Before It Bursts
The next day, Yom-yom-i was brought in for another ultrasound.
Lee Jun had expected him to be frightened. Instead, the little squirrel lit up at the news.
"Hehe, Hyungnims' Hyungnim!"
Lee Jun scooped him up to carry him to the exam room, and Yom-yom-i could not have been happier. The Hyungnim of all his hyungnims — the one he was so grateful to — was holding him in his arms.
Watching that bright little face, Lee Jun smiled too. Or rather, he made himself smile. Yom-yom-i had already sensed his mood, and Lee Jun would not let that worry drag the squirrel's condition down any further.
"Haha. Did our Yom-yom-i sleep well?"
"Yes! My friends aren't hurting! That's why I'm so happy."
Looking at him as he answered, Lee Jun felt something twist in his chest. He didn't let it show. Kid's got way less energy than yesterday. The difference in vitality from the day before was stark, and it pained him enough that he stroked the small body with extra care. Yom-yom-i's face blossomed even wider. He loved being petted by Lee Jun.
Carrying him toward the ultrasound room, Lee Jun let himself hope. If this is something medicine can fix, that would be enough.
But a wish, in the end, is only a wish.
Watching the recorded ultrasound, Lee Jun pointed at the monitor and let out a long breath.
"It's a kiwi pattern."
What his finger had found was the gallbladder. The interior of it had taken on the mottled, seeded look of a cut kiwifruit — the classic kiwifruit-like pattern.
"That's the typical pattern for a gallbladder mucocele."
Cha Da-jeong's voice, answering him, had no strength in it either.
The gallbladder is a small pouch that stores the bile secreted by the liver. Bile sits there until it is needed, then travels down the bile duct into the duodenum. But when the bile inside grows thick and viscous, it struggles to pass through the duct — and worse, it can block the duct entirely. The disease that follows is the one Cha Da-jeong had named: a gallbladder mucocele.
Yom-yom-i's climbing liver values, the jaundice — all of it would have come from this.
"If you look here…"
Cha Da-jeong pointed at an uneven stretch of wall.
"The GB wall is irregular. That means as the gallbladder expanded, the wall got thinner."
If a sticky fluid can no longer drain through the duct, but the amount of bile flowing into the gallbladder never changes — the gallbladder has nowhere to go but out. It swells.
"…It does look that way."
There was no force left in Cha Da-jeong's voice. She could already see the prognosis.
Pump air into a balloon and it swells, the rubber stretching thin. Keep pumping, and sooner or later the balloon cannot take it anymore. It bursts. By the same principle, a gallbladder would, eventually…
"Looking at how dilated the common bile duct is, it could rupture. Best to take it out before it does."
The moment Lee Jun said the only answer was to remove the gallbladder before it tore, Choi Woo-jin — who had not gone home the night before, and had stayed at Mongmong Animal Hospital with him — picked up the thread.
"You want to operate on this one?"
"Then what? Leave it? It's obviously going to burst."
"You're right. You're right, I know you are. But this isn't a dog. It isn't a cat, either. Do you have any idea how fragile the tissue is? Ask Kim Jaeyeon."
Kim Jaeyeon, who had been on duty the previous night, happened to be walking into the exam room as Choi Woo-jin spoke. Choi turned to him at once.
"Kim Jaeyeon. Think you could do a cholecystectomy on a squirrel?"
"A squirrel? You mean the ones the director rescued yesterday? Hmm. Just lifting the gallbladder off might be possible, but flushing the common bile duct would be difficult."
"And if there are adhesions, even more so."
Yoo Mu-hwan, who had come in with him, added his own quiet weight to the warning.
"Looking at Yom-yom-i's results, his inflammatory markers were high, too. If we get significant bleeding on top of that, there won't be a thing we can do."
"That's exactly it. We can't even transfuse. And you know how soft this tissue is."
Skepticism hung in the air. Lee Jun spoke into it anyway.
"I know. I know. But it's still better to do it before it bursts."
"That's true, but…"
"You all know what happens to Yom-yom-i if we just stall for time."
No one answered him.
