Fifth Vital [EN]: Chapter 349

The Fifth Vital Sign – Episode 350 (349/502)

350. A Tiny Domino Effect of 100

Bang! Bang! Bang! Bang!

A dull thud, like something you’d hear at a construction site, echoed loudly throughout the operating room.

It might seem like a crude, brute-force approach, but this stage was actually quite crucial.

If not hammered in a precise direction, it could potentially pierce through the bone from the inside out, and the carefully aligned fracture line could be thrown off. It was a delicate balance of sensation and strength.

‘How can he control his strength so well? That must all be experience and skill, right?’

Lee Chan-hee thought to himself as he watched Tae-kyung concentrate on hammering.

Bang! Bang bang! Bang!

Tae-kyung, who had been hammering away with focused energy, carefully examined the side of the fractured bone, then scanned the bone left and right once more.

Then, without hesitation, he picked up the hammer and vigorously hammered it in.

Bang! Bang! Bang! Bang! Bang! Bang!

Before he knew it, the bone that had been fractured into three pieces was completely fixed.

“Doctor, it’s fixed.”

“So it is. It’s well fixed.”

45 minutes.

It had taken exactly 45 minutes from the incision to this point.

It was a ridiculously fast time.

’45 minutes? It didn’t even take an hour? No way!’

Lee Chan-hee exclaimed as he looked at the clock on the operating room wall.

He wondered how many more patients he would have to see and how much more he would have to learn to be able to do it so instinctively.

‘That’s why he was called a monster at Shinhwa University. Seriously! He’s amazing.’

Strangely, Lee Chan-hee felt a much greater respect for Tae-kyung as a doctor today than usual.

Come to think of it, it was only natural that Kim Gun-hyung would come looking for Tae-kyung periodically, wanting to scout him.

It was a fresh reminder of how lucky he, along with Choi Mo-na, were to be able to learn under such a master.

“Lee Chan-hee?”

“Yes, Doctor.”

“Why are you making such a surprised face?”

“How can I not be surprised? You fixed the bone in 45 minutes; how can I not be surprised? You’re really amazing, Doctor.”

“There’s nothing amazing about it. Okay! Let’s get the ultrasound in here, and all the micro instruments. Quickly!”

“Yes, understood.”

At those words, the nurse’s hands moved quickly to move the instruments.

All the surgical tools that had just been there, such as hammers and saws, which were reminiscent of a woodworking shop, were removed, and instruments for vascular surgery began to be lined up.

The ultrasound also came in from outside the operating room and was draped in sterile coverings so that it could be used in the sterile surgical field.

“Ultrasound!”

Tae-kyung then used the ultrasound to closely observe the blood vessels from the fractured area downwards. He saw a place where the faint blood flow was cut off.

‘Here it is!’

He quickly marked the spot with a sterile pen.

“Scalpel! No, right to the Bovie [electrocautery device]!”

“Here it is.”

This time, it was completely different from when he was fixing the fractured bone earlier.

He carefully cut into the tissue, stopping the bleeding one by one as it occurred.

As he delicately and carefully dissected, a very thin artery appeared.

“The condition isn’t good.”

“That’s because of the trauma.”

Some parts of it were already tattered due to the injury.

To connect the two severed blood vessels, it was unavoidable to pull on both sides of the vessels.

Here, too, it was purely a matter of sensation.

If pulled too much, it could break somewhere above, and conversely, if pulled too little, the connected area could break.

The most difficult thing was to pull just enough and carefully connect the blood vessels with the right amount of force.

In other words, the balance of power had to be well-matched.

But no one knows that proper balance of power. It is purely up to the surgeon’s experience and know-how.

Another thing to be careful of was not to connect too strongly or too narrowly, as this could cause turbulence in the artery inside, and that turbulence could cause blood clots.

If blood clots formed, the blood vessels that had been difficult to connect could be blocked again, so there were many things to be careful of and many things to keep in mind.

In the meantime, time was also running out.

In fact, some cells were already dying. Therefore, Tae-kyung had no time to hesitate.

“Okay, bulldog clamp [a device that gently grasps blood vessels to block blood flow] please.”

“Here you are, Doctor.”

Tae-kyung now grabbed the blood vessel on the body side from the severed area with an instrument to prevent further bleeding.

Then, he picked up the blood vessel that was connected to the severed foot and looked at it carefully.

“……!”

“Doctor, what’s wrong? Is something wrong?” Lee Chan-hee, who was next to him, frowned and asked Tae-kyung, who was looking at the blood vessel.

“It won’t work. The blood vessel length is not enough right now. Graft [short for vascular graft, an artificial blood vessel] please.”

“Yes, Director. What size should we use?”

“Just bring everything we have.”

Tae-kyung was in a hurry.

“Quickly!”

The medical staff gathered in the operating room also knew his urgency, so as soon as the order was given, someone ran out as if they were shot.

Among them, a male nurse hurriedly ran to the corner of the operating room where the supplies were located and began looking for artificial blood vessels.

“It was somewhere around here… definitely ah!”

At a time when every second counted, the male nurse, who was urgently looking for artificial blood vessels, took out the drawer itself where the artificial blood vessels were gathered and ran into the operating room with it.

Sreureuk-

As the operating room door opened, he showed Tae-kyung the drawer he was holding.

“Director, here it is. Which one should I give you?”

Tae-kyung quickly scanned the inside of the drawer and continued.

