Saber Surgery (2)
Jiiiing.
The operating room door opened and the staff came out.
“I’m sorry, but I’ll go first.”
Choi Ki-seok left his rest with his colleagues and walked quickly.
Ten minutes have already passed since the Saber team meeting.
Team members who knew my schedule would understand, but I still wanted to attend the meeting as quickly as possible.
‘Why did he do that?’
I thought about what Hyukpil Jang said at the heart clinic.
Jang Hyuk-pil decided arbitrarily to have Saber’s surgery on Wednesday without consulting his teammates.
It was an arbitrary action that was not typical of him.
“Is Mr. Choi late too?”
I met cardiopulmonary technician Yoo Byung-se in front of the elevator.
“I just finished scrubbing. I guess Driver Yu is also late because he’s running errands?”
“Well, that’s kind of it.”
The two people got into the elevator together.
“The date for Saber’s surgery has finally been set. Are you nervous?”
“I would be lying if I said no.”
“It would be enough for me to just run the heart and lungs as usual, but that’s not what the surgeons do….”
“That’s the fate of a surgeon.”
Choi Ki-seok answered calmly.
If you cannot overcome the burden of surgery, you will not be able to undergo the surgery.
That is why Jang Hyuk-pil emphasized the heart of a lion.
I arrived at the conference room while I was talking with Byungse Yoo.
“It came sooner than I thought. Take a seat.”
“yes!”
As Choi Ki-seok sat down, Jang Hyuk-pil continued speaking.
“Anyway, everyone must have been surprised. Saber surgery was suddenly decided. It wasn’t an issue that could be handled arbitrarily, but the patient’s condition when I saw him in the morning wasn’t very good.”
“….”
“So, I decided to cancel the practice and have the surgery quickly. Originally, I was planning to tell everyone first, but I had no choice because the director was pestering me.”
Jang Hyuk-pil continued speaking with a bitter smile.
“The formal meeting of the Saber team will now begin, Mr. Kim.”
“yes!”
Jang Hyuk-pil entered his seat and Kim Tae-sik stood in front of the screen.
When I pressed the pointer, the presentation screen appeared.
“The patient’s name is Min-kyung Moon. She is 42 years old and has been receiving treatment at the cardiology department of our hospital for heart failure for the past few years. Then, the pain worsened and she was hospitalized as an outpatient.”
Taesik Kim cleared his throat once and continued speaking.
“As a result of thorough examination, the diagnosis was chronic heart failure, left ventricular aneurysm, and left anterior descending artery stenosis.”
“Then do I have to have Saber surgery and CABG (coronary artery bypass grafting) done together?”
“you’re right.”
Kim Tae-sik nodded to Choi Ki-seok’s question.
“Before explaining the surgical procedure, I will briefly explain the pathology.”
Saber surgery is performed to remove a left ventricular aneurysm.
Here, left ventricular aneurysm refers to a phenomenon in which part of the left ventricle damaged by myocardial infarction or heart failure becomes hard.
In this case, the motility of the left ventricle decreases and the surrounding tissue thickens.
There are three main side effects of left ventricular aneurysm:
It is an ischemic heart disease that causes regurgitation of heart valves and formation of blood clots within the ventricles.
“I will explain the surgical process next. First, all blood clots formed in the left ventricle are removed and CABG is performed. What follows is Saber surgery…” Kim Tae-sik explained
Saber surgery in detail using the materials he had prepared.
So that even anesthetists and cardiopulmonary technicians can understand the process.
“I think that’s enough?”
“All right.”
Taesik Kim and Hyukpil Jang changed places again.
“Has anyone experienced a saber surgery case?”
Everyone remained silent in response to Hyukpil Jang’s question.
“Isn’t there even Mr. Kang?”
“Yes. I have seen Professor Song perform Norwood surgery, but I have not seen Saber surgery.”
Kang Hana shook her head.
“To be honest, I have never come across a saber case either. It’s not a case you come across often.”
“Then wouldn’t you have been hasty in your decision to have surgery?”
“I can’t say it’s 100 percent true.”
