Hua Tuo Becomes a Surgeon - Chapter 5

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Chapter 5

Even with his weakened body, Hwabu was confident that he could beat up those two individuals well enough.

However, if he did so, there was a high chance he would be kicked out of the hospital and would not be able to experience the advanced medical technology of this era. He couldn’t let his anger get the best of him and waste this precious opportunity, especially since he didn’t know when the possession would end.

Hwabu hid his clenched fists behind his back and slightly lowered his head.

“I’m sorry.”

“That darn sorry of yours, aren’t you tired of it?”

“……”

As Choi Yongsoo glared at Lee Minho, Oh Gook-hwan clicked his tongue.

“Tsk, his punishment is ten days in the CICU (Cardiac Intensive Care Unit), so let’s stop here. Oh, right! Did you get the surgery consent form from this patient?”

“I talked to the guardian on the phone earlier and recorded the verbal consent.”

“When the guardian arrives, explain his condition well and get a written consent as well.”

“Understood.”

“I’ll take Dr. Song Jiho and Dr. Lee Minho to the OR, so make sure there are no accidents.”

“Yes! You’re taking Dr. Lee Minho to the OR? Didn’t we decide to exclude Dr. Lee Minho from any major tasks until the end of his internship?”

“Do you expect him to just twiddle his thumbs in this situation? And I’m taking him with me because I’m not comfortable leaving him here.”

“Oh, I see.”

At that moment, Kim Hyungsun, who had finished talking to the anesthesiology department, reported.

“Dr. Oh Gook-hwan, Dr. Shin from the anesthesiology department said that Room 3 will be available in 10 minutes.”

***

Hwabu was inwardly amazed to see that the perioperative nurse fully assisted him in the process of not only putting on his surgical gown, but also disinfecting his hands and putting on gloves, mask, and goggles, to prevent bacterial infection.

[perioperative nurse – registered nurse who works in the operating room.]

‘This way, neither the patient has to worry about infection, nor does the doctor have to worry about getting infected with bacteria!’

Remembering the past when he treated patients, he felt a slight pang of guilt, but he shook his head to cast away those thoughts.

At that time, the concept of hygiene was not as well-developed as it is now, and anyway, he had done his best to save his patients.

“Dr. Lee Minho, aren’t you ready for surgery?”

The anesthesiologist called out to Lee Minho. Hwabu quickly shook off his lingering thoughts and hurriedly responded.

“Yes, I’m on it.”

After covering the patient’s upper body was covered with a surgical drape, so that only the chest was exposed. The area to be incised was then thoroughly disinfected, and the position of the patient was adjusted to make it easier for the surgeon to operate.

After all that, Oh Gook-hwan and Song Jiho entered the operating room.

‘I finally get to witness the surgery I’ve only seen in videos with my own eyes!’

Hwabu’s heart was pounding even harder than when he first saw the patient in the emergency room.

A little later, when the anesthesiologist administered anesthesia to the patient, Hwabu thought back to the time when he first created the mafeitang.

In order to make the decoction, he had experimented with various herbs and poisonous plants, even trying them himself and feeding them to animals. After nearly dying due to poisoning several times, he finally managed to create it.

The fact that the mafeitang he had made had evolved into an anesthetic over thousands of years had left him feeling a lot of emotions.

“Dr. Oh, anesthesia is complete.”

“Thank you, Dr. Shin. Let’s begin the surgery. Scalpel!”

As the nurse handed him the scalpel that had been prepared in advance, Hwabu picked up to use the finochietto retractor (a retractor to spread the ribs) and prepared to spread the ribs.

In fact, in the operating room, interns are at the stage where they learn by watching senior doctors operate, so there is nothing that they do that would particularly put the patient at risk, except for helping out when necessary. Therefore, Hwabu had the leisure to observe how Oh Gook-hwan would perform the surgery while he was assisting.

‘I wonder how much of what I saw on the X-ray was correct?’

“Suction! Irrigation! Suction……”

While Oh Gook-hwan used a scalpel to cut the patient’s skin and then used a bovie (electrocautery) and scissors to cut through the thick muscle layer to expose the sternum and ribs, Song Jiho used suction to remove the blood that was oozing out, then sprayed it with saline solution, and then suctioned again.

