Chapter 16

Vrrrrrr!

Screeeech!

To the untrained ear, the sounds were nearly identical, but anyone familiar with bone drilling could distinguish the slight difference in tone as another hole was completed.

At first, Jaewon had no idea how Kang-hyuk was preventing blood loss during drilling.

But after watching closely, he tilted his head in confusion.

“Professor, is it possible that the lack of bleeding isn’t just luck… but that you’ve been cauterizing as you drill?”

Jaewon asked the question, but his face betrayed his own skepticism—as if asking, No way… right?

But Kang-hyuk was always unpredictable.

Instead of denying it, he replied as if it were the most obvious thing in the world.

“Oh? You actually noticed? Guess your eyes aren’t completely useless after all.”

“Wait… so you really—?”

“Of course, I’ve been controlling the bleeding while drilling. You think I just got lucky and avoided blood loss while making two holes in the skull? That’s not how it works.”

Jaewon simply blinked, stunned.

Because logically, Kang-hyuk’s words made perfect sense.

‘Yeah… what kind of bone just lets you drill two-centimeter holes without bleeding?’

The idea that there was no bleeding at all was scientifically impossible.

But the idea that Kang-hyuk had cauterized the bone before the bleeding even started?

That was just as ridiculous.

Whether that realization was fortunate or unfortunate, Jaewon didn’t have time to process it.

Kang-hyuk was already moving on.

“Anesthesiologist, what’s the blood pressure?”

“70 over 50. Still rising steadily.”

“Good.”

Peering through the holes he had drilled earlier, Kang-hyuk checked the brain.

Just moments ago, the brain tissue had been pressed tightly against the hole—swollen from increased intracranial pressure.

Now, it had receded slightly, indicating reduced pressure.

If the holes had been randomly placed, the effect wouldn’t have been this pronounced.

But Kang-hyuk had calculated the precise locations, sizes, and distribution for maximum relief.

“Blood pressure remains stable without vasopressors. Intracranial pressure is still high but not dangerously so.”

“Okay. Keep monitoring it. Anus, let’s move down.”

“M-Move… down?”

The way Kang-hyuk said “Anus” and “down” in the same sentence made Jaewon feel strangely uncomfortable.

For a split second, he nearly turned to check his own backside.

But even in his own chaotic thoughts, he knew that if he actually did that, Kang-hyuk would probably punch him.

‘He’s the type who’d 100% hit me.’

And he had already seen the tattoos.

Suppressing a sigh, Jaewon shook his head and focused back on the patient.

“Anus, you remember when we inserted a needle into his chest for [tension pneumothorax] ? That was just a temporary fix—it’s going to become a problem soon.” (T/N: a life-threatening condition where trapped air compresses the lungs and heart)

“Oh.”

“Look at this.”

Kang-hyuk pointed at the endotracheal tube sticking out of the patient’s throat.

Initially, the tube had been perfectly centered.

Now, it had shifted slightly to the right.

That meant the pneumothorax had worsened.

This was expected—Kang-hyuk had only relieved the trapped air with a needle, but the underlying lung injury remained.

“It’s the mechanical ventilation…”

Jaewon glanced at the anesthesia machine.

Pshhhhhh!

The ventilator hissed softly, forcing air and anesthetic gas into the patient’s lungs at a steady rate.

Compared to manual bagging, mechanical ventilation was stronger and more consistent.

That was usually a good thing—except when the lungs were injured.

Pshhhhhh!

With each breath, the endotracheal tube shifted more, worsening the air leak in the chest cavity.

As pulmonary tension increased, so did the patient’s vital signs.

The anesthesiologist spoke urgently.

“Professor, blood pressure is rising—110 over 80! Intracranial pressure is also spiking! We need an intervention.”

Normally, 110/80 mmHg was considered a normal blood pressure.

But just a short while ago, this patient’s BP was 50 mmHg.

A sudden jump like that wasn’t normal—it was dangerous.

Kang-hyuk already knew.

He didn’t even have time to nod before he responded.

“I know! Give me a syringe—the thickest one you have!”

Jang-mi instinctively turned to run toward the medical drawers.

But before she could take a step—

“Don’t waste time! Just give me whatever is already out! If you stall, he’ll die!”

“A-Ah! Okay!”

A surgical assistant quickly handed Kang-hyuk a 20cc syringe.

“This will do.”

Without hesitation, Kang-hyuk examined the needle gauge.

Then, without pausing, he stabbed the syringe into the patient’s right chest.

To an untrained observer, it might have looked like he was just randomly jabbing the needle.

But in reality, he had percussed the chest with his other hand, ensuring perfect placement.

Shhhhhh!

Because the needle was significantly thicker, the trapped air escaped faster than before.

But since the patient was still on mechanical ventilation, new air continued to accumulate—meaning the pneumothorax wasn’t fully resolved.

Instead, a temporary equilibrium was reached.

The patient wouldn’t die immediately, but if they didn’t fix the issue permanently, he wouldn’t survive much longer.

“Good. We bought some time.”

Kang-hyuk flicked the needle that was still inserted into the patient’s chest.

It had originally been prepped for mixing Betadine and saline, but now, it had saved a life instead.

“Alright, scalpel. Anus—hold that retractor.”

