Chapter 74
Chapter 74
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Translator: crow
Chapter Title: Hope? (3)
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Lee Min-jae's mouth opened very slowly.
Zone 1.
Right below the diaphragm, the uppermost part of the aorta before it branches off to all the major abdominal organs.
In other words, blocking it there meant cutting off blood flow to the entire abdomen.
Kidneys, liver, intestines... it meant abandoning everything.
On top of that, if blood flow to the legs was cut off for too long and something went wrong, the patient's legs might have to be amputated.
"...What?"
A dumbfounded sound escaped Lee Min-jae's mouth.
Lee Min-jae tried to shout something more.
He had to stop this insane act right now, he was about to mutilate the body.
But before his voice could burst out, the automatic door to the resuscitation room slid open.
Ziiing-
A group in surgical scrubs rushed in with perfect coordination. It was the trauma surgery team.
Leading them was the trauma surgery associate professor, Jeon Tae-jeong.
The moment he entered the resuscitation room, he scanned the area.
The floor turned into a sea of blood, the numbers on the monitors, and... under the eerie glow of the C-arm, a group of unidentified figures performing some horrific ritual.
His brow furrowed.
"What the hell is this? What's the patient's status?"
The first to react was Baek Eun-seo, who had barely held onto her senses.
Almost reflexively, she began reciting the briefing for the trauma patient.
"Yes, yes! Professor! Male in his twenties, found at the scene of a truck vs. passenger car TA in a stuporous state. Under MTP activation for open pelvic fracture and hemoperitoneum, transfusing 4 packs of pRBCs. The STAT labs just came back..."
"No, uh, that's. I get it. I get it, but..."
Professor Jeon Tae-jeong cut off her frantic briefing with a hand gesture.
He even stammered. It was probably a scene he'd never witnessed in over ten years of surgical life.
His gaze was fixed on the bizarre act unfolding behind Baek Eun-seo, under the C-arm light.
"What the hell are you doing right now?"
The temporary master of my body replied indifferently, without taking his eyes off the C-arm monitor.
"Performing REBOA."
"..."
A flash of confusion crossed Professor Jeon's face, as if questioning whether he'd really heard Korean.
"...So. That, right now, who's doing it?"
Professor Jeon's face hardened like stone.
REBOA.
Emergency medicine?
Without the trauma surgery team?
My mouth opened again.
"Me."
At that moment, a collective gasp escaped from the trauma surgery fellows and surgical residents standing behind Professor Jeon.
"Ah, uh, Professor! That's!"
Lee Min-jae jumped in first, his face almost tearful, desperately trying to intervene. He approached Professor Jeon very cautiously, attempting to somehow package this utterly unreal situation.
"Ah, yes, Professor! The patient's condition was so critical that we were trying to buy some time before the trauma team arrived... uh... yes... our emergency medicine second-year resident, Dr. Han Hyun-jae, is performing the REBOA procedure right now..."
Lee Min-jae's pathetic, desperate cover-up.
But it didn't help Professor Jeon's mental processing much.
Professor Jeon Tae-jeong glanced back and forth between Lee Min-jae and me (God's Scalpel) under the C-arm.
His brain was visibly struggling to process the three words that could never coexist in one sentence: [second-year], [emergency medicine], [REBOA].
Finally, his mouth opened.
"Are you all insane?!?!"
Professor Jeon Tae-jeong's face was flushed beet red.
"Do you even know what REBOA is? Huh? Do you think blocking the aorta with a balloon is kid's play! I'm not looking down on emergency medicine or anything. But this! This is a procedure even our trauma surgery fellows with two years of experience attempt! And you're doing this right now, in this resuscitation room...!"
That desperate cry, unfortunately, didn't reach the master of my body.
God's Scalpel treated all the shouting like mere mosquito noise and ignored it completely.
His gaze fixed solely on the C-arm monitor.
From the tips of God's Scalpel's fingers, the guidewire was finally advancing toward the target point.
"Okay... past the LSA (*left subclavian artery)... good. Sheath."
An emotionless voice flowed from his mouth, demanding the next piece of equipment.
"No, not the sheath, you crazy bastard!"
Professor Jeon Tae-jeong finally lost his reason.
He looked ready to grab my shoulder.
"You, aren't you listening to me right now? You lunatics! Stop it now! Stop!"
He pointed at the C-arm monitor and yelled.
"Plus, you said there's bleeding from the pelvis, so why is the wire going all the way up under the diaphragm? Why target Zone 1? Are you crazy?"
Only then did the master of my body turn his head.
"If you half-ass it in Zone 3 and there's undetected abdominal bleeding keeping the blood pressure from stabilizing, there won't be time to deflate the balloon and move to Zone 1. This patient dies in those few minutes."
"Okay, even if that's true!"
"Ultrasound confirmed no hemoperitoneum (*blood in the abdominal cavity)? No, it's 100% ruptured somewhere in the abdomen too. Blocking just the pelvis is pointless."
The logic was flawless.
But Professor Jeon didn't back down.
"What if it's ACS! The abdomen's distended!"
"Bladder pressure (*bladder pressure) under 20, it's fine."