Hwabu’s eyes lit up with admiration.

Finally, the sternum and ribs were exposed, and they were fractured just as they had appeared on the X-ray.

‘It’s so much easier to operate when you can see the inside a person’s body with X-rays or ultrasound!’

Knowing the condition of the chest cavity gives the surgeon the time to plan the surgery in advance.

“Dr. Lee Minho, finochietto.”

“Yes.”

As soon as Oh Gook-hwan’s words fell, Hwabu quickly inserted the finochietto retractor he was holding between the ribs and turned the handle.

When the retractor was widened, the bones would break, but since the broken bones would be reconstructed, it was crucial to spread them wide enough to have a clear view.

After turning the handle far enough, the structures inside the ribcage, such as the lungs and heart, were revealed.

The lungs and heart were obscured by blood from a hematoma, making it hard to see.

[hematoma – pooling of blood in tissues or outside of blood vessels]

Song Jiho immediately poured saline solution and suctioned, and the blood clots were washed away, revealing the structures surrounded by yellow fat.

On one side of the lacerated lung, tiny foamy blood rose with each breath, and the pericardium surrounding the heart was pooling and surging with blood.

Seeing that, Lee Minho’s mind automatically envisioned what the attending doctor, Oh Gook-hwan, would do next.

‘If it’s myocardial contusion, we need to observe it as if it were acute myocardial infarction, so first we’ll control bleeding and then drain the blood that had accumulated in the pericardium!’

[myocardial contusion – a bruise on the heart muscle]

[acute myocardial infarction – heart attack; the blood flow to the heart muscle is abruptly cut off]

The lungs could wait, the priority was the heart.

Just as Lee Minho had predicted, Oh Gook-hwan first addressed the bleeding around the myocardium, then meticulously examined the heart and surrounding structures before making a hole in the pericardium and connecting a drainage tube.

It took about an hour to do this.

Hwabu marveled as he watched Oh Gook-hwan cauterize the blood vessels leading to the bleeding site, ligate the slightly thicker vessels, and clamp the very large ones before cutting the cross-section and suturing them with precision.

‘Connecting those thin vessels with such a fine thread was even more impressive than what I saw in the video!’

Could he do that himself?

Although he hadn’t attempted it yet, he thought he could do it with this young body. No, he was confident that he could do it better than that if he became more proficient in using the instruments.

‘I’d like to do an operation like that at least once before the possession ends…… But it will be difficult as an intern.’

The thought of his own situation, which could end at any moment, left a bitter taste in his mount as his admiration faded.

Oh Gook-hwan sutured the lungs, which were foaming with blood due to the trauma, and then connected a drainage tube and pulled it out of the patient’s body.

Woodududuk.

Afterward, he straightened his back, which had been bent down until now, and the sound of his bones clicking was heard.

“Phew! Let’s take a short break.”

While a nurse wiped his face with a towel, he twisted his upper body from side to side, producing the sound of bones clicking again.

“Yes.”

After a moment, Oh Gook-hwan stepped back, and assistant Song Jiho moved to his place and began examining the areas that had been operated. Hwabu, too, moved closer to get a better view of the areas he hadn’t seen earlier.

“Dr. Song.”

At that moment, Oh Ji-hwan, who was resting, called Song Jiho.

((tl: okay, irdk what happened but Oh Gook-hwan’s name became Oh Ji-hwan. I reread the previous chaps and there’s no other Oh Ji-hwan.))

“Yes, doctor.”

“Now that we’ve stopped all the bleeding from the myocardial contusion, what potential risks remain for the heart?”

“There’s a high possibility of developing coronary artery thrombosis or mural thrombosis formation.”

[coronary artery thrombosis – formation of a blood clot within the coronary arteries, which supply blood to the heart muscle.]

[mural thrombosis formation – refers to blood clot formation along the walls of blood vessels, which can obstruct blood flow and potentially result in complications depending on the location and size of the clot.]

“What should we do then?”

“We should monitor the patient’s progress, and if blood clots form, administer heparin.”

“Good that you know. Dr. Lee.”

This time, Oh Ji-hwan’s gaze turned to him, and Hwabu continued to examine the surgical site as he answered.

