Chapter 176
Rattle-
The stretcher carrying the patient began moving toward the emergency operating room.
The director went into the men's changing room without hesitation.
[Dead Doctor Gallery]
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Come on, if nobody calls it, we'll do rock-paper-scissors. @ScalpelGod @ThoracicSurgeryOld-Timer
Posted by: Hell Joseon Slave 1
Cut the crap and decide fast. Patient has cardiac tamponade, pericardiocentesis failed, clot suspected, we're going for an emergency thoracotomy. Abdominal ultrasound is clean. Who's taking it?
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[Comments]
Hippocrates' Descendant : This is the moment when the specialties of multiple ghosts overlap! The boundary between thoracic and trauma—how fascinating!
Scalpel God : What's the cause?
ㄴ Hell Joseon Slave 1 : Trauma. Blunt trauma.
ㄴ Thoracic Surgery Old-Timer : If it's tamponade from blunt trauma, it'd probably be a cardiac rupture or aortic injury, but I specialize in lung cancer.
ㄴ Thoracic Surgery Old-Timer : GG.
ㄴ Scalpel God : I’ll do it, yeah. Anyway, I have both GS and CS.
Hmm.
Nice and clean.
No fluff.
Is this what a real alpha-male surgeon's decision-making looks like?
Then, from inside the back of the changing room, hurried sounds came.
The sounds of closet doors opening and closing, fabric rustling.
‘Looks like the director is finally coming out too.’
I took a deep breath.
Once the surgery began, the thoracic surgery on-call doctor would come running down within ten or twenty minutes.
So all I had to hold out for was the first twenty minutes or so.
I couldn’t let my clumsy movements throw off the director’s tempo.
‘Then direct possession would be better than guide mode.’
I hand over control of my body.
I retreat into a corner of my brain and put that monster in the driver's seat.
Clack.
Director Lee Jae-yoon came out from the inner door of the changing room.
He was already fully changed into scrubs, with a mask and cap on.
Not even a minute had passed?
‘Does changing clothes take that long? He’s insanely fast.’
Without even a chance to marvel, I closed my eyes.
There’s no time.
‘Possess me, Scalpel God.’
Whoosh-
I could feel my body blacking out in an instant.
And then, almost immediately, my vision brightened again.
Pop-
‘Hmm, is this already my fifth or sixth possession...?’
Familiar.
That strangely comfortable sense of alienness—of this body being mine and not mine.
Most of them are this guy.
My body, with the Scalpel God in control, naturally turned its head to look at the operating-room entrance.
The stretcher rolled noisily into the operating room, and behind it was Director Lee Jae-yoon, who was about to follow after it.
The Scalpel God flexed and unflexed his hand once to check the feel, then paused when he saw the director.
...?”
Lee Jae-yoon sensed someone’s presence and half turned around.
?
The Scalpel God’s eyes wavered.
“You...”
The Scalpel God started to speak, then closed his mouth.
‘Right, they looked like they knew each other.’
Since the surgery the director showed me last time was probably Scalpel God’s, if that guess was right, there was also a good chance the two of them knew each other.
The Scalpel God quickly regained his composure, as if that wasn’t what mattered right now.
Director Lee Jae-yoon stared straight into my eyes and asked,
“Dr. Han. So, have you thought about what surgery to do? I mean, the approach.”
It was a test.
A test to see whether some random resident from another department really knew his stuff when it came to the heart.
“Uh... yes. I think Left Anterolateral Thoracotomy(* left anterolateral thoracotomy) would be better than Median Sternotomy(* median sternotomy).”
Lee Jae-yoon asked without stopping his steps.
“Why? The view is much better with the former. Because of the time?”
“Yes.”
My voice came out steady.
“In the first place, for a trauma patient like this, sternotomy doesn’t seem worth considering.”
“Right. That’s the right answer.”
He nodded, looking satisfied.
“And immediately after the thoracotomy, it’d be good to clamp the descending aorta directly by hand or with forceps to cut off the downward blood flow too.”
“…Right. Do that.”
…
***
Every motion of lathering and scrubbing from fingertips to elbows was quick.
‘The surgical hand scrub procedure...’
