Chapter 88

“165!”

It wasn’t the blood pressure, but the heart rate that was shooting up to 165.

This was the result of Kang Hyuk resecting about half of the [adrenal gland], causing the burst cells—and the steroid hormones inside them—to pour into the venous circulation.

The problem was that if left alone, things would only get worse.

“What’s the blood pressure! The bleeding just—!”

Professor Han Yoo-rim, who had been managing a relatively smooth surgery in the lower abdomen, shouted.

He turned to the monitor and saw the blood pressure had hit 220.

Anything higher could barely be measured, so it was essentially at its maximum.

“Hey! Baek Kang-hyuk! Is this really okay?!”

Yoo-rim shouted, his voice filled with panic.

The chief of general surgery was supposed to have this all wrapped up.

Besides, the trauma surgery department, which was under general surgery, was always under scrutiny from the media and public opinion.

As long as there were no mishaps, the next executive director’s seat was practically guaranteed.

But now, what the hell was going on?

“Uh… [Tachycardia] shifting to… [Arrhythmia]! [Ventricular tachycardia]!”
(T/N: [Tachycardia] = rapid heart rate. [Arrhythmia] = abnormal heart rhythm. [Ventricular tachycardia] = a potentially life-threatening fast heart rhythm from the heart’s lower chambers.)

Gyeongwon, who was continuously monitoring the patient, shouted.

Yoo-rim was stunned at those words.

[Ventricular tachycardia]—it had been so long since he’d heard the term, it didn’t even register at first.

So it was about a minute later that Yoo-rim finally screamed.

“[Ventricular tachycardia]?”

[Ventricular tachycardia] could quickly turn into [ventricular fibrillation].
(T/N: [Ventricular fibrillation] is when the ventricles—responsible for pumping blood throughout the body—quiver instead of contracting, rendering them unable to pump blood.)

In other words, what’s commonly known as cardiac arrest.

Yoo-rim’s face went pale.

‘Why did I even join a surgery I didn’t need to be in…’

When things go well, nobody really notices.

But once something goes wrong, it always looks catastrophic.

‘Taking in all those bus accident patients… That was the real problem.’

Why did the the proctology professor—join emergency surgery? The question was already floating in his head.

He could already hear people accusing him of being greedy for patients, accepting them all when he lacked the competence.

The more he thought about it, the more his breathing became shallow, and it felt like he was going to die.

It was a kind of panic.

But the much younger Gyeongwon was unfazed.

“Yes! [Adenosine] going in! Please get the bleeding under control!”
(T/N: [Adenosine] is a medication that temporarily blocks electrical conduction in the heart.)

They had been preparing for this ever since they started manipulating the [adrenal gland].

He injected [beta-blockers] and then [adenosine] in succession.

A heart rate of 165 was definitely challenging.

But it wasn’t entirely unexpected.

“B-blood loss…”

Yoo-rim, on the other hand, was half out of his mind.

If Kang Hyuk had even a moment to spare, he would have smacked him on the back of the head.

Unfortunately, there was no time for that.

Swish, swish.

As the blood pressure spiked, blood was rushing fiercely toward the [adrenal gland].

Just as fiercely, the destroyed [adrenal gland]’s steroids were flooding through the veins into the rest of the body.

It was a vicious cycle.

If it wasn’t stopped quickly, the patient would die.

And it would be Kang Hyuk’s mistake.

‘Damn! I was too impatient!’

If Jaewon or the orthopedics professor had seemed a bit more reliable, this wouldn’t have gotten so out of hand.

Kang Hyuk would have patiently waited for the 30-degree endoscope.

He would have spotted the rare variant vein behind the [adrenal gland].

But there was no use in excuses.

That wouldn’t solve anything.

Kang Hyuk hated wasting time on that sort of thing.

‘I’ll have to go by feel… I have to catch it.’

He stared at the barely visible vein behind the [adrenal gland] through the cut surface.

It had only been about 10 seconds since the steroid storm began, but the effects were dramatic.

Even from a distance, he could see the vein throbbing.

Both systolic and diastolic blood pressures had surged, explosively increasing venous blood flow.

It was the worst possible scenario.

‘I have to catch it fast…’

Through a tiny gap, Kang Hyuk targeted the vein.

Even in a life-or-death crisis, there wasn’t the slightest tremor in his fingers.

Just by looking at his hands, you’d think he was calm.

But one look at his contorted face would prove otherwise.

Clack.

The [laparoscopic hemostatic forceps] in Kang Hyuk’s right hand closed on empty air.

At the same time, the surgical stapler slipped uselessly into the abdominal cavity.

‘A little higher.’

But instead of panicking, Kang Hyuk coolly pinpointed the vein’s exact location.

Clack.

He caught the wildly pulsing vein.

The surgical stapler made of alloy clamped on and wouldn’t let go.