Jang Hyuk-pil nodded to Choi Ki-seok’s question.
“However, all the principles of surgery are the same. There are only three things: cutting, sewing, and connecting. Saber surgery does not deviate from these principles.”
“….”
“Okay, then let’s talk realistically from now on. First, I will analyze the Saber case conducted at another hospital.”
A case study was conducted led by Hyukpil Jang.
There were a total of 4 Saber surgery cases.
Among them, there are two survivors and two deaths.
Among the deaths, there were 2 table deaths.
There was one case of death due to complications after surgery and one case of safely returning to daily life.
After the analysis was completed, role division among team members began.
Jang Hyuk-pil, who places great importance on the individual skills of the sergeant, assigned quite a lot of parts to Choi Ki-seok.
“This is the end of today’s meeting. Tomorrow, after receiving training from a specially invited celebrity, we will practice saber surgery with Fresh Cadaver.”
“A noun?”
“You can look forward to it.”
Jang Hyuk-pil answered Kim Tae-sik’s question with a smile.
The smile I see for the first time during today’s meeting. Is there something secretly prepared?
* * *
That evening.
Ki-seok Choi finished his work and went to the hideout. Jeong Seol-hwa arrived first and was drinking coffee.
“You came early?”
“I missed you honey.”
He hugged Jeong Seol-hwa, who approached him trembling jokingly.
After hugging her, I leaned back on the sofa.
“Phew…”
I sighed naturally.
My heart was heavy when I thought about the Saber surgery that was suddenly postponed two days later.
“What’s wrong? Are you worried?”
“I was supposed to have Saber’s surgery on Wednesday.”
“Isn’t that actually a good thing?”
“That’s true, but… thinking about surgery gives me a headache.”
“You can do not just Saber surgery, but even more difficult surgeries. Trust me.”
“thank you.”
Jeong Seol-hwa’s support made my heart feel lighter.
“Is everything going well in the circulatory department?”
“Nothing in particular.”
“How about keeping your colleagues and seniors in check?”
“It’s still the same. But these days, I just say it’s okay and move on. If I worry about it all, I’ll only be tired.”
“Good job. You can use your skills later to press it.”
“huh.”
Jeong Seol-hwa nodded slightly.
“Now that I think about it, there is one thing that bothers me…”
“What is it?”
“Do you know Elita?”
“Anyway, I know that much.”
Choi Ki-seok answered confidently.
Elita is a lung cancer treatment that was released a week ago. It attracted public attention as the first domestically produced global new drug and was even nicknamed a miracle cure due to its outstanding efficacy.
“But why Elita?”
“I have some reservations about using Elita on lung cancer patients… Some patients have skin redness. I’m not sure if it’s because of Elita or not, but their immunity seems to be low.”
“Do you think that’s enough to be suspicious?”
“I’m not weird, right? So tomorrow I’m going to ask the professor about Elita’s side effects.”
“Oh, by any chance. Is Elita going to the elderly too?”
“Yes. I believe it starts this week.”
Choi Ki-seok frowned at Jeong Seol-hwa’s answer.
The fact that Elita was joining Choi Mi-soon was a turn-off.
I felt like I shouldn’t put too much effort into her treatment just because it was an internal medicine job.
Jiyiing.
The call phone I kept in my gown trembled.
I checked the number and it was an emergency room call.
“I’m going to leave.”
“Yes. Have a hard time today too.”
Seol-hwa Jeong kissed his cheek, and Ki-seok Choi hurried to the emergency room.
“Doctor. This is the patient.”
The emergency room intern pointed to the patient sitting on the bed.
“I’m sorry. I called the cardiology department, but the doctor on duty didn’t answer the phone…”
“It’s okay. I don’t mind calling you often.”
Choi Ki-seok comforted the intern.
You can gain experience with patients by answering emergency room calls. If you get treatment there, you can recover your stamina, so it’s like eating pheasant and eggs.
I looked over the test results and faced the patient.
The patient’s name was Park Jin-kyung, and he was young at 27 years old.
“What makes you uncomfortable?”
“My chest hurts so much. Every time I cough, blood comes out. Cough. Cough.”
