Chapter 163: Who You Are With Matters (2)

“Ah.”

The anesthesiologist carefully checked the patient’s vital signs again. Blood pressure and heart rate were almost non-existent. The overall condition of the patient was poor, so he had decided it would be best to proceed quickly. However, after hearing Suhyuk’s words, he realized the heart rate was excessively fast. Due to the reflux, there was already significant strain on the heart. What could happen if anesthesia is induced now?

‘If blood pressure drops further… It might lead to death.’

It would put even more stress on the heart.

“Wait a moment… I’ll prescribe some medication.”

While the doctor stood frozen, Soohyuk sprang into action.

He picked up one of the numerous drugs available at the anesthesia table - Amiodarone.

The drug itself was not special. However, isn’t this how internal medicine works? Even with the same medication, its effectiveness can vary greatly depending on when and how it is administered.

“Good. It’s decreasing. Well…it hasn’t completely stabilized yet.”

Considering his body, especially the heart, was severely damaged, there was no way a single drug could fully heal him. In this situation, any medication would merely buy time. The crucial factor remained the outcome of the surgery.

Suhyuk turned towards the thoracic surgeons.

“You’ll be attaching the extracorporeal circulation machine later, right?”

“Uh… Yes. We need to.” The response came from the fellow, who had many more years of experience than Suhyuk but also someone whom Suhyuk had helped once before unintentionally.

“Yes, then we will induce anesthesia now. Anesthesiologist, please proceed.”

“Um… Yes. Alright, understood.”

Once connected to the extracorporeal circulation machine, the patient should be fine. The extracorporeal circulation machine acted as an artificial heart. The question was whether the patient could hold on until it was connected. Thanks to Suhyuk, he bought some time for this process.

“Anesthesia… Yes, everything looks good.”

Fortunately, the induction was successful. As expected, there were slight fluctuations in blood pressure, but thankfully, the patient’s heart held up.

“Okay. Let’s disinfect immediately and start the open-heart surgery.”

As soon as anesthesia was administered, the thoracic surgeons and operating room nurses sprang into action. Some scrubbed the chest with Betadine, while others went outside to wash their hands.

“Hmm.”

Baruda sighed at the sight, sounding somewhat wistful - a tone Suhyuk might not have noticed before, but they had spent enough time together now.

‘Why… Does he wish he could perform surgeries too?’

“Many treatments ultimately require surgery, don’t they? Isn’t this case similar?”

‘Well, indeed… that’s true.’

More conditions than one might think eventually necessitate surgical intervention. Apart from today’s surgery, Baruda pointed out several other instances where Soohyuk couldn’t fully participate due to his condition.

If Suhyuk’s body was healthy, regardless of which department he belonged to, he would have tried his best to participate in these surgeries. However, Suhyuk had mobility issues with his legs. Honestly, it was difficult for him just to stand here now.

‘What can’t be done cannot be forced. Surgery is not possible.’

[Currently, that is true.]

‘It sounds like you think it might be possible later. The nerve damage…is irreversible. Even if there were a chance, it would be too late for me.’

[Understood. Let’s give up on surgery.]

Fortunately, Baruda wasn’t someone who blindly pursued unrealistic goals. Instead, due to his thorough understanding of Suhyuk’s condition, he could remain pragmatic.

[Instead, let’s focus on anesthesia assistance. Since induction is complete, there shouldn’t be any major problems, but…]

‘I still can’t relax until we attach the extracorporeal circulation machine. No…’

“Even with the extracorporeal circulation machine attached, you need to be cautious beyond just the heart. The overall condition of the patient is actually…”

Originally, anesthesia departments disliked surgeries involving high-risk patients the most. Anesthesia could become unpredictable depending on the patient’s overall health status.

This particular patient had not only been deemed risky by the anesthesia department but also by Internal Medicine and even the surgeons themselves. If the patient were slightly older, they likely wouldn’t have been admitted for surgery at all.

‘Yes. Right, let’s stay focused.’

[It will be a valuable experience.]

‘No, it’s about staying alert for the patient’s sake.’

[For future patients as well.]

‘No… Uh… Never mind. Yes, let’s do that.’

Suhyuk wanted to say something about Baruda’s blunt words but instead turned towards the monitor showing vital signs. Currently, they were just disinfecting and laying out drapes, so there was no significant change yet.

Naturally, the expression of the anesthesiologist observing them remained grim.

We almost lost him right at the start…

The patient had been on the brink of death moments ago. If it wasn’t for Lee Suhyuk, the likelihood of that happening would have been high.

Hastily, he grabbed his phone, intending to call the professor responsible for anesthesia in thoracic surgeries.

“What? Hey! This case is more urgent! It’s a trauma patient!”

“Ah…”

“The blood pressure is already unstable, risking his life. What? You want me to go over there? Are you insane?”

“M-my apologies.”

However, most of their conversation consisted of the anesthesiologist venting frustration.

‘Seems like it is more urgent over there…’

The anesthesiologist was also a third-year resident, which meant he wouldn’t have much else to do if not for this surgery. That’s why as soon as he heard ‘trauma patient,’ he had a hunch.

‘Well…if it’s a trauma case with heart damage, that explains everything.’

Could the injury be limited only to the heart? Given the nature of severe trauma patients, they likely sustained multiple injuries. This implied several surgical sites would need attention simultaneously, meaning the anesthesiologist would have to monitor and manage several times more than usual.

