The Surgeon’s Factory
Archbishop Raymond Lailic. To summarize his life: he began his service as a military surgeon on the Western Front. Recognized for his outstanding performance, he rose through the ranks to become the Chief Military Surgeon and eventually the Imperial Personal Healer. Five years into that role, he petitioned the Imperial Court to allow him to care for the common people, following the will of the Divine. The Emperor granted his request, and he took the position of Archbishop, overseeing all clinics and cathedrals in the capital. The public called him "The Most Faithful Servant of the Lord."
Archbishop Raymond quite liked that nickname. Whether he was kneeling in the mud of the Western Front or on a silken carpet, he always held one belief in his heart: "The servant of the Lord must always be among the Lord’s flock."
His life was, metaphorically, that of the eldest son who worked most faithfully in the Divine’s courtyard. The scriptures said the eldest son must help the father and protect his siblings. The fine clothes and abilities bestowed upon the eldest were given by the father for that very purpose. Thus, he had lived a life of serving others, always guarding against pride. The scriptures also said the eldest son does not demand wages; it is enough for him to guard his father’s house. So, he had lived a life pursuing the Divine’s will rather than wealth. Raymond had always tried to live according to that will, and he took pride in the fact that he was doing so.
It was five years ago that he first heard the name "Director Shun." A man in a crow mask who kept performing healing miracles that other healers could not. At first, the Church’s reaction was one of caution. Someone not affiliated with the Church was encroaching on their territory. But Director Shun immediately began supplying all the medicine he created exclusively to Church-affiliated healers.
— "Medicine can be poison depending on how it is used. Our guild will strictly manage it so that those who are not professional healers cannot handle our drugs."
Director Shun passed on every technique he developed solely to the Church’s clinics. The Church immediately dropped its guard. The man they thought would be a rival to healers was, in fact, their staunchest supporter. Since then, Director Shun’s actions were a continuous string of goodwill. Whenever he developed a new drug, he requested cooperation with the Church. He hired displaced healers for his clinics and opened his own wallet to provide treatment to the commoners. He taught countless secret techniques—which would have been perfectly normal to keep as family heirlooms—without any conditions. There was no reason for the Church to dislike Director Shun. Before long, caution turned into gratitude. As a healer and an Archbishop, Raymond admired and respected Director Shun. But at the same time, he was jealous of him.
'Why him?'
He had always been the faithful servant and the eldest son of the Lord. He believed that because he served the Divine so diligently, the Divine had bestowed such abilities upon him. But Director Shun was different. He had never sat at the Church’s table. He had never once spoken the name of the Lord. He had never knelt in the sanctuary, never opened a prayer book, and never practiced fasting. Yet, the Divine… 'How could You bestow such abilities upon a man like that, rather than upon me and the priests who have offered prayers our entire lives?'
It felt as if the Father, the Divine, loved Director Shun more. And so, the Archbishop was jealous of Director Shun. It was like the envy of an eldest son who had lost his parents' love to his younger brothers. 'I have prayed for over fifty years. Is this vessel still in this state?' Whenever he felt this, he would often place a hand on his chest and lament. After the lament, he would, as always, cover the place where the envy had been with prayer, feeling ashamed of his own pettiness.
Then, one day.
'Triage… is it….'
News arrived that the subjugation expedition had suffered devastating losses due to a variant monster. As the Archbishop, Raymond hurriedly sent letters of cooperation to other clinics. By the time he had secured the cooperation of all the clinics and checked the clock, two hours had already passed. 'I must hurry.' He urged his aged body and climbed into the carriage. On the way to the North Gate, he heard about the situation on the ground from his attendant priest.
"Director Shun is leading the clinic healers and holding the line on the field in our stead."
That man again. "And he has proposed a new classification system called 'Triage' there."
Triage. A classification system completely different from the existing one. In the old system, priority for the wounded was determined by rank and title. It was a strategic decision based on the belief that the life of one 1st-class individual was more valuable than the lives of three 0-class individuals. But Director Shun’s Triage presented a completely different standard. Prioritize those who are in more urgent need, rather than those who can hold out. Prioritize the 0-class who might die soon over the 1st-class who won't die immediately.
