Chapter 120

“What?”

“The aorta.”

Kang-hyuk replied while still pressing down on the carotid artery.

Meanwhile, the Emergency Medicine resident and nurse pushed the bed into the operating room.

Gyeongwon, already fully prepared, came running up.

“I saw the transmitted imaging… What on earth is going on here?”

When Kang-hyuk turned his head, he saw the scan displayed on the Anesthesiology computer monitor.

Though the metallic blade caused considerable noise in the image—

It wasn’t enough to obscure the damage.

If Gyeongwon were just an ordinary anesthesiologist, maybe he wouldn’t have caught on.

But he was handpicked by Kang-hyuk himself.

He was a weirdo who had expressed personal interest in the Severe Trauma Center.

So neither Kang-hyuk nor Jaewon needed to explain anything.

“What do you think is going on. It’s exactly what it looks like.”

“T-This is…”

A blade like an awl hovering at the brink of puncturing the aorta—this reaction was absurdly calm.

Gyeongwon faltered for a second but quickly regained composure.

He remembered who he was working with.

And what his job was alongside Kang-hyuk.

“I’ll begin anesthesia.”

“Good. Keep the respiratory rate as low as possible.”

“The respiratory rate? But with vascular injury, don’t we need more oxygen delivery?”

The aorta might not have ruptured yet—

But the carotid had.

Kang-hyuk’s blood-drained fingers were proof enough.

Major vascular damage meant blood volume in circulation would inevitably drop.

The only compensation possible was to increase the oxygen carried per unit of blood.

“You’re not wrong. But not now.”

“Because the bleeding hasn’t spilled outward? That’s… that’s not enough of a reason.”

Normally, Gyeongwon accepted everything Kang-hyuk said without question.

But when treating a patient, he only moved when it made sense to him.

The exact opposite of Jaewon.

Jaewon often argued about little things—but once in the OR, he was utterly loyal.

“From the scan, the carotid is already… torn over three centimeters.”

Gyeongwon stared at the patient’s neck with determined eyes.

Even without external bleeding, it was critical.

Especially in a tight space like the neck, internal bleeding was even more dangerous.

It could compress vital structures.

Sure, Kang-hyuk’s impeccable pressure was holding it back for now.

But the fact remained: circulating blood was insufficient.

“You don’t know.”

Kang-hyuk shook his head as he looked at Gyeongwon.

Didn’t know what?

Gyeongwon tilted his head.

“W-What do you mean?”

“There’s a case report. In situations where an awl-shaped weapon is embedded, it gets driven deeper with each breath. This patient wasn’t stabbed into the aorta from the start.”

Jaewon, still squeezing the ambu bag, chimed in.

“R-Right! I saw it at first. You could kind of see what looked like the handle.”

He remembered vividly.

The patient collapsed at the scene they reached by helicopter.

A glint of metal near the neck.

A small pool of blood.

‘I almost pulled it out by reflex and got smacked.’

Jaewon glanced at his wrist.

The redness had long since faded.

The one who smacked him was, of course, Kang-hyuk.

‘I almost killed him.’

But he didn’t resent Kang-hyuk.

He was grateful.

If he had pulled the blade then, the torn carotid would’ve erupted on the spot.

Even Kang-hyuk wouldn’t have managed that in the field without proper equipment.

“S-So that’s what happened! Understood. I’ll reduce the respiratory rate as much as possible!”

Now that he grasped the situation, Gyeongwon sprang into action.

“Connecting gas.”

Once resolved to act, he didn’t hesitate.

“Muscle relaxant going in. Blood pressure may fluctuate a bit—don’t be alarmed.”

With his excellent anesthetic skills, he began taking control of the patient’s vitals.

‘Control,’ huh?

That might sound excessive, but—

Anyone who had witnessed a top-tier anesthesiologist at work would understand why the word fit.

Kang-hyuk never blamed anesthesiologists for saying, “The anesthesiologist is the captain of the OR” in their textbooks.

‘Not that they all are.’

As with any field—

There were terrible ones too.

Fortunately, Gyeongwon wasn’t one of them.

“For now… blood pressure is stabilized. Holding systolic at 90. Let me know before you touch the carotid. I’ll be watching, but just in case…”

Whoever said, “The hand is faster than the eye”—

They must have watched Kang-hyuk operate.

The moment you thought you saw something, he was already ten steps ahead.

Gyeongwon had been overwhelmed more than once.

“Got it. First, let’s disinfect. Cut the clothes off.”

Kang-hyuk was already gloved.

Jaewon nodded and cut off the patient’s upper garments with trauma shears.

The pants were half-off already thanks to the central line and catheter.

Snip, snip.

Kang-hyuk listened to the shears while checking the fluid lines.

There were three bags of Hartmann’s solution running.

‘They must’ve really panicked earlier…’

No surprise—once he mentioned carotid rupture and aortic risk, everyone scrambled to stabilize BP.

