Chapter 12

“Y-Yes!”

‘What else could “We’re about to transport a corpse” possibly mean?’

It meant the patient’s life was hanging by a thread.

And Jaewon agreed with Kang-hyuk on that.

The patient’s vital signs had already changed from just three minutes ago.

Swoosh.

Following Kang-hyuk’s request, Jaewon poured Betadine over the patient’s head.

The Betadine soaked into the short-cropped hair and scalp, quickly starting to dry.

As soon as Kang-hyuk confirmed this, he soaked a piece of gauze in Betadine and wiped the patient’s neck.

Then, he gripped the scalpel.

“I’m securing the airway first. Pull the skin slightly.”

“Aren’t you… going to intubate first instead of making an incision?”

Normally, in a hospital ward or under standard conditions, the first method to secure a patient’s airway would be [endotracheal intubation], just as Jaewon had mentioned. (T/N: a tube inserted into the trachea to help with breathing).

A tracheotomy required cutting into the neck with a scalpel, whereas intubation only required inserting a tube down the throat.

But, like most procedures, there were exceptions.

“Anus, this patient fell.”

“Ah! Right. Understood. I’ll assist!”

As Kang-hyuk pointed out, for trauma patients, especially those involved in falls or car accidents, intubation was contraindicated.

If the patient had a cervical spine or head injury, the standard practice of tilting the head back during intubation could cause permanent damage.

In such cases, a tracheotomy was a far safer alternative.

Screech.

Without hesitation, Kang-hyuk made a horizontal incision on the patient’s neck.

A tracheotomy was generally easier when the patient’s head was tilted back, but Kang-hyuk seemed completely unfazed by the challenge.

From Jaewon’s perspective—who, as a surgeon himself, had occasionally performed this procedure—it was nothing short of astonishing.

‘Does he have an ultrasound scanner built into his hands? How is he cutting so precisely above the strap muscles?’

Even more unbelievable, there was almost no bleeding.

Considering they were on a helicopter, where using an [electrocautery device] was out of the question, this was a remarkable feat. (T/N: a tool that uses heat from electricity to burn or cut tissue, often used to stop bleeding during surgery.)

“Don’t just stand there—grab the incision with forceps. If the assistant is less busy than the lead surgeon, something’s wrong.”

“A-Ah, yes!”

At this point, Jaewon was skilled enough to perform most surgeries as the primary surgeon rather than an assistant.

But standing next to Kang-hyuk made him realize just how lacking he truly was.

Screech.

As Jaewon used forceps to pull the strap muscles to either side, Kang-hyuk made another incision down the center.

His precision was remarkable—the strap muscles parted cleanly, without a single unnecessary cut.

And just below them, the thyroid gland remained completely untouched.

‘Wow…’

Jaewon recalled assisting in multiple thyroidectomy surgeries during his residency.

But those procedures had all been performed using electrocautery.

Seeing the thyroid gland this cleanly exposed without the use of such tools was a first for him.

“Focus. In emergency incisions, it’s best to avoid cutting the thyroid. Do you know why?”

“It would cause bleeding.”

“Exactly. This is an organ that will bleed no matter what if it’s cut.”

The thyroid gland was, as its name suggested, a gland responsible for producing thyroid hormones.

And for it to function, it required a high supply of nutrients, which in turn meant a high blood supply.

In other words, the more you cut into it, the more it would bleed.

Using an electrocautery device or an ultrasonic dissector would help control bleeding, but with only a scalpel, the result would be disastrous.

Understanding this, Jaewon used his forceps to grip the lower part of the thyroid gland and lift it upward.

Seeing this, Kang-hyuk’s expression softened slightly.

‘Even after spending a year doing nothing but rectal surgeries, he’s still sharp?’

This wasn’t just about instinct—it also showed dedication.

Screech.

Feeling slightly more satisfied, Kang-hyuk swiftly made another incision.

This time, the cut was made horizontally in the space cleared by lifting the thyroid gland.

It was a precise cut through the cricothyroid membrane, located between the cartilaginous rings of the trachea, resembling a stack of interlocked rings.

Whoosh.

Immediately, trapped phlegm and air were expelled.

Some of the mucus splattered onto Kang-hyuk’s shirt sleeve, but he didn’t seem to care.

“Anus! Wipe it with gauze!”

“Y-Yes!”

Jaewon quickly wiped away the mucus to clear his vision.

Then, Kang-hyuk inserted a tracheostomy tube through the incision.

He inflated the cuff balloon at the end of the tube.

Thunk.

The balloon expanded inside the trachea, sealing the airway securely so the tube wouldn’t dislodge easily.

“You mentioned Jung-heon, right?”

Without even glancing away from the tube, Kang-hyuk turned his attention to the rescue team.

The paramedics, still in awe of Kang-hyuk’s almost miraculous surgical skill, quickly snapped back to reality.

“Y-Yes! That’s right!”

“Team leader, please handle the ambu bag.”

“A-Ah… Got it! Leave it to me!”

As expected, the rescue team was highly trained in basic medical procedures.

There was no need for Kang-hyuk to instruct them on the proper pressure or ventilation rate.

Satisfied that Jung-heon was handling the ambu bag properly, Kang-hyuk moved back to the patient’s head.

By now, the Betadine he had poured earlier had completely dried.

“Alright. Time to open the skull.”

