Chapter 73
“We’ll begin.”
Everyone held their breath.
But there is no silence on a battlefield.
Even in the midst of chaos, the system had to keep running.
Lee Minjae left everything to the lunatic performing the procedure on the patient and started checking the systems behind him.
Lee Minjae whispered to the trembling Park Seongjeong.
“First-year.”
“Yes, doctor!”
“Record it. Have you documented all the drugs and IV fluids given by time slot, along with their types and amounts? From here on, write everything down by the second. Everything I say, everything Han Hyeonjae does, every change in the patient’s vitals. What have you got written down so far?”
Park Seongjeong, with a face that looked ready to burst into tears, fumbled through the whiteboard he had scribbled on.
“The, uh, arrival time was 09:14. From 09:16, NS
(*normal saline)
1-liter loading started, and at 09:18 tranexamic acid
(* hemostatic agent)
1 gram was given. At the same time, MTP was activated, and two minutes later, transfusion of 2 units of Rh-negative O-type pRBCs began. The STAT lab results are still…”
“That’s enough.”
Lee Minjae nodded as he listened to the concise briefing.
Even if the world fell apart, the records still had to remain.
They were the only lifeline that would save our necks later.
At the center of all those whispers and commotion, the owner of my body was focusing all his attention on a single point.
A faintly beating cross-section of the femoral artery on the ultrasound monitor.
And the skin, fat layer, and muscle covering it.
The Scalpel God’s left hand moved the probe minutely to find the optimal angle, while the needle in his right hand trembled faintly.
I held my breath.
Now.
The exact instant the needle tip pierced the patient’s skin.
“….”
His hand stopped in midair.
Just before the needle tip touched the skin, he froze all movement.
Why?
What’s the problem?
The Scalpel God slowly turned his head.
And then he looked down at his chest.
At the ID badge with my name on it, [Emergency Medicine Han Hyeonjae].
“Han… Hyeonjae.”
The Scalpel God awkwardly murmured my name.
“Yeah, Hyeonjae. Sorry.”
…
……What?
What.
What the fuck.
What the hell is he apologizing for, you crazy ghost bastard.
I could hear the sound of every circuit in my head burning out.
Sorry?
Now?
In this situation?
No, right?
That’s not what I’m thinking, right?
‘Sorry, Hyeonjae. Thinking it over, this seems like something beyond my abilities. If I barged in for nothing, I’d only ruin your doctor career, so I’m going back now.’
…Not that, right?
‘Sorry, Hyeonjae. I think my hand just slipped and ripped the aorta. This patient is going to die within thirty seconds, and you’re going to be a murderer.’
…That’s not it either, right?
While the other me inside screamed in fear and anger, the temporary owner of my body revealed his true feelings.
“Uh, there. Quiet for a sec. Let me focus.”
…
Ah.
No, this fucking lunatic!!!!
I realized it.
He wasn’t apologizing for his own failure or for the patient’s death.
In other words, in this urgent situation, the Scalpel God was deploying the fullest extent of his social skills to indirectly tell Lee Minjae and Park Seongjeong, who were whispering to each other, to shut the hell up.
My doctor life was turning into a social-skills training manual for a ghost with a shattered personality.
A lunatic who didn’t even have social skills installed at the genetic level.
The Scalpel God returned to perfect concentration, gathering all his attention on the monitor and the needle tip.
He raised his head and stared at the black-and-white fluoroscopic image displayed by the C-arm.
The outlines of the patient’s pelvis and femur were faintly visible, ghostlike.
“Radiology tech. From here on, give me short pulses continuously. Until I tell you to stop.”
“Y-yes, sir!”
The radiology tech’s tense voice rang out.
Beep, beep, beep.
With short, broken beeps, the image on the C-arm monitor began flickering in real time.
The Scalpel God looked back at the patient’s groin with the ultrasound probe.
On the screen, the femoral artery was throbbing as a black, round circle.
He laid the needle down at a 45-degree angle.
And with a single motion, he shoved the needle under the skin.
There was none of that infuriating hesitation or trembling I went through every time I drew blood.
How does he have hands like that?