“The one that says number 5…”

“This one?”

“Yes, unwrap that one. And give me number 7 thread [a thread thickness mainly used to suture blood vessels, with needles on both sides of the thread, and the thread thickness is about the thickness of hair].”

“I’ll also take a micro forcep [a very small forcep used for microsurgery such as blood vessels].”

Soon after, Lee Chan-hee placed the ends of the artificial blood vessel and the artery together so that Tae-kyung could suture easily.

“Lee Chan-hee, don’t tremble!”

In a split second, Tae-kyung, who caught his junior’s trembling hand, shouted.

It wasn’t that Lee Chan-hee did it on purpose or made a mistake, nor was it because he lacked skill.

It was just that his fingertips trembled slightly for a moment because he was putting force on a very small and thin area.

“Yes! Doctor.”

Tae-kyung was very carefully suturing one stitch from the blood vessel and one stitch from the white artificial blood vessel with a very small thread and needle, carefully pulling and connecting them.

Of course, subtle force control was required here as well.

If it was too much, the blood vessel would tear, and if it was too weak, blood would leak through the gap during connection.

Therefore, even more attention had to be paid to force control.

Right now, Tae-kyung was connecting the blood vessel on the far side of the severed blood vessel to the artificial blood vessel.

After that, it was a repetition of fine sutures.

It was a very delicate task, stitch by stitch, very meticulously. And he checked the time from time to time to see how much time had passed.

In fact, Tae-kyung was anxious because of Gong Sae-chan.

Of course, it was wrong to violate the signal and speed on the motorcycle, but he didn’t want a young man with a bright future to live without a foot.

“Okay, let’s go up now.”

“Yes.”

Now, all that was left was to connect the artificial blood vessel to the severed blood vessel on the body side.

The method was the same as before, but in fact, only those who have done it know this technique.

It is similar to the process of setting up about 100 very small dominoes with a very small pair of tweezers, not just setting them up, but setting them up closely at regular intervals.

Of course, the most important thing here is that if you make a mistake, the patient’s foot will be gone.

“Ha…….”

Tae-kyung concentrated all his nerves, and his neck was more severely pulled than usual, so he raised his head for a moment.

In fact, it was common for the neck to be pulled more often than you think when you are operating with your head down in one position.

Tae-kyung, who raised his head, checked the time once again. Looking at the clock, there was no time to delay.

He carefully took his hand and reopened the blood flow that had been blocked by the bulldog.

And with a worried heart, he carefully took the ultrasound to Gong Sae-chan’s foot.

“I, I see it. Doctor, I see blood flow!”

With each heartbeat, red blood flow was visible.

“I see blood flow.”

At that moment, the faces of all the medical staff who had been holding their breath in tension lit up.

“Wow! That’s really a relief.”

“I was so worried… Doctor, is it done now?”

“It’s too early to be completely relieved, though.”

Unlike the medical staff whose faces lit up, Tae-kyung’s expression was still serious. The surgery went well, but he couldn’t rest easy yet.

“Blood clots can form overnight, and the veins may not be intact, so they may not drain well. Then it can pool and cause necrosis again, and we’ll have to use thrombolytics [medications to dissolve blood clots] for the next few days and watch closely. This is just the beginning. Let’s observe the patient well in the ward.”

“Yes, Doctor.”

“By the way, I heard that this patient flew away when the accident happened, is that right?”

Ui-jin, who had been watching the patient and the monitor during the surgery, asked curiously.

“Yes, Dr. Ui-jin. That’s right. I heard the paramedics explaining it in the emergency room earlier, and they said he collided with a car and flew 5 meters.”

“Oh my gosh! That could have been a disaster. The blood vessels were severed and the bones were fractured, but he was lucky at this point.”

“I, I used to see motorcycle accident patients often at the old hospital, and I saw a lot of people who were really badly injured. He’s really lucky at this point.”

“When I was an intern, there was a patient who came in with his back all torn up.”

Starting with Ui-jin, the nurses and Lee Chan-hee, as well as the medical staff gathered in the operating room, all took turns saying a word about motorcycle accident patients who had been seriously injured.

“I saw a patient who came in with all the bones in his body fractured. His fingers were all fractured, and his rehabilitation took a very long time, and he had a hard time throughout his hospitalization.”

“Oh my gosh, all the way to his fingers? That must have been really hard. Director, you’ve seen a lot of motorcycle accident patients, right?”

“I’ve seen a lot. There were cases of multiple fractures and cases where organs were spilled out, but the most severe case was a patient who came in with his head burst open.”

“H, his head?”

“Yes, I remember it was a collision between a dump truck and another car.”

“Anything can be dangerous and scary if an accident happens, but I think we should be especially careful with motorcycles.”

“I hope Gong Sae-chan never rides a motorcycle again…”

“But some people who enjoy speed are addicted, so it won’t be easy to quit.”

“That’s true too. I heard that this patient has had several accidents already.”

“He should stop riding after this accident.”

“Dr. Lee is right. I saw his mother was very surprised earlier, so he should stop riding for the sake of his parents.”

“I understand why that father was shouting and getting angry.”

“Me too. As a parent, there’s nothing worse than seeing your child sick, but he brought it on himself, so how angry and upset would he be?”

“Maybe he’ll realize something himself. Anyway, thank you all for your hard work. Thank you for your hard work, patient.”

Tae-kyung continued, looking at Gong Sae-chan’s face.