The logic of this method was simple. Change the order. And do not give up on either the 0-class or the 1st-class. It was a perfect answer, strategically, doctrinally, and academically. It made one wonder why no one had proposed such a method until now.
'Why haven't I thought of something like this until now?'
The feeling of jealousy reared its head again. He wanted to make this achievement his own. A method came to mind. It was a simple matter of having the command transferred to him in the name of the Archbishop. If he took command on this field, history would record the name of Archbishop Raymond, not Director Shun, as the one who applied Triage in the field. History and records were bound to focus on what was visible. As an Archbishop who had studied the scriptures, he knew this fact well. But.
'Good heavens…. The viper is raising its head again.'
He shook his head, shaking off the temptation. It was something he must not do. It would disappoint the Divine as an eldest son and a servant. He steeled his heart. 'On this field, I must be nothing more than a healer.' While he was coaxing himself, he arrived at the scene. The scene was, literally, a living hell. Insufficient manpower. Insufficient resources. Yet, the healers and rescue workers were struggling. Repenting for being blinded by ambition once again, the Archbishop headed toward the guild building.
"Move! Move out of the way!"
"This is the Church’s healing detachment! Please open the way!"
Walking through the path opened by his attendant priests, the Archbishop stepped into the guild building. And when he entered the building, he finally saw him. The man with the crow’s beak—Director Shun.
'This is my first time seeing him in person.'
The Archbishop suppressed the surging emotions and spoke to Director Shun. "I heard a rough account from the other healers on the way. Triage, you say. It is truly a magnificent classification system."
— Hand over the command to me.
That sentence was rising to his throat.
— I am the Archbishop of the capital diocese.
— I am a former imperial personal healer.
— I want my name to remain on the first page of this historic moment.
— Because I have dedicated my whole life to this.
— Because I am growing old.
— Because I want to remain in history.
Suppressing the ugly ambition, he uttered the next words. "Is there anything I should do here?" Having asked, he felt relieved. He had managed not to fall for the temptation again today. But the next moment, Director Shun made an unbelievable proposal.
"Archbishop."
"Please, speak."
"In that case, would you mind taking command of the field classification from now on?"
"—?"
Raymond stopped breathing for a moment. Had Director Shun read his mind? The Archbishop couldn't help but ask. "…Then what about you, Director?"
"It seems I need to return to my main line of work."
The crow’s beak pointed briefly toward the red and black flags. The Archbishop couldn't continue for a moment. His heart wanted to accept immediately. It was a chance to leave his name in that historic moment. But as a religious man, he couldn't accept it out of ambition. So, he refused once. "Director. I don't know the reason, but I don't think this is a position for me. You created this classification system, so wouldn't it be right for you to continue to take command?"
"No. I created the classification system, but I am lacking in too many ways to apply it to reality."
However, the Director’s attitude was firm. "I don't know how far healing magic can reach. That is because I cannot use holy magic. My field of vision is not very wide either. I have no experience commanding on the battlefield, and I don't properly know how to distribute resources."
This was his sincere truth. He had managed to command the field somehow until now, but that, too, had reached its limit. Director Shun knew well how lacking he was as a Triage Officer. His Triage classification system was based on 21st-century South Korea, where there was no holy magic. But in this situation, that standard was not correct. Equipment, manpower, the miracles that could be used. The classification criteria were different in every aspect.
"I could create the draft of Triage, but completing it is impossible. That is why I need the Archbishop’s help."
The Triage Officer needed here was not a 21st-century doctor. What was needed was someone who had experienced countless battlefields in this world and had led numerous healers. "And, as expected, it is in my nature to save people with my own hands."
But there was one biggest reason. It was because the role of a treatment team leader was where he could truly shine more than as a Triage Officer. "So, Archbishop, please classify the patients in your own way. I will save the people under the red flag."
"…."
The Archbishop looked at Director Shun in silence for a while. 'I misjudged the man.' He had thought of him as merely a lucky genius. He had even harbored jealousy, wondering why the gods gave this man greater abilities than himself. But, 'Did he not even need to belong to the Church?' Now he felt he understood. Why the gods had bestowed such genius upon him. Philanthropy. Director Shun was naturally practicing the very spirit that the doctrine emphasized so much.
