Chapter 40: Chapter 40

“You’re the professor…?”

Kim chuckled.

He was the very intern who had been at the place when Suhyuk first woke up from the vegetative state. And it was also resident Kim Jinwook who checked the condition of Inbae who had been treated with Suhyuk’s first aid.

He’s become a professor now.

“I watched the news well. Did you identify the cause of the death of the cadaver?”

“I accidentally found it,” said Suhyuk.

Kim Jinwook shook his head.

“I think you have the ability to have figured it out well enough.”

His memories are still fresh in his mind. A 15-year-old middle school student who just woke up from a persistent vegetative state and diagnosed himself. He’s now grown up into an adult, getting a lot of media highlights.

“Have a seat!”

Kim gave a cup of coffee to him, which he brew himself.

“Thank you.”

The smell of coffee spread gently in the room, and it tasted good.

“Well, did you learn a lot at school? Or was there any stuff you could learn?”

“I’ve learned a lot,” said Suhyuk.

He narrowed his eyes, asking, “Really?”

Suhyuk just scratched his head.

“Those in the same class as you must envy you a lot. And have a lot of jealousy too. But you don’t have to hide your abilities or do average. Just keep marching as you would.”

So they exchanged conversations like that.

Then Kim Jinwook asked out of the blue, “Are you okay, because your face looks bad?”

“Yes, I’m okay. ”

Though he still felt nauseous, he felt much better now.

“Did you decide on your speciality?”

Suhyuk was about to reply but did not. Actually he’s been struggling about that in his heart, though Kim did not sense it, because he was only quiet for a brief moment.

Suhyuk soon opened his mouth, “Well…”

“Wait a moment,” said Kim, answering a phone call.

“Yes, this is Kim Jinwook.”

“Professor, we have an emergency patient.”

“Have you checked the patient’s condition?”

“It seems to be a patient with an aortic dissection.”

Aortic dissection refers to the tearing of the intima of the aorta in the chest.

“Is it true or not? Did you check the CT?” Kim Jinwook pressed him, who was muttering.

“Yes, he is a patient with that symptom.”

“Are you sure?”

Some sort of unsure tiny voice was coming out of the cell phone, “In my mind…”

After breathing a short sigh, he opened his mouth again,

“Let me go down now and get ready.”

He was a resident that Kim prized, but he did not progress as much as Kim wanted, possibly because of his insufficient training.

After he hung up the phone, Kim looked at Suhyuk regrettably.

Though he wanted to talk a bit more, he had no choice but to treat the patient.

But there are plenty of opportunities. As Suhyuk has come to Daehan MS for practice, Kim could see him anytime.

“I’ll see you next time.”

The two stood up.

When Suhyuk tried to go out, Kim Jinwook turned around and asked,

“Would you like to come and observe?”

Trainees like him go into the operating room anyway and observe. It does not matter even if their observation comes earlier than usual. Who would oppose when the professor in charge of operation wants to bring one as an observer?

Suhyuk nodded his head with a smile of expectancy.

Arriving at the elevator, Kim Jinwook pushed on the buttons, regardless of whether it was the elevator for the medical staff or one for patients and their guardians, the situation could not be more urgent.

The door of the elevator opened, and the two went inside.

Kim asked with strange eyes, “A patient with aortic dissection. What kind of condition does he have now?”

“If it is aortic dissection, the patient seems to be in a dangerous condition. It seems to be an emergency…”

Kim Jinwook nodded as if he had expected that kind of reply from him.

‘If so, does he know the cause of it?’

“Any cause?” Kim asked.

Suhyuk opened his mouth, “The main reason is that 80% of the cause is known to be related to hypertension, so it happens mainly to senior people. It seems that there are other causes such as congenital. For example, genetic defects such as denaturation in the media itself, arteriosclerosis or aging… ”

“That’s enough,” Kim waved his hands, asking him to stop.

He regretted asking him tactlessly because it was the obvious answer to the obvious question.

He wondered what kind of doctor he would really be.

Kim Jinwook, who went down to the emergency room, rushed to check on the patient’s condition. He identified the patient’s condition clearly after checking the CT. The aortic dissection that the resident said without confidence was right. Treatment is divided into two types. Type B can be treated with medication, while Type A requires surgery. The patient was rapidly progressing from B to A, and he required surgery.

“What about the guardian?”

“He was brought to the emergency room alone.”

Kim Jinwook, who immediately contacted the guardian, verbally signed the operation agreement. He could not afford to wait until the guardian came.

When the aortic dissection transitions up or down or swells up and the blood that the heart pumps out bursts then it is too late. The patient will die from excessive bleeding.

In the meantime, Suhyuk observed the CT very carefully. Aortic dissection with tearing of the inner membrane. It will be a dangerous surgery that needs stopping of the heart.

Then his cell phone vibrated. It was from Choi Suryon.

“Hello!”

“Suhyuk, where are you?”

He forgot that he was supposed to have an outing with the team members tomorrow, Saturday, when they have a day off.

“Ooops… I do not think I’ll be able to come…”

“Why? Any business to do with your professor?”