Jin-kyung Park was covering his mouth and coughing, but when he removed his hand, there was blood on it.
Choi Ki-seok took out an alcohol swab with forceps and wiped her palm.
“When did the symptoms start appearing?”
“I think it’s been about 5 months. But, doctor, strangely, it only happens when I have my period.”
“All right.”
Choi Ki-seok checked the patient’s lung sounds with a stethoscope.
There are two main types of lung sounds, one is alveolar breath sounds and the other is bronchial breath sounds. In the case of Park Jin-kyung, there were no abnormalities in either case.
‘what?’
I tilted my head and looked for crackles or wheezing.
Nothing more this time.
Choi Ki-seok frowned without realizing it.
Stamina: 6/10
Main Symptom: Chest Pain/Hemoptysis
Part of Pain: Lung
Diagnosis: ???
Current Status: Non-Emergency
Progress: Poor
Past History: None
Ki-Seok Choi used the Eye of Hippocrates and frowned.
This is the first time that the diagnosis name is not displayed.
“Teacher, why are you doing this?”
“First of all, there is nothing clear in the inspection… Could you please wait a moment?”
Choi Ki-seok turned his attention to the monitor.
I tried to look at past medical records, but today is my first visit. There is no particular disease to associate with.
Click. Click.
I racked my brain through meaningless clicking.
The fact that the diagnosis cannot be determined through the eyes of Hippocrates would mean that the patient is suffering from a disease for which the official name has not yet been determined.
‘It’s a rare disease in the lungs… Have you seen a similar case?’
Time passed anxiously.
“Cough. Cough.”
The patient vomited blood again.
“Didn’t you say that before?”
Choi Ki-seok wiped away her blood and asked.
“What do you mean?”
“I heard these symptoms only appear when you have your period.”
“Yes, that’s right. I guess I got some strange curse.”
“Please wait a little longer.”
Choi Ki-seok accessed the mail drive and quickly looked through the papers sent by Song Myeong-jin. Because I usually separated the data, I was able to easily view data related to the lungs.
‘found!’
I found the annotation of the paper and clenched my fists.
We finally discovered the identity of the disease afflicting Park Jin-kyung.
Since there have been less than 50 cases worldwide so far, it was natural that the Eye of Hippocrates could not catch it.
“Patient. I think we need to do a detailed examination.”
“Please do all you can. It’s so hard.”
“Okay, I’ll have to check the test results first, but there’s a good chance you’ll need hospitalization.”
“Teacher Yoon. For the patient Jin-kyung Park, we have a chest CT and a lung PCNB (percutaneous needle biopsy) test.”
“CT and PCNB?”
Intern Ki-hwan Ki opened his eyes wide.
No matter how much I thought about it, I couldn’t understand the test Ki-seok Choi gave.
The cause of hemoptysis . Most of the cancer is in the bronchi. But all the tests were focused on the lungs.
Moreover, if it’s PCNB, wouldn’t it be a biopsy?
I couldn’t believe they were performing a biopsy when there was no basis to judge the patient as having cancer.
‘Are the rumors wrong?’
Ki-Hwan Ki couldn’t shake the feeling that he was testing the patient to extort money from him.
Soon, the patient left the emergency room, and Ki-Seok Choi calmly waited for the test results.
Twenty minutes had passed since the patient returned to the emergency room.
The emergency results of the radiology department were displayed on the monitor. It occurred to me,
“Teacher. What happened?”
Yoon Ki-hwan asked, standing close to Choi Ki-seok.
“Do you see this?”
“Ah…”
There was a small lump at the lower part of the lung that Choi Ki-seok pointed to.
“What is this?”
“The biopsy showed it was a uterine cell. ”
“Wow. This is absurd. Why are there uterine cells stuck to the lungs?”
Yoon Ki-hwan clicked his tongue without even realizing it. He
was embarrassed to see this case for the first time.
“I don’t know that either. But one thing is certain: uterine cells are parasitic in the lungs, causing hemoptysis every time you menstruate. “I did it.”
Choi Ki-seok’s eyes were fixed on the patient who was bleeding.