Hierarchy, fame, title. The nobility of wanting to save people purely, without any interest in the things of the mundane world. How could one not respect such nobility? He now understood why the gods loved him. It didn't matter that he was a man outside the Church. It must mean that the gods wished for him to achieve something outside the Church.
"…I understand, brother."
The jealousy melted away like snow. In its place, pure respect filled the void. "I will take command of the field. May the will of the Divine be with you, brother."
* Julian — Before Director Shun changed his position to treatment team leader, he asked the Archbishop for a few facts. "Now that the criteria have changed, the Archbishop and the healers must re-classify them."
"I understand, brother."
Triage is a very fluid classification system. It was not strange for patients to move between yellow and red depending on the situation on the field. "Classification must be re-done at least once every 10 minutes."
Also, the Triage Officer must periodically re-check the patients. A patient who was yellow could suddenly deteriorate, and a red patient could become yellow after receiving treatment. This was also why it was difficult for Director Shun to focus on healing. Classifying, healing, commanding, re-classifying. Among them, this re-classification work was particularly holding him back. But now, that too was over.
"Lastly, this is the most important thing." Director Shun pointed to the black flag. "Before classifying them under the black flag, if they are still breathing, please contact me once."
"Yes?"
"I trust the Archbishop’s judgment, but even so, I do not want to give up on a patient I can save."
"That means…."
"It means that the patients who appear red in my view should be sent to me."
It was a bold declaration. It showed his confidence that he could save patients that other healers had to give up on. "Are you sure?"
"I have handled even worse patients than this."
Julian was confident. Obstetrics, Pediatrics, Internal Medicine. These were not his specialties. That was why he had relied on the grammar of the "misunderstanding" trope. But Trauma Surgery was different. 'This is not a misunderstanding.' He had even performed surgery on a patient with a bullet lodged in their heart. And that was in a world without the miracle of holy magic. How much more so in a world where miracles existed?
"So, even if they look hopeless, please contact me once."
"I understand, brother."
"Then I will be preparing at my clinic."
Director Shun left those words and headed to D-Sector, where his clinic was located, along with the students he had brought. Afterward, Archbishop Lailic began classifying patients with his attendant priests as a Triage Officer. "Send this yellow patient to the 3rd Sector Plenirunium Clinic."
"I hear there is space at the 2nd Sector Reinfeld Clinic. Send 3 wounded there."
"Contact the Merkur Clinic in E-Sector and tell them we are sending 2 people."
When the wounded arrived, he classified them first, transported them to clinics in order of urgency, and if necessary, treated them on the spot with holy magic. There were healers who worried whether Archbishop Lailic could replace Director Shun, but as if to dispel those worries, the Archbishop successfully performed his role as a Triage Officer. In fact, his command was even smoother.
"Cast a high-level heal on this patient and classify them as green."
"Everyone, rotate with those in the prayer room. Those who haven't exhausted their holy power, go as well."
Unlike Director Shun, he actively incorporated holy magic into Triage. This was because distributing the limited resource of holy power was something he had done until he was sick of it on the battlefield. The Archbishop also felt quite proud. Although he was just adding a spoon to the table, he was able to add the experience he had accumulated onto the foundation Director Shun had laid. It was in the middle of the wounded being handled with such vigor.
"This person is…."
While re-classifying, the Archbishop’s gaze lingered for a moment on a patient under the black flag. A patient with a large claw mark carved into their abdomen. Through the open wound, intestines were spilling out. If he used Regeneration, he could save them. But if he did that, he would have to give up on 100 patients who could be saved with a high-level heal. That was why he had classified them as black, but….
'If it were Director Shun….'
He harbored hope and contacted the D-1 Trauma Specialist Clinic. A reply came back immediately.
— [Up to 3 people is fine.]
If any other healer had answered like that, he would have scoffed. That they had holy power to rot. That they had lost their minds in their youthful vigor. But because Director Shun said so, it didn't sound like a bluff. The Archbishop’s deliberation was not long. "Re-classify all black-flag patients with injuries like this to red, then send them to the D-1 Clinic."
The Archbishop’s heart was pounding as he said that. Along with the hope that the tragedies he had had to give up on until now on the battlefield might become stories of the past starting today.