‘Then I really am on my own…’

He couldn’t help but sigh at the thought.

At that moment, Suhyuk approached him, leaning on his staff. “Doctor.”

“Oh, Doctor Lee Suhyuk. Thank you for your help earlier.”

“Firstly, let me assist with monitoring vital signs… Since it’s my patient, I might be able to help.”

“Thank you.”

“By any chance, do you know when the professor will arrive?”

“The patient who came through emergency services… seems to be in very bad shape. He probably won’t come until this surgery is finished.”

“Oh.”

Compared to the anesthesiologist, Lee Soohyuk didn’t have much experience with critically injured patients. However, there were times when the intensive care unit was inadequate, and occasionally, he observed trauma cases from the surgical ward.

“Well, it must be intense over there too.”

Of course, that alone was enough for him to realize how demanding the trauma center could be.

‘I guess we’ll have to handle this together.’

“Yes, I’m nervous since it’s my first live surgery. I’ll make sure to document everything in the Database.”

‘Right, capture all of it.’

While they prepared themselves mentally, the draping was completed, and the thoracic surgery professor approached the patient, scalpel in hand.

There was no separate administration of local anesthesia. Not only was his blood pressure low, but there was also no time for it. Both the anesthesiologist and thoracic surgeon were relieved to connect the patient to the extracorporeal circulation machine as soon as possible.

Ziiing.

The professor swiftly made a vertical incision down the sternum with the scalpel. As bright red blood flowed out, the fellow assisting promptly suctioned it away.

Suhyuk found this sight fascinating since he had been working in the operating room for almost two years now, and opportunities like this might be rare going forward. Unfortunately, he couldn’t afford to focus solely on that aspect.

“How’s the blood pressure?”

“It’s stable. The issue is…the heart rate. It’s increasing again.”

The patient’s vital signs were the cause of concern. It couldn’t be due to just the amount of blood loss. The accumulated problems until now seemed to have reached their breaking point.

“It will be difficult to administer more medication.”

“Yes, if we give it now, his blood pressure…will likely drop further.”

A rapid heart rate could be problematic, but so could a slow one. After all, when someone dies, their heart stops beating. Even though there was a trend towards the heart rate increasing again, administering drugs while within normal range would lead to complications.

“What should we do?”

In response to Suhyuk’s question, the anesthesiologist shrugged and then addressed the thoracic surgeon.

“The patient’s heart rate is becoming unstable again! Please speed up!”

“Damn it. Got it!”

The solution was to pressure thoracic surgery. The professor of thoracic surgery seemed to agree with this opinion and started working faster. However, from Suhyuk’s perspective, it still appeared slow.

[It is not easy. There are limitations on which drugs can be used… Yet, they continue trying.]

‘Should I pray?’

[To whom?]

‘Well.’

If there were a God, perhaps it would be the entity that had Baruda embedded in its head. Thus, Suhyuk began praying towards that being. At least at this moment, he couldn’t do anything except pray.

“Saw please!”

Meanwhile, as the incision on the patient’s chest was completed, the professor requested for a saw. A nurse promptly handed over the prepared saw, filling the operating room with the loud sound of bone cutting.

Wiiiiiing.

Krrrrrkrrrkkrrkrrk.

For someone hearing it for the first time, the sound was somewhat harsh. It was the noise of bones being cut.

[Hrmm, the pH level is gradually changing.]

Naturally, Baruda analyzed this as if it were not related to a human life. Suhyuk found it both astonishing and helpful. Having such an objective viewpoint allowed Suhyuk’s own mind to remain calm.

‘Changing pH levels?’

[Yes, apparently due to differences in bone composition. That explains it.]

‘Ah… So higher pH levels indicate harder areas?’

[Correct. Fascinating, isn’t it?]

‘Uh… yeah, I guess.’

Suhyuk shook his head at Baruda’s perspective before turning towards the monitor. The patient’s blood pressure had dropped further compared to earlier. It seemed that the process of cutting through the bones might be exerting pressure somewhere.

‘Is this okay? It seems like physical pressure is being applied to his heart.’

[It’s not good. If more pressure is exerted…it will be dangerous.]

‘What should I do?’

[Didn’t you see earlier? There is nothing you can directly do.]

‘Hmph.’

Suhyuk looked reluctant, but what could he do? Baruda was right after all. Even if it felt awkward, there were some things that needed to be said.

“Um…”

“What now?” The response was predictably cold.

Suhyuk’s association with Lee Hyunjong had already made him quite infamous among medical professionals. Expecting kindness from thoracic surgeons who held negative feelings towards Lee Hyunjong might have been too much to hope for.

“Right now, about…the metal plate in the ventricular septum.”

“Huh?”

“I think it’s pressing down too hard. Considering both the decreasing blood pressure and the EKG pattern, it appears to be applying direct pressure on the heart.”

“Wait, let me see.”

However, there wasn’t any doctor who would treat patients poorly due to their mood. Moreover, thoracic surgery was currently responsible for this patient’s care. As people working in a challenging field with low financial rewards, they all had a strong sense of duty.

“Hey, hey! You, you’re pushing it down!”

As a result, the professor discovered that the metal plate was angled slightly more downward than usual.

How did he know?

It was fascinating how Suhyuk could accurately guess without even looking, but the professor didn’t lavish him with praise. Instead, he relentlessly grilled the first-year resident.

Regardless of the process, the outcome was positive.

“Yes, his blood pressure is returning. Please continue as before.”