Last Chance (3)
When I arrived at the emergency room, the intern who had called waved his hand vigorously.
Choi Ki-seok approached the bed with brisk steps and looked down at the patient.
The patient’s name is Freed.
He was unconscious, wearing a cervical spine immobilizer, and had a bloody compression bandage wrapped around his head.
As a result of checking with the patient monitoring device, his vitals are dropping by the minute.
Click!
When examining the eyeball with a light, a raccoon eye was discovered.
Raccoon eye, also known as raccoon eye, is a condition in which the area around both eyes appears black due to bleeding at the base of the skull.
Physical strength: 4/10
Main symptoms: Headache / Unconsciousness / Respiratory trouble
Affected area: Brain / Skull
Diagnosis: Systemic shock / Acute subdural hemorrhage / Traumatic intraparenchymal hemorrhage / Brain herniation / Hydrocephalus / Diffuse brain injury / Acute renal failure
Current status: Emergency
course: Poor
Past history: Cerebral arteriovenous malformation
Family history: None
Cautionary factors: Had surgery for cerebral arteriovenous malformation.
‘This is crazy!’
Choi Ki-seok used the eyes of Hippocrates and bit his lip.
The patient’s condition was not easy.
The damage to his head was extensive and he also suffered from acute heart failure.
“Sir. What should we do now?”
“We need to operate right away. But before that, let’s call the urologist on duty. The surgery will take place after treatment for kidney failure is over.”
“All right.”
The intern quickly left the room.
At that moment, the patient’s family and police officers approached him.
“Sir. My husband…”
Freed’s wife trailed off, looking down at Freed.
“The patient is in critical condition. Surgery is required immediately, so guardians, please fill out the documents.”
“My husband… can we live?”
“I’ll do my best. That’s all I can say for now.”
Choi Ki-seok explained the surgery and signed the consent form.
His gaze shifted to the police officers.
“What happened to this person? How could he get such a shock to his head?”
Choi Ki-seok raised his voice without realizing it.
Freed was not in a car accident or fall. However, the extent of the trauma was so severe that it made me frown. I needed to know what caused these injuries.
“Well… the truth is… we mistook Freed for a wanted criminal. There was a scuffle during the process and Freed fell and hit his head on the floor.”
“You mean you just fell?”
“That’s right.”
The police’s answer was questionable, but I let it go.
Because saving the patient was more urgent than fighting with the police.
“Is this you?”
The urologist on duty who received the intern’s call stood next to him.
“Yes. I asked for your cooperation because I suspected acute renal failure due to acute subdural hemorrhage.”
“You looked good. Your blood creatine level has risen by more than 50 percent of the baseline value. There are also problems in the urine and blood test results.”
“Then how should I treat it?”
“It would be better to administer low doses of acetylcysteine and dopamine and begin dialysis.”
When the patient was treated as instructed by the urologist on duty, the symptoms of renal failure rapidly subsided.
Now all that is needed is neurosurgery.
“If you have an emergency, please call me anytime.”
“thank you.”
After sending the doctor on duty, Choi Ki-seok looked for a surgeon who could perform the surgery. Since Leon was on vacation, the number of surgeons available to perform the surgery was reduced to two.
The problem is that no matter how many times I call, neither of them answers the phone.
‘What the hell are you doing!’
Choi Ki-seok could barely hold back the swear words that were about to come out of his mouth.
I calmed down and tried to connect the phone to the point where my phone was on fire, but I failed every time. So I had no choice but to leave a text message explaining the current situation.
“Doctor. You said you need surgery right away.”
Freed’s wife stamped her feet and said.
“I’m sorry. Please wait a little longer.”
While Choi Ki-seok was comforting his guardian, the call phone rang.
I thought that the surgeon who was ready for surgery had finally come to his senses, but there was an unexpected number.
It’s Matthew.
“Yes, Chief.”
[Mr. Choi. Is there a black patient in the emergency room right now?]
“That’s right. I need surgery right away, but I’m having a hard time because I don’t have any surgeons.”
[Admit the patient to the ward for now.]
“This patient has various diseases, including acute subdural hemorrhage and traumatic intraparenchymal hemorrhage. If surgery is delayed, he may die.”
[But there is no way. I’m taking care of Surgeon, who was waiting for surgery.]
I was lost in my thoughts at Matthew’s words.
Was that why the sergeants didn’t answer the phone?
“Then how…”
[Soothe the guardian well and get him hospitalized. If we leave now, the surgeons will arrive in two hours, so the surgery will be performed then. Until then, just take the vitals carefully.]
“I heard you well.”
Choi Ki-seok paused before continuing.
“I heard all the nonsense you said. But I will not follow your instructions.”
[Mr. Choi. Are you crazy?]
Matthew’s voice rose.
“Yes. I’m crazy. I went completely crazy because of the director’s instructions to leave the patient alone. Of course, the surgery will be possible in two hours, but the subject will be a corpse, not a person. Am I wrong?”
[….]
“I’ll say it again, I will not follow the director’s instructions.”
[Sounds stupid… How can you perform surgery when there is no one to do it! As I said….]
Pop!
I hung up the call without listening to everything he said.
My mouth hurts if I keep talking with Matthew.
Choi Ki-seok connected the call with Lucas before Matthew called again.
Lucas answered the phone right away and started explaining the situation.
