Fifth Vital [EN]: Chapter 139

Fifth Vitality – Episode 139 (139/502)

139. Thick Leg Bone

“Teacher. No, senior?”

Euijin called Taekyung with a respectful and serious tone that he didn’t usually use.

“Dr. Jung?”

“Senior. I know, but I don’t think this is right.”

Euijin couldn’t help but be surprised that a guardian of a patient, who wasn’t even the patient undergoing surgery, was allowed in the operating room.

“I know. I know.”

It was natural for Euijin, the anesthesiologist, to react this way.

“Guardians shouldn’t be allowed in the operating room. That’s obvious.”

“Why are you doing this when you know that better than anyone else?”

“But why is there a rule that guardians shouldn’t be allowed in the operating room?”

“What? Well, it’s because it interferes with the surgery.”

“That’s right. The implicit rule that guardians shouldn’t be allowed in the operating room is to prevent interference with the surgery and harm to the patient. Everything is to prevent harm to the patient. It’s not for our sake.”

“Senior?”

“In other words, wouldn’t it be right to allow them in if it’s necessary for the patient?”

“…….”

That’s right. Taekyung’s words were so right that he couldn’t argue with them.

He could clearly see why Taekyung had dressed the patient’s guardian in surgical gowns and brought them in with the medical staff.

It was all for the patient.

Especially, he thought that only a doctor who cares about the patient more than anyone else could make such a decision. But even though he supported Taekyung more than anyone else and respected him as a doctor, he found this difficult to accept.

“That’s true, but… I still don’t think this is right.”

“Euijin. I know how you feel and what you’re thinking right now. But look over there.”

Following Taekyung’s words, Euijin’s gaze turned to the bed.

“The patient, who was so adamantly refusing, is now getting into position.”

“……!”

It was true. Doseungwon, who had been refusing surgery until just a moment ago, was now taking the position to receive spinal anesthesia.

“You might not feel good about this. But let’s just think about our patient. Dr. Jung and I are both doctors. Let’s just think about the patient. Okay?”

“Ha! Do you know that you’re a really unique person, Senior?”

Taekyung had always been the type of person who would find a solution for anything related to the patient. Euijin eventually decided to follow Taekyung’s lead for the sake of the patient.

“So, you’re allowing it?”

“I’ll administer the anesthesia.”

“Yes, I knew you would understand me, Dr. Jung. Thank you, Euijin. I’m counting on you.”

After finishing the conversation, Taekyung and Euijin returned to their respective positions.

‘Fortunately, it seems like the two of them have resolved it well. Now, all that’s left is for the patient to decide on the surgery.’

Lee Chanhee, who had been nervous due to the serious atmosphere between the two on the bed, wore a relieved expression as the conversation seemed to have ended well.

“Patient, you will have the surgery, right?”

“Yes… Doctor. I will have the surgery.”

Lee Seunghui’s persuasion had a definite effect. The sincerity of his girlfriend, who came all the way into the operating room to support him warmly, moved Doseungwon’s closed heart.

Doseungwon was ashamed that he had thought of running away alone with bad intentions, leaving behind his girlfriend who cared so much about him. He had been pessimistic about his sudden accident and had forgotten what was really important.

“Thank you, patient.”

Taekyung was sincerely grateful that Doseungwon had decided to have the surgery.

“You made a good decision.”

“I don’t know what to do in the future, but I think the best I can do now is to have surgery. I felt encouraged when Seunghee said she would be by my side during the surgery.”

Doseungwon continued, exchanging affectionate glances with Lee Seunghui.

“I’m sorry to the doctors for causing you trouble because of me.”

“It’s okay.”

“Don’t mention it. I’m so grateful that Doseungwon made up his mind.”

Doseungwon’s one word of apology instantly erased the troubled feelings of the operating room staff, including Taekyung and Euijin.

“Okay! Then let’s proceed with the surgery. As I explained to you earlier, we will proceed with spinal anesthesia. And there may be loud noises during the surgery. So, I was going to give you both earplugs, but is that okay?”

“No. Doctor, we don’t need earplugs.”

The amputation that Doseungwon was about to undergo was bound to generate noise during the surgery. Taekyung prepared earplugs so that the patient and guardian would not be surprised. But Doseungwon and Lee Seunghui refused.

“I don’t think I’ll be able to talk to Seunghee if I wear them.”

“I’m okay too, Doctor.”

“I understand your intentions, but you might be surprised because the noise is loud.”

“Doctor. I delayed the surgery with my foolish behavior, but I’m a pretty tough person. And to be honest, I want to have surgery without earplugs.”

“Okay. I understand.”

Taekyung decided to end the conversation for now and proceed with anesthesia.

“Dr. Jung. Please administer the anesthesia.”

“Yes. I will proceed with spinal anesthesia for Doseungwon.”

After that, the spinal anesthesia was successfully completed under Euijin’s lead.

“Anesthesia is complete. You can prepare for surgery.”

“Thank you, Dr. Jung. A screen will be placed in front of you two during the surgery. The guardian can stay next to the patient as you are now.”

“Yes, thank you, Doctor.”

“Thank you.”

Lee Seunghui took a seat right next to Doseungwon’s face. And as Taekyung said, a large screen was installed to prevent them from seeing the surgical scene.

“Okay! Let’s get ready for surgery.”

As the surgery preparation began in earnest, Taekyung went to Doseungwon’s leg and quickly unwrapped the tightly wound bandage.

‘The boundary is too messy.’

The leg, injured by the explosion, was really messy even after seeing it again.

Taekyung brought a bucket and povidone [an antiseptic solution] from one corner. Then, after mixing povidone and saline solution in a 1:1 ratio, he poured it on the patient’s affected area.

