Chapter 37 – Starting Anew (4)

Kim Ji-hyuk and Kim Yun-seok saved the baby against all odds.

Now, it was the mother’s turn to be saved.

‘Fortunately, the baby is safe. The problem is the mother! However, saving a mother who has completely exhausted her physical strength is no easy task! She has to hold on somehow…’

From now on, it was time to focus on gifting a healthy mother to the young life that had just met the world.

However, that did not mean saving the mother was an easy task by any means.

“Yun-seok, the baby was so beautiful. Right?”

“Right! He looks like a doll. I think he will grow up to be quite handsome. It’s a relief he came out into the world healthy.”

Was it the pride that they also had a hand in saving the child? The voice of Yun-seok, who was dripping with sweat, was bright.

“Right! So beautiful. So, shouldn’t we make sure to show this beautiful baby to his mother?”

Ji-hyuk showed a faint smile as he looked at Yun-seok.

“Yeah!”

Yun-seok nodded.

“Good! Then shall we begin now?”

“Yeah!”

Ji-hyuk and Yun-seok, who had confirmed with their own eyes that the baby was safe.

Although it was a fragile life whose survival could not be guaranteed yet, the fact that he had safely entered the world was a great source of strength for them.

“Let’s save her! For sure!”

“Yeah!”

Ji-hyuk and Yun-seok looked at each other, their determination burning.

With that, Ji-hyuk and Yun-seok began the mother’s main surgery.

Red blood bottles hung in clusters on the stand.

If it were a modern hospital, they would be plastic packs instead of bottles.

With that thought, Kim Ji-hyuk shifted his gaze and looked around the operating room.

‘Is surgery even possible in a place like this?’

The operating gowns of the nurses, which looked like aprons, were already stained red with blood.

The equipment and personnel were in an incomparably poor state compared to the era Kim Ji-hyuk had lived in.

‘When in Rome, do as the Romans do. Now, I have no choice but to rely entirely on my experience and skill!’

Kim Ji-hyuk was in a situation where he had to perform the surgery believing only in his experience and his own skill.

“Yun-seok! As soon as we open the abdomen, a lot of blood will come out. So prepare plenty of irrigation fluid and brace yourself!”

“Got it! It’s not the first or second time, and by now, I’ve adjusted to some extent, so it’s manageable.”

‘Right, Grandfather! Because you are South Korea’s best surgeon!’

“Yun-seok, we need to have enough gauze. We have to block the ruptured spot first for there to be a next step.”

“Got it. I’ve already prepared it.”

Sterilized gauze was piled high like a mountain in a red plastic basket.

“We are starting now! Nurse! Scalpel, please!”

Ji-hyuk glanced at the pile of gauze and reached out his hand toward the nurse.

“Yes. Here it is.”

In that way, the surgery began under Ji-hyuk’s direction.

A moment later.

Whoosh, whoosh—

Just as Kim Ji-hyuk had said, as soon as the abdomen was opened, red blood poured out like an erupting volcano. The organs that had been shocked by the traffic accident vomited blood all at once.

‘Does this… make sense?’

Kim Ji-hyuk’s pupils trembled.

The patient’s internal organs were mangled to the point where they could not be distinguished by the naked eye, and the spleen, which had already ruptured, was pouring out blood.

The cause of the massive bleeding was the spleen, which holds the largest volume of blood.

“Yun-seok! Block it first!”

Ji-hyuk began to hurry a little.

“Got it!”

“Please have more people assist! Quickly. Nurse, take some gauze and help Yun-seok!”

Yun-seok alone could not handle the speed at which the blood was leaking out.

“A-Ah, okay.”

First, they had to block the loss of blood pouring out from the spleen.

In addition to Yun-seok, the nurse took gauze and began packing.

“It’s not enough! Push it further inside! Yun-seok, we need more gauze!”

“Got it!”

Thud, thud—

The pile of dark red gauze accumulated in another empty plastic basket.

