Adventure (4)
Surgical observation room.
Song Myeong-jin and Yasada Kwon Il-soo were sitting side by side for a long time.
We gathered together because we knew that the current Norwood surgery would be Ki-Seok Choi’s last surgery at MHC.
“This is the last Norwood surgery… I think Professor Kwon has a lot to think about.”
“Honestly, it’s not a surgery I have good memories of.”
Kwon Il-soo smiled bitterly at Song Myeong-jin’s words.
He chose Norwood Surgery as a project surgery during his medical school days, and as a result, he lost his position as chief to Hyukpil Jang.
Even now, when I think about that time, a corner of my heart aches.
“What are your expectations for today’s surgery?”
“The level of difficulty is the highest among Norwood cases. Even if you are Mr. Choi, it won’t be easy.”
“Then shouldn’t Dr. Kwon have performed the surgery?”
Yasada, who had been silent, joined the conversation.
“Head Chief. Teacher Choi surpassed me a year ago. “It is Dr. Choi, not me, who has the high success rate in surgery.”
“Is it already like that?”
Yashada’s eyebrows rose to the sky.
“Training in pediatric thoracic surgery must not be that easy… I surpassed Dr. Kwon in just four years.”
“I don’t believe it either.”
Kwon Il-soo’s eyes were fixed on Choi Ki-seok, who was performing the surgery.
A pediatric thoracic surgery part that requires more delicate skills than general thoracic surgery.
Choi Ki-seok pulled this off without difficulty.
His ability to learn was like that of a sponge, and he absorbed everything taught to him without hesitation. If you teach one thing, you know ten, and his ability to apply knowledge was also unrivaled.
What Kwon Il-soo achieved through half a lifetime of training, Choi Ki-seok surpassed in just four years.
“Hmm. “I hate to admit it, but I’m in the same situation.”
“….”
“Mr. Choi’s lung esophageal surgery surpassed mine. “One time, out of curiosity, I looked at the charts of patients that Mr. Choi had operated on… and he was superior to me in terms of surgery time and progress.”
“Did I tell you? “Mr. Choi is not an ordinary person.”
Song Myeong-jin smiled as he looked at Yasada and Kwon Il-soo.
“Anyway, I don’t know why they suddenly say they are supporting NSF. “If you say you’re going back to Korea, I can understand that.”
“After the surgery, I will hear it from myself. “You may know ten ways of water, but you don’t know one way of people.”
The two people nodded as if they agreed with Song Myung-jin.
I didn’t know that the six bright eyes would soon fall from the monitor.
* * *
“What should we do now?”
“First, we restore the ascending aorta where the malformation occurred.”
Ki-Seok Choi tied the blood vessels above the aorta and main pulmonary artery with vascular forceps given to him by a disinfection nurse.
This is to prevent bleeding.
After completing the basic procedures, he looked down at the surgical site for a while.
The patient’s ascending aorta was very thin.
If I were to exaggerate somewhat, would I say it resembles a thread?
The aorta is the place where the arteries that supply blood to the entire body diverge, and if a problem occurs at the upper part of this area, problems with the heart are bound to occur…. Although the blood vessels are thin in children, the growth of blood vessels has not yet finished, but it is a symptom of hypoplastic left heart syndrome
. The impact seemed likely to be greater.
“Meth.”
Ki-Seok Choi used a scalpel to vertically split the outer part of the main pulmonary artery located near the ascending aorta. Then the blood vessel split like a squid.
Cheeeeeeeek.
When some of the blood vessels were torn and bleeding occurred, the first and second assistants began suctioning.
There were limitations in preventing bleeding with vascular forceps.
“Keep your head straight. “This is the game I’ve been watching from now on.”
“yes!”
“5-0 prolene.”
Geek.
After tightening the suture needle with a needle holder, the cut pulmonary artery fragment was anastomosed to the thin ascending aorta.