The textbook surgical scrub, only faintly remembered.
Tap.
After shaking the water off and holding our hands chest-high, we pushed open the operating room door and went in.
“We’re going in.”
The patient was already anesthetized and draped.
“We’ll do a time-out.”
The anesthesiologist called out while holding the chart.
“Patient registration number 28ER110027, Han Seung-ho. 32-year-old male. Diagnosis: traumatic hemopericardium. Procedure: emergency thoracotomy. Surgeon: Lee Jae-yoon, assistant: Han Hyeonjae. Is that correct?”
“Correct.”
“Correct.”
“No marking because it’s an emergency surgery.”
The monitor’s heart-rate tone rang out ominously.
Then Lee Jae-yoon opened his mouth.
“Scalpel. No. 10.”
As soon as Lee Jae-yoon’s short command fell, the nurse handed over the instrument.
The scalpel cut the skin between the patient’s left ribs.
Sskrrk-
Lee Jae-yoon sliced along the patient’s left fifth intercostal space in one swift motion.
A red line appeared, and blood began seeping out.
“Bovie.”
Sizzle-
Smoke rose with a burning smell.
…
“Retractor.”
The Scalpel God was already holding the retractor at the ready.
The rib spreader went in, and with a rattling sound the chest cavity was forcibly pried open.
Crack.
The rib cartilage broke, but...
‘That’s not the problem right now.’
As soon as the field was exposed, dark red blood could be seen sloshing up.
“Suction.”
“Already on it.”
Even before Lee Jae-yoon could say anything, the suction tip was already precisely zeroing in on the pooled blood and sucking it away.
Chuk-
Chwaaack-
As the blood was sucked away, the field opened up in an instant.
Without missing that split second, Lee Jae-yoon’s hand moved.
‘…Wow.’
Lee Jae-yoon silently marveled.
The exposure was a work of art.
The moment he wanted to see something there, space had already opened up.
‘How could this not be the hand of a surgeon?’
A perfect assist, moving like another pair of his own hands and feet.
The flow of the surgery didn’t break.
No, it almost felt like Lee Jae-yoon was getting pulled along by the resident’s tempo.
Normally, if the assistant is clumsy, the surgeon starts yelling.
Especially in an emergency surgery like this.
Yet this operating room was bizarrely silent.
Even if the surgeon so much as turned his head, the assistant would automatically twist the retractor angle and open up the field.
It felt like he was looking one step ahead of the surgeon and clearing the way.
I’d worried his hand might have gotten stiff from not operating in a while, but there was no sign of that at all.
He knew exactly where Lee Jae-yoon was going to cut and what he wanted to see.
And so Lee Jae-yoon and the Scalpel God had the descending aorta clamped.
A measure to block the blood flowing from the heart to the lower body and maximize blood flow to the brain and heart.
It was a crucial maneuver for preserving the patient’s vitals.
“Professor.”
“What is it, Dr. Han?”
Without taking his eyes off the surgical field, Lee Jae-yoon answered.
He didn’t notice the emergency medicine resident’s mistake in calling him Professor instead of Director.
“After opening the pericardium, instead of compressing the bleeding point with a finger, I’ll insert a Foley catheter and inflate the balloon to block it. I already told the surgical team to prepare the equipment earlier.”
The Scalpel God suggested the next step.
A temporary technique for when it’s hard to suture a torn heart right away: insert a urinary catheter into the hole and inflate the balloon to seal it from the inside.
I know it’s a textbook trauma-surgery method, but in regular thoracic surgery it’s not something you’d often use.
Lee Jae-yoon nodded without hesitation.
“…Do that.”
And accepted it without a word.
Because it was the most efficient method.
…
***
Meanwhile, Professor Seong Chan-hyeong of anesthesiology, who was keeping an eye on the vitals, felt like his mind was about to leave his body.
He kept looking back and forth between the monitor and the operating table, unable to close his mouth.
‘Isn’t that guy an emergency medicine resident? Why is he in the operating room?!’
It was beyond common sense.
And on top of that.
‘But why is he so good?!’
Seong Chan-hyeong, clinical assistant professor in the Department of Anesthesiology and Pain Medicine at Cheongjin University Geoje Hospital.
