Trauma Center : Golden Hour - Chapter 6
‘Ziiing.’
Kang-hyuk slid the scalpel down the patient’s [sternum], carefully following its natural ridge.
(The sternum is the flat bone located at the center of the chest that connects to the rib cage.)
Since the [sternum] is covered by a thin layer of skin, it was easy to cut straight through to the bone in a single stroke.
“Hmm.”
Kang-hyuk observed the white bone exposed through the incision and placed the scalpel down.
“Electric knife.”
“Here it is.”
“Switch to a blunt tip.”
“Oh, right. Let me replace it.”
As the nurse replaced the tip with a blunt one, Kang-hyuk gently ran his finger over the incision he had made.
To an observer, it might have seemed like a pointless gesture.
But to Kang-hyuk, it allowed him to determine the best way to proceed with cutting and navigating inside.
“It’s ready.”
“Good.”
Kang-hyuk inserted the blunt-tipped electric knife into the incision he had created.
‘Crackle-crackle.’
The sound of burning filled the air as the incision widened further.
After all, there was solid [bone] beneath.
Using a sharp tip to delicately cut through it would be time-consuming and inefficient. Burning through in one go was much faster and more practical.
“That’s done. Hey, Anus.”
“Yes.”
Jaewon, now fully accustomed to being addressed as “Anus,” responded without hesitation.
“How much is left?”
“We’ve done about… one-third.”
“Hmm. Speed it up. I’ll need help once I get past the chest.”
“Yes, sir. But really, doing this alone….”
“Focus on your own tasks. I can handle it.”
“Yes….”
Jaewon still wore a skeptical expression.
But what could he do?
Kang-hyuk was determined to cut through the chest [bone] on his own.
Resigning himself, Jaewon decided to focus on his own work.
‘Crackle-crackle.’
Kang-hyuk continued widening the incision with the electric knife.
The lower part of the [sternum] was already done, and now he was cutting through the upper section.
‘Crackle-crackle.’
Since there was no [bone] directly underneath this part, an empty space was soon exposed.
An inexperienced or careless surgeon might have damaged the underlying tissues at this point.
But Kang-hyuk, as if he had been watching the area from the start, switched off the electric knife at the perfect moment.
He then inserted his finger into the incision to both feel and expand the inner space.
‘Snap-snap.’
Thanks to the precise incision, the connective tissues between the skin and the underlying structures were easily severed.
“All done. Metal plate.”
“Yes, doctor.”
The nurse handed Kang-hyuk a thin metal plate.
He inserted it smoothly into the space he had just created.
The plate sat perfectly between the [sternum] and the tissues below.
“Now, the saw.”
“Yes. What RPM should I set it to?”
“25,000.”
“Understood.”
As soon as Kang-hyuk received the electric saw, he stepped on the pedal to test it.
‘Whirrrr.’
The saw emitted a sharp, unsettling noise, which made Kang-hyuk grin.
“Not bad for an unused operating room. They’ve got some quality equipment here.”
Both the nurse and Jaewon glanced at him, their faces questioning how he could judge that from just the sound.
But neither dared to voice their thoughts.
Inside the operating room, the surgeon was king.
And outside of it, Jaewon couldn’t imagine defying Kang-hyuk either.
“Alright, let’s cut through the [sternum].”
“Yes, doctor.”
The anesthesiologist responded, adjusting the depth of anesthesia.
This would lower the patient’s [blood pressure] slightly, but it was necessary.
The pain of cutting through [bone] could still cause the patient’s [heart rate] and [blood pressure] to spike, even while unconscious.
For a patient like this one, with [cardiac tamponade] and other heart issues, such a reaction could be fatal.
(Cardiac tamponade is a condition where fluid builds up in the sac around the heart, putting pressure on it.)
“Hmm.”
Kang-hyuk nodded at the anesthesiologist’s adjustments and positioned the saw over the [sternum].
While most surgeons would grip the saw with both hands, Kang-hyuk held it with just one.
His other hand gripped the metal plate beneath the [sternum].
“Spray some water.”
“Yes.”
The assisting nurse grabbed a large syringe filled with [saline solution].
“Good. Keep spraying once I start.”
“Even when the bone dust piles up… do I keep going?”
No matter how advanced an electric saw was, even one with a diamond blade, cutting through the thick [sternum] of an adult male wasn’t as easy as slicing tofu.
If the blade was too sharp and efficient, it could damage the underlying structures.
As a result, the process naturally produced wet bone dust that obscured visibility.
This made cutting the [sternum] a tedious process of alternating between sawing and clearing the debris.
“Have you worked in a thoracic surgery room before? You seem to know your stuff.”
“Yes, for about five years….”
“Impressive. No wonder you’re good at assisting. But I don’t need that. Just keep spraying water.”
“Understood.”
As soon as Kang-hyuk finished speaking, he stepped on the pedal, starting the saw.
‘Whirrrr.’
The saw emitted the same sharp noise as before.
Kang-hyuk steadily pressed it against the [sternum].
‘Grrrrrrr.’
The eerie sound of the blade grinding through hard bone echoed through the room.
“Spray water!”
“Yes, doctor!”
At Kang-hyuk’s command, the nurse vigorously sprayed the saline solution.
This served two purposes: reducing the amount of accumulating bone dust and cooling the intense friction heat generated by the sawing.
Without water, the heat could scorch the [bone], hindering its ability to heal properly later.
‘Grrrrrrr.’
