Chapter 97
Chapter 97
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Translator: crow
Chapter Title: Dropping Bombs (4)
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The silence stretched on for more than ten seconds.
Hundreds of doctors were mulling over the information I'd dumped on them in those ten minutes, along with that provocative final proposal, each in their own heads.
Finally, Professor Kim Hyeok-jae from Oseong Seoul Hospital broke the heavy silence.
". . .Hah. Yes. That was a very . . . impressive presentation, Dr. Han Hyun-jae."
Professor Kim's voice carried a complex mix of emotions—admiration, perhaps, or bewilderment.
"Then, we'll begin the Q&A session now. If anyone has questions . . ."
Before the chair could even finish, that same resident who'd ripped into me earlier shot his hand up again.
He practically snatched the mic.
"I enjoyed the presentation."
His voice was even sharper and more aggressive than before.
"So, is Dr. Han Hyun-jae's conclusion that non-surgical Emergency Medicine should actively promote surgery? Are you saying every Emergency Medicine doctor should pick up the scalpel starting tomorrow?"
*Here it comes.*
"No."
He faltered for a moment at my firm denial.
"What I'm saying isn't that everyone should do it. It means we need systematic training for these last-resort situations and clear interdepartmental discussions with Surgery."
"And what exactly is this 'last-resort situation'?"
He latched onto my words without missing a beat.
"What's the standard? If an ER without the capability tries some half-assed damage control on a trauma patient, what do you think happens? That's not saving a patient—it's killing them."
Murmurs of agreement rippled through the lecture hall here and there.
But I didn't flinch.
I'd seen this question coming a mile away.
"I completely agree with your point."
I bowed my head first.
"Primarily, if the hospital lacks the capacity to handle trauma patients, we should refuse admission."
The murmurs died down a bit.
"Or, if a patient who’s already arrived is clearly beyond the hospital's capabilities, we should attempt immediate stabilization while rapidly transferring them to a higher-level hospital capable of definitive surgical treatment—or to another facility."
I paused to catch my breath.
"The last-resort situation I'm talking about is—"
I pointed at the screen.
"As you saw earlier: patients who walk in without prior ambulance contact, with no time even for transfer . . ."
I pointed again at the cover of the Japanese paper.
"Or cases like the one in Japan, where geographic limitations mean no immediate backup options. At Sado Hospital back then, even attempting helicopter transfer to the nearest university hospital or base would have guaranteed the patient's death."
I adjusted the mic.
"My presentation isn't about situations with no one who *can* do it. It's about moments when no one who *must* do it is there."
That brief silence shattered as a hand went up from the middle rows.
"Great presentation. Could you elaborate a bit more on the patient's ICU prognosis?"
*Hmm, why ask that?*
*This isn't the Critical Care Society.*
The question was sharp.
"After performing such extensive procedures in the ER, the patient's course in the TICU—Trauma ICU—would surely differ from a typical trauma case in terms of abdominal compartment syndrome, rebleeding, infection control, and so on. I'm curious about the data on that."
I clicked my tongue inwardly.
But at the same time, I let out a sigh of relief.
*'Gotta answer this. Not too tough.'*
"Thank you for the great question. The patient was transferred to the Trauma ICU immediately post-op, and we continuously monitored intra-abdominal pressure via bladder pressure for the first 24 hours."
*Good tone.*
"As you mentioned, ACS risk was high, so we intentionally kept an open abdomen for 24 hours to prep for relaparotomy. Fortunately, intra-abdominal pressure didn't rise significantly. We successfully completed the relaparotomy and definitive closure on post-op day two. No signs of infection, total ICU stay was 14 days, and . . ."
As I rattled off my prepared response like a parrot, the lecture hall filled with murmurs once more.
*'Dude's prepared. Even knows the ICU charts inside out.'*
*'Is that guy really EM?'*
I ignored the buzz and wrapped up my answer.
The doctor who'd asked nodded lightly, looking satisfied.
*'Phew. Dodged that.'*
I glanced toward the back of the audience, at the entrance where Professor Cheon Eun-jeong stood.
And there she was, staring at me in utter disbelief.
I could feel her soul screaming at me through wild gestures and expressions.
*'Hyun-jae! It was just a simple case report! When did I tell you to give some heretical lecture on expanding EM's scope?! Wrap it up and get off! Can't you see the professors' faces?!'*
Or so it seemed.
*Hmm.*
I paused for a second.
*Yeah, let's think positive.*
*She's probably cheering me on, low probability or not.*
Professor Cheon was surely shouting with her whole body: *'Go get 'em, Han Hyun-jae! Flatten those arrogant Seoul bastards! You're our hospital's pride!'*
With that steadfast belief, I clenched my fist toward her.