Then Professor Jeon struck at the most fundamental contradiction in this absurd situation.
"...Fine, even if all that checks out! Why the hell are YOU doing the procedure!"
At that question,
"......"
For the first time, the master of my body couldn't continue.
Hmm...
It seemed the fundamental fact that this body belonged to a second-year screw-up, left by its original owner, flashed through God's Scalpel's mind.
Even after several seconds, God's Scalpel couldn't find a rational answer to the question.
But the next words were a perfectly star-like move that would drive both fans and haters in the back gallery insane.
"If we keep this up, the patient's going to crash. Hand over the sheath."
God's Scalpel gave up on a logical response and just pushed everything with the urgency of the situation.
Right then, Professor Jeon Tae-jeong made his decision.
"Hey."
He said.
"Give it to me. I'll do it. I don't know where you trained or whatever, but this is something a specialist should handle. Step back. Give it here."
"......"
God's Scalpel glanced back and forth between the patient with the inserted guidewire and Professor Jeon Tae-jeong glaring at him with gloved hands.
And he seemed to actually think about it.
Him doing it versus the trauma surgery professor doing it.
Which was the more rational and normal procedure in this situation.
And that calculation probably included whether that trauma surgeon could actually perform the technique.
Given God's Scalpel's personality, if the professor wasn't up to par, he would've thrown a fit to do it himself.
God's Scalpel silently extended the end of the guidewire he was holding toward Professor Jeon Tae-jeong.
Professor Jeon Tae-jeong received the guidewire from my hand—no, from God's Scalpel's hand.
"Sheath kit."
At his voice, someone behind quickly handed over the next equipment.
Professor Jeon followed the wire, pushing in the dilator (*vascular dilator) and sheath (*tube) together.
The movement looked slightly different from the near-miraculous genius displayed by God's Scalpel.
It was the brutally skilled motion of a craftsman etched into the muscles through immense experience and training.
It was right then.
"The angle's too high."
God's Scalpel, borrowing my mouth, began pointing things out.
Professor Jeon Tae-jeong's hand hesitated. His brow twitched.
"What?"
"I said the angle's too high. At that angle, the sheath tip could scrape the posterior abdominal wall. Lower it a bit to enter parallel to the vessel path."
"..."
Professor Jeon Tae-jeong's face turned red then purple.
"No, looks like you did some training somewhere and think you know it all, but I got this..."
Professor Jeon tried to push in the sheath.
But he felt a sudden resistance, like it caught on something.
On the C-arm monitor, the sheath tip was blocked by the vessel wall and couldn't advance further.
God's Scalpel said in a similar tone once more.
"Pull the sheath back 3mm, lightly pull the wire while retracting, rotate the sheath 15 degrees counterclockwise, then push again."
Professor Jeon Tae-jeong hesitated for a moment.
Between his pride as a surgeon, this ridiculous situation before his eyes, and the fading life of the patient.
In the end, reason won over pride.
Professor Jeon silently began manipulating the sheath exactly as instructed by the master of my body, with minute adjustments.
3mm retreat, wire pull, 15-degree rotation.
Then advance again.
Sssllide-
Like magic, the sheath slipped smoothly into the vessel without resistance.
Professor Jeon Tae-jeong's mouth opened just a fraction. He looked back and forth between the C-arm monitor and my face in disbelief.
"Uh... thanks..."
A word of gratitude slipped from his mouth.
I inside was stunned by the sight.
Teaching a trauma surgery professor and even getting a thank-you.
After that small success, control of the procedure began to reorganize in a bizarre form.
Hands: Professor Jeon.
Mouth: God's Scalpel.
Mouth skin: Han Hyun-jae.
"Confirm the tip curve. Don't over-angle."
"Follow the wire straight up. If you feel resistance at the branch, don't force it—pull back a bit and rotate."
"Good position now. Right above the abdominal aortic branch just below the diaphragm. Stop there."
God's Scalpel's interference was relentless, and Professor Jeon Tae-jeong started off frowning but soon realized the instructions were astonishingly precise and followed them silently.
Finally, the catheter was perfectly positioned in Zone 1.
"Prepare for ballooning."
At Professor Jeon Tae-jeong's words, Lee Min-jae handed over the syringe pre-filled with normal saline.
Professor Jeon connected the syringe to the catheter port.
"Balloon inflation starting now. Watch the blood pressure changes."
He began pushing the syringe piston very slowly. On the C-arm monitor, the small balloon at the catheter tip gradually inflated.
The moment that balloon perfectly sealed this young man's aorta from the inside.
Every gaze in the resuscitation room turned to one goal.
The vital signs monitor.
[BP 50 / 28]
Everyone's hearts seemed to stop. The balloon was blocking the aorta, yet blood pressure was still crawling on the floor.
"No..."
A despairing groan burst from Lee Min-jae's mouth.
"Just wait a bit."
Professor Jeon calmed Lee Min-jae.
1 second, 2 seconds, 3 seconds.
In that hellish time, a miracle happened.
The number that was 50 changed to 55.
Then 60.
[BP 75 / 40]
"Blood pressure's rising."