The Returning Doctor Wanted to Live Quietly - Chapter 378



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Episode 378. Decided to Live Quietly (10)

Nakamura swallowed hard.

He had to tell her about the identity of Lee Jin-hyeok that he had heard about, but he just couldn’t open his mouth.

But it felt like I had to say something.

He stuttered in German.

“That, that… … .”

“Why, what?”

“… … .”

“What did you say?”

“… … Okay, let me check again.”

“what?”

“I just can’t believe it. I’ll call again, again.”

“… … ?”

Everyone looked puzzled at Nakamura’s answer.

I can’t believe it.

What on earth does that mean?

But I couldn’t ask Nakamura, who immediately took out his cell phone.

Japan has a large time difference from Germany.

What needed to be taken into consideration had to be taken into consideration.

* * *

The left hepatic artery and left portal vein were re-clamped with a bulldog clamp.

As the blood flow to the liver was completely blocked, Jang Hyuk-jun and Jin-hyeok’s hand movements were quick.

[5 minutes after blood flow blockage]

Jang Hyuk-jun took the lead.

The so-called giant rope.

From right to left.

Pull it back towards 10 o’clock.

To put it in difficult words.

Right entrance where the middle vein flows into the inferior vena cava.

So, it was like pulling a string behind the left portal vein, past the border between the left superior parietal lobe and the left lateral region.

The result is exposure of the middle vein.

Then Jinhyeok took action.

The left upper leaf was bitten with a sponge forceps that had a rounded tip and was hollow inside.

[8 minutes after blood flow blockage]

Jang Hyuk-jun picked up the Harmonic scalpel.

An ultrasonic knife that vibrates 55,000 times per second.

It was similar to the bovi (electrocautery) in that hemostasis and resection occurred simultaneously, but its use was different.

Because it was mainly used when removing the liver.

Crunch.

Crunch.

Cut off the liver surrounding the bile duct.

It’s cut off again.

Of course, the movement was like shouting.

He himself is also a doctor.

He said he was from the main branch of Dae Asin Hospital.

Stop ignoring the Korean medical community.

[10 minutes after blood flow blockage]

“Please give me some scissors.”

“Here it is.”

“How are you going to get in?”

“I’m going big.”

“It also removes Glisson’s (a thick membrane surrounding the liver)?”

“That’s right.”

“Let’s go right away.”

A short conversation.

Jang Hyuk-jun took the surgical scissors.

The days are narrow.

Sharp Caesar.

The target is Gleason Basin.

No, the left bile duct below that.

Contextual information from right to left.

Cut again from right to left.

Jinhyuk also did not stay still.

By pulling on the right bile duct, he was able to focus on the left bile duct that Jang Hyuk-jun was attempting to resect.

And again.

“Let’s go for frozen section examination.”

A request was made to the pathology laboratory.

[13 minutes after blood flow blockage]

“I don’t think there are any mutations.”

“Then, let’s start with the opening shaping.”

This time, both of them held a needle holder and forceps.

There are four openings in the bile duct that connect to the liver.

Although there were no anatomical changes or deformations, they began to trim the cut opening.

This is a plastic surgery done because humans cannot survive without a bile duct.

So it was more like preliminary work before rebuilding the passage that carries the bile produced in the liver.

When you’re waving your hands like that for a long time.

The scrub nurse started the countdown.

“45 seconds left.”

“I haven’t finished it yet.”

“But we still have to close it.”

“35 seconds left.”

“Let’s close it with a cap first. Please give me the cap.”

“Here it is.”

“25 seconds left.”

“I’ll do it.”

“Then this is me.”

“5 seconds left!”

But the voices were mixed.

They both moved their hands quickly.

He removed his hand, placing an opaque plastic cap over the opening of the bile duct that was being formed.

At the same time.

“Timer is running out!”

Again the bulldog clamp was removed.

The blood began to flow.

* * *

The color of the liver changes.

From white to red again.

It was the effect of reperfusion.

Five minutes break.

Let the scrub nurse wipe away the sweat from your forehead.

“thank you.”

Jang Hyuk-jun and Jin-hyeok shouted at the same time.

They both looked at each other and smiled brightly.

A situation where your hands and feet fit together.

The vitals didn’t waver either.

Even the surgery was going as expected.

So the five-minute break was like honey.

“The skill is quite… … .”

“It grew, right?”

“Yes. It has increased a lot.”

“Well, actually, I’ve never seen you before. We’ve never been in an operating room together.”

“But I remember asking you to teach me how to do an ABG (arterial blood gas analysis). It was a long time ago.”

“… … .”

Jang Hyuk-jun shrugged his shoulders without answering.

A vision that comes from the medical school of Seosin University.

Swapped with Cole.

Just a few years ago.

No, just 5 years ago.

But the events that happened so recently feel like a distant memory.

Before I knew it, I was married.

Hajun was also born.

This is possible because I have grown in many ways.

Of course, I was always getting scolded for my spending habits.

Jang Hyuk-jun turned his head towards the patient.

“People, aren’t they really stupid?”

“What is it?”

“It’s obvious that you’re going to get sick. You smoke. You drink. You don’t exercise. You keep regretting it.”

“I might do something I regret after the surgery?”

“Habits last a lifetime. This is the excuse I always make to my wife. I got in big trouble for it again this time.”

Jang Hyuk-jun smiled awkwardly, but Jin-hyeok ignored him and muttered to himself.

“Then the doctor has to step in and catch him.”

“… … .”

“… … .”

Then, both of them suddenly became silent.

A patient who clearly lived his one and only life the way he wanted.

That karma has come back to haunt me.

In the end, I had surgery.

But like any other patient, it is certain that it will happen again.

I quit smoking for a while.

