Chapter 23
Clack.
Jaewon groaned as he watched Kang-hyuk slam the receiver down.
“Ah…”
He was already being treated like an outcast within the surgery department—now Kang-hyuk was picking fights with anesthesiology too.
‘Is this guy even sane?’
But the one responsible for stirring up trouble remained completely unfazed.
No, indifferent would be a more accurate description.
“What are you looking at? I took care of anesthesiology for you. Go get the OR ready. The gangster’s already inside.”
“I mean… I get it, but shouldn’t you at least try being a little nicer to anesthesiology?”
Jaewon glanced toward the treatment room.
The patient still hadn’t been moved.
Of course not.
Simply inserting a [central venous catheter] wasn’t nearly enough for a patient in this condition.
(T/N: A central venous catheter is a tube placed in a large vein to quickly administer fluids, medication, or monitor blood pressure.)
Right now, an intern was inserting a urinary catheter, another resident was placing an [A-line], and the nurses were setting up various monitoring devices.
(T/N: An A-line, or arterial line, is used for continuous blood pressure monitoring and frequent blood sampling.)
Only after all of that was done could the patient be transported.
In other words, there was still time.
“Anesthesiology? What, was I wrong to tell them to come down and do their job?”
“No, it’s just… maybe you could’ve phrased it more gently.”
“And if I did, would they listen?”
“Well… no, but still—”
“Our department’s already treated like garbage. Might as well act like we belong here.”
“What if the entire surgery department complains about you? No surgical team can function without anesthesiology backing them.”
Jaewon wasn’t just nitpicking.
Kang-hyuk knew that too, which was why he didn’t punch him.
Instead, he simply glared with a chilling intensity.
“I’ll handle it. You just focus on learning from me and saving lives. The rest is my problem.”
“But—”
“Shut your mouth and get ready! Are you trying to let that patient die?”
“N-No, sir! I’ll prepare right away.”
Jaewon had no interest in arguing with Kang-hyuk any further.
Besides, the patient’s condition was so critical that they couldn’t afford delays.
Without another word, he ran into the operating room.
Kang-hyuk watched him go before turning in the opposite direction—toward the emergency room.
‘Two more patients haven’t arrived yet.’
If their injuries were manageable, the ER residents could probably handle them.
But he had a bad feeling.
Since midnight, heavy snow had been falling nonstop.
And when road conditions were bad, patient conditions were even worse.
WEEEOOOO—
Just then, the second ambulance pulled up in front of the lobby.
The first patient was still being stabilized, so there weren’t enough medical staff to rush forward.
Kang-hyuk naturally placed himself among them.
Clunk.
The moment the doors opened, paramedics covered in blood spilled out.
They immediately yanked open the rear doors and pulled out the patient.
“Shit…”
One of the interns swore involuntarily at the sight.
No one even thought to scold him.
The patient’s condition was that bad.
It looked like a classic motorcycle accident.
“The driver? Didn’t they wear a seatbelt?”
“A-Ah, no.”
The paramedic nodded while moving the stretcher.
Rattle.
The wheels of the gurney rattled against the floor.
“They rolled across the asphalt.”
Kang-hyuk muttered, examining the asphalt debris embedded in the patient’s face.
If left untreated, those fragments would get tattooed into the skin, leaving permanent scars.
That was serious enough, but the real problem was elsewhere.
“Did a car run them over?”
“I… I don’t know. The patient wasn’t inside the vehicle when we arrived, so there was a delay in finding them.”
“Figures. Nighttime, snowstorm… easy to miss someone.”
Not wearing a seatbelt didn’t just worsen injuries—it also made patients harder to find.
If they were thrown from the vehicle, rescuers might not even notice them.
That was if they were lucky.
If they weren’t, they could get hit again by another car.
Like now.
Kang-hyuk frowned at the tire marks clearly imprinted on the patient’s outer clothing.
This wasn’t just a minor injury.
At least it wasn’t their torso that got run over—just their leg.
“Scissors.”
“Here.”
First, they needed to check what was inside.
With a sharp snip, Kang-hyuk cut open the clothing.
What he uncovered was a pair of heavily swollen, bluish thighs.
Pressing down revealed trapped blood beneath the skin.
A sickening, gurgling sound followed.
‘Left femur is fractured… both legs are developing [necrotizing fasciitis]. Damn it.’
(T/N: Necrotizing fasciitis is a severe bacterial infection that rapidly destroys muscle, fat, and skin tissue.)
Kang-hyuk swallowed a curse and immediately barked orders.
As always, the key to increasing survival rates was proper emergency intervention.
The faster and more precise it was, the better the patient’s chances.
“Professor, the first surgery patient is being taken in now!”
A resident, who had been setting up the [A-line] in the treatment room, called out while wheeling the first patient away.
Kang-hyuk gave him a nod.
“Tell Anus I’ll be there soon! I just need to finish up here!”
“Yes, Professor!”
The resident didn’t need to ask who Anus was.
By now, everyone knew that Jaewon was Anus.
There were many theories as to why, but none of them sounded as absurd as Jaewon’s own explanation.
‘He calls me Anus because I worked in colorectal surgery? That makes no damn sense.’
So, some were still investigating if there was a better reason.
“Get me a scalpel! Breathing is unstable!”
