Chapter 19
The door closed.
The surroundings grew quiet.
Only a cold light fell over the patient.
According to Ms. Sora, this place was normally maintained to standards approaching those of a sterile room for the Guild Master's treatment.
In other words, even if I performed major surgery here—cutting through flesh—there would be no major issue with infection control itself.
Of course, it couldn't be considered as perfect as a proper operating room, but this wasn't the time to worry about that.
Baekho Guild's medical staff, who had been inside, withdrew as well.
I knew they were all skilled in their own right.
But right now, there was a greater chance they would only get in the way.
Because this surgery wasn't ordinary Hunter trauma treatment.
Equipment from the status window.
The hint I had gotten from Dr. Na Ha-young.
And the surgical strategy I had devised myself.
It was a treatment that could only barely be attempted if all three of those things worked together.
“Scalpel Level Up.”
[2P of skill points will be consumed.]
[Hunter-exclusive scalpel Lv.1 → Lv.2]
[Incision bonus enhanced.]
[Penetration into high-ranking Hunters' mana-hardened tissue increased.]
I finally began spending my points.
First, I started with the scalpel, which could be called the foundation of every surgery.
The moment I finished speaking, a thin blue glow shimmered over the scalpel that had materialized in my hand.
There was no major visible difference.
A thin, cold, sharp surgical knife.
But the sensation against my fingertips was clearly different.
‘I can cut through it.’
Was it a surgeon's intuition?
In my previous life, I had cut through countless layers of skin.
I had opened the fascia, passed through the peritoneum to examine organs, and reached my hand into a blood-filled chest.
The sensation of the blade entering.
The sensation of the tissue resisting.
A surgeon knew by touch whether a body would yield to the blade or drive it back.
With this scalpel, I could now carve a path through an S-rank Hunter's flesh.
That left me with three points.
Under normal circumstances, I would have had to enhance both the suction device and the forceps to deal with an abscess that extensive around the spine and infected necrotic tissue.
A suction device to drain the abscess.
Forceps to safely grasp and spread apart the tissue around the nerves.
I would need both.
But I didn't have enough points to enhance them both.
So I chose another path.
“Purchase a Hunter-exclusive
Kerrison rongeur
from the shop.”
[3P of skill points will be consumed.]
[New job equipment acquired.]
[Hunter-exclusive Kerrison rongeur Lv.1]
[Initial acquisition bonus applied.]
[For this surgery, synchronizes once with the highest-grade job equipment.]
[Synchronization target: Hunter-exclusive scalpel Lv.2]
[Hunter-exclusive Kerrison rongeur Lv.1 → temporary output boost equivalent to Lv.2]
[Boost duration condition: Until the end of the current surgery on Han Yura.]
[Current skill points: 0P]
A new instrument settled into my hand.
A Kerrison rongeur.
Normally, it was an instrument used in spinal surgery.
Put simply, rather than cutting away bone or hardened tissue all at once, it was a tool that nibbled away at them bit by bit with small jaws.
If the scalpel was a knife that opened the way, the Kerrison rongeur was the instrument that nibbled away at the hard tissue pressing on the nerves at the end of that path.
And that was exactly what Guild Master Han Yura needed now.
Eight years of infection.
Dungeon toxins and mana contamination.
As a result, the tissue around the spine had hardened, adhered to itself, and partially transformed into something resembling infected bone.
If I cut through it all at once with a scalpel, I would injure the nerves along with it.
So I couldn't cut away too much at once.
Only as much as was absolutely necessary.
I had to preserve the tissue that could be saved and remove only the dead tissue.
That was why I needed the Kerrison rongeur.
“It’s not standard practice, but this should let me use it for nerve decompression, too.”
To reiterate, that wasn't its original purpose.
A Kerrison rongeur was meant for gradually removing bone or hardened tissue during spinal surgery.
It could be adapted to separate tissue adhered together by infection.
Or to remove hardened areas pressing on nerves.
But it wasn't designed to clear away a mass where abscess and necrotic tissue had become tangled together, right beside the spinal nerves, like this.
In other words, if I used it incorrectly, it would lead to 'nerve damage' rather than decompression.
If I went even slightly too deep, paralysis from the waist down would become permanent, and the patient's already faltering urinary function would lose even its chance to recover.
Moreover, even if the surgery succeeded using only the Lv.2 scalpel and Kerrison rongeur I had.
If I asked whether those alone could completely save Guild Master Han Yura, the answer would be 'No.'
What I could do now was emergency decompression, nothing more.
Drain the abscess that had pooled inside to reduce the pressure on the nerves and remove some of the necrotic tissue.
If I succeeded, the patient's condition would improve far more than it had so far, but it would still be a long way from a complete cure.
On a surgical grading scale, it would be 70 points at best.
No, if recovery was included in the assessment, it might be closer to 50.
There would still be old infection remaining inside the patient's body, and there was no guarantee how much the already damaged nerves would recover.
Stabilization around the spine and pelvis would also be necessary.
