Chapter 237

Episode 237 Gunshot Wound (2)

“I will proceed with an Anterolateral Thoracotomy,” announced Han Ihyeon of Thoracic Surgery.

This was not a minor procedure like inserting a tube into the Chest to drain Blood. He was declaring that, right on the Emergency Room Bed, he would use a Mes to slice between the Patient's ribs and pry them open with a retractor to visually examine the Heart and lungs with his bare eyes.

In the Emergency Room, not the Operating Room.

“Pardon?”

Han Ihyeon ignored the bewildered responses of the other medical staff.

“Teacher Han Hyeonjae?”

“Yes, Professor.”

“You are going to do a burr hole, right?”

“Yes.”

I replied, tightly clenching my blood-stained gloves.

While stopping the bleeding from the penetrating chest wound was crucial, the Patient's right pupil had already dilated to 8mm, indicating that the brainstem was being crushed. In this Situation, if the pressure inside the skull wasn't relieved, the Patient would become brain dead before the Chest could even be opened.

“Can you do it At the same time?”

The Patient's Head and the right side of the Chest.

With only a few steps of distance between them, two doctors had to hold blades, tear flesh, and drill into Bone simultaneously. It was a Situation that demanded a movement path akin to an acrobatic act.

“….”

I quickly turned my Head and stared into the Void at a Window invisible to others.

Korean Slave 1 (Male): Is a burr hole and thoracotomy possible At the same time?

Mes of the God (Male): Separate procedures by two people? Is there another Doctor?

Korean Slave 1 (Male): Yeah, yeah, yeah, yeah.

Mes of the God (Male): Possible.

BrainDriller: Possible.

Cool confirmations from a legendary Trauma Surgery Doctor and a neurosurgeon.

“It is possible, Professor.”

At my answer, Han Ihyeon nodded.

“Good. If so, give me a number 10 blade, a number 20, a Metzenbaum, a Mayo, lung forceps, a Satinsky, and a laparotomy sponge.”

The moment Han Ihyeon issued the order, the nurses preparing the scrub Started moving busily.

The sound of sterile drapes being torn open and the clattering friction of metal surgical instruments being poured onto trays filled the Resusc.

“I will do the burr hole First.”

“Alright.”

Han Ihyeon replied, roughly disinfecting the entire right Chest of the Patient with a giant sponge soaked in betadine.

“Oxygen saturation is 84!” shouted the Intern watching the Monitor frantically.

The Oxygen saturation, which should have been at 100, was plummeting to a catastrophically low number.

“I know, I know. It's probably because of the lung,” Han Ihyeon replied nonchalantly.

His attitude implied it was an obvious outcome since the bullet had penetrated, causing the lung to crumple like a piece of paper and fill with Blood. That terrifying composure brought a strange sense of Relief Midst this absolute chaos.

I made up my mind and Quietly closed my Eyes.

‘Possession, BrainDriller.’

Agh.

Seriously, even in this urgent Situation, I can't focus because of this nickname. Look at the state of this old neurosurgeon's nickname.

[Would you like to use 2-Person Possession?]

[Cost: 5,000 LP]

‘Yes.’

[Please designate the target.]

‘Mes of the God.’

Flash!

My vision went dark in an Instant.

The blinding lights of the shadowless surgical lamps and the noisy Alarm Sound were blocked out in a single Moment. Control of my body slipped away, and an alien sensation rushed into its Spot.

The Possession was complete.

BrainDriller, who had taken over my physical body, glanced around the interior of the Resusc and the monitoring equipment as if intrigued, but quickly snapped out of it and moved close to the Patient's Head.

And at the edge of my vision.

Behind Professor Han Ihyeon, who was handling the Patient's Chest, Mes of the God could be seen floating in the air like a dusty, blurry silhouette, with advice mode activated.

『2cm forward and 2cm above the right tragus.』

BrainDriller muttered in his Mind, guiding a gloved Finger over the disinfected right temporal region of the Patient to point out a specific spot.

Inside the skull.

The ultimate target point for the epidural hematoma, where the middle meningeal Artery had ruptured and Blood was pooling.

“Since the GCS is 4, we will skip local anesthesia. Give me a number 10.”

The Patient was in a coma, unable to feel pain due to the brainstem being crushed, so the Judgment was that even wasting a single Second to inject anesthesia was a luxury.

At that Moment.