Professor Seong had plenty of experience watching people get stripped bare, soul and all, after stepping into the OR back when Lee Jae-yoon had still been a thoracic surgery professor at the main hospital.
What kind of person was Lee Jae-yoon?
The tyrant of the operating room.
The director was famous for being ferocious and touchy in the operating room.
And yet he looked so docile now.
No, more than docile, he even looked relaxed.
When he first heard that an emergency medicine resident would be coming in as the assistant, Seong Chan-hyeong thought he’d misheard.
‘No matter how crazy that guy is, isn’t this crossing the line? Is he trying to kill the patient?’
Thinking that, he went in trembling.
But what do you know.
The only thought crossing Professor Seong’s mind right now was this.
‘Was he originally from thoracic surgery? Did he get board-certified and then train in emergency medicine?’
***
Lee Jae-yoon lifted the scalpel and cut the pericardium wide open.
Gush!
The pooled black blood and clots burst out.
“Suction!”
The Scalpel God had already placed the tip on it before the director could even speak.
Fwoosh-
An enormous amount of blood was sucked into the canister.
Once the field was properly exposed, a hole the size of a finger came into view.
Blood was spurting out of it in gurgling bursts.
“Foley, give it to me!”
The Scalpel God shouted.
He snatched the Foley catheter handed over by the nurse and shoved the tube in without hesitation.
“I’m going to inflate the balloon. 10 cc.”
Whoosh.
As saline was injected, the balloon at the end of the catheter swelled up.
When the Scalpel God tugged the catheter slightly, the balloon pressed against the inner wall of the heart, and the bleeding stopped as if it had never happened.
“Bleeding’s under control.”
“…Ha.”
Lee Jae-yoon let out a short sound of admiration.
Meanwhile, I was watching this scene and could hardly contain my shock.
‘Blood and clots are pouring out, so why is everyone this calm?!’
The fingertips were steady as a machine.
Not even a slight tremor.
Even though it was my own body, I got chills.
And Lee Jae-yoon in front of me looked like a madman too.
‘What’s with that guy?’
Even if he had been in the field until recently, he shouldn’t have been doing emergency surgery, so why hadn’t his knife skills rusted at all?
‘Did he disguise himself as a doctor in some back alley and do emergency surgery part-time every night or something?’
Setting aside the fact that ghosts are on another level to begin with, the director was a living human being.
I checked the timer in the corner of my vision.
‘Possession time is 30 minutes... and there’s still plenty left.’
Since the hole had been plugged with the Foley catheter, the vitals would stabilize.
Now all that remained was to stitch it up properly.
‘Is Scalpel God going to handle the rest by himself?’
At that moment.
Whirr-
The automatic operating room door opened and someone rushed in, out of breath.
“Sorry! I’m late!”
A young man drenched in sweat.
He was a thoracic surgery resident.
“You are?”
Without even looking up, the director asked.
“I’m Hong Seon-ho, a fourth-year thoracic surgery resident! The on-call professor is on his way right now!”
….
Lee Jae-yoon silently looked at Hong Seon-ho.
Then he lowered his gaze again and looked at Scalpel God, who was drenched in blood and holding the patient’s heart.
“Did you scrub in?”
Lee Jae-yoon said briefly.
“Of course.”
As Hong Seon-ho, now in a sterile gown, timidly moved up beside the operating table, Lee Jae-yoon said,
“Take over here, and you can head out of the OR. Good work.”
That was it.
My role, no, the ghost’s role, ended here.
The Scalpel God handed the instrument he’d been holding to Hong Seon-ho, looking a little regretful.
“Hold this. Be careful not to let the balloon slip.”
“Ah, yes. Thank you.”
Hong Seon-ho took over in a daze.
The Scalpel God took off his bloodstained gloves and looked up at the clock hanging on the operating room wall.
[Surgery time elapsed: 12 minutes]
[Possession time elapsed: 17 minutes]
I also looked at the floating clock.
Just then, my body was about to leave the operating room.
“Dr. Han.”
Director Lee Jae-yoon, holding a needle holder to stitch the patient’s heart, said without even looking at me,
“Among all the hands I’ve worked with so far, yours is the second best.”