This is a procedure to normalize the function of the ascending aorta by increasing the size of the ascending aorta using a pulmonary artery fragment.
Anastomosis of different blood vessels was not easy.
Because it was a treatment that required both precise dexterity and an artistic sense of design. However, Choi Ki-seok decided on the direction of surgery just by touching the blood vessel once.
It just seemed.
Or would it be more accurate to say that the anastomosis method came to my mind automatically?
The experience and knowledge I had accumulated over the years poured out information as if I was anxious to have surgery.
Geek. click. Geek. click.
Choi Ki-seok firmly connected a portion of the cut main pulmonary artery and the ascending aorta using a simple interrupted suture method.
“Guillaume, would you like to test your blood flow?”
“Ah yes.”
Guillaume, who had been staring blankly at his treatment, suddenly came to his senses and started the test.
As the ascending aorta was reshaped, blood flow from the right ventricle naturally flowed into the ascending aorta and coronary artery.
The first stage of Norwood’s surgery was completed successfully.
“Next is pulmonary artery correction.”
Ki-Seok Choi separated both ends of the main pulmonary artery and connected a Gore-Tex tube in its place.
Just now, part of the main pulmonary artery was separated and joined to the ascending aorta, which was a treatment to prevent problems with pulmonary artery blood flow.
No matter what anyone says, isn’t the heart a passage and a place where blood flows?
The key to heart surgery is to ensure proper blood flow to the heart and surrounding areas.
Norwood surgery follows.
With the help of the staff, Choi Ki-seok proceeded with the surgery.
By removing the area with an atrial septal defect, the vascular flow in the right atrium returned to normal, and the problems of aortic and aortic valve stenosis and tricuspid valve occlusion were completely resolved.
Just like that, Norwood’s surgery was nearing its end.
“wow. “It’s only been three hours.”
Guillaume checked the surgery time and clicked his tongue.
The typical operating time for Norwood surgery is six to seven hours, but Ki-Seok Choi showed an amazing feat of shortening it by half.
“Time is important, but what is more important is surgical accuracy.”
“I can’t say it myself, but Professor Choi’s workmanship was flawless.”
Choi Ki-seok remained silent in response to the first assistant’s words.
As if there was still someone left to fight.
“Mr. Choi. The patient’s temperature rose to 38 degrees. “Respiratory rate and pulse are also increasing.”
“….”
“I had my vitals just a little while ago, but now I’m helpless.”
Rosette’s mood became cold following the report from anesthetist Lewis.
Bleep. Bleep.
While the staff remained silent, the patient monitoring device made an unpleasant noise.
“professor. Please say something. If this continues, the patient will die.”
The first assistant, who had been silent, finally opened his mouth.
Choi Ki-seok was frustrated as he was only looking down at the patient without doing any treatment.
“Treatment without knowing the cause is meaningless.”
“….”
“Just wait a little longer.”
Unlike the other staff members who were stomping their feet, Choi Ki-seok calmly stared at the surgical site. Asking Luis to keep his vitals just a little longer.
Soon, a strange look appeared in his eyes.
[You used the Dragon’s Eye level 3 three-dimensional rendering mode. Stereoscopic mode is the ability to reconstruct invisible areas. If you select an object that is not fully visible, reconstruction begins. As the level increases, the detail of the reconstructed image increases.]
[The heart and the main pulmonary artery and ascending aorta were selected as stereoscopic objects. Three-dimensionalization begins.]
When I used the skill, horizontal and vertical lines appeared in my field of vision, as if I was looking at the world through graph paper. In addition, a 3D reconstructed surgical field of view emerged above the surgical site.
“Jonathan. Would you like to lift the left branch of the main pulmonary artery?”
“All right.”
Under Choi Ki-seok’s instructions, first assistant Jonathan gently lifted the blood vessel with forceps.
“….”
“….”
It was a simple act, but its impact was enormous.
The lower part of the blood vessel was pitch black and dead.
