The brilliant eyes of the two doctors with the patient about to undergo surgery before them.
But even shining eyes have many kinds.
The eyes of Choi Moo-gyeol and Park Seok-hun had different feelings.
For example, in Park Seok-hun’s eyes, there was a slight tension, and the zeal to absolutely save the person.
The hand that trembles minutely before every surgery.
Park Seok-hun looked at his own hand and took a deep breath.
This is a kind of tension.
The sensation that a person’s life depends on my hand.
But he did not exactly dislike this sensation.
Only when there is an appropriate tension does concentration rather rise to the maximum during surgery.
Park Seok-hun was that kind of doctor.
A cautious type of doctor who believes excessive confidence often ruins surgery.
Meanwhile, Choi Moo-gyeol’s eyes were quite different from his.
Fear of surgical failure?
He does not even think of such a thing.
What fills Choi Moo-gyeol’s eyes is rather close to anticipation.
Anticipation for a new surgery.
Because he is a neurosurgeon who mainly operates on the organ called the brain, it is easy to mistakenly think he always sees the same brain.
But the detailed flow of cerebral veins and cerebral arteries differs from patient to patient. Even if the large trunks are the same.
The shape of the skull, and the volume and ratio of the brain, are also different for each person.
Exploring the mysteries of such diverse brains is always an interesting thing to Choi Moo-gyeol.
What specialness will today’s patient have?
What new discovery will be found in the surgery?
The only moment when his indifferent eyes shine sparkling with anticipation is right now.
The two took one deep breath each, then entered their respective operating rooms.
Whirr—, clank.
When the operating room door closed, the noise outside was cut off as if with a knife.
This place is like a battlefield where only the doctor, the patient, and the disease confront one another.
“Shave the patient’s head.”
“Yes. I will begin shaving.”
Whirr—.
The first assistant cleanly shaved the hair at the surgical site.
Under the light of the surgical light in the operating room, the patient’s head after shaving looked especially pale blue.
It is precious hair for a woman in her twenties, but hair cannot be more important than life.
Because hair will grow again, but once life is lost, it is over.
‘Now the question is how much to incise.’
Choi Moo-gyeol looked at the monitor displaying the patient’s brain CT images.
Inside the head, a white pattern spreads long and wide like a crescent moon. That is the subdural hemorrhage site.
‘She strongly hit the front and side windows from the driver’s seat. So part of the brain has been pushed slightly out of its original place.’
“Good.”
It did not take long to decide the incision site.
“We’ll go with a fronto-temporoparietal incision.”
Fronto-temporoparietal refers to the frontal, temporal, and parietal lobe region.
In other words, it is an anatomical term that bundles together the frontal lobe (Fronto), temporal lobe (Temporal), and parietal lobe (Parietal).
It means he will incise the skull region spanning the three areas.
The first assistant, who had a question, said.
“Opening all three parts seems a little different from the surgical method you usually use, Doctor.”
“Hm?”
“I thought you originally liked the method of opening narrowly with minimal incision to reduce damage to the patient……”
“Now we need to open widely. Do you know why?”
A question thrown by a skilled senior doctor at the site of emergency surgery.
If someone who doesn’t know sees it, they might wonder if there is time to exchange questions in an urgent situation like surgery.
However, surgery is always a real combat zone and at the same time an educational site.
All doctors go through a beginner period. For such beginner doctors to develop into veteran doctors, countless repetitions of surgeries like these are necessary.
Of course, there are humans like Choi Moo-gyeol who are good from the start, but that is because Choi Moo-gyeol is peculiar.
Beginner doctors assist veteran doctors, receive questions, and actually accumulate experience, gradually becoming veterans.
In other words, each surgery like this at a large hospital is an excellent educational experience.
So a senior’s question does not end as merely a question.
It can be said to be, soon, education and at the same time a lecture on medical skill for the junior.
The first assistant answered after a moment of thought.
“It must be because you intend to find the bleeding point quickly, right?”
“Fifty points.”
“Ugh…….”
“If I open narrowly. Do you think I would fail to catch the bleeding point and wander? If that were the only reason, I wouldn’t incise this widely.”
“Then if there is another reason……”
“What is the brain’s condition right now?”
“It’s swollen…… Ah, I understand what you mean.”
The reason this case is not a surgery that can be finished with a small incision or minimally invasive method.
The patient Park Sang-mi is in a state where the brain itself received impact and is severely swollen.
Removing the blood alone is not enough.
They must create space and lower the pressure quickly to reduce additional brain damage.
To do that, they must open the skull widely and create enough spare space for the brain to breathe.
The first assistant also had skill, so he understood immediately.
This kind of short exchange helps beginner doctors properly handle similar cases in the next surgery.
Swish swish—.
Choi Moo-gyeol picked up a skin marker and drew a bold line on the patient’s shaved head.
“Prep the patient’s surgical site.”
“Yes. I will prep it.”
Following Choi Moo-gyeol’s instruction, the scrub nurse widely applied Betadine, a disinfectant, to the patient’s surgical site.
The purple line left by the marker was clearly visible even under the red disinfectant.
Those lines clearly marked the expected incision site that Choi Moo-gyeol would perform.
A blue perforated drape was placed over the exposed patient’s scalp.
Only the incision line is clearly visible.
The anesthesiologist said.