But though they’d caught the blood pressure—

Other aspects were lacking.

“Gangster. Get the antibiotics ready. That blade wasn’t sterilized.”

“Ah, yes, sir! Which one?”

“Ceftriaxone and Metronidazole.”

“Yes, Professor.”

Ceftriaxone was a third-generation cephalosporin, a broad-spectrum antibiotic.

It handled most bacteria.

But it was weak against anaerobes—Metronidazole filled that gap.

“What about the bloodwork?”

Kang-hyuk asked as he watched a new nurse hook up the antibiotics per Jang-mi’s orders.

Gyeongwon quickly pulled up the patient’s chart.

“Hmm… most haven’t come back yet…”

“The blood type. That should be up.”

People assumed all tests came back together.

They didn’t.

Labs had limited staff and machines.

Plus, each test took a different amount of time.

So there was a silent agreement between lab and clinical staff—

Run the urgent tests first.

“Yes. Type B.”

“B. Okay. Order 5 units of Type B from the blood bank.”

“Yes, Professor.”

Five units meant nearly 2 liters.

An adult male’s total blood volume was just over 5 liters.

So this was almost half.

But Gyeongwon thought even that wasn’t enough.

‘The aorta…’

He recalled watching aortic dissection patients die on the table during his residency.

No matter how many units they transfused—

It was no use.

The blood poured out too fast.

‘But if it’s Professor Baek… he might manage.’

This wasn’t just any surgeon—it was Kang-hyuk.

So Gyeongwon swallowed his doubts and placed the order.

Meanwhile, the patient’s clothes were all cut away.

Kang-hyuk immediately doused the torso in Betadine disinfectant.

It was almost like he was pouring it.

“What are you doing? Go scrub in. You know we’ve got no time.”

“Ah, yes.”

Kang-hyuk chased Jaewon out, who had been frozen watching him disinfect.

It wasn’t just directed at Jaewon.

It was something he said to himself, too.

‘Still hasn’t woken up…’

He couldn’t help but think of the patient he brought in by ambulance a week ago.

Even in hindsight, the treatment had been flawless.

Thanks to full Neurology support, even the mid-treatment tests were on point.

But the patient’s condition had only worsened.

Now, it was nearly terminal.

‘They said if we request a panel today, they’ll declare brain death.’

That’s what Professor Choi had said during morning rounds.

He said it plainly—but Kang-hyuk couldn’t forget it.

‘I won’t lose this one too.’

Kang-hyuk looked down at the new patient with renewed resolve.

He was soaked in Betadine.

Click.

Just then, Jaewon returned.

Water dripped from his hands.

Jang-mi handed him a disposable paper towel almost reflexively.

Soon, Jaewon was fully prepped with scrubs and gloves.

“Okay. I can’t take my hand off this.”

Kang-hyuk gestured at his chin with his right hand.

No need to explain why.

It was clear what his hand was stopping.

“Yes, Professor.”

“So… we have to start the operation like this.”

“By myself?”

Jaewon looked uncertain.

He had assisted in countless surgeries, some of which he had partially performed himself.

But he still didn’t feel fully confident.

And most surgeons would feel the same faced with a patient like this.

“You’re not alone. I’m right here. It’s not like my left hand’s useless.”

“Your left hand… is just an assistant, though, right?”

“Was that supposed to be a joke…? You’re single, aren’t you?”

“What? N-No, I’m not!”

Jaewon shook his head with an awkward, embarrassed look.

Kang-hyuk wanted to tease him more, but—

There really wasn’t time.

“Start with the carotid rupture. I doubt the esophagus or anything else is intact, but… this comes first.”

“Yes, Professor. Hmm…”

Jaewon hesitated, then grabbed a marker.

Kang-hyuk usually made incisions in one go.

But this was the proper way.

If you’re unsure, follow protocol.

So Kang-hyuk said nothing.

In fact, he praised him.

“Yeah, right there. You’ve got a good eye now.”

“A carotid rupture… it’s not like this is my first time seeing one.”

“Not exactly a good thing. But you’re doing well.”

Based on Kang-hyuk’s past surgeries, Jaewon marked the skin and made his incision.

Slice.

The blade bit into the flesh.

Blood began to ooze—but it didn’t obstruct.

Kang-hyuk wiped it immediately with gauze using his left hand.

“Alright, go deeper there. No, you idiot, not with the scalpel. Use the Bovie!”

“Ah, yes.”

Kang-hyuk’s left hand even served as a guide.

He had already retracted the incision perfectly to give access to the carotid.

Sizzle.

With a crackle, some muscle fibers were cut away.

If it were Kang-hyuk, he might have just pulled them aside.

But he knew Jaewon’s limits, so he didn’t complain.

‘As long as you seal the vessel properly, that’s all that matters…’

He could only hope Jaewon would pull it off.