Chapter 111

“Ha, but…….”

Jaewon looked into the hole Baek Kang-hyuk had just drilled into the skull.

Just as Kang-hyuk said, there was no sign of bleeding anywhere inside.

‘The worst-case scenario…….’

One of the easiest causes of increased intracranial pressure to resolve was bleeding.

Of course, even if bleeding was the cause, if too much time passed, treatment was often difficult.

But compared to general brain swelling causing increased intracranial pressure, bleeding was a much better situation.

“But, well.”

Kang-hyuk replied confidently, almost as if he were someone a little lacking in medical knowledge.

Because of that, Jaewon started to wonder if he was misunderstanding something.

‘No, that’s not it.’

No matter how many times he thought it over, this was basic knowledge.

It was something any doctor should know, even if they weren’t in neurosurgery or neurology.

“Is there…… any point? Can this…… really resolve swelling this severe?”

Jaewon pointed to the brain tissue that was trying to force its way out through the artificially made hole.

Even with a hole made in a flat part of the cerebral cortex, this was the result.

That meant the [herniation] through the original opening would be even more severe.

( T/N: ‘the abnormal protrusion of an organ or tissue through an opening, especially the displacement of brain tissue due to increased intracranial pressure’ )

Beep beep.

As if to back up Jaewon’s words, an alarm sounded on the monitor.

It meant the blood pressure was dropping even further.

Yet the heart rate remained unchanged.

That meant the body’s ability to compensate was completely lost.

In a situation where increased intracranial pressure was present, there was only one thing this finding indicated.

“Brainstem herniation…… it’s in progress…….”

( T/N: ‘a life-threatening condition in which the brainstem is abnormally displaced due to increased intracranial pressure, often resulting in loss of vital functions’ )

Jaewon said, glancing between the monitor and Kang-hyuk.

At the mention of brainstem herniation, Kang-hyuk’s face stiffened slightly.

Of course Kang-hyuk knew.

He knew far more than Jaewon and had much more experience.

He just didn’t know how to give up.

“Still, we have to do what we can.”

‘Do everything a doctor can do.’

It was one of the things Kang-hyuk often muttered out of habit.

And something he kept as a rule to live by.

Jaewon, who saw himself as Kang-hyuk’s disciple, also tried his best to follow it.

But today, a surge of emotion welled up.

“What’s the point in doing what only we can do for a hundred days, a thousand days?”

So he finally let out a thought he had always kept in his heart.

“What are you talking about?”

Kang-hyuk asked, even though he could already guess what Jaewon was feeling.

All the while, his hands were already busy, turning the patient’s waist slightly.

No matter how the argument with Jaewon went, his plan was to make a hole in the spinal cord.

He doubted how much this would help, given that brainstem herniation was already in progress.

But he was the type who couldn’t rest easy unless he tried everything possible with the patient in front of him.

Jaewon didn’t bother to stop what Kang-hyuk was doing.

Instead, he lightly assisted with positioning and answered.

“At the hospital, they always complain about too many deficits, and this time, to be honest, even the staff addition was basically achieved through Professor’s half-trickery, wasn’t it?”

“Half-trickery? You brat. The agent is right here, you know.”

“Did I say anything wrong? If we had done it the normal way, they would’ve cut staff, not added.”

“They did add staff. What’s the point of saying that?”

Normally, you’d have to position someone in the fetal posture to find the space between the vertebrae, but Kang-hyuk just found it right away.

His fingertips were almost as sensitive as his abnormal eyesight.

Jaewon watched as Kang-hyuk pressed down on the spot with his index fingernail and continued speaking.

“And just look at today. Even the country doesn’t care. The helicopter? An official document, really…… how does that make sense? If you think about it, the patient’s condition worsened just because there was no helicopter. If the helicopter had come on time…… there might have been a chance.”

Every condition has a golden hour.

There were some differences depending on the illness.

For the brain, it was usually at most an hour, as little as twenty minutes.

“So what are you trying to say?”

Kang-hyuk asked, cleaning the spot he had marked with Betadine.

Jaewon helped him as he answered.

He looked furious, but he didn’t neglect his duties.

After all, he was a doctor.

Someone who valued life.

“I’m just saying…… how much does it really mean for us to give our all, just the Severe Trauma Center, when everyone else has given up? Today, at least, the nearby fire station helped, but that’s not the norm. If it had just been us, we wouldn’t have even been able to get the patient out of there.”

“Mhm.”

Kang-hyuk let out a low sound in response.

Normally, he would have told him to shut up and punched him.

But today was different.

‘It’s understandable to have complaints.’

It was kind of funny to think this way when he’d only lived as a trauma surgeon for a few months.

But, honestly, just one day in the Severe Trauma Center was enough for anyone to think this way.

You didn’t need to be especially observant or attentive.

Neglect toward severe trauma patients was just that rampant.

“Jaewon.”

So Kang-hyuk called Jaewon’s name in a very quiet voice.

Jaewon realized it was almost the first time Kang-hyuk had called him by his real name and nodded hurriedly.

“Y-yes.”

“Let’s talk about that later. I’ll buy you a drink.”

“Drink……?”

For Kang-hyuk to mention drinks.

This was someone who almost never even ate meals together, let alone had company dinners.

‘Is he planning to kill me without anyone noticing?’ (T/N: See what you did Kang-hyuk? They no longer think like a normal human beings lol.)

A strange sense of foreboding tangled up Jaewon’s thoughts.

