Chapter 54 – The Gentleman Who Studied in America (2)

3rd floor conference room.

“Professor Chung Ki-ryeo, why is the atmosphere like this?”

Watanabe asked, startled, as the doctors entered with solemn expressions led by Professor Chung Ki-ryeo.

“Hehehe, I do not know either! Could it be because of our great victory in the Korea-Japan soccer match today?”

Professor Chung Ki-ryeo’s shoulders were heavily squared with pride.

Sigh—

Watanabe looked highly displeased.

“Professor, please stop.”

Watanabe raised his hand and did not hide his discomfort.

“No, even so. How can they play such an important match on a muddy ground like that? Forcing the game in that kind of weather…”

Professor Chung Ki-ryeo was not someone who would stop just because he was told to.

“Ah! That is enough. By the way, is today’s conference prepared? Does theory even exist for you ignorant butchers? How dare you throw down a gauntlet to internal medicine?”

Watanabe tried hard to change the subject.

“Hahaha, originally, ignorant kids are also ignorantly good at studying.”

Professor Chung Ki-ryeo had no intention of backing down even a little.

“Professor Chung! This is not something that works just by studying ignorantly, you know?”

Hehehe, Professor Watanabe’s eyes blazed as he burned with fighting spirit.

“Let us wait and see! We will only know who is taller or shorter once we measure.”

“Fine! Professor, we will teach you a proper lesson today.”

Professor Watanabe was quite fluent in Korean.

A moment later.

The surgeons led by Professor Chung Ki-ryeo and the physicians led by Professor Watanabe entered the conference room. In this way, internal medicine and surgery began a full-fledged debate.

Today’s topic was a heated discussion on whether medical treatment or surgical operation was more effective for coronary artery-related diseases.

In other words, using a house as an analogy, the question was whether to rebuild it, or to leave the house’s original structure intact and only repair the interior.

“Basically, open-heart surgery is the most effective for coronary artery disease!”

Dr. Ko Sang-han of surgery tried to seize the initiative first.

“Hahaha, where does such an anachronistic idea come from? Are you living in the 19th century? This is the 1950s, when medicine is developing dazzlingly worldwide! Many good drugs have been developed now, so there are endless treatment methods without having to open the chest unreasonably! When I was a student at the University of Tokyo School of Medicine…”

Rebutting this, Shim Jae-wook, an internal medicine specialist from the University of Tokyo School of Medicine in Japan, stiffened his neck with an arrogant expression.

“There is clearly a limit to drug therapy!”

Kim Yun-seok chimed in to support Ko Sang-han’s claim.

“Yes, yes! There is a limit. But it is much better than dying from the side effects of invasively opening the chest!”

Shim Jae-wook’s logic was valid to some extent.

After all, one of the biggest breakthroughs in organ health was the development of heart surgery.

Entering the 1950s, it was certain that heart surgery was developing rapidly.

Cardiologist John Gibbon successfully performed heart surgery using a machine for the first time.

Finally, a new path for heart surgery had opened.

Using this, paths for bypass surgery and even heart transplantation, the dream surgery, were opened.

However, just because a path was opened did not mean the journey would be smooth.

It could be a bumpy, rough road, or perhaps a road blocked after going a certain distance.

As such, it was also true that heart surgery still had a long way to go as of 1954.

In fact, there were almost no successful cases in the country.

“Professor John Gibbon successfully performed heart surgery…”

“That is the case in the West. Are there any successful cases of heart surgery in our country?”

When Kim Yun-seok brought up Professor John Gibbon as an example, Park Kang-min of internal medicine countered.

“…”

Kim Yun-seok had nothing to say.

In fact, the first successful open-heart surgery in South Korea was performed by Professor Hong Phil-hoon of Severance Hospital in 1956. Officially, as of 1954, there were no successful cases of heart surgery.

At that moment, Watanabe’s expression was bright, while Professor Chung Ki-ryeo’s face was rotting away.

“Dr. Shim! You know the proverb, ‘Should we not brew soy sauce for fear of maggots?’ right?”

Kim Ji-hyuk, who had been quietly observing the discussion, finally stepped in.

“Well, that is true.”

“Does internal medicine have a method to medically treat mitral stenosis? The mitral valve is stuck together like a flattened piece of dough; can that be treated with drugs?”

“Th-that is an act of God, is it not?”

Of course, medical treatment of mitral stenosis was impossible.

“At best, your prescription would be anticoagulants like antiarrhythmics or Dicumarol.”

“That is the best!”

Shim Jae-wook raised his voice.

“That is why I asked if we shouldn’t brew soy sauce for fear of maggots. You just make a minimal incision in the patient’s left chest, cut two ribs, and widen the stenosed mitral valve. Then we can arrest the respiratory failure.”

Indeed, this was the surgical method used by Professor Hong Phil-hoon of Severance Hospital two years later, in 1956.

“Hahaha, widening a stenosed mitral valve? With what? Absurd! Then why don’t you insert a balloon between the mitral valves and inflate it to widen them? You should speak words that make sense.”

Park Kang-min sneered and mocked Kim Ji-hyuk.

“Dr. Park! That seems like a very good idea.”

Professor Chung Ki-ryeo slapped his knee and stepped forward.

“Pardon??”