The unexpected discovery of vascular necrosis that occurred during surgery hit the staff like an ax on the back of their necks.
“Septic shock occurred as blood vessels died. “There is no way the patient’s vitals are normal.”
“….”
“From now on, we will cut out the necrotic tissue and replace it with an artificial blood vessel.”
Choi Ki-seok seemed like a bystander, but once he decided on the direction of treatment, he showed off his lightning speed. It took less than five minutes to cut out the necrotic tissue and suture it.
“How about Luis Vital?”
“I think we’ll have to wait a little longer.”
“All right.”
The staff, including Choi Ki-seok, held their breath and stared at the patient monitoring device. As the terrible wait continued, my vitals gradually returned to normal.
“At this level, it won’t be a problem to close it. “The surgery is complete.”
Following his instructions, the staff busily sutured the surgical site and disconnected the heart-lung machine.
The surgery success rate is 30 percent.
The Norwood surgery, which was avoided even by the world’s leading pediatric thoracic surgeons, was successfully completed.
“Everyone worked hard.”
Choi Ki-seok left the rosette after consoling the staff who gave their strength until the end.
But why do I feel relieved and regretful at the same time?
While wondering about my own unknown intentions.
* * *
That evening.
Choi Ki-seok visited a tavern in central New York with his three teachers, Song Myeong-jin, Yasada, and Kwon Il-soo. We often ate together, but today was the first time we all drank together.
With the right amount of alcohol added, the atmosphere became more cheerful than ever.
“Mr. Choi. “It was great.”
Kwon Il-su, who was sitting next to him, put his hand on his shoulder.
“I never thought they would catch necrotic blood vessels. “I thought I was panicking because I was just looking at the patient for a while, but that wasn’t the case.”
“If I panic, the patients and staff have nowhere to lean on. “Contrary to what I looked like, I was very alert.”
“I trusted Mr. Choi from the beginning.”
Song Myeong-jin chuckled and continued speaking.
“There is a unique look in Dr. Choi’s eyes when a patient is in danger. “Because I saw those eyes.”
“Thank you for the compliment.”
“is it so. “It’s your last day at MHC, so don’t be humble and enjoy it to the fullest.”
Choi Ki-seok burst out laughing at Song Myeong-jin’s joke.
The reason why he was able to earn money all this time.
It was not only in the game ability, but also in the teachers of these three people. They watched him with affection and worked hard to pass on everything they had.
That favor was not enough to repay over a lifetime.
“Anyway, it’s a shame I’m leaving tomorrow.”
Yasada shook his drink and continued speaking.
“Are you not planning on changing your decision?”
“yes. Although I did all my training in the United States, Korea was always in my heart. “Korean thoracic surgery is a barren field that all doctors avoid, and I want to pioneer that barren field.”
“Then why did you apply to NSF?”
“I don’t think I’ll have anything to do with NSF activities if I go back to Korea. “I wanted to do something meaningful before that.”
“Hmm… I think it’s dangerous. Has the region been decided?”
“yes.”
In response to Yasada’s question, Choi Ki-seok nodded and explained the area where he would be dispatched.
“It’s a short-term mission of 3 months, so I don’t think you need to worry too much.”
“I feel relieved that it is a short-term mission. “It would certainly be meaningful to practice medicine in a new environment.”
Song Myeong-jin continued.
“In our country, there were great people like Dr. Jang Ki-yeo and Father Lee Tae-sik, and in the world, there were great people like Norman Bassoon. “If Mr. Choi works hard, he will definitely be able to learn from their hearts there.”
“yes. “I will keep that in mind.”
As drinks passed, the conversation deepened.
The drinking party ended around midnight and the three teachers decided to sleep at Song Myeong-jin’s house.
After saying his sad goodbyes, Ki-Seok Choi looked at the backs of his three teachers and lowered his head to 90 degrees.
‘I will never forget the teachings of these three people.’
