Chapter 29

‘Ding!’

The elevator, which had been on the third floor, came to a halt on the first floor.

It was still before dawn, and the area in front of the elevator was deserted.

Even though Kang-hyuk and Jaewon weren’t using a hidden elevator, there was no one waiting.

“Working at dawn means no waiting. It’s nice, right?”

“Ah, well… yeah.”

Jaewon nodded at Kang-hyuk’s words as he followed behind him.

‘If we only worked at dawn, it would be a lot better…’

The Trauma Surgery Team was facing more issues than one could count. There were so many problems that it was hard to pinpoint a single biggest one.

However, if Jaewon had to choose just one, he wouldn’t hesitate.

It was manpower.

Calling it a team felt almost ironic, as the only trauma surgeons were Kang-hyuk and Jaewon.

Because of Han Yoo-rim, the head of General Surgery, they couldn’t even rotate night shifts anymore. Their schedule had become even more grueling.

In fact, calling it “grueling” didn’t even begin to describe it.

If either of them collapsed right now, no one would be surprised.

‘How am I supposed to get through morning consultations…?’

But Jaewon couldn’t afford to dwell on that thought.

After all, Kang-hyuk had morning consultations too, yet he was still moving briskly ahead.

And now, the two had arrived once again at the emergency operating room, where Lee Ki-young was being treated.

There was no room for unnecessary thoughts here.

Not for the patients, and not for the doctors either.

Clack.

Without a word, Kang-hyuk slipped his foot into a small opening at the bottom right of the operating room door.

The once tightly shut door slid open.

This wasn’t a coincidence.

If the doors were fully automatic, they would open and close whenever someone passed by.

That would make surgery impossible.

So, the doors were designed to be manually operated.

But using hands to open them would risk contaminating sterilized hands.

That’s why they were designed to be foot-operated.

Even in small details like this, careful thought and consideration for saving lives were embedded.

(T/N: Ohhhh! I was always wondering about this. Wow, I’m glad that the author of this novel is an actual doctor. These small details are amazing.)

—

“Ah, Professor.”

As Kang-hyuk entered, carrying a cooler box filled with preserved organs, Jang-mi greeted him.

It seemed nothing had happened in his absence.

Her expression was calm.

“Hey, gangster. You didn’t beat up the intern, did you?”

“What? Why would I do that?”

The intern, who had been weighed down by the pressure of guarding the OR alone, let out a hollow laugh at Kang-hyuk’s joke.

Kang-hyuk gave him a nod.

“Since you’re laughing, I guess you weren’t hit.”

“When did I ever hit anyone?”

“You hit me.”

“Wha—? When did I…?”

Jang-mi’s face twisted into the most unfair expression imaginable, her words trailing off.

Of course, Kang-hyuk wasn’t really concerned about that.

“Anyway, how’s the patient?”

The playful tone vanished in an instant, replaced by a serious one.

A voice answered from behind the anesthesia machine—it was Jin-yong, a third-year anesthesiology resident.

“Vitals are stable. No complications so far.”

Kang-hyuk’s gaze shifted to the intern, waiting for his report.

The intern, looking tense, responded quickly.

“I just kept flushing with warm saline and suctioning, flushing and suctioning repeatedly.”

Finally, Kang-hyuk turned his eyes toward Jang-mi.

Even though she wasn’t a doctor, she was a part of the Severe Trauma Team.

Among the medical staff here—excluding Jaewon—she had spent the most time tending to Kang-hyuk’s patients.

By now, she had accumulated quite a bit of experience.

“The latest test results are in. No signs of [disseminated intravascular coagulation] yet.”
(T/N: A severe condition where blood clots form throughout the body, leading to organ failure.)*

Kang-hyuk nodded as he looked at the monitor Jang-mi pointed to.

The blood test results displayed clotting factor levels.

Clearly, Jang-mi had learned quite a lot from caring for critical patients.

But she wasn’t finished speaking yet.

She hesitated before continuing.

“Um, Professor.”

“What?”

“We’ve already used nine blood packs. If we keep going…”

“What? The numbers look fine.”

“There’s a risk of cost reductions.”

Jang-mi frowned as she spoke.

For medical professionals, having to worry about budget cuts while treating a patient was utterly humiliating.

But whether Kang-hyuk was oblivious to such things or simply didn’t care, he showed zero interest in the topic.

So, as a member of the team, Jang-mi had no choice but to bring it up.

“Cost reductions?”

Of course, Kang-hyuk looked at her as if she were speaking nonsense.

He held out his hand toward her even as he spoke.

They couldn’t afford to waste time talking.

Especially when dealing with a patient like Lee Ki-young, whose time was already running out.

Jang-mi understood that all too well.

She quickly helped Kang-hyuk into a fresh pair of gloves and nodded.

“Yes. Professor, ever since you started working, the internal audit team has sent more than ten warnings. All related to cost reductions…”

“But they haven’t actually cut anything yet, have they?”

“That’s because the reports haven’t been submitted to [HIRA] yet.”
(T/N: The Health Insurance Review and Assessment Service (HIRA) is a South Korean government agency responsible for evaluating medical claims, ensuring healthcare cost efficiency, and assessing the quality of medical services.)

“What reason would HIRA have to cut our treatment costs?”

Cost reduction meant exactly that—the reduction of medical reimbursements.

In South Korea’s healthcare system, patients only pay a portion of their medical bills, while the rest is covered by the National Health Insurance Service.

