The Edge of Despair

"Suction!"

The sound of blood and vomit tearing from the patient's mouth split the air of the Resuscitation Room.

At the same time, Han Jae-eon, without a single moment of hesitation, shoved the laryngoscope in and slammed the tube down. Securing the airway. Airway. The alpha and omega of trauma patient care. You have to make them breathe first to have a next step.

My role was Circulation. Along with Lee Min-jae, my job was to somehow stop the blood leaking from the patient's body and replenish it just as fast.

I climbed on top of the patient's limp body.

A horrific wound was exposed beneath his shredded pants. Bone fragments protruded through skin and muscle, with blood gushing out from around them.

An open pelvic fracture.

"Pelvic binder is on!"

We tightly secured the patient's pelvis with a massive belt—a pelvic binder. It was a desperate struggle to stabilize the shattered pelvic bones and reduce internal bleeding even by a fraction. But the blood soaking through the binder showed no signs of slowing down.

Everything was the worst-case scenario.

In my head, the terms defining every godforsaken situation I'd heard until my ears bled over the past year echoed like screams.

Massive hemorrhage, shock, metabolic acidosis, hypothermia, coagulopathy.

Lethal triad or whatever—right now, the person in front of my eyes was simply about to die.

"We've run two liters of fluid, so why the hell isn't his blood pressure budging?!" Lee Min-jae screamed, practically wailing.

Lee Min-jae's hand squeezed the pressure bag so hard it looked ready to burst. The two transparent fluid bags hanging from the IV pole were already shriveled flat. The clear, sterile liquid was rushing furiously into the patient's body through thick IV lines, but it was like pouring water into a bottomless pit. The speed of the bleed somewhere inside was faster than the speed of the infusion.

Yet the blinking numbers on the monitor mocked our prayers.

Please go up, you piece of shit blood pressure.

Pressing down on the patient's abdomen, I cursed the numbers flashing on the monitor before me. Those red digits mocked my every effort.

Bullshit, I cursed inwardly.

Two liters? Even if we poured twenty liters in, it wouldn't go up. Instead of rising, the pressure was dropping further despite the massive fluid resuscitation. It meant there was no blood left to flow in his vessels. Right now, the patient's body was just a sieve. While fluids poured in through the line secured in one arm, blood was geysering out from beneath his shattered pelvis.

The heart rate was blinking frantically. Yeah, only the heart was working its ass off right now. Since there was no blood in the body, it was a desperate, dry pumping action to squeeze the very last drop to the brain and heart. But that wouldn't last long either. It would tire out soon, and slipping into V-fib or asystole would happen in the blink of an eye.

Even though we were practically shoving oxygen down his nose and mouth with a 15-liter reservoir mask, it was still dropping. It meant there was no blood left to carry the oxygen. What good is a green traffic light if there are no cars on the road? There are no delivery trucks.

"Doctor! He's going to arrest before we even get him in the elevator! When is the trauma surgery team coming?!" Baek Eun-seo's voice trembled.

To that naive first-year, this situation must look like the end of the world. She wasn't wrong. At least for this patient, it was indeed the end.

Lee Min-jae roared at Park Seong-jeong, who stood frozen in front of the whiteboard. Park Seong-jeong's face was already stark white, completely drained of color. Yeah, that was the normal reaction for a first-year. I was the crazy one for trying to throw myself into the middle of this hell.

"One of the lines is blocked! It's backflowing!" a nurse shouted.

Damn it. Was the line that was backflowing earlier blocked again? A precious line, secured with great difficulty due to the low blood pressure, had died.

"Get the IO needle! We'll drill a hole straight into the bone and blast it in!"

Lee Min-jae looked half out of his mind now. Intraosseous access. It meant drilling a hole into the shinbone to force fluids in. That was truly a last resort. But right now, we had nothing left but last resorts.

Even amidst the chaos, the fourth-year Han Jae-eon was silently bagging the patient at the head of the bed, securing the airway. What on earth was that senior's mental fortitude made of?

"Han Hyeon-jae! Apply proper pressure! Don't take your hands off!"

Lee Min-jae's thunderous command snapped me back to reality.

The sensation beneath my palms was horrific. The abdominal wall, which should have been firm, was nowhere to be found; only an unpleasant, helpless sensation of pressing down on a squishy bag of blood was transmitted to my hands. Did this act of leaning my body weight to compress even mean anything? Wasn't it just a futile struggle, like trying to plug a burst dam with bare hands?

"Blood is here!"

It was a voice like a savior's. An intern who had run from the blood bank held two packs of O-negative blood in his hands.

"Uh, hang them immediately! Hurry!" Lee Min-jae shouted.