Wearing sterile gloves, he checked the affected area one by one, pouring and pouring again. Only after pouring for a while did Taekyung raise his head and say.

“Please lay the surgical drape well around this area so that it is not contaminated.”

“Yes, Doctor.”

Taekyung, who went out and washed his hands thoroughly for a long time, came in with his hands raised in front of his chest.

“Pen, please.”

The nurse handed Taekyung a sterilized pen.

Around the patient, sterilized drapes were neatly and tightly laid out, separating the surgical field.

Taekyung began to draw a pre-operative incision line above the affected area with the sterilized pen he received.

“Wait, let’s release the tourniquet for a moment.”

As the pressure of the tourniquet (a device that blocks bleeding by compressing limbs) was lowered and blood flowed to the affected area, excessive bleeding began to flow again.

Taekyung carefully brought his head closer to see the affected area in detail, being careful not to contaminate the sterilized gloves. Then, he reached out and poked around the affected area with a syringe needle, starting from right above the affected area.

This was a process to determine how much to save and how much to cut off, checking for bleeding in the area where the needle was quickly poked and removed.

“It seems like blood is coming up to here.”

Lee Chanhee, who knew the process Taekyung was doing now, carefully examined the area poked with the needle and said.

‘This part would be good.’

Taekyung, who grabbed the sterilized pen again, marked the incision line on Doseungwon’s knee, drawing the blueprint for the surgery.

He drew a [ㅅ] shape about 10cm above the knee when viewed from the side.

“Dr. Jung, let’s start the surgery.”

With all the surgical preparations completed, Taekyung informed Euijin, the anesthesiologist, that the surgery would begin.

“Yes, Doctor.”

“Scalpel, please.”

Taekyung, who received the scalpel, concentrated on the incision line and moved the scalpel. The feeling of putting the scalpel on the incision line was completely different from the abdomen.

Since a tourniquet cannot be used on the abdomen, the incision is made in a location with as little muscle as possible. However, in surgeries like this, it is impossible to avoid the muscle, and it should not be avoided.

Squeak- Squeak-

As the muscle was cut with the scalpel, the toughness became more pronounced depending on the degree of muscle development. Perhaps because it was the leg muscle of a firefighter, it felt like cutting tough fiber strands.

“Okay, please receive it.”

As the muscle was cut along the lines of both incisions, the messy affected area fell off. It was so severely contaminated that there was no way to attempt to save it.

Thud-

The cut part fell into the iron bucket with a thud.

“Wait, lower the tourniquet pressure.”

“Understood.”

The pressure of the tool to prevent bleeding is lowered again to check for bleeding in the muscle. If bleeding occurs here, bleeding may continue in the sutured muscle later, so confirmation is necessary.

“Tooth forcep, please.”

While grabbing the muscle here and there with forceps, the bleeding area is cauterized with a bovie (electric scalpel) [a device using heat to stop bleeding].

There is a lot of bleeding when cutting muscle. It is not bleeding from blood vessels, but it flows out slowly from here and there.

Each of those bleedings must be stopped for a safe post-operative period.

Meanwhile, Doseungwon’s expression, lying behind the screen, looked so comfortable that it was hard to believe he was the one undergoing surgery. It was because of Lee Seunghui right next to him.

“Oppa, are you okay?”

Lee Seunghui asked in a small voice that only Doseungwon could hear, so as not to interfere with the surgery.

“I’m okay.”

“Isn’t it hard?”

“Not at all. I don’t feel any pain because they gave me good anesthesia. By the way, I’m so sorry that you had to come all the way into the operating room because of me.”

“What are you talking about? Are we strangers? Don’t say you’re sorry.”

“Because I had an accident, our future…”

“Shh! Let’s not think about that now. Okay? Let’s just think about the surgery going well.”

“Okay.”

“Oppa, do you remember our first date? You were so embarrassed that your ears turned red.”

Lee Seunghui was taking good care of Doseungwon, continuing the conversation with a soft voice and warm eyes.

While the two were encouraging each other, the work of stopping the bleeding continued.

After stopping the bleeding for a while, the smell of burning permeated the operating room. And the thick leg bone sticking out in the middle of Doseungwon’s leg came into Taekyung’s sight.

‘What should I do with this?’

There was worry in his eyes as he looked at the leg bone. It wasn’t that he was worried that the work on the protruding leg bone would be difficult or harmful to the patient.

It was the worry that the sound of cutting the far side of the femur (the bone that supports the thigh) would be heard by the patient and guardian.

Hearing the sound of one’s own body part being cut off by a saw, of all things, would never feel good.

It could be a deep wound.

“Let’s do this later.”

“Later? Ah, is it because of the patient?”

Taekyung nodded at Lee Chanhee’s question. In the end, he decided to cut the bone later and decided to find other clinically important structures first.

“Kelly, please.”

Taekyung, holding a Kelly forcep (which has a blunt end and can grab something), tried to grab a certain structure, but it was buried in the surrounding muscles, making it difficult.

“Dissector (which has a blunt but thin end and is used to separate structures).”

“Yes, Doctor.”

As Taekyung grabbed the dissector to dissect the muscles from each other, Lee Chanhee used the instrument to pull the muscles up and down.

After that, he was gradually widening the space between the muscles by bringing the two ends of the instrument together, inserting them between the muscles, and then spreading them again.

‘They’re all gathered on this side.’

When looking at the cut surface of the leg head-on, the important structures are concentrated in the center and at 5 o’clock.

Taekyung continued to separate and dig under the bone. Then, as if he had grabbed something, he grabbed it with Kelly forceps and pulled.

Drrr-

At that time, the sound of fixing the Kelly and the pulled structure came out of the muscle.