Chapter 238

Episode 238 Gunshot Wound (3)

"Tutta."

The inner voice of the Mes of the God spoke.

"What."

Tutta replied nonchalantly, his attention focused on treating the head with bone wax after putting down the drill.

"Let's switch places. We've temporarily put out the fire on the head side anyway. Now we need to help that guy with the chest."

"What? Wait, what just popped up in front of my eyes? 'Do you want to switch possession?' Do I press 'Yes' for this?"

"Yeah. Press it."

Flash!

My vision shook violently once again.

It was the real-time switching of the two-person possession system.

Control of my body was handed back to the Mes of the God.

Without a moment's delay, the Mes of the God moved away from the patient's head and turned toward the blood-drenched chest.

"I will assist."

"What?"

Trauma Surgery assistant professor Lim Seonghyun, who had been awkwardly trying to secure a clear view next to Professor Han Ihyeon after finishing the abdominal ultrasound, looked at me with a dazed expression.

It was only natural for him to be bewildered, considering that the guy who was drilling into a skull just a moment ago was suddenly trying to thrust his hands into a thoracic cavity held open by a retractor.

The Mes of the God stared straight into Lim Seonghyun's eyes and added calmly, "I've completed a rotation in Thoracic Surgery, so I'm familiar with this."

"Ah..."

Professor Han Ihyeon glanced at my face and gave a brief nod. He seemed already aware of my crazy performance, having saved an aortitis patient even after securing the signature of the Thoracic Surgery Section Chief, Cho Kyeongwoon.

Under Han Ihyeon's tacit approval, Lim Seonghyun had no choice but to take a step back as if pushed away.

Looking into the right thoracic cavity where blood was gushing and spurting, Han Ihyeon asked, "Hyunjae. What should we do in this case? The pulmonary vein damage is too deep to be caught even with a Kelly."

"We will perform a Pulmonary Hilar Twist."

It was a technique never used in a standard operating room. It was an extreme measure utilized only in trauma centers or battlefields where damage control was required.

"Aren't you going to do it? If more air passes through, it's brain death."

At the urging of the Mes of the God, Han Ihyeon clenched his teeth tightly.

"Ah, right. We have to do it. Move aside!"

Han Ihyeon plunged his left hand deep into the thoracic cavity filled with blood. Grabbing the mangled lower lobe of the right lung, he lifted it forcefully toward the patient's head. It was the preparatory work to expose the lung root.

"Give me the Metzenbaum."

"Metzenbaum."

Before the nurse could even pick up the instrument, the Mes of the God had already snatched the scissors from the cart and slapped the handle into Han Ihyeon's palm. It was a reaction as swift as a first assist who had worked in tandem for decades.

Han Ihyeon mercilessly cut the pulmonary ligament that was anchoring the lung to the chest wall. Now, the lung hung solely by its root, where the blood vessels and bronchi clustered.

"Suc—"

"Suctioning."

Shuuuuuuuuuk!

Before Han Ihyeon could even finish his sentence, the Mes of the God thrust the suction tip near the bleeding point to secure a clear view.

Han Ihyeon looked at me briefly as if feeling awkward, but soon focused again on operating inside the patient's chest cavity, which was pulsating like crazy.

Clasping the entire mangled right lung firmly with both hands, Han Ihyeon twisted the lower lobe of the right lung clockwise, rotating it forcefully by 180 degrees.

Crick—

Crick.

At that moment, a miracle happened.

Just as water stops when a high-pressure hose is bent sharply in the middle, the massive arterial bleeding heading toward the right lung and the bloodbath spouting like a fountain from the lung parenchyma stopped, quite literally, in dramatic fashion. The twisted pulmonary hilum had choked off the blood vessels tightly.

At the same time, as the bronchus was also twisted shut, the influx of air being forced through the torn vein by the positive pressure ventilation of the ventilator was physically blocked.

It was the exact moment the progression of the fatal systemic air embolism was halted instantly on the spot.

"Sponge!"

"Here it is!"

Snatching the laparotomy sponge handed over by the nurse, Han Ihyeon packed it tightly into every empty gap of the vacated thoracic cavity to finalize the packing.

With the bleeding controlled and the air influx blocked, a blood-splattered Han Ihyeon lifted his head, panting heavily.

"Let's check the brain now. We need to see if the pressure has dropped."

At those words, the anesthesiologist moved toward the patient's head. Pulling a penlight out of his pocket, he peeled back the patient's right eyelid.

Click—

"Light reflex is returning... 5mm. It went down from 8mm to 5mm. The brainstem compression has been relieved."

An audible sigh of relief leaked out.

"Ah, by any chance, was Tranexamic acid administered?" asked the Mes of the God.

"Yes! One gram was just completely mixed with the blood products and administered!"

"Ah, okay. Since the transfusion volume is high, hypocalcemia will follow. Give some calcium chloride as well."

"Yes! How much?" asked the nurse who was preparing the medication, holding up a syringe.

The Mes of the God scanned the EKG waveform flashing on the monitor and issued the order. "Just give 0.5 grams for now. We can add more later after seeing the ABGA results."

"Yes!"

The air inside the resuscitation room finally began to loosen up a bit. It was right after chasing away three Grim Reapers all at once: massive hemorrhage from a penetrating chest wound, systemic air embolism, and brain herniation.

"BP is 90 over 60!"

Finally, a hopeful number burst forth. The patient's systolic blood pressure, which had been past the River Styx and right on the verge of high-fiving the King of the Underworld, miraculously recovered to scrape past the line at 90.