“Yes!”

Jaewon had already picked up a rib spreader (Army retractor) before Kang-hyuk could even instruct him.

Seeing that, Kang-hyuk turned his attention to the patient’s right chest.

More specifically, to the gap between the broken ribs and the intact ones.

Screech.

Without wasting a second, Kang-hyuk pressed the scalpel into the intercostal space, making a long incision.

Then, he extended his hand.

“Rib cutter. Now.”

Clack.

A nurse handed Kang-hyuk the electrocautery.

Holding it firmly, Kang-hyuk glanced at Jang-mi.

“Lower the power back to 15. Anesthesiologist, reduce the oxygen level.”

“Yes!”

“Yes!”

Both Jang-mi and Gyeong-won responded simultaneously.

Beep, beep.

They executed his instructions with exact precision.

Only once everything was properly adjusted did Kang-hyuk fully grip the electrocautery.

Despite the urgency of the situation, there was only one reason why Kang-hyuk had paused before proceeding.

If the electrocautery temperature was too high, or if the oxygen concentration was too rich, there was a risk of ignition—a fire inside the body.

Both of those risk factors had been present just moments ago, making their removal an absolute necessity.

Most surgeons wouldn’t have thought about it, but Kang-hyuk had read multiple case reports on such incidents.

“Alright, making the incision now. Anesthesiologist, stay ready in case of emergencies.”

“Understood.”

Even with that final warning, Kang-hyuk wasted no time.

He pressed the electrocautery tip against the incision.

Buzz.

A sharp burning smell filled the air as he cut through.

From the very start, Kang-hyuk had planned to fully open the thoracic cavity in one go—so his incision was deep.

Squelch!

With a wet, unsettling noise, the chest cavity was fully exposed.

The moment Kang-hyuk removed the electrocautery, Jaewon immediately hooked the rib spreader (Army retractor) onto the incision and pulled upward and downward.

For the first time, Kang-hyuk had a clear view of the thoracic cavity.

A broken rib fragment had pierced the lung.

With each mechanical breath, air hissed through the torn lung tissue.

Hisssss.

This wasn’t a wound that could simply be sutured.

“We’re removing it. We’ll perform a [lobectomy]. Get the suture materials ready!” (T/N: a surgical procedure to remove a damaged lobe of the lung)

“Understood!”

“When I ask for them, hand them over immediately.”

“Yes!”

A surgical nurse picked up the suture thread with a needle holder, ready to pass it at a moment’s notice.

Kang-hyuk turned back to the damaged lung, then looked at the anesthesiologist.

“Pause ventilation for a moment.”

“BP is low—maximum hold is 20 seconds. Any longer is too dangerous.”

“Twenty seconds is plenty. Stop on my signal.”

“Got it.”

With Gyeong-won on standby, Kang-hyuk extended his hand.

A nurse instinctively reached for the suture, but hesitated.

Given the circumstances, it didn’t seem like he wanted sutures.

“Give me saline—just a little Betadine mixed in.”

“Here it is.”

“Good. Anesthesiologist, now!”

“Understood!”

Because Gyeong-won had been listening intently, he reacted instantly.

The ventilator abruptly stopped, and with it, the patient’s lungs collapsed slightly, allowing clearer visibility inside the thoracic cavity.

The reason for stopping ventilation was simple.

Lung tissue is too soft, making damaged areas difficult to pinpoint with the naked eye.

But with the right trick, the problem became obvious.

Swish.

Kang-hyuk swiftly spread a thin layer of the Betadine solution over the lung surface.

His speed and precision were so refined that the entire right lung was coated in under 10 seconds.

“Professor…”

“Alright. Resume ventilation.”

“Understood.”

With a sigh of relief, Gyeong-won restarted the ventilator.

Pshhhhhh!

Immediately, air escaped through the lung tear—but this time, it was visible.

Ordinarily, air is invisible, but because the lung was coated in Betadine solution, the escaping air formed bubbling foam.

Anywhere the bubbles appeared was a site of lung damage.

“The lower lobe is completely destroyed. The middle lobe is still intact. We’ll limit this to a lower lobectomy. Sutures!”

“Here, Professor!”

With practiced efficiency, Kang-hyuk grabbed the sutures and tied off the bronchus leading to the lower lobe.

With the airway sealed, the air leak immediately stopped.

“Two more sutures.”

“Here!”

“Good.”

Now that the bronchus was secured, Kang-hyuk could afford a slightly slower pace.

Not that he actually slowed down—his movements were still shockingly fast.

‘How did he find the artery so quickly?’

Jaewon could only stare in disbelief.

Even at Hanguk University Hospital, where many skilled surgeons worked, none had ever amazed him like this.

‘If I specialized in trauma surgery, could I become like him…?’

The thought shouldn’t have even crossed his mind.

But after watching Kang-hyuk’s mastery, he found himself considering something he never had before.

And the worst part?

Kang-hyuk noticed.

‘A slight twitch in the facial muscles, a subtle blush… He’s getting inspired. And what’s the most inspiring thing here? My surgery, obviously. Anyone would be tempted watching me work.

‘Looks like I just recruited another follower.’

(T/N: Wow! This chapter was intense!)