*** Inside the D-1 Clinic. Before the trauma patients sent by the Archbishop flooded in, I quickly gave instructions to the healers under my command. "First, apprentice healers, when a patient enters, focus on casting low-level heals to maintain their lives as much as possible until surgery. And for anesthesia before surgery, use chloroform."
Chloroform. Following cocaine, it was the second anesthetic I was introducing to this world. The time when chloroform was created was quite a while ago. During the Octagon incident in the past, the anticonvulsant I used when managing the Count’s newborn was the brother of this anesthetic. The name of the anticonvulsant was Chloral Hydrate. It was an anticonvulsant that was born by accident while I was trying to make an anesthetic. And as a result of repeated improvements to that anticonvulsant, the anesthetic I had desired was completed.
"You must finish preparing the patients for surgery before I begin. Time is life, so I ask for your cooperation."
"“Yes!”"
The healers prepared to welcome the patients who would soon be flooding in. And in the midst of that chaotic situation, I nodded to Ayla. "Student Ayla, how much more Refresh do you think you can use?"
"I'm not sure, but I think I can use it as much as my strength allows."
"Good. Then you come into the operating room."
Ayla, who still had plenty of holy power, went into the operating room. Her friends who had exhausted their holy power also had work to do. I took one friend to assist in the operating room, and the remaining three were attached to the side of each healer in the emergency room. In a situation like this, no matter how many hands you have, it’s never enough.
After Ayla stood like a folding screen in the corner of the operating room for a few minutes, the patients sent from the field flooded into the D-1 Clinic. "Director, we have a patient! 30-year-old male, multiple penetrating wounds and lacerations to the abdomen caused by monster claws. In particular, 4 deep lacerations are confirmed in the right upper quadrant and left flank, and a significant portion of the small intestine has prolapsed outside the abdominal cavity." Healer Kou briefed quickly. Originally, he was in charge of diabetes. But it wasn't that he couldn't see other patients. From the start, all healers in this clinic had to go through the emergency room as a basic requirement. That gentleman had also worked with me in the emergency room once. So, I made him a tie (surgical assistant).
"Extensive bruising and swelling that appear to be blunt trauma are observed on the back, which are traces of hitting a wall or floor hard while being blown away. Consciousness is clouded, and there is no massive leakage of intestinal contents yet, but the possibility of claw fragments remaining in the abdominal cavity is very high. There is a high risk of rapidly progressing to multiple organ failure."
"It’s been a while since I worked with Mr. Kou. As expected, the briefing is clean, so I like it."
"Thank you, Director."
"I will perform a laparotomy immediately."
As soon as I confirmed that the patient was anesthetized, I prepared to cut the abdomen. There was one thing to do before that. "Ayla’s friend. What was your name?"
"It’s Joel, Director."
"My hands aren't free right now, so I need someone to do a timeout. Could you record the time?"
"Understood!"
"Then I will perform a timeout. 30-year-old male, 9:14. Then I will begin the surgery."
First, I didn't force the prolapsed intestines back in, but wrapped them in gauze soaked in water and gathered them on the right side. Afterward, the scalpel began to cut the patient’s abdomen.
"Student Ayla. Refresh."
"Yes. I will cast Refresh."
The small bleeding that occurred when cutting the abdomen was stopped by her Refresh. Originally, I would burn the flesh with a Bovie (*electric cautery) to stop the bleeding. But here, I substituted it with Refresh. This saved 1 minute.
"Mr. Kou, please aspirate the blood. I will do the Packing."
"Suction."
While Kou sucked out the blood pooled in the abdomen, I pushed 4 pieces of gauze into the abdomen. Each in the upper right, upper left, lower right, and lower left. Since serious bleeding often occurs in these areas, I pressed them with gauze regardless of whether I could see it or not.
"Heal. Low-level. Not blood vessel regeneration, just hemostasis."
"Heal."
Usually, time is needed to press with gauze and wait for hemostasis. But that was skipped with a low-level heal. This saved 3 minutes.
"I will evaluate the interior. 2nd-degree splenic rupture, liver right lobe laceration. Confirmed blunt trauma to the back and related arterial rupture. Confirmed lacerations in three places in the small intestine. I will perform the spleen first."
Do I have to remove the spleen? It’s a bit of a waste to remove it for only a 2nd-degree rupture. "First, I will check the holy magic reactivity. Student Ayla, Refresh."
