We'll Walk Out Smiling
The door swung open.
The operating room came into view, and Lee Jun's gaze found the team already waiting, their preparations complete.
Han Na-hyeok. Choi Woo-jin. Eom Jin-han. Kim Jaeyeon.
These four had stood with him through every mitral valvuloplasty he had ever performed. Yoo Mu-hwan was stationed at the anesthesia machine; Cha Da-jeong waited at the ultrasound.
Eom Jin-han, who would run the extracorporeal circulation, was going over the heart-lung machine with painstaking care. Yoo Mu-hwan stood before the bank of monitors that would track every flicker of the patient's condition.
After checking Bokshil's status, Yoo Mu-hwan connected the leads to the patient monitor at once. Beside him, Han Na-hyeok prepared for intubation.
Yeo Un-hyeok, assigned to anesthesia and medications for this surgery, was checking the drugs they would need. He had already checked them several times. Even so, something could still be missed — so his eyes moved quickly over the vials and syringes.
Everyone was busy, and Lee Jun was no exception. He verified that every piece of equipment was in place while checking Bokshil's vitals.
Yoo Mu-hwan's gaze drifted to a crimson blood bag — blood prepared for a hemorrhage they hoped would never come.
The veterinarians gathered in the operating room moved through their assigned tasks. It was a situation that could easily have become chaotic. But their motions were so clean, so free of wasted effort, that the whole room flowed like water — natural, and fast.
Bokshil lay on the table beneath the surgical lights, her belly smooth. The area they had clipped the day before had been shaved again that morning with a razor, down to the skin. Removing the fur was the first step in preventing contamination.
Her belly, chest, neck, and all four legs — now as smooth as if they had never grown hair — began to stain with Betadine.
The rule was absolute: a gauze pad never returned to a place it had already been. Start at the surgical site and work outward. Kim Jaeyeon followed that principle, disinfecting the field several times, and the time it took was remarkably short.
The moment disinfection was finished, a surgical film was applied — an adhesive drape thinly coated with povidone, another layer of infection control.
When every preparation was complete, Han Na-hyeok spoke.
"Sedation going in for intubation."
Before they could secure the airway for inhalant anesthesia, they would inject a sedative — to blunt the physiological stress that intubation itself could provoke.
Yoo Mu-hwan administered the injection. Han Na-hyeok's eyes sharpened, waiting for the precise moment to intubate.
Bokshil looked up at him, and a flicker of fear crossed her eyes. It wasn't Han Na-hyeok she was afraid of. It was instinct — a premonition of what was coming.
Lee Jun spoke to the little dog lying on the table.
"It's okay, Bokshil. I told you yesterday, remember? After this, breathing is going to feel so much easier. So don't worry."
Bokshil's ears pricked at his words. She gave a small bark, then grinned, mouth stretching wide as if to say ahh, her eyes curving into crescent moons.
Han Na-hyeok couldn't help but laugh.
"Ha. That face. She looks like she's asking me to pop a piece of candy in her mouth. Tell me I'm not the only one seeing this."
"She's smiling. First time I've seen a patient this relaxed before surgery."
Eom Jin-han picked up the thread, and Choi Woo-jin added his own.
"What about the draping? No — even before that. She just lay there while we scraped her down with a razor."
From beside the anesthesia machine, still watching the patient monitor, Yoo Mu-hwan spoke.
"That's right. Thanks to her, we saved a great deal of anesthesia time."
This was already a very long surgery. Unlike human patients, animals needed anesthesia even for clipping and disinfection — no animal would lie still while a razor-sharp blade traveled across its skin. So they normally had to anesthetize before they could even begin preparing the field. Bokshil had skipped that entire process. She was receiving everything she needed before surgery with her mind still bright and clear.
"Watching this, I really do envy how well Jun communicates with them."
Han Na-hyeok said it, then turned to Bokshil.
"Bokshil, this is going to go down your throat now. Relax… ah—"
Then it happened. Bokshil opened her mouth a little wider. She let the tension drain from her body.
Lee Jun, watching, spoke.
"She's listening to you, too."
"…Huh. So she is."