They all knew how this story ended.
Lee Jun fell silent and stared at the monitor. Yom-yom-i's wretched gallbladder filled the screen, swollen and enormous. Looking at an organ that might tear at any moment, he saw the face that had beamed at him only a little while ago — my friends won't hurt anymore — and the proud little look Yom-yom-i had worn when the exam was over.
He drew a deep breath, and then he spoke.
"There's emergency, and then there's that kind of emergency. Ugh… I don't even want to think about it."
Choi Woo-jin's face tightened as he said it; a case that had come in with a ruptured gallbladder had clearly risen behind his eyes. He was not the only one. Every person in the room knew exactly what the prognosis looked like once that emergency arrived. They furrowed their brows and nodded.
That was when it happened. A frantic yowl split the air outside, followed by a burst of barking.
Hoesaegi, Gkamnyangi, and Sapsaree were shouting at the top of their lungs.
"Hy- Hyungnim-ong! It's an emergency-ong! Yom-yom-i's hurting-ong!"
"Hyung-ah! Yom-yom-i just collapsed!"
"Come out, hurry-ayo! Yom-yom-i's in big trouble-ayo! It hurts-ayo!"
"What?"
Lee Jun was out the door in an instant. Choi Woo-jin scrambled after him.
"W-what's going on? W-why are they like that?"
The others came too. The three animals almost never raised their voices like that inside the hospital, and everyone in earshot felt the danger in it.
The three of them shot off the moment they saw Lee Jun. Nails clicking, paws hammering, they tore down the corridor — and behind them the staff came thundering after, shoes slapping tile, breath coming hard.
Outside the operating room, the Surgery in Progress light came on. Inside, the shadowless lamp poured bright and clean across the table.
"We're starting."
Lee Jun announced the beginning of the operation, and a moment later Yom-yom-i's abdomen was opened. Even with ordinary surgical scissors, not a single drop of blood appeared.
Choi Woo-jin marveled. That's Lee Jun for you. That one sentence was enough. He had seen Lee Jun's gift for threading past vessels more than once or twice — and this time, it had to be that way.
How much blood could there possibly be in a body this small? On top of that there was anemia, and no way to transfuse. The key to this surgery was to hoard every drop, to keep blood loss to an absolute minimum.
The flicker of awe passed. Choi Woo-jin's eyes went cold and steady again. What he had to do was just as critical.
His job was to make the field easy for Lee Jun. They had worked together so long their hands were in sync, and Choi Woo-jin was an outstanding surgeon in his own right. Of course he knew exactly what Lee Jun would do, and how. And one thing more: he knew how easily the tissues of an exotic animal tore, how readily they turned to pulp. Assist with too much force and the tissue ripped. Assist with too little and you stole the view.
Having opened the skin, Lee Jun began a blunt dissection of the fascia. Red muscle showed through. Open that muscle, and the internal organs would be waiting underneath — and there was no opening red muscle without blood.
Lee Jun put out his hand, and an instrument settled into it at once: the SonoBlade, an ultrasonic surgical unit that cut and coagulated in a single stroke. He took the blade Choi Woo-jin passed him and carved through the muscle in clean, unhurried passes. There was no hesitation in his hands. Only someone who knew exactly what lay where could move like that.
Pale fat came into view. Choi Woo-jin seated a Balfour retractor and opened the field. Lee Jun's fingers worked through the fat, and in a breath he had drawn the gallbladder up into the light, then retracted it with a Stay Suture.
"We'll have to separate it from the liver."
"Right."
A short exchange. That was all they said, and it said everything. In the process of peeling gallbladder from liver, there must be no bleeding — or if blood came, it had to be reduced to almost nothing. That was the meaning packed into those two lines.
The instruments Lee Jun was using were built for bloodless work. But an operating room is a place where anything can go wrong, and there is no such thing as being too careful. Choi Woo-jin held the field open so Lee Jun could work without obstruction, a gauze sponge ready in one hand, and swallowed. One slip here and it was over. Please. He put all the force he had into his eyes and watched nothing but Lee Jun's hands, ready to pack a bleed the instant one appeared.