"Refresh."
There was no reaction. Unfortunately, I had to cut it out. If I had lingering attachments and the patient crossed the Jordan River, it would be putting the cart before the horse, so I immediately began the resection. After lifting the spleen gently, I tied the blood vessels. After double-ligating the splenic artery and vein respectively, snip. The small bleeding in the middle was immediately stopped by Ayla’s Refresh. 'It’s annoying to catch these small bleedings. This is so comfortable.'
This is why I adore Ayla. So what if she can only use Refresh? Originally, these micro-bleedings are quite annoying when performing surgery. But it’s a waste to use a heal for these micro-bleedings that could just be pressed with gauze. However, when Ayla is there, the story changes. Since I have never seen her holy power exhausted, I can ask for Refresh without hesitation. Thanks to that, the spleen resection that would take 15 minutes was handled in 10 minutes.
"Spleen resection complete. Now let’s treat the aortic rupture. Give me the Bovine pericardium patch."
The assistant healer handed over something like a bandage. A Bovine pericardium patch. It is a bandage made by processing the heart membrane of a cow. With this, I can patch up a torn aorta or heart. It was also an item I enjoyed using in my past life. Snip, snip. After cutting the bandage to fit the torn aorta, I stitched it with thread. And this time, a heal.
"Good. I treated the aortic rupture as well."
Already, two serious problems were solved in a snap. Next, the liver and small intestine. These two were not difficult either. Put in gauze, cut off the parts that were impossible to save. And heal. With this, all bleeding was blocked.
"Now let’s wash it."
After rinsing the inside of the abdomen once with holy water, "I will perform a Temporary Abdominal Closure. Give me the Gutta-percha."
Gutta-percha. I began to apply heat to the sheet made of tree sap. I covered the open abdomen with the sheet that had become mushy due to the heat and fixed it with thread. The reason I didn't close the abdomen was the same reason I didn't put the skull back on in a craniotomy. Right now, the organs inside the abdomen are swollen. If I close the abdomen in this state, the organs will push against each other and necrotize inside. So I leave it open like this and add something on top. At least until the swelling goes down.
"Let’s do the reconstruction surgery in 3 days."
I postponed the surgery to reconnect the cut intestines until a few days later. Surgery is an act that puts a burden on the patient’s body. If I did everything from hemostasis to reconstruction in one day, the patient might not be able to endure it. Therefore, today, I focused only on keeping them alive. A so-called Damage Control Surgery. It is a surgical method spread by a GOAT professor of trauma surgery in 21st-century South Korea.
"Now, I will finish the surgery. Student Joel. Please sign out."
"…Yes?"
"I will do it. 9:35. Surgery time 21 minutes."
All the healers in the room except Kou stared at me, having lost their souls. They probably didn't expect me to save a patient who needed the miracle of Regeneration in just 20 minutes. And that, only with low-level heals and Refresh.
In the midst of those gazes, I savored a moment of intoxication. 'Look. If I focus only on treatment, I can save someone even if their stomach is blown open in about 20 minutes, right?' That was why I told them to classify such patients from black to red. Originally, a surgery that would take 40 minutes is cut in half if you have holy magic. And even that is enough if you only have low-level heals. There is no reason to give up.
"Teachers, please finish up this patient. Mr. Kou, Student Ayla, and Student Joel, move to the next operating room."
If I run the operating rooms like a factory here, I can save even more time. Because of the keyword "factory," a negative image of a factory-type hospital might overlap, but it is unexpectedly a formal operating method for trauma surgery. Staggered Operating. It is a surgical room operating method used in trauma medicine. While surgery is in full swing in one room, they start preparing for the next surgery in another room. And I go into the next room and get the baton passed to me, and the preparation team moves on to the next patient and starts preparing again. If I do this, I can save about another 10 minutes. For a patient where every minute and second is precious, this minor detail often greatly improves the survival rate.
"Student Ayla, change your surgical gown and come to the next operating room immediately."
I urged the healers who were staring, having lost their souls, and moved to the next operating room. And in the next operating room, I shuddered shallowly at the cool sensation felt at my fingertips. 'Yes. This is the taste.' This cool and heavy sensation. As expected, people should eat and live by doing what they are good at.