The patient would need antibiotics, as well as rehabilitation.
In other words, this wasn't the surgery that would finish the job.
It was the first surgery, forcibly wrenching back the flow headed toward death.
Under normal circumstances, it wasn't a method a doctor should choose lightly.
Right.
If I hadn't had the data Dr. Na Ha-young—no, Dr. Na—had shown me at Daehan Central University Hospital, this surgery would have been nothing more than an unstable emergency treatment.
“I’ll begin the surgery.”
First, I would begin with decompression.
Normally, I would make a minimal incision with the scalpel here, then gradually remove the tissue pressing around the nerves with the Kerrison rongeur.
But that sequence was dangerous as well.
If I pushed the Kerrison rongeur straight in while the pressure inside had not yet been relieved, the abscess could burst and spread.
If the pooled infected fluid seeped into the surrounding tissue, it could destroy even the functions that had barely survived.
If I had only these two pieces of equipment, it would already have been a grueling task from this point onward.
'The first thing isn't to scrape it out, but to drain it.'
I had to lower the pressure pushing against the tissue from inside first.
So instead of the Kerrison rongeur, I took out something else first.
A Hunter extraction artifact used to pull cores from the heart of a dungeon.
A dungeon core extraction needle.
“It’s a good thing it at least looks like medical equipment⋯.”
At a glance, it looked like a thick, long metal injection needle.
But it was entirely different from an ordinary needle.
The tip wasn't sharp like an awl; instead, it consisted of several layers of interlocking spiral blades.
Rather than simply piercing, it seemed designed to slowly bore into a hard surface and bleed off the pressure inside.
A small transparent tube resembling a pressure gauge was attached near the handle, and thin blue mana fluid trembled inside it.
It was an instrument closer to a drainage valve than a suction device.
Insert it.
Fix it in place.
It was a tool for slowly releasing the pressure trapped inside without letting it burst.
“Y-you’re going to use something like this in surgery?!”
When Dr. Na Ha-young first heard what I intended, the doctor was so dumbfounded that an exasperated shout escaped.
Dr. Na had shown me Hunter surgery records and papers, only for me to ask to borrow not surgical equipment but equipment for dungeon raids.
And now I was going to use equipment for extracting the most important thing in a dungeon—the core—on the body of a patient who was on the verge of death?
It must have sounded like nothing but the rantings of a lunatic.
But I saw a new possibility in those records.
“A dungeon core is, in the end, a nucleus containing compressed mana, right?”
“That’s true, but what does that have to do with the patient’s body?!”
“It has everything to do with it.”
Among the Hunter surgery records Dr. Na had shown me, there was an entry like this.
A high-concentration mana abscess.
It wasn't an ordinary pocket of pus, but a pressure lesion formed when dungeon contamination became entangled with a Hunter's mana.
It created pressure from inside.
That pressure pushed against the surrounding tissue.
The displaced tissue hardened further, as if in self-defense.
In other words, the reason the area around Guild Master Han Yura's lower back and pelvis had become absurdly hard wasn't simply because she was an S-rank Hunter.
It was because the mana abscess trapped inside had continued generating pressure.
If that was the case, I couldn't start by opening it.
I had to drain it first.
The pressure hardening her body from inside.
A dungeon core extraction needle was not originally equipment meant for use on the human body.
But if it was equipment that could pierce a dungeon core's hard outer shell and draw out its internal pressure without letting it burst, there was a possibility it could be adapted to the mana abscess trapped inside this body.
Of course, it was insane.
But it wasn't simply reckless madness.
It was madness grounded in an understanding of the pathology.
I carefully positioned the tip of the dungeon core extraction needle against the lower part of Guild Master Han Yura's back, at the point where the abscess was generating the strongest pressure.
I felt resistance at my fingertips.
Hard.
Absurdly hard.
But this was different from before.
Perhaps because I had gauged the tissue's response with the scalpel, I could now distinguish, however faintly, between the superficial layer and the pressure deeper inside.
“Going in.”
Slowly.
Very slowly.
The tip of the extraction needle burrowed into the tissue.
It didn't feel like piercing with an ordinary injection needle.
The spiral tip pushed the mana-hardened tissue aside little by little, making a path inward.
And then, at some point.
Pop.
The resistance beneath my fingertips changed.
It felt as though I had passed through a wall blocking something and reached a space where pressure had pooled.
I immediately opened the valve near the handle just a little.
Psssshh⋯.
A low, thick sound seeped out.
It wasn't the sound of blood draining.
Nor was it the sound of pus bursting.
Pressure that had been trapped for a long time.
Something—a mixture of rotten mana and an abscess—was escaping along a narrow drainage path.
“⋯!”
The readings on the monitor trembled slightly.
At the same time, I could feel the mana-induced hardening that had been pressing around Guild Master Han Yura's lower back and pelvis loosen by the tiniest amount—just barely.
'It's a success.'
The first step of the surgery.
The first gap through which to turn back the flow headed toward death.
That was the moment it fell into place.