"Well, that turned out well," the Mes of the God said, speaking through my mouth as he glanced at the monitor.

"The pulse is 105 too!"

The heart rate, which had been spinning out of control over 140, was also regaining stability.

The anesthesiologist holding the patient's airway quickly began to finely manipulate the dial of the ventilator. "Maintaining tidal volume and raising the respiratory rate slightly. Setting a target of PaCO2 at 35."

He was artificially inducing a mild hyperventilation state to expel a bit more carbon dioxide from the body by adjusting the ventilation volume. It could be understood as a measure to prevent the pressure inside the skull from building up again by minutely constricting the cerebral blood vessels.

Meanwhile, on the chest side, Professor Han Ihyeon was withdrawing his hands. "Hemostasis confirmed. Nothing else is pouring out."

Having finally confirmed with his own eyes that the massive bleeding wallowing inside the thoracic cavity had stopped due to the twisted and squeezed pulmonary hilum, Han Ihyeon carefully twisted out the rib retractor that had been brutally holding the chest open.

Screeeeech—

The sound of metal friction against bone echoed through the resuscitation room.

"Give me the Ioban. And the tape too."

Han Ihyeon did not forcibly stitch up the massive incision on the chest wall. After covering the wound site with wide, thick gauze, he began layering the sterile, transparent adhesive film and medical tape handed over by the nurse.

Rip!

As the film adhered to the skin, it sealed the inside of the thoracic cavity into a near-vacuum state. The suction of external air or contaminants into the chest cavity was perfectly blocked.

Finishing touches were also well underway on the head side.

『Wrap the bandage tightly. If that temporary drainage tube we placed earlier slips out because of a bump during transport, both you and I are completely fucked.』

『I know, you nag.』

Even while letting the meticulous advice of the Head-Opening Tutta slide right past his ears, the Mes of the God used my two hands to wrap the patient's head very securely. Thick sterile bandages crossed over the temporary cranial incision, wrapping it without a single gap.

Thud!

Right then, the heavy door of the resuscitation room opened, and a 3rd-year Thoracic Surgery resident, Jeong Jaesang, rushed inside. Sweat was beaded all over his forehead, and he was completely out of breath.

"Professor! Pant, pant... I spoke with Professor Jeong Sangmok from Neurosurgery! He just got the call and is coming down...!"

"I am already here."

Neurosurgery staff member Professor Jeong Sangmok, who looked as though he had rushed down from the operating room in his scrubs just moments ago, followed into the resuscitation room.

"Uh... Professor?"

While Jeong Jaesang was caught off guard, Trauma Surgery's Lim Seonghyun began the briefing.

"Right anterior chest close-range penetrating wound. Upon ER arrival, GCS 8, BP 60 over 40. Resuscitative Anterolateral Thoracotomy and Burr Hole were performed simultaneously on the spot. 50cc of hematoma was drained from the brain, and intra-thoracic hemorrhage and SAE control have been completed. Current vitals are BP 90 over 60, Saturation 98, and the right pupil has constricted from 8mm to 5mm."

Professor Jeong Sangmok tilted his head in puzzlement. Opening the chest and brain simultaneously on an emergency room bed was insane enough, but hearing that the crazy stunt had succeeded perfectly and restored the vitals of a dying patient clearly left him quite bewildered.

The patient had broken free from the immediate danger of cardiac arrest, miraculously securing a temporary survival state that would allow them to physiologically hold out for another 1 to 2 hours to undergo surgery in the OR.

"Moving up to the OR!" Lim Seonghyun shouted toward the trauma team nurses.

"Yes, moving them just like that! One, two, three!"

Bang!

Clack!

Rattle, rattle!

The medical staff joined in and began pushing the heavy stretcher. A long streak of dark red blood stains followed the wheels on the floor of the resuscitation room. The bed began rolling toward the operating room.

And then.

Right after the storm had swept through, the door of the resuscitation room, where the smell of blood had not yet faded, slid open. A man dressed in a suit shirt rushed inside. The disposable plastic gown he had hastily thrown on for infection control fluttered with his stride. From his appearance, he was undoubtedly a member of the hospital administrative team.

"Professor!" the man shouted toward Lee Minjae, who was the first to catch his eye.

"Uh, why? What's the matter?" Lee Minjae replied, turning around as he caught his breath.

Wiping the sweat from his forehead, the man said urgently, "Th-the reporters out there are gathered in droves. Because of the briefing regarding the 58th Division incident, cameras are being set up and it's absolute chaos!"

"...Reporters?"

Lee Minjae's brow furrowed. Since a national issue like an accidental shooting at a military base had erupted, it was a natural sequence of events for the media to rush over like a pack of wolves. However, the thought of microphones being shoved into the face of a doctor who had been fighting a blood-splattered battle until just moments ago seemed to bring a surge of sheer annoyance.

"Sigh... Let's head out for now."

Tossing his blood-stained gloves into the medical waste bin, Lee Minjae walked toward the exit of the resuscitation room with a scowling face.

But then.

'…Uh?'

Tucked safely away behind the consciousness, pondering whether to undo the possession or not, my soul sensed a chill.

The Mes of the God still held tight control over my body. This old geezer who absolutely loved the spotlight began exiting the resuscitation room right behind Lee Minjae, walking with an incredibly natural and majestic stride.

'Oh, shit.'

What in the world.

'What is this ghost bastard trying to do?'

Should I undo the possession?