“Yes, sir!”
“Prep for [subclavian central line insertion], get a urinary catheter in! Check if urine is coming out—it could be blocked!”
(T/N: A subclavian central line is a catheter inserted into the [subclavian vein] to deliver medication or fluids.)
(T/N: The subclavian vein is a large blood vessel under the collarbone, often used for central line placement.)
“Understood!”
Even as he urgently made an incision on the patient’s neck, Kang-hyuk continued shouting instructions.
Anyone watching from the outside would think that one Kang-hyuk was performing surgery while another, with the exact same voice, was shouting orders.
But there was only one Kang-hyuk.
And yet, he never faltered.
Screech.
His incisions, always executed with a level of precision bordering on artistry, gradually revealed the airway.
“Prepare the tube. Size 8.”
“Ah, yes.”
Even in this urgent situation, Kang-hyuk swiftly assessed the patient’s height and weight at a glance, selecting the most appropriate tube size.
Naturally, the incision he made was perfectly tailored to fit the tube.
“Hand it over now.”
“Yes.”
“Good. Airway secured. What about the urinary catheter?”
“Ah, not yet.”
“Hurry up!”
“Y-Yes! Sorry!”
Kang-hyuk found it absurd that he had finished a [tracheostomy] while someone else was still struggling with a urinary catheter.
(T/N: A tracheostomy is a surgical procedure to create an opening in the trachea for direct airway access.)
But considering the constant rotation of interns, the reality wouldn’t change anytime soon.
This wasn’t just the fault of the flustered intern fumbling with the catheter.
Shaking his head, Kang-hyuk shifted his focus downward.
The resident had already disinfected the right chest area with [betadine solution], leaving it exposed.
(T/N: Betadine solution is an antiseptic used to clean the skin before procedures.)
“The ultrasound is on the way.”
The resident looked at him expectantly, clearly hoping for praise.
As if on cue, a rattling sound echoed from somewhere nearby—an intern was hastily wheeling in the ultrasound machine.
But Kang-hyuk simply picked up a catheter.
And stabbed it straight in.
“You should also learn how to do it without an ultrasound when time is critical.”
“A-Ah, yes.”
“In emergency medicine, every second counts. Wasting time on setup when a patient is dying is inexcusable.”
“Yes, I’m sorry.”
The resident had been expecting a compliment, but instead, he got a scolding.
Still, he wasn’t upset.
Because Kang-hyuk’s speed was insane.
Pfft.
The needle pierced the vein, reaching the empty space where only fluid should be.
The fact that it had been barely seconds since the needle had entered the skin was utterly baffling.
The resident stared at the drop of blood forming at the catheter’s tip and inwardly swore.
‘Holy shit… Did he even aim? How is he this fast?’
To be fair, the resident’s shock was a bit exaggerated.
Kang-hyuk could actually see the [subclavian vein] beneath the skin—at least, he could anticipate its precise location.
So, in essence, it was the same thing.
“Do we have the blood type?”
“Yes, A type.”
While Kang-hyuk had been performing the [tracheostomy] and central line insertion, another intern had been struggling to draw arterial blood.
For once, his team had actually been useful.
“Good. Start an A-type transfusion. Just one pack for now. Adjust the speed—not too fast, since his blood pressure isn’t critically low.”
“Understood, Professor.”
“And what about the urinary catheter?”
Had it been him, he wouldn’t just be inserting the catheter by now—he’d be making one if needed.
When he looked down, the intern was still struggling.
“I-It’s not going in…”
“For fuck’s sake. Move.”
“S-Sorry…”
Kang-hyuk pushed the intern aside and forced the catheter in.
There was resistance.
Only then did he take a proper look at the patient’s face—a middle-aged man.
‘[Benign prostatic hyperplasia]?’
(T/N: Benign prostatic hyperplasia (BPH) is an enlarged prostate, which can obstruct urinary flow.)
That could explain why inserting the catheter was difficult.
Still, it was just an inconvenience—not an impossibility.
Moments later, the catheter slipped into the bladder.
“Hmm.”
But Kang-hyuk didn’t look satisfied.
The moment the catheter entered the bladder, he could tell—it was empty.
Hardly any urine flowed through the tube.
“Son of a bitch.”
The combination of thigh muscle trauma and [anuria] only pointed to one thing—[acute kidney failure].
(T/N: Acute kidney failure occurs when the kidneys suddenly lose their ability to filter waste from the blood.)
(T/N: Anuria is when the kidneys stop making urine or produce very little (less than 50 mL per day). It’s a serious condition that can be caused by kidney failure, severe dehydration, or blocked urine flow.)
Acute kidney failure was terrifying even when caused by something as simple as medication.
But when it was trauma-induced, it was exponentially worse.
“Call nephrology! Administer [diuretics]—do whatever it takes to get urine flowing!”
(T/N: Diuretics are medications that help your body get rid of extra water and salt by making you pee more. They are often used to treat high blood pressure, heart failure, and kidney problems.)
“Y-Yes! And what about you, Professor…?”
“The surgery patient’s already in the OR! I have to deal with that first! Keep working on getting urine output until I get back!”
“Yes! I-I’ll call nephrology now!”
Without waiting for a response, Kang-hyuk sprinted toward the operating room.
There, another patient was desperately waiting for him.
