Trauma Center : Golden Hour - Chapter 2

“Hey! Did you run an ABGA (Arterial Blood Gas Analysis)?”
“Y-Yes, Doctor.”
“What’s the result?”
“It’s normal.”
“Then notify Internal Medicine and discharge the patient already! Don’t you want to go home?”
“N-No, sir! I’ll notify them right away.”

At the resident’s scolding, the intern hurriedly dashed off.

‘Creak.’

Next to him, a patient who had gone for a CT scan was being wheeled back in. The patient was still unconscious, and the intern who had accompanied them to ensure they didn’t fall during the scan looked grim.

“Intracranial hemorrhage!”
“Why are you telling me this? Call NS (Neurosurgery)!”
“Yes, sir!”

Again, the resident barked orders, and the intern ran off. The resident, having yelled so much, cleared his throat as if it were sore, then let out a quiet sigh.

“Damn it. What’s with today…?”

The emergency room of Hanguk University Hospital was notoriously busy. As a hospital belonging to one of the top academic institutions in the country, it had recently received government funding under the guise of improving emergency medical care. But today was particularly overwhelming, even for a resident who had worked in this ER for four years.

“New patient! Stab wound to the left abdomen!”

As if mocking the resident’s plight, a paramedic in blue scrubs entered with an emergency worker, bringing in a patient. The patient’s face was pale, their forehead slick with cold sweat, eyes shut, and bandages soaked in blood, as if they were drenched in it.

“Shit.”

The patient looked in terrible condition. The resident cursed and rushed over to the stretcher.

“What happened?”
“We found them outside a bar. Cause is unknown. A passerby on their way to work early in the morning found them and called it in.”
“Unknown cause…?”
“There was a knife nearby. Maybe that’s what did it.”
“Can I see it?”

Examining the shape and size of a weapon could give a rough idea of the wound’s severity. But it was rare for a doctor to actually see the weapon used.

“The police took it. It’s evidence.”
“Do you have a picture?”
“Here it is.”

Experienced paramedics often took pictures in advance. The resident sighed after looking at the photo.

“That’s not a kitchen knife—it’s a sashimi knife….”
“Oh, did I say kitchen knife? I’m not used to calling it sashimi knife.”
“What’s the blood pressure?”
“Systolic is 60….”
“Goddammit. Alright.”

A systolic blood pressure of 60 meant the patient’s condition could deteriorate rapidly. The resident rushed the patient into the treatment room.

“Hey, interns! Everyone, over here!”

He called the interns to gather around. While inserting a central venous catheter, he intended to assign them various tasks like running an ECG or performing arterial blood tests. Though there wasn’t much time to check the results immediately, it was critical to run initial tests.

“And call the trauma team!”

While disinfecting the site for the central line in the right subclavian vein, the resident shouted again. One of the nurses nodded and ran to the station, recalling that the trauma team had been established a year ago under the hospital director’s orders. What exactly the trauma team did or how effective it was remained unclear.

“Yes, this is Yang Jaewon from General Surgery.”

Like most surgeons, the doctor on duty, whose name was listed on the schedule, answered immediately. Even if they were in an outpatient clinic, they were accustomed to picking up calls unless they were in the operating room. Emergencies didn’t happen only in the ER.

“Dr. Yang Jaewon, this is the ER.”
“Ah, yes….”

The mention of the ER darkened the voice on the other end. If the call had come from the ICU or a hospital ward, the reaction wouldn’t have been so grim, as the patients there were usually already under their care or at least likely to be surgical patients. The ER, however, often felt like handling someone else’s problem.

“You’re on trauma team duty today, right?”
“Yes, I am….”
“We’ve got a patient with a stab wound to the left upper abdomen. Their blood pressure is low, and I’m inserting a central line now.”
“What about the labs?”
“Not ready yet….”
“Got it. The situation’s bad, right? I’ll come down.”
“Thank you.”

The nurse breathed a sigh of relief after hanging up. Yang Jaewon, known for his even temper, was on duty. If it had been someone stricter, the resident might have received a scolding about calling without test results or making an unnecessary fuss, even though the surgeon would have had to come anyway.

“How’s it going?”

Yang Jaewon must have been nearby, as he entered the treatment room less than a minute after the call ended. The resident, who had been grumbling the whole time, forced a smile. Yang Jaewon wasn’t a resident but a general surgery fellow, three years his senior, having even completed his military service.

“I just finished inserting the central line and am starting IV fluids.”
“What’s their blood type?”
“The test is underway. Results will come out soon.”
“The blood pressure… still unstable, huh?”
“Yes.”
“Where exactly were they stabbed?”

Yang Jaewon tilted his head as he examined the wound. Just as reported, the stab wound was on the left upper abdomen. Its length was about 5 cm, but the depth was unknown.