And then — the common bile duct came into view, and Lee Jun isolated it.
It happened in a heartbeat. Choi Woo-jin, assisting at his elbow, was startled. So was Kim Jaeyeon, who considered himself fast and precise. Only Yoo Mu-hwan, running the anesthesia, remained unmoved. His goal was a single thing: that no anesthetic accident would occur, no matter what else happened in the room. He wanted Yom-yom-i to leave this table alive and reach recovery. Every nerve he had was fixed on the squirrel's condition.
Choi Woo-jin found his composure again a moment later.
"Cotton swab!"
Lee Jun's voice was low. A sterile swab was held out at once — Kim Jaeyeon's hand. Lee Jun took it and pressed it firmly along the bile duct, hunting for the point of rupture. Whatever had torn would have to come out with the rest.
Kim Jaeyeon stood ready with five swabs in his grip. Finding a tear would take at least that many, he had thought.
It didn't. Lee Jun found the rupture with a single swab.
"Here it is."
At those words, Choi Woo-jin clipped the duct with a Hemoclip. Lee Jun followed with the Ligasure, cutting the gallbladder free, ruptured portion and all.
Not a single drop of blood fell.
"Hah—"
A small breath of relief slipped out of Choi Woo-jin as he confirmed it: the Ligasure had sealed as it cut, and there was no bleeding at all.
"Let's confirm bile duct patency."
"Okay!"
Lee Jun spoke quietly to the man still letting that breath go, talking as he cut.
"We're lucky we have this."
"Yeah. Really lucky. Without this, can you imagine how much he would have bled?"
"If I didn't have this equipment, honestly, I might not have even dared to try."
"No. You would have done it anyway."
"I think so too."
Kim Jaeyeon put that in after Choi Woo-jin, and it was true, and they all knew it. Even with the odds low, Lee Jun would have tried. Without surgery the chance of living was zero. Attempt it, and that chance rose — even if only a little.
In that moment, Lee Jun found himself wishing the chance would be a hundred percent.
The wish lasted a heartbeat. Then he put his whole mind back on the field.
"Looks like bile's spread, doesn't it?"
"Looks that way. We'll need a thorough lavage."
"We will."
The inflammatory markers had already been high. Fail to irrigate the cavity properly, and it would not matter how cleanly the surgery itself had gone — the prognosis would turn. He would not let that happen. The bile that had leaked from the ruptured duct, the sludge that had sat inside it — all of it had to come out.
Lee Jun opened his eyes wide and searched the abdominal cavity. Washing it took far longer than removing the gallbladder had. He rinsed with a patience that bordered on stubbornness, and Choi Woo-jin and Kim Jaeyeon, assisting on either side, put their whole concentration into helping him.
The tense, grinding minutes stretched — and then, at last, a glad sound left Lee Jun's mouth.
"Closing the abdomen."
Choi Woo-jin let out a low breath.
"Hah. We made it."
Because Yom-yom-i's heart had kept beating until the end. And because he himself had assisted, cleanly, all the way through.
"Thank goodness. Really — thank goodness."
Kim Jaeyeon added his own quiet joy to the room. But the happiest words of all came from Yoo Mu-hwan.
"He's all right."
Meaning his condition was holding. There was nothing better anyone could have said.
Under the mask, the corner of Lee Jun's mouth lifted. His eyes curved with it. Thank you for holding on. Yom-yom-i. The little squirrel lay stretched out on the table, all four limbs splayed, and Lee Jun found him so dear it hurt — for enduring this brutal, narrow stretch of time.
That was when Choi Woo-jin spoke.
"The little guy… we got lucky, huh?"
"Yeah."
"Please let him wake up clean. No events or anything."
By "events," he meant emergencies.
"Wake up safe and recover well, Yom-yom-i. And then smile at us and say thank you."
Lee Jun thought how wonderful it would be if, just as Choi Woo-jin had said, Yom-yom-i woke with that wide bright smile and told them he didn't hurt anymore. Yom-yom-i. You have to say that. You hear me?