Still, it was too rare an offer to refuse.

“Gangster, you come too.”

“What? Ah, yes.”

Kang-hyuk decided on Jang-mi’s attendance before Jaewon could even make up his mind.

Since Jang-mi accepted so readily, Jaewon had no grounds to refuse.

“I’ll go too.”

“What are you saying. You go if I tell you to go.”

“Ah.”

“Hold the patient. Needle’s going in.”

“Ah.”

By the time Jaewon came to his senses, Kang-hyuk was already holding a very long and thick needle.

It was a spinal needle.

A needle typically used when you needed to access a narrow, deep structure.

Since the spinal cord was hidden between vertebrae, there was no other way to reach it but with this needle.

Poke.

Kang-hyuk pushed the needle in without any hesitation.

Then pushed it further inside.

“A bit…….”

Jaewon, wondering if it had gone too deep, muttered without realizing it.

Kang-hyuk answered without taking his eyes off the needle.

“A bit what.”

Just then, clear fluid appeared at the needle tip.

It was cerebrospinal fluid, which meant the needle had gone in properly.

“No, nothing.”

“What’s with you today? Are you getting spring fever? It’s still winter.”

“No…… It’s nothing.”

“Anyway, hold the line steady. We need to secure it.”

“Yes.”

No matter how easily the line was placed, losing it was always disappointing.

Not just because of the effort, but because the injury to the tissue was the bigger issue.

This wasn’t just any regular blood vessel.

It was the spinal canal, directly connected to the brain.

An injury here increased the risk of infection.

It was best to be careful in every way.

“Ngh.”

Jaewon knew this very well, so he did his best to hold the patient steady.

Vroooom.

No matter how good a driver Jang-mi was, they were speeding.

Holding the patient steady in a shaking ambulance was difficult.

“Good job.”

Kang-hyuk praised Jaewon for hanging in there, then firmly secured the line with silk tape.

Then he connected the line to a small drain bag.

Sluuurp.

The drain bag was usually under negative pressure.

Thanks to that, the cerebrospinal fluid that had built up inside started coming out quickly.

“That’s coming out really fast.”

“It means the pressure is that high.”

“Not really something to be happy about…….”

“Yeah, true.”

Kang-hyuk nodded, watching the cerebrospinal fluid gush out, enough to call it “pouring.”

‘At least it’s coming out well, that’s a relief.’

The problem was that cerebrospinal fluid didn’t make up a big part of the overall increased intracranial pressure.

General brain swelling was the key issue.

To resolve this, they’d have to wait and see over time.

But in that time, brain damage could progress—a totally different issue.

There was a very high chance the patient might never wake up.

“How much farther?”

Kang-hyuk asked, folding the middle of the stretcher so the head was above the waist.

He was, of course, asking Jang-mi.

She answered gently as she braked.

“We’re almost there.”

“Oh. Already?”

“Told you. I drive way better than you, Professor.”

As Jang-mi said, the ambulance stopped perfectly in front of the ER.

She even aligned the back door to face the main entrance.

Kang-hyuk, impressed again by Jang-mi’s skill, jumped out.

Jaewon and the field agent did the same.

Without hesitation, they hurriedly pulled the patient’s stretcher out.

“Here, over here!”

Jang-mi had already brought in a transfer bed from inside.

Kang-hyuk and Jaewon lifted the stretcher and transferred the patient.

The agent ran to the administration office to register the patient.

Just a few months ago, the administration office would have asked a million questions.

But now, thanks to Kang-hyuk, they were used to this type of registration.

“Should we go to the OR?”

Jaewon and Jang-mi shouted to Kang-hyuk almost at the same time.

There really was no other choice.

Whenever they brought in a patient, they always went straight to the OR without hesitation.

And usually, the results were good.

But Kang-hyuk shook his head.

He looked at them as if he couldn’t believe how clueless they were.

“You haven’t learned the basics.”

“What?”

“The basics of treatment are diagnosis, you idiots.”

“Then…… what…….”

Wasn’t he always the type to diagnose in the field and only treat at the hospital?

And now he was saying this, so of course they were dumbfounded.

Kang-hyuk shook his head, watching the two flounder.

He pushed the bed in the opposite direction of the OR.

“First, we need CT and MRI. We have to see what the brain swelling looks like.”

“CT…….”

It was a word that should have felt very familiar.

They had done the scan nearly every day since residency.

But now, it felt so distant.

They could hardly remember doing one since joining trauma surgery.

Especially not before surgery.

Clatter.

While Jaewon was spaced out, Kang-hyuk pushed the bed toward the CT room.

“Uh, uh? Professor?”

Even the tech looked bewildered.

It was his first time seeing Kang-hyuk in the CT room.

Kang-hyuk was the only one who looked at home.

“Head CT! No contrast!”

“Ah…… Yes, yes, understood.”

“Slave! Go to the MRI room and keep the next patient from going in. We’re coming right after CT.”

“Yes!”

“Gangster, call neurology and ask if an EEG is possible. Request a consult too.”

“Ah…… yes!”

On top of scans, he was even asking for help from other departments.

It was a totally unfamiliar scene.

‘Is he just trying to do whatever he can.’

Jaewon hurried after Kang-hyuk, watching as he desperately struggled for the trauma patient.

Not everyone neglected trauma patients, after all.

At least one person was doing his utmost.

With everything he had.

(T/N: Are we reading the same novel? WTH, is that really you Kang-hyuk?)