctor Pung put down the scalpel and held out his hand to the side.

Bovie.

Electrocautery [a device using heat to cut tissue and stop bleeding].

In simple terms, it’s an electric knife.

It can cleanly cut through body tissue while simultaneously stopping bleeding with an electric current.

Doctor Pung picked up the Bovie and began to cut through the chest.

“…….”

Sizzle—

There’s the smell of burning flesh.

Whoosh—

I frantically suctioned away the flowing blood.

And with my other hand, I helped guide Doctor Pung’s Bovie.

“Good. You’re doing well.”

Doctor Pung briefly commented on my assistance.

Then, he picked up scissors and began cutting the chest muscles.

Snip, snip—

The reddish-brown muscles split, and bright red blood flowed.

Roughly cutting through the patient’s body like that, Doctor Pung said quietly.

“10%.”

“?”

“The probability of a patient with traumatic pericardial tamponade [blood filling the sac around the heart, restricting its function] in the emergency room surviving.”

He continued.

“Let’s challenge that 10%. Like you said, this patient would have kept going into arrest while being transferred to another hospital. If we don’t save him now, this patient will die.”

“……Yes.”

Zzzzzz—

Doctor Pung opened the pleura [the membrane surrounding the lungs] with the Bovie.

Soon, the inside of the chest began to be visible through the narrow ribs.

Because it was covered in blood clots, it wasn’t easy to distinguish anything yet.

Doctor Pung shouted the next step.

“Finochietto!”

Finochietto retractor [a surgical instrument used to spread the ribs apart].

A device used to spread the ribs.

Just by looking at it, it looks like an industrial tool.

Doctor Pung hooked the Finochietto between the ribs and spread them.

Meanwhile, the patient’s blood pressure is dropping even further.

“Blood pressure is 60!”

“Wait a minute.”

Thump—

Doctor Pung put his hand between the ribs.

Then, he carefully began to massage the heart.

In response to Doctor Pung’s squeezing hand movements, the blood pressure measured on the monitor recorded up to 100.

‘This is open cardiac massage!’

My eyes widened.

It’s the first time I’ve seen someone squeezing a heart directly with their hands up close.

At that moment, Doctor Pung shouted.

“Shin-sun, what are you doing?! Not spreading the Finochietto!”

“Yes!”

I snapped to my senses.

With one hand, I began to turn the handle of the Finochietto clockwise.

Soon, two metal bars spread up and down, widening the space between the ribs.

Crack, crack—

The sound of bones breaking.

I flinched and was startled.

Is this okay?

“It’s okay, what does it matter if a few ribs break? Life and death are on the line!”

Then, he grabbed my hand and turned the handle about two more turns, widening the space even more.

Snap—

I was surprised by the force transmitted to my hand.

‘……Was this guy’s grip always this strong?’

Doctor Pung is also desperate.

He was doing his best as if he was about to die.

Rip—

Soon, the patient’s body was opened.

After a while, he looked inside the chest cavity and clicked his tongue.

“Damn it…… one stab and he screwed up the lung and heart as a set.”

As Doctor Pung said.

The situation is serious.

The left lobe of the lung was stabbed and torn badly.

“Doctor, the lung…….”

“Let’s look at the lung later for now. The heart comes first.”

“Yes.”

Doctor Pung first covered the torn area of the lung with a few gauze pads.

As soon as his hand left the heart, the blood pressure inevitably dropped back to the 60s.

Swish—

Doctor Pung lifted the lung.

A hematoma [a collection of blood outside of blood vessels], where bleeding had solidified, was observed there.

It seemed to be about the size of a 500cc milk carton.

“Let’s get rid of this first.”

Doctor Pung carefully removed the hematoma.

Clotted, bright red lumps came out of the patient’s body.

And then.

The heart was visible.

‘……This is a living person’s heart.’

The heart beats.

In front of my eyes.

The heart was covered with a thin pink pericardium [the sac surrounding the heart], and there was a knife mark on the pericardium.

It’s bigger than one fist, but smaller than two.

Originally, the heart rate is 60 to 100 beats per minute.

But now it’s faster.

It is working hard to maintain life somehow.

But that power was significantly weakened.

‘The biggest problem is bleeding!’

Gush, gush—

Torn heart muscle.

Every time that muscle contracts, it is spewing blood.

It’s kind of ironic.

It’s beating to live, but the more it does, the more the blood in its body runs out.

“See? There are two lacerations.”

I felt puzzled at Doctor Pung’s words.

Two?

That’s strange.

Clearly, there was only one injury that reached the heart…….

‘Wait. It’s possible enough.’

Soon, a picture was drawn in my head.

A little while ago, the scene where the incident occurred.

The patient’s injury occurred with a fierce struggle.

Stab—

The blade enters the body.

The patient struggles and resists.

In the meantime, the blade mercilessly stirs inside the patient’s body.

Then, it leaves two sharp wounds on the heart and exits.

“Doctor, then that means the injury is more serious than expected…….”

“Let’s open the pericardium first.”

Hasty conclusions are forbidden.

Nothing is certain yet.

The details can only be known by opening the pericardium that surrounds the heart.

“Shin-sun. Grab one side of the pericardium with forceps!”

“Yes.”

I grabbed the forceps.

And carefully lifted the thin pericardium.

Rustle—

Doctor Pung cuts the pericardium.