Even with just one hand, Kang-hyuk held the saw with absolute stability.
He drew a perfectly straight line with deliberate precision.
[Human bones] were naturally inconsistent, with some areas being harder or softer than others.
Because of this, small deviations during sawing were considered inevitable.
However, Kang-hyuk’s sawing showed no such imperfections.
It was as precise as if a machine had done it.
‘Grrrrrr.’
Since his sawing was flawless and without trial and error, the process, though slow, took significantly less time overall.
“Incision complete. Hey, Anus.”
“Yes, yes.”
“Have you finished suturing?”
“Ah, not yet. I’m almost done, though….”
“You’re slow, aren’t you?”
“No, not really….”
Jaewon’s expression betrayed his frustration.
To most people, it might sound strange, but in general surgery, the most sought-after specialty was [proctology].
Unlike other specialties, it rarely involved emergencies, and its skills could be directly applied even outside of university hospitals.
Moreover, with a steady stream of patients, it was financially rewarding.
This meant getting into the field was difficult, and it naturally attracted the best surgeons.
In other words, Jaewon wasn’t just someone who aced his exams; he was a skilled surgeon in his own right.
‘I’m pretty fast at suturing, though….’
Jaewon glanced at the already wide-open chest in disbelief.
‘What is this? He’s way too fast.’
And yet, his precision was unmatched.
Usually, the metal plate placed under the [sternum] would show small scratches, at the very least.
But the plate Kang-hyuk had used looked as if it were brand new.
The saw hadn’t even touched it once.
‘Is he from thoracic surgery…?’
While Jaewon pondered, Kang-hyuk pulled apart the split [sternum] and secured it with an Iron Intern device (a tool used to hold open and stabilize surgical incisions).
With that, the pulsating [heart] came into view.
“Thankfully, there isn’t too much blood pooling yet.”
Kang-hyuk muttered, placing his palm on the pulsating [heart].
The patient had a wound severe enough to cause [cardiac tamponade], and the use of vasopressors had led to some blood reaccumulating.
However, thanks to Kang-hyuk’s swift actions, the blood hadn’t built up enough to compress the [heart].
“Anus, come up here.”
“Yes, I’m done now.”
“You didn’t rush it, did you? You’re not a kid anymore.”
“No, I didn’t.”
“We’ll see about that later. Anyway, take this forceps.”
Kang-hyuk expertly pinched the outer membrane of the [heart] with forceps and looked at Jaewon.
Jaewon quickly moved to Kang-hyuk’s side and took the forceps.
“Don’t let go of this. It’ll be annoying if you do.”
“Yes.”
“You know what surgery is needed for [cardiac tamponade] patients, right?”
“Uh… yes. I’ve studied it, but this is my first time seeing it in person.”
“Well, that’s better than nothing. Hold on tight.”
“Yes.”
After entrusting the forceps to Jaewon, Kang-hyuk picked up a scalpel.
As he carefully made an incision in the outer membrane of the [heart], he glanced at the anesthesiologist.
“Anesthesia, now… hmm.”
“Yes?”
“Never mind. Did you deliberately lower the heart rate?”
“Yes, I figured you’d be cutting into the [heart].”
“Hmm… What’s your name?”
“Park Gyeongwon.”
“Good job.”
Kang-hyuk left a brief compliment before continuing with the scalpel.
His movements appeared careless.
Even though the heart rate had been lowered, the [heart] was still beating relentlessly.
And yet, he was cutting into it.
Jaewon felt a chill just watching.
“Now, pull the forceps tighter.”
“Oh, yes.”
But the result was nothing short of perfect.
The outer membrane of the [heart] was cleanly removed, without a single scratch on the inner structures.
To be precise, only the pre-existing wound remained.
Kang-hyuk pointed at the wound near the center of the [heart], where blood was still trickling out.
“The muscle is slightly torn. If it had been hit just a bit harder, this wouldn’t be [cardiac tamponade]—it would’ve been a full-blown [heart rupture].”
As he spoke, Kang-hyuk sutured the wound.
The bleeding stopped instantly.
“All done. Let’s close.”
“Wow…”
“What?”
“No, I was just wondering if surgeries are supposed to end this quickly.”
Jaewon realized it had only been about an hour and a half since they’d started.
“Is that a problem?”
“No, not at all.”
“Then stop saying pointless things. Remove the Iron Intern and hold the [sternum] together.”
“Yes.”
“Also, bring me the drill and the wire.”
“Yes, doctor.”
After receiving the drill from the nurse, Kang-hyuk drilled holes into both sides of the split [sternum].
Then, using the wire like suture thread, he tightly secured the [sternum].
The once-wide-open chest was now firmly closed.
The patient, who had been on the brink of death, was saved.
However, Kang-hyuk’s expression seemed a little off.
“Why… what’s wrong?”
“I feel like I forgot something important.”
“What? Don’t tell me!”
Jaewon’s face went pale as he glanced at the surgical site.
The nurse assisting also froze.
Had they accidentally left a tool inside the closed chest?
But Kang-hyuk wasn’t the type to make such mistakes.
“Oh, right.”
“What is it?”
“My faculty induction ceremony is today.”
“When is it?”
“It started about ten minutes ago.”
(T/N: What a perfect way to start this series! Intense medical action right at the beginning! How do you feel about this novel so far? Please comment on your thoughts especially the way I added the footnotes. Is it okay if I add the medical definition on the same line or you want it at the very end of the chapter?)