Discarding the gauze fully soaked with blood and packing with new gauze was repeated dozens of times.

Finally, when gauze was piled layer upon layer on the affected area in that way, the bleeding stopped to some extent, and now it was time to proceed with suturing as an emergency.

“Yun-seok, hold on just a bit more. More! Pull it a bit more. I can’t secure the field of vision!”

Now, they had to clamp the abdomen with a retractor to widen it further, block the bleeding spots, suture the torn areas, and separate any adhered organs from the abdominal wall.

“I get it! I’m doing my best too!”

Using an old-fashioned retractor was not easy.

Yun-seok, pulling the retractor with all his might, soon had a red, flushed face.

Thanks to Yun-seok’s struggle, the field of vision was secured, and as the bleeding temporarily stopped from the packing, Ji-hyuk could see the inside of the patient’s abdomen in more detail.

However, the condition was even worse.

“Th-this is crazy! The large intestine is completely adhered!”

The adhesion was so severe that the large intestine was stuck to the abdominal wall. The fact that the organs were stuck to the abdominal wall like this meant that all the organs were tangled together as one lump.

“Wh-what is all this? The large intestine is completely…”

Yun-seok had a blank, devastated expression.

It was a shocking scene that made even Yun-seok’s mind turn blank.

Yun-seok could not continue speaking and was lost in shock.

“Ji-hyuk, w-what should we do about this?”

“Colonic dissection!”

“Dissection? So you’re saying we detach that adhered large intestine?”

“We have no other choice right now, do we?”

The surgery to dissect the large intestine adhered like melted taffy to the abdominal wall was not an easy one.

Even for a veteran surgeon who possessed high surgical skills and rich experience in modern times, it was not an easy surgery.

It was a highly difficult surgery that required very precise and fast hands, like a computer.

However, since there was no precise equipment anyway, Kim Ji-hyuk judged that a colonic dissection, which did not require special equipment, was fully worth trying.

“Let’s do it. If we just do it like we are now, it’s fully doable.”

“Hmm, got it! If that’s the only way, we have to try it somehow.”

Yun-seok respected Kim Ji-hyuk’s judgment and nodded.

Slice, slice—

In that way, Kim Ji-hyuk began the dissection of the large intestine that was stuck like melted taffy to the abdominal wall.

Slice, slice—

“……!”

Ji-hyuk’s hands dissecting the large intestine were extremely delicate and accurate.

Yun-seok, who was watching that scene, thought,

‘Maybe, no matter how hard I try in my life, I might never be able to catch up to Ji-hyuk!’

Gulp—

Yun-seok swallowed his dry saliva.

‘The adhesion is too severe!’

The abdominal cavity was so full of adhesions that there seemed to be no boundary between the small and large intestines.

‘If only we had a camera, we would be able to see the back…’

Since an endoscopic camera was out of the question, Ji-hyuk had to rely on what was visible, and for the invisible parts, he had no choice but to deduce and infer based on his experience.

“Ji-hyuk, will it be okay?”

“It’s fine! For now.”

To Ji-hyuk’s ears, Yun-seok’s words sounded like ‘How about giving up now?’

‘First, I must find the area with the least adhesion! We can start from there.’

Ji-hyuk’s plan was to find the area that was not adhered, start the dissection from there, and gradually secure space.

“Found it! Right here!”

In that way, Ji-hyuk searched every nook and cranny of the abdomen and found a normal abdominal wall. Now, starting from here, they had to secure space by dissecting the adhesion very slowly and precisely.

Tick—

Tick—

Time flowed aimlessly.

Before they knew it, almost three hours had passed since Ji-hyuk started the dissection.

“Are you okay? Your surgical cap is completely soaked in sweat!”

Ji-hyuk, who had continued the tedious dissection without straightening his back even once, was soaked in sweat all over his body.

“Then wipe the sweat for me.”

“Huh? Oh, okay. Sorry!”

Yun-seok took gauze and wiped the sweat flowing down from Ji-hyuk’s forehead.