Soon, the bare face of the heart, which had been veiled, is revealed.

I continued to clear the view while absorbing the blood with suction.

At that moment, Doctor Pung’s eyes widened.

“Fortunately, the coronary artery isn’t damaged.”

“……!”

It’s a blessing in disguise?

It’s still hopeful news.

So, to explain this situation easily…….

Q. Who feeds our body?

= A. The heart

Q. Then who feeds the heart?

= A. Coronary artery

The heart is an organ made up of muscle. That muscle also needs a supply of oxygen to work.

That’s why it’s a big deal if the coronary artery is damaged.

Fortunately, it’s not that situation yet.

“If we sew it up well, he might live.”

“Really?”

“You have eyes, so you can see it.”

“…….”

“Why? Now that you see it with your own eyes, you don’t know what’s what?”

“……Yes.”

I answered honestly.

Textbooks and practice were different.

The field is all bloody.

And the heart is surrounded by surprisingly yellow fat, so I can’t even tell where the coronary artery is.

Besides, the patient is lying on his left side.

The picture was different from the anatomy book I usually saw.

“First, stop the bleeding from the heart wound. If we sew it up quickly, we can save this patient!”

Doctor Pung says as he prepares the suture.

He doesn’t explain everything kindly.

I have to keep up with his speed on my own.

I blocked the bleeding area of the heart with gauze and placed my finger on it to stop the bleeding.

Then, the heart’s throbbing is felt.

Thump, thump

Thump, thump…….

The first heart I touched was smooth and hot.

Atrium [upper chamber of the heart] once.

Ventricle [lower chamber of the heart] once.

Regular rhythm.

And the heat of the intermittently spewing blood is also felt.

But then.

A change occurred.

Thump, thump

Thump

Thump

Vibrate—

The heart stopped.

I shouted urgently.

“Doctor, it’s an arrest!”

Beep, beep—

As if in response to my cry, an alarm sounds from the machine.

Third arrest.

The pulse graph lies helplessly on the floor.

Doctor Pung shouts loudly towards the outside of the field.

“Order additional RBCs (red blood cells) and proceed with the transfusion!”

The nurse hurriedly calls the blood management office.

“Give me another dose of epi (epinephrine, cardiac stimulant)! Keep giving the volume without stopping!”

“It’s already the 8th RBC!”

“Bring all the blood in the hospital and keep pushing it in. If you give me time, I can save this patient!”

Grab!

Doctor Pung grabs the heart with one hand.

And gently massages it while ordering a prolene suture [a type of surgical thread] from the nurse.

And says to me.

“Hey, Shin-sun!”

“Yes!”

“Listen carefully. Did you see the wound on the heart earlier?”

There are two wounds in total.

3cm in the right ventricle.

4cm in the left ventricle.

His words continue quickly.

“If you give me 15 seconds for each, I can sew it up. In the meantime, you squeeze the heart with your hands, matching my suture and breathing!”

Heart massage!

You’re telling me to do that now?

I swallowed hard.

“Think of it as CPR with your hands and squeeze gently!”

“Yes, I will!”

I took over the heart as if passing the baton.

First, I wrapped the left ventricle side of the cone-shaped heart with my hand.

And I started squeezing gently with the feeling of going from the tip of the cone to the bottom.

‘……It feels like this when you hold a heart in your hand.’

The weight of an adult male’s heart is about 300 grams.

But in reality, it felt much heavier than that.

And because it is made of thick muscle, it was harder than I thought.

Gurgle, gurgle…….

I gently massaged the heart.

The heart had already given up on beating on its own.

But I have to keep massaging.

Otherwise, the patient will die.

“Good. You’re doing well.”

In the meantime, Doctor Pung starts the suture.

Swish, swish—

Doctor Pung’s needle holder moves quickly over the patient’s heart.

‘……How is that possible?’

The heart is constantly moving because I am massaging it.

But he is accurately suturing it.

Moreover, the shape of the wound is an irregular stellate shape, so it is by no means straight and comfortable.

But Doctor Pung’s hand movements were unwavering.

‘Amazing…….’

I felt it again.

How amazing Doctor Pung’s suture is.

It was like watching a surfer balancing on a swaying wave and moving forward powerfully.

“Grab this.”

“Yes.”

I snapped to my senses and grabbed the thread with my other hand, helping Doctor Pung’s suture.

And after a while.

“That’s it. Cut!”

Clack!

With the cutting as the last step, all the sutures were finished.

It was literally instantaneous.

1 minute?

No. It doesn’t seem to have been even a minute.

That’s how fast and bold Doctor Pung’s suture was.

“Is the blood pressure doing well?”

“Systolic pressure is 90.”

“Is the blood still going in?”

“I’ve been putting it in since earlier, but…….”

The wound has been sewn up.

Blood is also being put in.

But the heart is not beating.

Doctor Pung’s eyes, reflected above the mask, became anxious for the first time.

‘It’s not beating.’

Was it too late?

Maybe so.

Even while thinking that, I was not giving up on the heart massage.

Please.

Please come back.

You just need to beat again!

At that time.

A sensation was felt in my hand.

Thump

Thump,

thump

Thump, thump…….

“……Doctor, the heartbeat is coming back!”

It was a miraculous sensation.

Although its power was weak, the heart seemed to be telling me.

I want to keep running.

I can run.

I want to live.

The heart, saying that, began to beat roughly.