Chapter 131

“Ah, Army.”

Jaewon barely managed to say the name of the instrument as he reached toward Jang-mi.

“H-here it is…”

Jang-mi, flustered by the nauseating smell, wasn’t her usual quick and responsive self either.

Still, both of them had been through the wringer at the Severe Trauma Center, and they somehow managed to expose the wound.

The tear caused by the forklift measured about 15 cm long and split wide open.

“Ugh…”

The foul smell grew even stronger.

It was only natural. The bigger the hole, the more that could come out.

“Quit groaning and focus. The wound…”

Kang-hyuk looked down at the boy’s exposed abdomen for a moment.

The wound, formed just above the pubic bone, was located right in the center of the lower abdomen.

‘How did this happen…?’

Kang-hyuk imagined the boy running around the rough factory grounds like a playground.

Just like how he used to wander near a beautification site as a kid.

‘Hey! That’s dangerous over there!’

He’d heard it so many times it practically formed calluses in his ears.

And yet, back then, those warnings sounded almost exciting.

Thud, thud, thud.

No one had ever seen it or told him, but…

Kang-hyuk could almost picture the scene of the accident.

The kid must’ve built up his own experiences.

Thinking things like ‘this place is safe,’ or ‘I could get hurt there.’

But even the most dangerous place could feel familiar once it became a playground.

Screeech—

There must have been unanticipated overtime work in the area the kid believed was safe.

He must have dashed in and gotten hit by the forklift.

‘Yeah… the first point of impact was the abdomen. It didn’t climb up from the thigh…’

Forklifts inside factories were supposed to move slowly.

Given how narrow the factory interior was, even if the driver wasn’t particularly law-abiding, they wouldn’t have been able to go fast.

‘The abdomen was hit first… Then the driver hit the brakes… but the kid fell and got crushed.’

Only now did each of the boy’s wounds become crystal clear to Kang-hyuk.

It felt as if his clouded vision—blurred by overlapping memories from childhood and recent blood donation—was finally sharpening.

“Uh, Professor?”

Jaewon called out to Kang-hyuk just then.

By the time he came to, around 30 seconds had passed.

In any other department, someone might’ve muttered, ‘What kind of bastard can’t wait even 30 seconds for the professor to gather his thoughts?’

But this place was different.

Kang-hyuk never paused for more than a second—ever.

Sure enough, everyone was looking at him with worried eyes.

Baek Kang-hyuk definitely seemed off today.

“What’re you all staring at? It’s a tough case. You think everything’s easy for me?”

Feigning composure, Kang-hyuk brushed it off and waved his hand.

No one on the team had mind-reading abilities.

So they just let it go, assuming it was one of those things.

“Yes, Professor. So, what should we…”

Jaewon was still holding the Army to expose the boy’s wound.

Kang-hyuk peeked into the wound again and then shook his head.

Normally, even a slit this narrow would be workable.

But not today.

‘The bladder and rectum… If anything goes wrong, the kid could end up permanently disabled or dead. I don’t like it, but…’

Kang-hyuk was the type of surgeon who considered not just the operation but the recovery afterward.

Some might call that arrogant.

But he didn’t care.

He had the skill to back it up.

Still, a person couldn’t always operate that way.

So for this case, he decided to focus purely on the moment.

“Scalpel. We need to open this wider.”

“Ah… Yes.”

Jang-mi had been expecting they’d go straight into internal exploration.

She set down the sharp mosquito and quickly fitted a blade onto the scalpel before handing it over.

Kang-hyuk used it to extend the wound horizontally.

It felt like worsening the trauma just to perform surgery, something he always avoided.

‘Feels like I’ve never seen this before… or have I?’

Jaewon tilted his head slightly, still holding the Army.

This technique—widening for visibility—was a basic in trauma care, commonly done.

But it still felt like the first time seeing Kang-hyuk do it himself.

Regardless, Kang-hyuk widened each side of the wound by nearly 5 cm.

That was nearly the same as the total original length.

Rip.

As the incision ended, Jaewon—using the same amount of force—was able to spread the wound almost twice as wide as before.

“Whoa…”

Thanks to that, everyone in the OR could now see the boy’s abdomen much more clearly.

As expected, the bladder was badly damaged.

More precisely, it had holes on both front and back.

The rectum right behind it was also punctured.

Through the gap, feces were leaking steadily.

“Hey, Gangster, you’ve got that diluted antiseptic, right?”

“Ah, yes.”

Still in a daze from staring into the abdominal cavity, Jang-mi replied.

She handed over the antiseptic prepared earlier in a syringe used for abdominal irrigation.

As Kang-hyuk received it, he said:

“Make as much of this as you can. You can see it’s no joke. Got it?”

“Yes, Professor.”

Jang-mi nodded firmly.

Operating rooms were the kind of places where even a drop of sweat on the surgical field was a big deal.

And now there was feces.

This was a case of what they jokingly called [pooptamination] (T/N: A slang blend of “contamination” and “poop” to describe severe fecal contamination).