“Dr. Park just gave a great idea! If the mitral stenosis is severe, there is a limit to using a scalpel. If we connect a balloon to a tube, insert it between the stenosed mitral valves, and inflate it, it should be possible without having to use a scalpel precisely. It is a kind of mitral valvuloplasty!”

‘As expected of Professor Jang Ki-ryo! Yes! That is the surgery that will later be called percutaneous mitral balloon valvuloplasty! If we can develop this surgical method first, South Korea will become the mecca of heart surgery! That is exactly what I intend to do!’

“Hahaha, our Professor Chung has too rich an imagination! How is that even plausible? Even if it were possible, mitral stenosis is usually caused by rheumatic fever. That means it has invaded and collapsed even the valves and subvalvular structures. Even if something is possible with a balloon, you cannot just save the mitral valve!”

Ahem—

Watanabe snapped at Professor Chung Ki-ryeo with a confident tone.

“…”

Professor Chung Ki-ryeo could not offer a proper rebuttal.

“If that is not feasible, we can replace the mitral valve entirely! If the mitral valve is severely damaged and cannot be reconstructed, we can just replace the valve!”

“Impossible! Are you saying the heart is some kind of robot? Detaching and attaching it?”

The internists shook their heads in unison.

“It is fully possible! It would be possible by processing pig or cow valves or using a portion of the pericardium to make an artificial valve. If that happens, a normal life will be possible without taking anticoagulants.”

Kim Ji-hyuk refuted the internists’ words in a firm tone.

“Oh, Ji-hyuk! I think you’ve gone too far this time. How can we transplant a pig’s valve into a human? Hey, next you’ll say we can make an artificial heart too.”

Kim Yun-seok pulled Kim Ji-hyuk’s sleeve.

“It is possible. An artificial heart, too!”

Snicker—

Ji-hyuk curled the corner of his mouth as he looked at Kim Yun-seok.

“This guy, this guy! You’ll get in big trouble if you just say whatever comes to mind!”

“Dr. Kim Yun-seok, no! Dr. Kim Ji-hyuk’s words make sense. Pigs actually share the most similar genes with humans, don’t they? Therefore, if it is just a valve and not the heart itself, the rejection reaction surely won’t be large. It seems like a brilliant idea.”

A look of interest returned to the brightened face of Professor Chung Ki-ryeo.

“Ah! Professor Chung! Such wild imaginations are bad for mental health! Please do not do that!”

“No! Professor Watanabe! Let’s be honest. You know that the medical treatment you are advocating for is not a fundamental solution, don’t you? It does not escape the level of prolonging life at best! Can you say it is not?”

“Ugh, but we cannot just let the patients die, can we?”

“Then what about the quality of life of the patients who have to endure that pain? How is that living? They are as good as dead, only breathing.”

Professor Chung Ki-ryeo glared fiercely at Watanabe.

“That is true, but…”

“Yes, that is correct. With the current medical level of South Korea, it might be impossible. Using pig or cow valves may sound absurd. But if there is a 1% chance, is it not our job as doctors to challenge it? How is a life where your chest hurts and you gasp for breath after walking only a little a proper life? If it were possible, I would want to undergo surgery even if I had to risk it!”

Professor Chung Ki-ryeo said with a face full of conviction.

“Isn’t thinking that it is possible too much in the realm of imagination? If you imagine in that way, you could just make a bypass for a blocked coronary artery and connect it to the heart?”

Sigh—

Watanabe let out a deep sigh. His eyes were full of wrinkles.

“Exactly, Professor Watanabe! Coronary artery bypass grafting! That is it.”

Kim Ji-hyuk immediately shot back.

“Coronary artery bypass grafting?!”

Coronary artery bypass grafting!

As a surgery that sends blood to the heart by creating a bypass instead of the blocked coronary artery, it was first successfully performed by Sabiston of New York University in 1962, so it must still be an unfamiliar surgery.

“Yes. That is correct. There is not only one way to travel from Busan to Seoul, is there?”

“So?”

“If it gets blocked in Daejeon after passing through Pohang or Daegu, you can just go around! That is coronary artery bypass grafting.”

“Are you saying we create a new blood vessel?”

At this point, Watanabe, who was a cardiologist, also seemed curious.

“Yes. The bypass will be fully possible if we use the greater saphenous vein! In that case, instead of the open-heart surgery you worry about, we can create a bypass with only a minimal incision.”

“Using the greater saphenous vein?”

The greater saphenous vein was a major superficial vein located in the lower extremity, starting from the foot and going up to the groin. In other words, harvesting it was relatively simple, and since it was one’s own vein, there would be no transplant rejection, so it was certainly not an impossible story.

“Yes! If we dissect the subcutaneous tissue slightly inside the groin to expose the greater saphenous vein, and then make an incision along the skin following the flow of the vein, harvesting the greater saphenous vein is simple!”

“That is a great idea! Dr. Kim Ji-hyuk! What do you think, Professor Watanabe? Is this not worth researching? Coronary artery bypass grafting? If only this surgery is possible, as Dr. Kim Ji-hyuk said, it seems a way to fundamentally treat fatal heart diseases like angina or myocardial infarction will open.”

Professor Chung Ki-ryeo asked with a flushed face.

“Hmm… Dr. Kim Ji-hyuk?”

Watanabe called Kim Ji-hyuk in a low voice.

“Yes?”

“Are you perhaps…”

Watanabe narrowed his eyes with a serious expression.