Han Na-hyeok answered with a look of surprise — already having completed the intubation.
Anesthesia began. Lee Jun spoke to Bokshil.
"Bokshil, take a little nap. When you wake up, it won't hurt anymore."
Her eyes fluttered, then slid shut.
The veterinarians in the operating room moved in silence.
Lee Jun took his place as lead surgeon, Choi Woo-jin immediately at his side. Han Na-hyeok took the opposite side of the table. Kim Jaeyeon stood a little apart, ready to step in wherever he was needed. Cha Da-jeong, on ultrasound, waited as well — during surgery, they would only need the probe in truly exceptional circumstances.
There were many people in the room. The operating room was quiet.
A moment later, Yoo Mu-hwan's voice broke the stillness.
"General anesthesia status: good."
"Medication status: good."
"Heart-lung machine is ready."
"Drugs prepared. Blood products: good."
Transfusion, should they need it, was ready as well.
Lee Jun spoke to all of them.
A simple, clear wish for the surgery to succeed.
"Yes!"
The answer rang through the operating room. Lee Jun continued.
"Beginning mitral annuloplasty and artificial chordae implantation. I'm in your hands."
He bowed his head as he declared the start of the work — a bow that held both his trust in the colleagues around him and his plea to the little dog on the table: hold on.
His colleagues bowed their heads in return. They carried the same wish.
Lee Jun took the scalpel in his hand. Choi Woo-jin's hands moved, drawing Bokshil's chest skin taut and spreading it open — exactly the incision line Lee Jun needed.
The scalpel in Lee Jun's hand drew across the skin of the dog on the table.
Ziiip.
The blade moved without hesitation. The skin parted. Subcutaneous tissue appeared. Choi Woo-jin dabbed the bleeding points with electrocautery, and Lee Jun began blunt dissection of the subcutis.
The subcutaneous layer was richer in capillaries than one might expect. Cutting straight through with the scalpel would save time, but it would also bleed — so he split the tissue as if tearing it, to keep the blood loss down. On top of that, Lee Jun's blade slipped around vessels with such ease that almost no blood appeared at all.
Han Na-hyeok and Choi Woo-jin were assisting. Their movements shifted with every motion of Lee Jun's hands. But no words passed among the three of them. They had operated together so many times that a glance was enough. A cue, and they were already there.
They worked through hemostasis and blunt dissection, and before long the latissimus dorsi came into view. Lee Jun slid the Metzenbaum scissors he had been using for dissection beneath the muscle. He held out his hand without a word, and Choi Woo-jin was already offering the scissors he had waiting. Their movements were as natural as water running downhill.
The latissimus dorsi parted, and the sternum was exposed.
The mitral valve was a structure inside the heart. To operate on it, they had to expose the heart itself — and to do that, they had to cut the sternum that ran down the center of the chest.
"Sternotomy!"
Tension rippled through the operating room. They all knew: once that bone was cut, there was no going back. Everyone went sharp.
Ziiing!
The electric saw came to life, and in an instant the sternum split. Choi Woo-jin used a Finochietto retractor — a toothed device with formidable spreading force — to open the thoracic cavity and secure the surgical field.
Time elapsed so far: a little over ten minutes. It was extremely fast, but the three of them wore expressions as if nothing unusual had happened. It always went this way.
Even as Choi Woo-jin locked the chest retractor in place, Lee Jun's hands never stopped. He split the fatty tissue and thymic remnants above the heart, and the pericardium came into view — a careful touch that never grazed a nerve.
The heart appeared in an instant.
Now came the moment to connect the cardiopulmonary bypass machine: the device that would take blood from the body, oxygenate it, and send it back in.
"Let's connect the heart-lung machine."
"Lines are here."
Cha Da-jeong answered, already holding the tubing connected to the machine.
Tap-tap-tap-tap-tap.
Eom Jin-han struck the fluid lines that would run from the extracorporeal circuit into Bokshil's body with a hemostat, without mercy. It was to knock loose even the smallest bubbles clinging to the tubing, so that no air would enter the blood.
He had done this before the surgery as well. Even so, Eom Jin-han struck them again, shaking out air he could not even see, offering a silent wish for Bokshil's success.