And gave a short, intense nod.
*'Fighting!'*
Professor Cheon clutched her neck.
Her body swayed, but it had to be from being moved by my cheer.
*Heh.*
I turned back to the audience.
"Dr. Han. That was a truly profound philosophy lecture."
*Philosophy, huh.*
"But here's the thing. Your argument boils down to one single case. Or two, if we include that Japanese paper."
He sneered.
"You're seriously advocating expanding the entire department's scope based on simple case reports like this? Isn't this just demagoguery, not academia?"
This was a fact-based attack.
Lack of data.
More powerful than any logic I'd prepared—a fundamental strike.
Every eye in the hall locked onto me again.
In the back, Professor Cheon was waving her hands like *'Please surrender!'*
I gripped the mic tighter.
What would God's Scalpel say in a moment like this?
*'Out of line? The patient lived, didn't he?'*
Yeah.
That spirit.
"Yes, unfortunately, as you know, there are almost no retrospective or multicenter studies on ER-led laparotomy to cite."
I took the hit head-on.
Professor Cheon clutched her neck again.
*What's with her neck joints lately?*
"In that sense, for those who've taken something away from this presentation—"
I caught my breath.
"If you use this technique in that last-resort situation like I described today and save a patient—"
I locked eyes with that third-year resident glaring at me.
"Then maybe we could pool more cases and conduct that precious multicenter study you all want so badly."
Silence.
Then the murmurs swelled.
*"That guy's insane, right?"*
*"Is he really a second-year?"*
*"He just assigned homework to every professor?"*
*"This dude's for real . . ."*
I glanced to the back.
Professor Cheon . . . clutching her neck again.
*Ehehe, maybe book her an ortho clinic slot.*
**
Meanwhile, at Seoul Catholic Sacred Heart Hospital, Park Ju-seong had one thought.
With a graver expression than any professor in the room.
*'. . .That guy's dangerous.'*
The look he gave the second-year on stage wasn't awe or admiration.
It was the wariness you'd have for an unpredictable natural disaster—or an uncontainable beast.
*'Sure, EM could pull off surgery like in that case.'*
Park Ju-seong ran the simulation in his head.
As a last resort, risking everything, in that one minute while the patient flatlines right in front of you.
It could happen.
But if he saw an EM doc actually doing it, he'd call them crazy.
*'That's why I have to tell that young punk up there he's insane.'*
He rested his chin, deep in thought.
*'And the case of saying it outright at a conference? Even crazier.'*
This wasn't an incident report.
That second-year was packaging this case as a proud achievement—a new paradigm.
And using it to argue for expanding the whole department's scope? No sane person would.
Dragging in a Japanese paper to claim *'EM docs should suture guts and hearts too.'*
And not even a professor—just a second-year resident.
*'Keep lunatics like that far away.'*
Park Ju-seong shook his head.
Bring in a guy like that, and the entire hospital system could shake to its roots.
Rules and protocols were written in blood.
One mutant could ruin it all.
*'It should be that way, but . . .'*
Against his rational judgment, a pragmatic, strategic calculation crept into his mind.
*'For Catholic Sacred Heart Hospital—the only one in the Seoul region prepping for trauma center designation without a regional trauma center . . .'*
Park's expression grew subtly complex.
Korea's trauma centers, especially non-university ones without standalone buildings like Ajou or Pusan National University, had clear structural limits.
Even entering the trauma center, paths often overlapped with the regular ER, or initial care involved collab with Emergency Medicine.
*'From Catholic Sacred Heart's perspective, with no plans for a dedicated trauma building . . .'*
Even if trauma surgeons pulled 24-hour shifts, the first to face the patient and make the call would most likely be an EM doc.
What they needed wasn't some average EM physician saying, *'Not my job—wait for Surgery* in a time-critical minute-by-minute crisis.
*'. . .Means that lunatic's worth targeting.'*
Guts to ignore every rule.
Guts to grab the scalpel first—professors and seniors be damned—to save the patient.
And . . . above all, that inexplicable surgical skill that actually pulled it off.
Having a guy like that planted in the ER could be a stronger weapon for Catholic Sacred Heart's integrated trauma center vision than any cutting-edge equipment.
Park Ju-seong regretted just watching last fall at the spring conference—arms crossed, thinking *'That old coot's scouting young talent again'*—as Oseong Seoul's Kim Hyeok-jae slipped his card to Han Hyun-jae and slathered on the *'Let's grab dinner sometime.'*
*'Ah, damn. Should've slipped him my card too.'*