I still can’t draw blood… well, not quite, but for a second-year resident, my hands are embarrassingly bad.
The tiny resistance of the skin being pierced, then the fat layer, and then the fascia.
And finally, the moment the tip of the needle pierced the exact center of the vessel on the monitor.
Bright red arterial blood burst from behind the needle like a tiny fountain.
A perfect one-shot success.
A very low murmur of admiration broke out from a corner of the resuscitation room.
“Oh….”
Several young medical staff had their mouths hanging open in awe.
“He put that in so fast. So skilled.”
“He put it in on the first try.”
“But… but isn’t this usually something trauma surgery professors or interventional radiology specialists do….”
“Shh. Be quiet.”
A murmur rolled in like waves.
At the back, Lee Minjae was on the phone.
“Hello, blood bank? This is Lee Minjae from Emergency Medicine. The trauma patient in Trauma Bay 1, yes, MTP is active, but we’re running a little late. Keep sending blood packs in a 1:1:1 ratio. Packed red blood cells, fresh frozen plasma, platelets. Yes. Keep sending them nonstop. Yes.”
“Vitals, BP 52/palpable, HR 168. It’s dropping. Be careful.”
Han Jae-eon’s calm voice rang out.
The Scalpel God, even amid all that noise, moved on to the next step without the slightest agitation.
He slowly slid a thin guidewire with a curved tip into the needle.
A slender silver line appeared on the C-arm monitor.
That line was gliding forward.
His fingertips kept twitching.
Carefully, carefully, his fingers moved in tiny, minute motions.
It meant he was adjusting the direction of the wire in minuscule increments so the vessel wall wouldn’t be damaged, as if handling a living creature.
How in the world can anyone do such a crazy thing?
I don’t think I could ever specialize in this field.
How do you even do this? How does a person take this stupid little thread and put it into a blood vessel?
Modern medicine is insane.
Everyone watching the scene held their breath.
Everyone in the resuscitation room held their breath at the sight of the slender silver line on the C-arm monitor crawling up the vessel.
In the middle of this surreal procedure, with control of my body taken away from me, I could only feel like I was watching it all from a front-row VVIP seat.
Don’t they sell popcorn here?
Just then, the resuscitation room door flew open, and a nurse rushed in, practically screaming.
In her hand was a freshly printed sheet of A4 paper, still warm.
“Doctor! The STAT lab results are in!”
At that shout, Lee Minjae reflexively reached out his hand.
He snatched the paper away and scanned the numbers on it like a madman.
“pH 7.1, lactate 12, potassium 6.5, hemoglobin 5.8… damn, he’s completely wrecked.”
A groan burst from Lee Minjae’s mouth. Without even letting go of the other hand holding the phone, he started barking orders at the nurse.
“Two amps of bicarbonate, now, through the IV line, and prep one amp of calcium gluconate. Tell the blood bank to keep sending platelets and FFP
(*fresh frozen plasma)
in the proper ratio and keep them coming.”
While he was spewing out orders like a madman, the owner of my body was ignoring all that noise perfectly, as if it belonged to another world.
Where on earth did he get that superhuman concentration?
I could only guess.
The owner of my body didn’t move an inch.
His eyes were fixed only on the guidewire dancing inside the C-arm monitor.
The wire was steadily advancing past the iliac artery and toward the lower part of the abdominal aorta.
Watching that, Lee Minjae asked me—no, no, he asked the Scalpel God.
“Where are you going to inflate it? Below the renal arteries, right? It’s pelvic bleeding. We’re almost there.”
The question was only natural.
At the very least, the biggest problem right now was the blood gushing from the pelvis.
And the complication rate and survival rate were both the lowest.
In the case of a pelvic fracture
(* pelvic fracture)
Zone 3 REBOA, inflated below the renal arteries, is considered the standard.
That’s because blood flow to the kidneys and intestines has to be preserved as much as possible.
The bottom line is that, even if you clamp off the aorta, you still have to keep at least the bare minimum of organs alive.
But the words that came out of Scalpel God’s mouth deviated slightly from the common sense I knew.
“No.”
Without taking his eyes off the C-arm monitor, he answered flatly.
“I’m going to inflate it in Zone 1.”