“First, let’s do a CT scan. We need to see the wound to figure out what to do.”
“Understood, doctor. Should we intubate as well? The breathing is unstable.”
“Yes, do that. Intubate and proceed with the CT.”

While the two were discussing, the door to the treatment room opened again with a loud creak.

‘Creak.’

“What the hell?”

Both of them instinctively turned their eyes toward the door. Normally, interns or nurses moved cautiously and didn’t make such noises.

Standing there was a man in a suit they had never seen before. Broad shoulders, pale skin, and long, flowing hair.

He didn’t look like a doctor.

“Sir, you’re not allowed in here.”

The resident waved his hand dismissively, his expression indifferent. In a busy emergency room, it wasn’t unusual to encounter all sorts of people, including those who wandered in aimlessly like this man.

“No, no. You shouldn’t do a CT first.”
“…What?”

This was the first time someone had given unsolicited advice. Before they knew it, the man had moved next to Yang Jaewon, peering down at the patient.

“Should I call security?”

Jaewon, unable to hold back, spoke up irritably. It was rare for him to lose his temper, given his reputation as a gentle surgeon, which only highlighted how absurd the man’s behavior was.

“I think I should be the one calling security,” the man replied.
“What are you talking about?”
“Two incompetent doctors are about to kill a patient.”
“What the hell…”

Before Jaewon could finish, the man pushed him aside and tore the patient’s shirt open. The thick sweatshirt ripped like tissue paper.

At that moment, Jaewon noticed the man’s forearm, partially exposed beneath his dress shirt, covered with fierce-looking tattoos.

‘Wait, could this guy be a gangster?’

Jaewon recalled an urban legend shared by senior doctors about a time when a gangster, stabbed during a fight, was rushed to the ER. The doctors were threatened with death if they failed the treatment.

‘Seriously, my luck is horrible today.’

Being dragged down to the ER while preparing for rounds was bad enough, but now the patient turned out to be tied to a gangster?

As Jaewon imagined himself getting beaten up, the man looked at him with an unexpectedly soft expression—though his words were anything but kind.

“Now, you two quacks…”
“Qu-quacks? That’s uncalled for…”
“Shut up and look at the patient’s chest.”
“The chest? But the wound is in the abdomen…”

Grumbling, Jaewon examined the patient’s chest and froze.

A large, blue bruise was spreading across the chest.

The man pointed to the bruise and continued, “Left upper abdomen, huh? Sure, the spleen is a vital organ. But judging by the direction of the stab wound, it barely grazed the surface. Yet the blood pressure is tanking, and the patient’s unconscious. So, do you have any idea now, you two quacks?”

“P-pericardial tamponade!” (T/N : Pericardial tamponade is a life-threatening condition where blood or fluid accumulates in the [pericardium] (the sac around the heart), compressing the heart and preventing it from pumping properly.)

“Well, the fellow is a bit sharper, I see. So, what should you do?”
“Pericardiocentesis! Get the ultrasound and a spinal needle ready! Call Thoracic Surgery too!”

Jaewon didn’t have time to wonder how the man had diagnosed the condition so accurately or how he knew Jaewon was a fellow. He was overwhelmed by the realization that the patient’s unstable blood pressure wasn’t due to hypovolemic shock but pericardial tamponade.

His panic doubled when an intern spoke up.

“Doctor, the Thoracic Surgery team is all in the operating room. They said it’d take at least two hours for someone to come down to the ER.”
“Did you tell them it’s pericardial tamponade?”
“They got angry and said it’s more likely cardiac rupture…”

The intern’s voice trailed off as Jaewon scowled. Cardiac rupture was even more critical than pericardial tamponade, making it impossible to fault the Thoracic Surgery team for their response.

“Doctor, the equipment you requested is ready.”

A nurse entered with a portable ultrasound machine and syringes. Even as the machine powered on, Jaewon could only stare at it in confusion. He had never performed the procedure himself.

“D-Doctor! The blood pressure is dropping!”

Bad news always seemed to come all at once. The resident, who had just finished intubation, called out urgently. As suspected, the heart wasn’t pumping properly due to the tamponade.

“Damn it.”

There was no time to hesitate. As the most senior doctor in the room, Jaewon had no choice but to act. Gritting his teeth, he grabbed the syringe and slowly approached the patient’s heart.

The man smirked, his tone dripping with sarcasm.
“You must hear how creative you are all the time.”
“What?”
“Coming up with such unique ways to kill people.”
“Who… Who are you?”

The man chuckled as if he’d heard a hilarious joke.
“Baek Kang-hyuk.”
“Baek Kang-hyuk…?”

Jaewon tilted his head, the name sounding vaguely familiar. Kang-hyuk shoved him aside and spoke again.

“Starting today, I’m a professor for this hospital’s trauma team. Step aside. If you do it like that, the patient will die.”