“Hey, spread it more.”

“Y-yes.”

“Hold the suction with one hand.”

“Yes.”

Once Jaewon was ready, Kang-hyuk began flushing with the antiseptic solution.

It wasn’t plain water—it was mixed with brown Betadine.

Soon, the boy’s small abdominal cavity filled up with fluid, and debris floated everywhere.

Jaewon used a wide suction tip to vacuum it all out.

“Another one.”

Before the solution inside the boy’s abdomen had even drained, Kang-hyuk reached out toward Jang-mi.

He’d already tossed the empty syringe onto the table.

“Here.”

“Nice.”

Jang-mi handed it over like a perfect baton pass in a relay race.

Kang-hyuk squirted more antiseptic in the same forceful manner.

This method allowed for very effective irrigation.

Even debris stuck to the walls could be dislodged easily.

“Which one are we on now?”

“This is the tenth.”

You’d think she’d be tired by now.

But Jang-mi was still going strong.

“Alright, that’s enough. Let’s look at the rectum.”

Kang-hyuk shifted his gaze to the now noticeably cleaner abdominal cavity.

Surprisingly, it was Jaewon who spoke first.

Unlike Kang-hyuk, who had been busy with the syringe, Jaewon had been staring intently at the wound the whole time.

“Hmm… I think we’ll need a colostomy.”

“A colostomy, huh…”

A colostomy is a surgery that temporarily creates an opening in the abdomen to pull out the colon so the patient can defecate.

Usually done when the bowel needs time to heal after serious damage.

While weighing Jaewon’s suggestion, Kang-hyuk examined the rectum.

The wound was nearly 4 cm.

Four centimeters might not sound like much…

But for a child’s rectum, that was massive.

“Okay. Let’s suture this first. Hand me the thread.”

“Yes.”

Jang-mi prepared to hand over size 7 thread as usual.

But Kang-hyuk stopped her.

“No, we need it tighter. Give me a 5.”

“A 5?”

“Yeah.”

“Uh… okay.”

With the size 5 thread in hand, Kang-hyuk began suturing the rectal wound.

Even in such a delicate area, his layered suturing was practically an art form.

Jaewon, watching it, felt his earlier doubts ease.

‘So it really was just because the patient’s a kid.’

Thicker thread had a clear advantage in tension.

Even a slightly clumsy suture would hold better.

After finishing the rectal sutures, Kang-hyuk stared at the repair.

‘The suture itself is solid. But… skipping the colostomy would still be risky…’

The rectum was the part that pushed feces out.

Its muscular layer was thicker than most other parts of the intestine.

Not to mention the strong surrounding muscles.

Could that wound withstand such force?

Kang-hyuk shook his head and looked at Jaewon.

“Let’s do the colostomy, like you said.”

“Ah… Yes!”

Jaewon nodded enthusiastically, clearly thrilled his opinion was accepted.

Kang-hyuk, smiling faintly beneath his mask, reached out toward Jang-mi.

“Forceps and ligature.”

“Yes, Professor.”

Jang-mi had already prepared the necessary tools as soon as the colostomy was mentioned.

So she was able to hand them over immediately.

“Good.”

Satisfied, Kang-hyuk nodded and picked up the sigmoid colon—the S-shaped part of the large intestine—with the forceps.

Just like its name, the sigmoid colon curved like an ‘S.’

It was the standard site used for colostomies when the rectum was compromised.

It was the last section of the colon, minimizing nutrient loss.

Plus, the stool it passed was already formed and easier to manage.

“Tie it.”

Kang-hyuk used the forceps to grip the colon, then tied off both ends above and below the spot with silk sutures.

If you cut it without tying it, its contents would spill out into the abdominal cavity.

That would undo all the irrigation work they just did.

He quickly finished the double tie and reached out to Jang-mi.

“Forceps and Metzembaum scissors.”
(T/N: [Metzembaum scissors] are surgical scissors used for cutting delicate tissue.)

“Yes.”

Without hesitation, Jang-mi handed them over.

Holding the colon with one forceps, Kang-hyuk spoke to Jaewon.

“Hold this.”

“Yes, Professor.”

Then, without a word, he reached his hand toward Jang-mi again.

She immediately passed him another forceps.

Kang-hyuk gripped the opposite side from what Jaewon was holding.

“Cutting.”

He sliced through the tensioned colon cleanly.

Then he pulled the proximal end—the part connected to the small intestine—out through the abdominal incision.

The earlier, large incision made this part easy.

“You can do it, right?”

Instead of finishing the task himself, Kang-hyuk looked at Jaewon.

Jaewon had done countless colostomies during his time as a general surgery resident.

“Of course.”

“Good. It’s not a critical step anyway… finish it later.”

Kang-hyuk was delegating as much as possible to Jaewon.

Not that Jaewon realized it yet.

But his hands had started trembling more and more.

‘Guess I’ve been pushing too hard since coming back to Korea…’