“Are we really… doing this here?”

“Yes. If we don’t, he dies.”

“Understood.”

Jaewon let out a deep sigh.

They had already shaved the patient’s head and performed an emergency tracheotomy.

And they had done it all inside a violently shaking helicopter.

Looking over at the pilot, Jaewon noticed that he was flying without saying a word.

The rapidly passing clouds and scenery outside made it clear just how fast the helicopter was moving.

The AW139 model, unlike the EC225, was known for its increasing turbulence at higher speeds.

Drrrrrrrrrr.

Right on cue, the helicopter trembled violently, as if determined to prove that very point.

‘Didn’t even notice during the procedure.’

In other words, Kang-hyuk’s operation had been so flawless that even the violent tremors of the helicopter were unnoticeable.

While Jaewon was still caught up in his admiration, Kang-hyuk had already swapped out the scalpel blade and gripped his instrument.

It was almost as if time flowed slower for him than for everyone else.

“What are you doing? Aren’t you pulling the scalp?”

“A-Ah, yes!”

“Don’t press down too hard! The patient’s intracranial pressure is already high—do you want to kill him? Honestly, you never fail to surprise me!”

“S-Sorry!”

Ignoring Jaewon’s apology, Kang-hyuk immediately made the incision.

Swoosh.

Since the scalp is one of the most [vascularized] areas of the human body, blood poured out profusely. (T/N: rich in blood vessels)

In a proper operating room, they would have either cauterized the bleeding vessels with an electrocautery device or at least clamped them with surgical clips.

But here, neither option was available.

Still, Kang-hyuk showed no sign of hesitation.

“Give me that.”

“The anesthetic syringe?”

“Yeah. The dental syringe.”

“Understood.”

It wasn’t a tool commonly used in general surgery, so Jaewon found it rather unfamiliar.

A dental syringe was typically used in dentistry, not for cranial procedures.

Yet, Kang-hyuk handled it with practiced ease, jabbing the needle directly into the freshly incised edges of the scalp.

At first, the bleeding worsened.

Naturally—he was stabbing a bleeding area with a needle, after all.

But after a few moments, the blood flow started to slow, and soon, the incised surface turned pale.

“This is…”

“Why do you look so shocked? You do know the anesthetic contains [epinephrine], right?” (T/N: a hormone and medication that increases heart rate and constricts blood vessels, often used to treat severe allergic reactions and control bleeding)

“I mean… yeah, but…”

He had never seen it used like this for a scalp incision.

But thinking about it, it made sense.

Jaewon had worked at Hanguk University Hospital, one of the most advanced medical institutions in South Korea.

With access to cutting-edge equipment, there was never a need for workarounds like this.

“Injecting a vasoconstrictor shrinks the blood vessels, stopping the bleeding. Don’t be shocked by every little thing—we don’t have time for that.”

“Y-Yes, sir.”

“Pull. I need a wider opening for the incision.”

“Yes, professor.”

Nodding sincerely, Jaewon pulled the edges of the incision apart.

With the gap secured, Kang-hyuk slid the scalpel deeper and made a clean incision.

Rip, rip, rip.

Unlike cutting skin, the fibers of the muscles snapped apart, producing a distinctive tearing sound.

Normally, when cutting through such dense muscle tissue, the scalpel blade might catch and skip, but Kang-hyuk’s incision was smooth and uninterrupted.

Within moments, the white surface of the skull was exposed.

“The bone is exposed. What’s next?”

As he asked, Kang-hyuk subtly adjusted his grip on the scalpel, already anticipating the next step.

Jaewon hesitated for a moment before answering.

“We need to remove the [periosteum]. But without an electrocautery device, that’s…” He trailed off, his expression twisting. (T/N: a thin, dense layer of tissue covering bones, supplying them with blood and nerves for growth and healing.)

Not just him—everyone nearby reacted the same way.

Screeeech.

Kang-hyuk had begun scraping the scalpel between the skull and the periosteum.

The skull is one of the hardest bones in the human body, and the resulting sound was eerily similar to nails on a chalkboard.

“Ugh.”

Thankfully, it didn’t last long.

With surgical precision, Kang-hyuk completed the delicate separation in just a few seconds—a process that would typically take minutes.

“Alright, Anus, pull back the periosteum completely.”

“Yes, professor. But… how are we making the hole? We don’t have a drill…”

Normally, when cutting through bone, a bone saw or a surgical drill was required.

For long incisions, a bone saw was preferred.

For circular holes, a drill was more effective.

But they had neither.

So Jaewon and the other paramedics assumed drilling into the skull was impossible.

At least, that’s what they thought.

“Do you really need a drill to make a hole in bone?”

Kang-hyuk, however, thought otherwise.

Reaching into his surgical kit, he pulled out a rather unusual tool.

It was a hammer and chisel.

Tools typically used in plastic surgery—not neurosurgery.

“Wait… you’re going to use that… on his head?”

“Less talking, more holding the head steady. If it shakes, the impact will be dispersed, making this harder. The helicopter is already shaking enough as it is.”

“O-Okay…”

“Alright, I’m going to strike it now.”

(T/N: Hey guys! I feel like there are too many T/Ns throughout the text. Is it still okay, or would you prefer me to move them all to the bottom? I’m worried they might be disrupting the flow of your reading. Let me know what you think!)