A voice suddenly popped out next to Suhyuk.

“Is it an emergency?” Kim Jinwook approached and looked at the CT.

Suhyuk, who was making a serious expression, nodded his head.

“Let’s go.”

Professor Kim Jinwook first walked back, and Suhyuk rushed to his cell phone.

“I’m sorry, Suryon. You guys have to play without me. Talk to you later then.”

***

“Come on, wash it thoroughly after me”

Kim Jinwook showed them how to disinfect.

They washed it as you wash hands, and then scrubbed it with a brush.

Suhyuk followed his demonstration.

It was an awkward move, but he cleaned it carefully because he knew how important it was. Sterilization work that he does not recall at all even from in his dream.

No, obviously he did not do it in his dream. For he just held a scalp and opened a patient’s stomach.

“Nurse Ms. Lee, please put on a surgical gown for this trainee,” said Kim.

Helped by the nurse, Suhyuk wore a surgical gown, and put on a hat, a mask, and gloves. Suhyuk looked down at his two hands, which reminded him of his old memories.

How long did he wear surgical gloves for? Actually it was the first time.

“Let’s go, it will be a good experience for you. So, focus when you watch it!”

Suhyuk nodded and went into the operating room.

There were a total of seven people in the operating room.

They were medical residents absolutely necessary for all surgeries.

Resident of anesthesiology, nurses specializing in thoracic surgery, extracorporeal perfusionist, resident of cardiothoracic surgery. All of them gathered to save a person’s life looked at Suhyuk with a curious look.

“Well, I’m a trainee observer.”

It is very rare for trainees to attend an emergency surgery. But in the operating room, the professor’s word is like law.

At Kim’s words, they quickly quenched their interest in him.

During the course of the anesthesia, they moved around in unison until the patient was fully asleep. Everyone doubled checked to carry out their duties steadily, and got ready.

The aorta is directly connected to the heart.

Since it is a dangerous operation, no error is tolerated.

Suhyuk slowly looked around. The patient’s condition was checked and various devices were attached to the patient’s body. Then. Snap! Snap! Snap! They began to knock on the IV cords as thick as knuckles relentlessly with the scissors handle and pen. Professor Kim did the same. They carefully checked whether the bubbles inside IV cords were removed fully.

Looking at them, Suhyuk muttered, “Extracorporeal circulation…”

It was a device that intentionally stopped the heart and lungs for surgery and artificially circulated blood and oxygen through the body. In addition, there was a lot of fluid to be injected into the patient’s body as well as several packs of blood. Hemorrhage was inevitable because of the incision of the aorta.

Suhyuk’s eyes turned to Kim this time.

When the anesthetized patient closed his eyes, Kim moved with his scalpel.

From now on, all the residents have to follow his words and movements.

“Start the aortic arch substitution.”

As Suhyuk came back behind Kim as if haunted by something, Kim said, “Watch closely.”

Kim, who incised the patient’s abdomen and surface, told the resident,

“Bovie!”

With the smell of burning flesh, the patient’s abdomen became completely open.

Suhyuk muttered without realising.

“Heparin, cardioplegia. Keep the body temperature from 27 to 28.”

Hearing Suhyuk’s murmuring behind him, Kim smirked and shook his head.

How did he know as far as this?

He gave an order, “Heparin.”

When heparin was injected into the IV, Kim’s hands moved.

As the surgical tools pushed the organs away, the heart was seen inside.

The heart was pounding as if it were alive.

“Cardioplegia, please stop the heart.”

The extracorporeal perfusionist immediately injected cardioplegia.

Kim continued to order, “Cooling down. Keep the temperature at 27, 28 degrees.”

Cooling down is intended to manipulate body temperature artificially to prevent damage to the aortic tissue during the operation time.

The movement of the heart became noticeably smaller.

Kim said loudly, “The heart is stopped. Is the cardiovascular circulation device working? Work it now.”

According to the order, the extracorporeal perfusionist waited for the right timing.

And when the heart was stopped, the artificial circulatory device worked.

The mingling blood began to circulate, making the ringers stranded.

Surgery cannot start without stopping the heart. As the heart keeps pumping blood all over the body, it needs to be put to sleep so that it can stop the blood flowing to the aorta for a while. If the heart is beating and blood is spewed out without treatment, the patient will die from excessive bleeding.

So all the preparations were over. The circulatory device, which suppresses the coagulation of the blood that meets the air and supplies blood and oxygen instead, started working. Also, the patient’s body temperature was dropped to minimize tissue damage.

Now, what’s left are the patient who wants to live, and the staff who are trying to save the patient.

“Let’s start.”

Kim’s hands moved.

It was exactly where the inner membrane was damaged.

The aorta was reminiscent of a thick, smooth earthworm.

Watching it closely, Suhyuk’s pupils were expanded.

Moreover, he mumbled like a person who lost focus, “Remove the damaged area and get the artificial blood vessels.”

Kim was a little surprised because he felt someone pushed him from behind.

It was Suhyuk.

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