The tapping stopped. Now they had to cannulate — a tube at the site that would receive blood in the heart's place, and a tube into the vessel that would send it back into the body.
At that sound, Lee Jun, Choi Woo-jin, and Han Na-hyeok's hands grew busy. This was the moment each of them had to perform their role without a single mistake.
Lee Jun calmly incised the ascending aorta. Then his brow furrowed slightly, and he spoke.
"The vessel is weaker than I expected."
Han Na-hyeok's face darkened as he brought his scalpel toward the vessel. This was a patient whose heart function had already declined. Everyone had assumed the vessels would be fragile. But for Lee Jun to make that face meant they were far weaker than even that assumption.
"Stay sharp. If this tears, we won't be able to contain it."
Han Na-hyeok's voice was heavy.
"Yes. We have to. Vessels like this can snap if you're not careful."
Lee Jun's answering voice was low as well. He knew that if they lost their nerve here, the rest of the surgery would become that much harder. And he knew, better than anyone, how easily vessels like this could tear.
There was another reason both their faces had gone grim. If the vessels had weakened this much, the valve and the chordae would be even more fragile than they had planned for. That would send the odds of success plunging. That was why the two of them had gone dark.
For a moment, the thought crossed Lee Jun's mind. What if I wrapped it with a vascular graft?
But here? Now? They didn't even have an artificial graft. How would that work?
There wasn't time to harvest one, either. If the vessels here are like this, the ones in the thigh won't be any stronger. It's useless. Before the question of time, the bigger problem was that there was no healthy vessel they could use as a graft.
We've already opened the chest. Standing here thinking about it won't help. Staring at it isn't going to make the vessel any stronger. Getting the heart in front of him beating again was the work these hands had to do. Standing still was a waste of time.
Start even a second sooner. Together with everyone in this room. And get this little one on the table — Bokshil — back on her feet.
Lee Jun thought of Bokshil, who had never lost her smile, even in the moment she was being anesthetized. If this was the same Bokshil who had promised herself she would get well after the surgery, she would hold on.
Lee Jun found his composure again.
"Even so, I think we can still make the connection."
"Yeah. I think she'll hold. Eom, you're going to have to be extra careful."
Meaning: when they ran the heart-lung machine, keep the pressure on the vessels as gentle as possible. Eom Jin-han answered.
"Yes!"
A voice with force behind it.
The moment Lee Jun gathered his will, the atmosphere in the operating room shifted. Lee Jun's hands moved, and Han Na-hyeok continued the surgery. The touch was meticulous, but the speed was still fast.
Han Na-hyeok and Choi Woo-jin's hands flew as they incised the vessels for cannulation. In the blink of an eye, the heart-lung machine was connected to the vessels, and Lee Jun spoke.
"Connected."
"Same here."
"Done."
Sweat beaded on Han Na-hyeok and Choi Woo-jin's foreheads as they said it.
"Hoo."
"Whew."
The two of them, who had been holding their breath, let it out. In that moment, Lee Jun's gaze was on the tubing that linked the machine to the heart.
From now on, the machine at the other end of those tubes would circulate blood and oxygen in place of Bokshil's stopped heart and lungs. Lee Jun's eyes were sharp as he checked the connections. If the connection was inadequate, Bokshil would never breathe again.
Satisfied, he turned his gaze to Yoo Mu-hwan.
"Vitals are stable."
Yeo Un-hyeok followed.
"Fluids are running well. Preparing cardioplegia."
Cardioplegic solution rapidly arrested a beating heart during cardiac surgery, protecting the myocardium.
"Heart-lung machine status: good."
This time it was Eom Jin-han, in charge of the cardiopulmonary circuit.
Every preparation to stop this small heart was complete.
In that case…
Lee Jun spoke.
Eom Jin-han answered with the same words.
In that instant, Lee Jun's nerves went razor-sharp. This was the moment blood flow changed abruptly — the pressure differential could rupture a vessel. If that happened, there would be no going back.
Tension hung thick in the air as the hoses mounted on the circuit began to fill with red.