Tick, tick—

The tedious dissection continued.

Actually, the abdominal wall that he had judged to be normal turned out not to be so when he dissected it.

The small intestine was adhered to that abdominal wall as well.

‘Sigh, the small intestine is torn!’

In the process, the small intestine was inevitably damaged.

‘Since it’s not torn much, we can just suture the small intestine! Since bowel obstruction might occur, if we remove as much adhesion as possible and insert a drainage tube, there won’t be a major problem!’

Without panicking, Ji-hyuk continued the dissection of the adhered bowel.

Tick, tick—

As a result of calmly proceeding with the dissection in that way, they finally succeeded in completely detaching the adhered large intestine from the abdominal wall.

“We did it!”

Yun-seok almost shouted in joy.

He stared blankly at Ji-hyuk’s face. In Yun-seok’s eyes, relief at Ji-hyuk’s successful surgery was mixed with an endless envy of him.

“It’s too early to relax! We must not forget that the patient is a mother. Her condition is still unstable. Since the dissection is done, let’s close the abdominal wall first.”

“Yeah!”

It was just as Kim Ji-hyuk began to close and suture the collapsed abdominal wall.

“Dr. Kim Ji-hyuk!”

Anesthesiologist Yong Tae-in’s urgent voice was heard.

“What’s wrong? Is there a problem?”

“Th-the patient’s intracranial pressure has deviated from the normal range!”

“What?! What is the cause?”

A surprised Kim Ji-hyuk asked.

“Th-that, I don’t know either! Suddenly, the ICP is rising…”

‘She was clearly fine just a moment ago!’

Yong Tae-in had a bewildered expression.

‘What a bolt from the blue. We are in a situation where we can’t even perform an ABGA (arterial blood gas analysis)!’

Ji-hyuk, too, could not hide his bewilderment.

Suddenly, an unexpected variable had occurred.

“Dr. Yong Tae-in, what is the current ICP status? Is it still rising?”

Kim Ji-hyuk’s voice became urgent.

“Yes. It keeps rising. What should we do? Perhaps a problem occurred in the brain…”

“Then, by any chance, do you have mannitol?”

“The 20% one?”

“Yes, yes. That one.”

“We have that. Should we administer it?”

Yong Tae-in asked in an urgent voice.

“Yes! Let’s administer 100 mL first, and if the ICP still rises, let’s administer it once more!”

“Got it!”

“Yun-seok, can you check the patient’s pulse?”

Kim Ji-hyuk’s speech was also getting faster. That was how serious the current situation was.

If they could not control the rising intracranial pressure as quickly as possible, it was a critical situation where the patient could suffer a fatal injury to her brain.

“Got it!”

Kim Yun-seok checked the patient’s pulse.

“Ji-hyuk, the pulse is only 40!”

‘Bradycardia!’

Intracranial pressure was rising; conversely, the pulse was falling.

“Nurse, please check the blood pressure!”

“It’s 220 now! What should we do?”

In addition, the blood pressure was rising—it was the worst-case scenario.

‘Let’s organize my thoughts. If we had performed an arterial blood gas analysis, all levels including arterial oxygen partial pressure and bicarbonate would be out of the normal range! In that case…’

Kim Ji-hyuk was mobilizing all the medical knowledge in his head to find the best solution.

‘It’s highly likely to be an SDH (subdural hemorrhage)!’

Subdural hemorrhage referred to acute bleeding occurring in the space between the arachnoid mater and the pia mater.

It was certain that damage had occurred to her brain due to the traffic accident.

‘It’s not difficult! If we just drain the blood accumulated below the dura mater, subside the edema, and then reduce the pressure and volume of the brain, there won’t be any problem! I can fully pull it off!’

Finally, Ji-hyuk had found the solution.

“Yun-seok! Let’s perform a lobectomy!”

“Wh-what?”

“So from now on, I need your help!”

“Me? What can I do?”

Surprised, Yun-seok blinked his eyes.