“Blade, please. Number 20,” Han Ihyeon shouted simultaneously from right next to him, feeling the contours of the Patient's ribs.

A small, sharp number 10 Mes to delicately cut the Skin and fascia.

A number 20 Mes to slice through the Thick pectoral and intercostal muscles of the Chest all at once.

The two blades flashed coldly under the shadowless lamp.

Two emergency surgeries Started at the same Time on a single Resusc Bed in the Emergency Medical center, not even in a regular operating room.

Exhibiting a high level of concentration, BrainDriller held my wrist holding the number 10 Mes vertically and began a straight incision about 5cm long into the Patient's temporal area.

Sliiiit—

The scalp is one of the tissues in our body most abundantly filled with blood vessels.

The instant the Mes passed through, crimson Blood surged out, but BrainDriller didn't even flinch.

“Give me a Penfield number 3.”

“Penfield number 3 is…”

Because this was the Emergency Room and not a neurosurgery operating room, the scrub Nurse got flustered by the unfamiliar name of the instrument and searched frantically over the cart.

“That one over there.”

“Ah, yes!”

BrainDriller pointed out the exact instrument and received it.

BrainDriller pushed the received Penfield dissector into the incision, forcefully scraping away the tough periosteum covering the white Bone, cleanly exposing the outer surface of the skull.

Skrrrch—

Scratch—

A bone-chilling friction sound of scraping Bone echoed.

“Give me a Mayo,” Han Ihyeon's Voice could be heard speaking casually.

A giant incision cut by the number 20 Mes had already opened on the Patient's right Chest, and Blood was gushing out Without rest.

The white, dusty mass resembling Mes of the God was already hovering right next to the Chest area in a state of excitement.

『He nicked the Intercostal artery! Hey, BrainDriller! Open your Mouth for a second! Let me give this guy some ad...vi...』

As the Artery passing beneath the rib was severed and Blood sprayed Like a fountain, Mes of the God shouted urgently.

However.

“Give me a Kelly!”

The instant the instruction left Han Ihyeon's Mouth, his Hand had already accurately located the spurting bleeding point and clamped it with forceps.

The bleeding stopped.

『What? What did you say, Mes-God?』

『Never mind. This thoracic surgery guy is actually pretty good.』

“Finochietto, please~”

Han Ihyeon took the heavy metal retractor used to pry open the ribs and open up the thoracic cavity.

“Weitlaner, please.”

BrainDriller likewise demanded a hook-shaped retractor to pull the scalp incision open to both sides and fix it in place.

It was a Scene where emergency surgeries on the Chest and Head were unfolding simultaneously.

Clack, clack, thud!

Screeech—!

The sound of the Patient's Chest being ruthlessly pried open by the Finochietto with a cracking noise echoed through the Resusc along with the metallic friction sound of the Weitlaner stretching and fixing the scalp.

“Irrigate with saline and suction.”

BrainDriller said.

Shhhhhhup—

Saline washed away the Blood pooled on the surface of the skull, and the suction machine forcefully sucked up the red water, Finally bringing the white surface of the Bone into view.

“Good,” BrainDriller remarked.

“The one with the 14mm bit… Ah, yes. That one. Thank you.”

The Moment BrainDriller took the equipment.

Han Ihyeon slipped his Hand beneath the ribs and began to exert strength, straining.

Snap—

A blunt, unpleasant sound of costal cartilage snapping filled the air.

Splaaaaash—

At the same time, a massive glob of blood clots pooled inside the thoracic cavity could not withstand the pressure and erupted toward Han Ihyeon's Gown and the shadowless lamp.

Splat.

Drip, drop.

“Suction, suction!” Im Seonghyeon thrust the suction tip deep into the hole where the bloody water was rising.

Han Ihyeon moved his hands again.

Shhhhhhhup—

Only then did the disastrous state of the right lung, which the bullet had ripped through, seem to reveal itself.

“The Lower lobe is in pretty bad shape. It looks like it even nicked a branch of the pulmonary artery as it penetrated….”

While a bloody battle was being waged on the Chest side, the movements of BrainDriller, who occupied the Head side, grew extremely precise as well.

“You there.”

BrainDriller called out to Yang Siwoo, a 1st-year resident who was standing with a dazed Expression.

“Ye-Yes!”

“Hold the Head tightly. If it shakes while the drill is turning, it could pierce right into the brain parenchyma. Don't take your hands off.”