The vein twitched a few more times, then stopped moving.

No more blood flowed through.

“Whew, I got the vein. What’s the blood pressure now?”

For once, Kang Hyuk was sweating cold as he asked.

Still glued to the monitors and medication, Gyeongwon answered without turning his head.

“Systolic is 180. It’s… dropping.”

“How much [adenosine]?”

“One ampule. Not much.”

“Fluids?”

“It’s been 30 seconds since I started a full load. I’ll maintain it for another 10 minutes.”

“Ten minutes…”

If a harmful substance gets into the body, what’s the best thing to do?

If there’s an [antidote], you inject it. That’s the best solution.

But unfortunately, there is no [antidote] for steroids.

In cases like this, you could use a drug that counters the effect of the substance, but there was a more effective way.

Dilution.

“Yes. In 10 minutes, I can load nearly 500mL. Now that the vessel is clamped, that should be enough.”

“500mL with one ampule of [adenosine]. And the [beta-blocker]?”

“5mg administered.”

“Okay, good. That’s just right.”

Kang Hyuk nodded, keeping his eyes on the monitor.

The patient’s blood pressure and heart rate, displayed on the monitor, were quickly stabilizing.

There had been a commotion, but the exposure to the steroid storm lasted only about 30 seconds.

If more medication had been given, what would have happened?

It could have actually caused the blood pressure and heart rate to plummet.

High blood pressure was dangerous, but in extreme cases, low blood pressure was much more critical.

“Uh… Is it done? Is it solved?”

At last, Han Yoo-rim, who had been spaced out, joined the conversation.

Even with his mask on, it was clear his mouth was hanging open.

He was probably quite shocked.

‘So a surgeon over fifty can panic like this during an operation…’

“Yes, Professor. Vital signs are stabilizing,” Gyeongwon replied politely, still respectful of his senior.

Of course, Kang Hyuk was different.

“I thought we had an AI system at our hospital, with all the shouting going on. Wasn’t sure if there was a machine that could understand all that.”

He responded with a sarcastic jab.

But Han Yoo-rim didn’t feel bad at all.

He only felt relief—whether it was because the patient lived, or he himself survived, was unclear.

Whatever the case, it was all good.

“Anyway, we made it, right?”

“Yes, there shouldn’t be any more critical situations. The 30-degree endoscope just arrived, too.”

Kang Hyuk glanced at the new nurse, who had been standing awkwardly ever since the chaos began.

At last, she hurriedly unpacked the 30- and 60-degree endoscopes from where they’d been stashed in the sterilization room.

They were clearly brand new.

“So we do use them after all, since we bought them,” Han Yoo-rim remarked, a bit self-conscious as he recalled authorizing the purchase.

It was a silly comment, but no one minded.

After a storm in the OR, you could say whatever you wanted, at least for a moment.

“Well, thanks to that, this patient’s alive,” Kang Hyuk even replied.

If Han Yoo-rim had been a little closer to Kang Hyuk, he would’ve been touched.

He knew how rare it was for Kang Hyuk to hold a proper conversation about anything besides medical debates.

“Anyway, let’s wrap this up. There’s not much time left.”

“Not much time? Why? Isn’t this patient out of danger now?”

Han Yoo-rim looked confused.

So did Gyeongwon.

By their assessment, this surgery was almost finished.

But no one had the whole Severe Trauma Center in their head the way Kang Hyuk did.

“My hopeless trainee is stuck doing a huge surgery.”

“Trainee…?”

“Come on, less talking, more stitching. I’m almost done here.”

“Stitching…”

“Eh, enough talking. If you want to chat, move your hands while you do it, like me.”

“Hmm.”

Han Yoo-rim wanted to argue, but couldn’t.

Kang Hyuk was already inserting the 30-degree endoscope and excising the back of the [adrenal gland] while chatting.

‘Is this maniac seriously already finishing the surgery?’

The patient had been at death’s door just moments ago.

How was it already time to wrap up?

It was hard to understand.

But sometimes, things you can’t understand just happen.

Especially around Kang Hyuk.

“Whew. The skin is all closed… How’s it going down there?”

“I—I’m almost done too!”

“You haven’t even closed the muscle layer yet.”

“Residents usually do the skin closure.”

“What are you talking about? There’s no one to do that here. I’m heading to the ER, so finish up, Chief. I’ll leave notes on any special instructions for prescriptions—just check them.”

“You—leaving? Now? Leaving me?”

Han Yoo-rim practically wailed.

He looked like he’d burst into tears if anyone so much as touched him.

“Come on, you’re not a kid. You’re the chief. If you’ve done trauma surgery, you should be able to finish too.”

“Hey! Are you telling me to move the patient myself? Call the intern! My back hurts—I can’t move the patient alone!”

(T/N: Wow, it’s refreshing to see Kang-hyuk admitting that he made a mistake and slightly panicking!)