“Yes, doctor.”

“Apart from the risk of blood clots forming as a sequela of myocardial contusion, what other risks might the patient face?”

From the time Oh Ji-hwan asked Song Jiho a question, Hwabu had a feeling that he would ask him as well, so he quickly searched through Lee Minho’s memories. And because of that, he was able to anticipate what he was going to ask.

“There’s a possibility of developing ventricular arrhythmia, as well as heart failure or supraventricular tachycardia.”

[ventricular arrhythmia – abnormal heart rhythms originating in the ventricles]

[supraventricular tachycardia – rapid heart rate originating above the heart’s ventricles]

As soon as Lee Minho provided the answer, not only Oh Ji-hwan, but also Song Jiho’s eyes widened.

Usually, Lee Minho would take a long time to think before providing an answer to such a question, but this time, he didn’t hesitate at all, and he even exuded confidence.

“Hoo! For a troublemaker intern, you seem to know quite a bit. So, what medications should be used when those situations arise?”

“I know that you should use antiarrhythmic drugs like lidocaine for ventricular arrhythmia, and digitalis for heart failure or supraventricular tachycardia.”

Oh Gook-hwan had a strange expression on his face when he heard Lee Minho’s answer.

In fact, he also knew that Lee Minho had been wronged and was being tormented by the residents. However, he couldn’t side with Lee Minho. If he did, he would be at odds with Professor Hwang In-bong, the attending surgeon.

He had been trying to pretend he didn’t know anything, because he wouldn’t survive in the university hospital if he was at odds with Professor Hwang, the chief of cardiothoracic surgery. But now, looking at Lee Minho, he seemed to have overcome all those hardships.

‘Is he pretending not to care? Well, if he wants to survive here, he has to look good in front of the professor, even if he’s dirty and filthy.’

He suddenly understood what was going on inside him.

“Ahem, is it because you’ve been on call for ten days straight? Seems like you’ve studied a lot, and your eyes have changed a bit. Your hunched shoulders have straightened, and your posture has improved a lot.”

“Oh! Thank you.”

“Now, let’s get back to work.”

As Song Jiho quickly stepped aside, and Oh Ji-hwan stepped forward and examined the patient’s chest.

“There seem to be no more issues with the lungs, so I will now begin the sternum reduction.”

When Song Jiho handed him the drill he had prepared, Oh Ji-hwan aligned the fractured sternum and costal cartilage, drilled holes on both sides, and inserted surgical wires.

***

‘The medical technology of this era is truly amazing!’

As Hwabu transferred the patient who had just undergone surgery to the intensive care unit (ICU), he mentally replayed the entire process from the beginning to the end of the surgery.

‘It feels like I’ve been hit in the back of the head with a hammer. In the era I lived in, I was called as a divine doctor and was revered by people, but here, I can’t even hand out my business cards.’

Watching the surgery firsthand sparked even more ambition in him.

He didn’t know when the possession would end, but he wanted to do one of these major surgeries before it ended.

“In a little while, when the anesthesia wears off, the patient will likely wake up. I’ll take my leave now, so keep an eye on him and contact the guardian when he wakes up.”

Hwabu nodded at the words of the anesthesiologist, who had been closely monitoring the monitor for a while.

“Yes. Thank you for your hard work.”

After the anesthesiologist left, Hwabu concentrated his mind and created a three-dimensional virtual image of the patient in front of him. Perhaps because he had seen it with his own eyes a while ago, it was much more detailed than when he created a three-dimensional model after watching a video at home.

Swoosh.

Hwabu moved his hand, making an incision on the chest of the three-dimensional patient he had created, just like Oh Gook-hwan had done.

‘Open the chest like this……’

As the chest split open, the patient’s insides, filled with blood, were revealed.

‘After irrigating the area, spread open the fractured ribs and sternum, make an incision to the pericardium, connect the drainage tube, and treat the blood vessels……’

The hand that had been holding the scalpel was now holding the needle holder, and he began to suture quickly and tightly to stop the bleeding and repair the severed blood vessels.

‘After finishing the treatment for myocardial contusion, suture the lacerate lungs…… and drill holes in the fractured sternum and fix it with wire……’