BrainDriller instructed Yang Siwoo to hold the Patient's Head firmly.

“Drill entering.”

Drrrr—

Drrrr—

Along with an unpleasant vibration, a grating sound echoed.

Every time it dug into the hard skull, a white bone dust resembling sawdust drifted into the Air.

『This is no joke. Is the muscle strength of this Korean Slave's body a bit lacking?』 BrainDriller remarked casually while concentrating on the drilling.

『The surgery for these guys over here is no joke either. There are a lot of clots. The lung condition is terrible.』 Mes of the God replied internally.

『Even if you tell me, I won't understand it.』

Leaving Mes of the God's nagging behind, the drill dug deeper and deeper.

A reddish part Mixed with Blood began to be observed in the once white bone dust.

It meant that it had passed the outer table of the skull and reached the cancellous bone layer.

And Finally, the drill reached the last layer—the hard inner table of the skull.

The Resistance felt at the tip of the bit reached its peak.

BrainDriller stopped his Hand.

“Give me a burr.”

“Ah, yes!”

Attaching the burr handed over by the Nurse, BrainDriller exquisitely shaved the edges of the hole, securing a drainage window for the hematoma to escape.

The inner table of the skull was Finally Completely opened, and the very Moment the drill was carefully pulled upward.

“…!”

The dark red epidural hematoma mass that had been crushing the brainstem began to gush out through the drill hole.

『Bingo.』

BrainDriller smiled.

“Frazier! Suction, please!”

“Suctioning!”

Shhhup—

While suctioning the erupting Blood, BrainDriller moved his hands rapidly.

『Hey, Korean Slave, watch closely. Blood keeps seeping out from the cancellous bone of the cut section of the Bone, right? In times like this, applying a hemostatic agent all day is useless.』

BrainDriller picked up a sticky lump of wax prepared on the sterile drape.

“Bone wax.”

He meticulously packed the bone wax into the rough cross-section of the drill hole.

『This is how you do it. You physically block the bleeding coming from the Bone itself.』

Just as the battle with the brain pressure seemed to draw to a tentative close, Mes of the God, who was watching Han Ihyeon's surgery from the Side, turned pale and began to shout.

『Driller, Driller, Shit!! Borrow me your Mouth! Hey!!』

『What is it all of a sudden?』

Splurt—

The Blood erupting from the Patient's right lung suddenly began to bubble and boil. Han Ihyeon's Face hardened in an Instant.

『Tell the thoracic surgery team that an SAE (Systemic Air Embolism) has hit! Air got sucked in through the torn pulmonary vein! If air travels to the brain and Heart, it's over!』

“It's an SAE! Reduce the tidal volume and PEEP!”

A Shout erupted through my Mouth.

At those words, the anesthesiologist who was managing the Patient's Airway… wait, when At all did they come down?

Anyway, an anesthesia staff member, who no one even knew when they arrived, reflexively turned the ventilator dial to adjust the pressure at BrainDriller's Shout.

『Tell him to do a LA Apex Aspiration! Air must have filled the left side of the Heart!』

“Please aspirate the left ventricular Apex with a syringe!! Quickly!!”

At those words, Han Ihyeon snapped his Head up.

His Gaze was a Mixed Expression of panic and astonishment.

“How do you know that…?”

“Quickly! If air fills up and blocks the coronary artery, it's an immediate arrest!”

“Ah, right! Give me a 50cc syringe!”

Following the instructions of Mes of the God, Han Ihyeon hurriedly plunged the syringe in.

As bubbly air bubbles were drawn into the syringe along with Blood, only then did the EKG waveform on the Monitor regain normalcy.

While Han Ihyeon finished the treatment, BrainDriller focused back on the brain.

Inside the hole, the dura mater that had been sunken in from being crushed by the hematoma was observed to slowly regain its elasticity as the pressure vanished, rounding upward once more.

It was a sign that the brain had Started to breathe again.

“Stapler, please.”

With flawless Hand movement, BrainDriller temporarily clamped and sutured the scalp incision.

Then, after covering the drilled hole with a Thick gauze, he let out a deep Sigh.

“Aspiration complete!” shouted Han Ihyeon, who was covered in Blood.

“Burr hole complete,” BrainDriller said calmly through my possessed Mouth.

Amidst the astonishment of the people, the temporary brain Surgery came to an End.