If NHIS decided to cut their payments, the hospital would have to eat the loss.

Surgical procedures already barely broke even, even when they were fully reimbursed.

If additional cuts were imposed?

Trauma surgery would become a money-losing department.

And when that happened, it would become a target—from both other departments and the hospital board.

Jang-mi could already see the disastrous future of the Severe Trauma Team.

‘I can’t let that happen.’

So, she gathered her courage and looked directly at Kang-hyuk.

Even if he didn’t care, she did.

For her, this was a big deal.

She wasn’t a head nurse—she was just a regular nurse with only five years of experience.

A nurse with only five years of experience wouldn’t even be considered a senior in any department except for a newly established Severe Trauma Team like this one.

For Jang-mi to directly confront a professor in front of others was a bold move.

“It’s not about justification—it’s about standards. If we exceed them, they cut funding. If we don’t, we get paid. You know that, more or less.”

“I’ve already sent everything to the review team. Research papers, case reports—all of it.”

But Kang-hyuk’s expression showed no concern whatsoever.

Jang-mi suddenly recalled something about his past.

‘Oh, right… He went straight to Doctors Without Borders after becoming a specialist.’

Just looking at his face and behavior, he didn’t seem like someone who would ever volunteer for a humanitarian organization.

It was strange.

And even stranger—how could someone who spent years in a volunteer group be this skilled at surgery?

Even if he had worked in Syria, this was bizarre.

“You think HIRA actually considers that kind of documentation?”

“They should. That’s their job.”

“In reality…”

“Alright, enough. Forget HIRA and whatever else. Let’s save this person first.”

Kang-hyuk dismissed her concerns with a wave of his hand.

Jang-mi knew exactly what this meant.

When he acted like this, there was no getting through to him.

So, with a sigh, she let it go.

“Understood.”

“Good. Anus, stand opposite me.”

“Yes, Professor.”

“Intern, you can leave now.”

“Yes, Professor. Thank you.”

The intern glanced at the clock in the operating room before stepping out.

When he had first been dragged into this surgery, he thought it would last at least three hours.

But barely twenty minutes had passed.

For a moment, he considered finding a quiet spot to rest before heading back to the ER.

But it was a snowy night—the kind where fewer minor injuries came in, and more critical patients flooded the hospital.

With a sigh, he turned back toward the ER.

—

“Hook up the omni clamp again.”

“Yes.”

“Finish removing the damaged liver, prepare for transplant, and get the new one ready. Got it?”

“Y-yes.”

Jaewon couldn’t help but think:

‘So this is how a liver transplant happens…?’

He had always imagined liver transplants as something done only after extensive preparation.

He had never heard of an emergency liver transplant being done on the spot like this.

“Focus. You protesting because you pulled an all-nighter?”

“N-no, sir.”

“This isn’t a one-man surgery. You need to step up. You understand how a liver transplant works, right?”

Jaewon hesitated.

Should he say yes or no?

Then he remembered Kang-hyuk’s personality.

In this situation, the only correct answer was to nod.

“Yes.”

It wasn’t exactly a lie.

Thankfully, this was a [cadaveric transplant], not a living donor transplant.
(T/N: An organ or tissue transplant using a donor who has been declared brain dead or deceased. )

If they had to resect part of a living donor’s liver, the difficulty would be on an entirely different level.

But a whole-liver transplant from a deceased donor?

It was relatively simpler.

It was like removing a broken part and replacing it with a new one.

“Great. Then we can speed things up.”

“…What?”

Jaewon blinked.

Hadn’t they already been moving fast this whole time?

And yet, this wasn’t even full speed?

What kind of madness was this?

“What are you standing there for? Move!”

“A-ah, yes!”

“Not there! You said you know how to do this!”

“Uh—uh…”

“Tch. Move your hands. Like this. Is that so hard?”

“R-right.”

And soon, Jaewon fully understood what Kang-hyuk meant by “speeding things up.”

It meant eliminating the first assistant and achieving maximum efficiency.

As a result, Jaewon was left completely wrecked, while Kang-hyuk removed the damaged liver in under five minutes.

But even after that, Jaewon wasn’t spared from Kang-hyuk’s shouting.

If anything, it only got worse.

It felt like he was being chewed up and spit out alive.

“Hey! Get the new liver in there!”

“Y-yes!”

“You think it just clicks into place like LEGO?!”

“S-sorry!”

There was a huge difference between studying from textbooks and actually performing surgery.

The act of placing another person’s liver inside a patient’s body was far more challenging than he imagined.

Mainly because the liver was so damn big.

Fortunately, the donor and the recipient had similar body sizes—otherwise, this would have been an even bigger struggle.

“Alright. What’s next?”

Kang-hyuk pointed at the newly placed liver.

Jaewon, feeling like a nervous medical student, forced himself to respond.

“First… we [anastomose] the portal vein.”
(T/N: The surgical connection of two tubular structures, such as blood vessels or intestines, to allow continuity of flow.)

If there was one thing Jaewon excelled at, it was answering exam questions.

“How?”

“That would be…”

“Sigh. Anus, watch carefully. Pay attention and learn. Forget about specialties. In Trauma Surgery, you need to do everything.”

“Yes, Professor.”

—

(This episode was planned in collaboration with the Korea Organ Donation Agency (KODA) to promote awareness of organ and tissue donation.)