[This is a difficult situation. There must be only one way.]
“That way…”
[Is there any other way? You have to do it yourself. It takes me over two hours to get back to the clinic. There is no other way than for Mr. Choi to gather his friends and perform the surgery.]
“Are you allowing me to perform the surgery?”
[That’s only half the answer. What I have given you is not just an opportunity to perform surgery, but an opportunity to save the patient.]
“Thank you. I will definitely repay your trust.”
[okay. I believe you can do it with your skills. FYI, don’t pay attention to Matthew’s bullshit. That patient is a patient in the cerebrovascular surgery department anyway.]
“Yes, I understand.”
“If there is a blockage, call me from the operating room.”
After hanging up the phone with Lucas, I called my classmates who were resting. Larry and Janet Claire responded to the call and arrived at the emergency room.
“Everyone is resting, but I’m sorry. The situation was so urgent that there was nothing I could do.”
When Choi Ki-seok explained the process so far, everyone gaped.
The highlight of all this was his refusal to follow Matthew’s instructions.
The confrontation between a new resident and the head of the surgical department was an event that will remain in the history of neurosurgery.
“You’re doing something again.”
Larry chuckled and placed his hand on Choi Ki-seok’s shoulder.
“I will help.”
“But if this continues, I don’t know if Manager Matthew will catch us too.”
“I’m worried about that too.”
Unlike Larry, Janet and Claire showed signs of hesitation. However, that only lasted for a moment, and all of the classmates who gathered together decided to serve as Choi Ki-seok’s assistant.
The only person who did not participate in this event was Nikolai.
He didn’t answer Choi Ki-seok’s call at all.
“let’s go.”
Choi Ki-seok pushed the bed with his colleagues and headed to the operating room.
Eventually, after the scrub was over, the staff took their seats on the operating table.
The surgeon for today’s surgery is Ki-Seok Choi.
The first assistant was Claire, the second assistant was Larry, and the third assistant was Janet.
While the anesthesiologist was administering general anesthesia, Larry opened his mouth.
“I’m really nervous. I never thought we’d be doing such a difficult surgery with my classmates.”
“I see. Even James Hopkins wouldn’t go this far, right?”
“It’s really unexpectedly hard training.”
The three people agreed.
Afterwards, while scrubbing, the three people heard from Choi Ki-seok about the patient’s condition and the direction of the surgery.
According to the explanation, this surgery was not easy.
There were more than one or two areas that needed to be repaired, and there was a high possibility that the patient would suffer nerve paralysis in the process.
‘If it’s Mr. Choi….’
Larry glanced at Ki-Seok Choi, who was standing next to him.
In fact, entrusting brain surgery to a new resident is no different from sending a newborn to the battlefield.
Nevertheless, I thought Choi Ki-seok would do something.
Because he was on a different level from other motivations.
“General anesthesia is over. I will check your vitals now.”
Choi Ki-seok nodded at the anesthesiologist’s words.
“We will now begin treatment for subdural hemorrhage and head trauma.”
“okay.”
At his words, Larry disinfected the patient’s bald head and covered it with a cloth.
Suuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuu
Choi Ki-seok split the patient’s scalp with a scalpel.
Although this is my first time in real life, I have performed craniotomies in the training room to the point of boredom.
To exaggerate a little, it is possible to perform a craniotomy even with your eyes closed.
With the help of my colleagues, I completed the craniotomy without a hitch. When the skull was exposed, a thin film made of hardened blood was found surrounding the entire brain.
“I don’t know if I’m sane. I can’t believe you left a patient like this alone for two hours.”
“I agree. In this condition, I don’t think I could have lasted even an hour, let alone two.”
“So. Besides, if the patient dies, it will be my fault.”
Now that my political power had risen, I had no intention of being fooled by others or watching helplessly as my patient died.
“Meth.”
I held the scalpel handed to me by the disinfection nurse and carefully cut the lower part of the film formed by blood.
Chii Iik.
When Claire, the first assistant, sprayed saline solution on the membrane, the membrane slowly peeled off due to the water pressure.
When the skin peeled off, a clean brain was revealed.
“It’s here.”
Ki-Seok Choi pointed to a part of the brain with forceps.
There, a trickle of blood rose like a fountain.
The blood generated here pooled around the brain, forming a film and increasing pressure in the brain.
Chii Iik.
Choi Ki-seok treated the bleeding area with an electric cautery. As a result, the leaking blood completely stopped.
This is the end of treatment for acute subdural hemorrhage.
“You have to stay alert from now on, you know?”
“I know that much even if you don’t say it.”
“don’t worry.”
His classmates nodded their heads vigorously at his words.
From now on, treatment for intraparenchymal hemorrhage must be administered. This is an area where the difficulty of surgery increases rapidly as it requires digging into the brain.
The bleeding site confirmed by examination was the thalmus.
The thalamus is a region that occupies most of the diencephalon and is responsible for conveying all sensory information except for smell and for determining position.
If the surgery goes wrong, the patient could suffer serious aftereffects.
“The stereotaxic device is ready!”
“thank you.”
Ki-Seok Choi used a stereotaxic device to delve deep into the brain.
After passing through the cerebral lobes and complex blood vessels and nerves, the thalamus, the surgical site, was soon revealed.
“Something happened. Something happened.”
Larry, who checked the awards, burst into laughter.