“The patient’s vitals are being maintained stably. Surgical preparation is complete.”
“Let’s begin.”
“Yes.”
“Yes, Doctor.”
Choi Moo-gyeol received the scalpel.
The blade touches the patient’s skin without hesitation.
Slice—.
The skin opens without resistance.
Choi Moo-gyeol’s hand was astonishingly stable.
The scalpel follows exactly the line drawn by the skin marker, without any shaking or trembling.
There is a sense of speed peculiar to emergency surgery, but there was no feeling of haste at all.
‘Astonishingly fast yet precise.’
Such a thought rose in the minds of the assistants and nurses.
It was a surgery they always saw, but still, each time they saw it, admiration burst anew.
To compare it to a martial arts novel, like a sword god who reached the extreme of the sword.
It was precise cutting without a single inch of deviation.
Swish—.
The skin and subcutaneous tissue opened, and the scalp was peeled back, leaving only a part of the edge.
Then the snow-white skull was revealed.
“Drill, from the perforator.”
“Yes, Doctor.”
At Choi Moo-gyeol’s words, the nurse prepared the medical drill.
Click—.
The nurse attached a perforator with a blunt tip to the handpiece and handed it to Choi Moo-gyeol.
“Set the RPM to seventy-five thousand.”
“Yes, Doctor.”
After the nurse adjusted the machine’s RPM and powered on the drill.
Whirr—.
The high-frequency sound made by the blade rotating at high speed is sharp.
Choi Moo-gyeol, with shining eyes, brought the high-speed rotating drill close to the patient’s exposed skull.
At a glance, he could look like a psychopath.
Krrrgh—.
The unpleasant sound produced as the power drill bored into the skull.
At the same time, pale skull powder flies like dust, and a hole is drilled.
The tip of the drill, called a burr, stops exactly at the point of penetrating the skull.
Choi Moo-gyeol’s hand moved so precisely that a safety device was unnecessary. Of course, the drill had a safety device to prevent touching the inside of the meninges, but to the extent that the function was unnecessary.
“Suction.”
Following the instruction, the first assistant sucked up the bone dust. The breathing in today’s surgery matched well.
One hole, two, three, increasingly more.
“This should be enough. Craniotome.”
Click—.
The blade attached to the handpiece is replaced.
Whirrr—. Grrrk—.
The craniotome cuts out the large area between the holes made by the perforator. Like a kind of small power saw.
“Switch to the angle attachment.”
Click—.
“Here it is.”
“I’m lifting out the skull, everyone focus.”
“Yes, Doctor.”
Snap—.
When Choi Moo-gyeol applied force, along with a sound like dry wood breaking, the skull incision separated from the rest.
At that moment.
The medical staff in the operating room simultaneously held their breath.
Bulge—.
Because the dura mater, which had been pressed by the skull, rose tautly.
Like a balloon.
There are three layers of membrane that protect the brain from impact. From the outside, they are called the dura mater, arachnoid mater, and pia mater.
Right now, the outermost membrane is swollen with blood pooled inside.
“The pressure pushing up from inside is stronger than expected.”
“There seem to be more bleeding sites than we thought.”
“Yes, that means the vascular damage is extensive.”
Choi Moo-gyeol’s eyes became even sharper.
The fact that the meninges swelled to this degree means that something like a war is happening inside.
“Scalpel.”
Choi Moo-gyeol carefully cut the surface of the dura mater in a cross shape and opened it.
Whoosh—!
The pooled blood poured out as if bursting.
Bleeding of a threatening color, like a black wave, was bringing the patient’s life into danger.
“Suction!”
The first assistant quickly pushed in the aspirator and began sucking up the blood.
Blood that had burst out from blood vessels throughout the brain torn by the traffic accident.
That blood filled the space between the dura mater and arachnoid mater, pressed on the brain, and eventually made even the patient’s consciousness cloudy.
If they suck up the blood that is the main culprit, the pressure on the brain can be reduced.
However, the problem now was not only blood.
In this patient, beneath that flooding blood, something called a ‘blood clot’ was hidden.
A blood clot refers to blood that has escaped from blood vessels and undergone coagulation, hardening like a lump.
In short, a clot of blood.
It is the main culprit directly pressing on the patient’s brain.
“Give me forceps.”
“Here they are.”
Before the medical aspirator could even suck up all the blood.
Choi Moo-gyeol began removing the blood clots beneath it one by one by moving micro forceps.
Thunk—.
The blood clots hidden beneath the blood are pulled out one by one.
‘Can he see them?’
Thunk—.
The blood clots fall with a sound onto the kidney basin held by the nurse.
‘How on earth is that possible? I can’t even see well because the blood obscures the view.’
The first assistant had performed surgeries with Choi Moo-gyeol for a long time, but it was still mysterious every time this happened.
The technique of accurately removing blood clots in an area obscured by blood.
Moreover, without additional damage to the patient’s body.
It was no exaggeration to call it truly a divine skill.
‘Could it be…… that he memorized exactly the positions seen on the CT earlier and is applying them in reality? But there’s no way he could memorize two-dimensional images and transplant them directly into three-dimensional reality…….’
The first assistant could only understand it that way.
‘……But this is Doctor Choi Moo-gyeol.’
He wanted to learn as much as possible from that person, that thought followed.
‘Of course, I don’t know if I can follow even that level of skill exactly.’