The nurse disconnected the fluid line and hooked up the blood bags. As the pressure bags were squeezed, dark red blood flowed through the tubes and into the patient's body. I was still frantically compressing the ‍‍‌‌⁠​​⁠‌​​‍​​‍​‌​⁠‍‌‍⁠⁠‌⁠‌‍‌‍‌‌‌‍⁠​‌​‌​‌‍‌‌‌⁠‍​​‌‍⁠‌‌⁠⁠patient's abdomen.

Ah, this texture is the absolute worst.

...Damn it.

Is this how it ends? Just like this, under my hands, am I supposed to just watch a person slowly turn cold? Is all this effort, all this struggling, just a show to delay the predetermined conclusion of death by a few minutes?

A wave of helplessness washed over me. That godawful feeling I had experienced countless times since entering this hellish emergency room, yet could never get used to. Everything in front of me seemed to move in slow motion. The wailing monitor, the seniors' screams that bordered on shrieks, the warmth of life faintly fading beneath my palms.

Ah, damn it. Should I open the gallery?

A memory from my first year suddenly flashed through my mind.

Possession. And the God of Scalpel.

Use Possession again?

I shook my head. No. This is different from back then. Even if I used it, I didn't think opening the belly would solve anything here... Splitting the abdomen open wouldn't fix this... Back then, only the abdomen was the problem, but now, the pelvic bones are shattered too. It's a double whammy. Wouldn't it just waste more time? Instead, my own body would just taste hell for the next twelve hours. The patient would die anyway, and I'd end up half-crippled. It wasn't a rational choice.

Ugh, screw it. I desperately shook off the temptation. For now, let's focus on the most basic thing I can do.

"Doctor!" I shouted toward Lee Min-jae, who was squeezing the bag almost out of his mind. "The blood! I'll squeeze the blood! Please check the ultrasound one more time!"

"Oh, right! Thanks!" Lee Min-jae handed the pressure bag over to me and grabbed the ultrasound probe again.

"Eun-seo!" I grabbed the shoulder of Baek Eun-seo, who was standing beside us, not knowing what to do. "You! That! Hold the pelvic binder tight from both sides so it doesn't loosen! If he bleeds ‍‍‌‌⁠​​⁠‌​​‍​​‍​‌​⁠‍‌‍⁠⁠‌⁠‌‍‌‍‌‌‌‍⁠​‌​‌​‌‍‌‌‌⁠‍​​‌‍⁠‌‌⁠⁠any more from his pelvis, it's really over!"

"Yes!" Baek Eun-seo quickly scrambled to grab the binder.

Lee Min-jae's face was slick with sweat. "FAST! Let's do a FAST scan! Where is it bursting like this!"

Soon after, Lee Min-jae's face contorted. "Ha... the spleen. The spleen is..."

I frantically squeezed the pump of the pressure bag containing the blood pack. Cold blood flowed through the tube and into the patient's body. Right, since I'm only squeezing the bag now... Let's ask for help. Earlier, there was too much to do, but ‍‍‌‌⁠​​⁠‌​​‍​​‍​‌​⁠‍‌‍⁠⁠‌⁠‌‍‌‍‌‌‌‍⁠​‌​‌​‌‍‌‌‌⁠‍​​‌‍⁠‌‌⁠⁠now, I just need to squeeze the bag. If not now, I won't even have time to ask.

I hastily opened the blue window in the air and began typing a post.

The gallery was pouring out useless comments. What did it mean that even the gallery, which always provided clear answers, was filled with meaningless banter? Would these crazy ghosts, who were genuinely dedicated to saving lives, leave comments like this if there was an obvious solution? Probably not. It meant the situation was incredibly bleak.

Right then, Han Jae-eon's voice, who was bagging at the head of the bed, drifted over.

"Doctor."

"What! What is it!" Lee Min-jae replied, snapping his head up.

"EtCO2 is 20. His heart is about to stop. We have no time."

The normal range is 35 to 45. An EtCO2 of 20 meant the heart was pumping almost no blood, leaving barely any blood to carry carbon dioxide to the lungs. One of the strongest warning signs of impending cardiac arrest.

And that warning immediately became reality.

"BP is 55 over 30! It's still dropping!" the nurse shrieked.

At the same time, the heart rate on the monitor spiked frantically, as if making its final stand. 155. 160. 165...

"Ah, fuck! This is driving me crazy! No! Don't do this, you piece of shit heart! Hold on!" Lee Min-jae screamed at the monitor.

Amidst the chaos, I saw a newly refreshed comment at the very bottom of the gallery window in my mind.

...What?

I doubted my own eyes. Fix this? This mess?