Smoking a cigarette.

I abstained from drinking for a while.

And binge drinking.

That’s the behavior of the patients I’ve seen so far.

So we had to crack down.

Like any professor at a general hospital, he scolds them, scolds their guardians, and yells at them to stop coming if they are going to keep living like this.

You also need to take care of the surgery afterward.

But.

‘There’s nothing like that here. They just leave it alone or let it run wild.’

Like any other American hospital, the reality in Germany is that everything is left up to the patient.

It was such a different place.

* * *

Jang Hyuk-jun opened his mouth while looking at the scrub nurse who was preparing to press the stopwatch.

“What would Korea have done?”

“I bet you got really scolded by the professor.”

“I guess so.”

“But let’s just leave it here.”

“We also have our strengths… … .”

“Because of the speakers who talk like beggars, only the shortcomings are highlighted. There are also advantages.”

There was another brief exchange of conversation.

Korean medical community.

Of course, there were also clear advantages.

It was the same with being good with your hands.

It was also the same with quickly treating patients.

Although there are many disadvantages, there are clear advantages as well.

Of course, there are many people who dislike doctors because of the endless fighting.

And then.

The phone in the operating room rang.

“They say it’s benign.”

Circulator Nurse’s Note.

Jang Hyuk-jun and Jin-hyeok just nodded their heads.

This means that tissue taken from the upper part of the bile duct, that is, from the bile duct on the side of the liver, not the pancreas, is also benign.

Fortunately, the worst was avoided.

Well, after the surgery, it’s up to the patient.

* * *

Surgery resumed again.

After a long phone call, Shusuke Nakamura opened his mouth.

“I don’t know about Dr. Jang, but… … Dr. Lee is said to be a famous genius doctor.”

“what?”

“That’s what a truly genius doctor is… … .”

When he trailed off.

Someone nodded.

“Is there anyone among us who hasn’t heard the word genius?”

“yes?”

“They’re all people who were called geniuses when they were in school. They always got first place.”

“No, that’s not it.”

“If not that, then what?”

“They say that if you see it once, you can do anything. They say that he is truly famous as a genius doctor.”

“What? What did you say?”

Everyone looked puzzled.

Because it wasn’t readily understood.

Then Nakamura began to tell everything he had heard.

I kept cross-checking, but I got the same answer.

Now he had to tell everything he heard, whether he believed it or not.

hereto.

“So Dr. Lee changed the CPR algorithm?”

“Yes, and that’s not all. I heard that he also received an award in recognition of his contributions from the International Congress of Emergency Medicine (ICEM).”

“… … .”

“Why didn’t you suddenly change the CPR algorithm a few years ago? It’s usually changed every five years… … .”

The explanation went on for a long time.

Everyone knew it.

A great achievement by Korean doctors.

It’s like publishing an SCI-level paper.

No, changing the CPR algorithm was an act that had global implications.

but.

“Th, what is that? Wasn’t that something that was done at the exaggeration level?”

“That’s right. Dr. Park’s name was listed at the very front of the paper.”

“Yes. That’s right. Youngjin Park. Yes. That’s it. Pushing. Why do you only put the names of the kids below you? Isn’t that something that happens often?”

“That’s true, but… … .”

“That’s true, but?”

“They say that it was Dr. Lee who took the lead. They say that it was Dr. Lee who first suggested it to Dr. Park.”

The experiment to change the CPR algorithm was conducted at the Asin Hospital Clinical Skills Center and the emergency room.

The first person to propose this was Jinhyuk Lee.

Thanks to this, there was talk that he received job offers from leading hospitals in the United States, including Johns Hopkins Hospital.

hereto.

“So a resident in his junior year wrote a book, won an award from ICEM, and even changed the CPR algorithm? Even the CPR guidelines published every five years by the American Heart Association?”

“Yes. It seemed too good to be true, so I checked through several channels, but everyone gave me the same answer.”

“Your drinking skills are so good that you can imitate everything just by watching it?”

“Well, um. I heard that he showed overwhelming skill in laparoscopic surgery since his internship.”

“… … .”

Everyone was silent for a long time after Nakamura’s answer.

A small country in the East.

No, it was a ruined country until just recently.

That was Korea.

It’s the miracle of the Han River.

The four dragons of Asia.

Everything became useless once we entered the IMF system.

But, in a hospital that was completed in only 1989.

Its history is also short.

He showed such behavior.

I couldn’t believe it at all.

* * *

After completing the plastic surgery of the cut bile duct opening.

Jinhyuk Lee and Hyukjun Jang are now checking their strength.

Everyone looked down at the operating room and said nothing.

So that the opening can be seen clearly.

1.5cm on the front wall.

No, it was moving with traction sutures placed at 2cm intervals.

That’s not all.

To reconstruct the severed bile duct.

So, the move to connect by detour to the factory was also close to standard.

The same goes for the joint.

The conversation that had begun before we knew it was simple.

The anterior surface of the anastomosis is closed with a single suture.

The back was sutured continuously.

And in an instant.

A situation where there is absolutely no unnecessary movement.

Everyone just let out a sigh as they watched Lee Jin-hyeok’s hand movements.

I already thought it was strange.

When you hear the history, it really does seem exceptional.

“Heh heh… … .”

“A real genius?”

“How could such a monster… … .”

“No, this is really… … .”

Of course, everyone just laughed in vain.

* * *

The surgery was already rushing towards its end.

Anastomosis of the bile duct and the jejunum.

The so-called HJ.

Hepaticojejunostomy was performed.

Of course, as with everything, the hardest part was finishing.

As everyone else just laughed, Amilon, who couldn’t accept it, intervened.

“If you’re not careful, bile can leak out.”

“Hmm.”

“If the anastomosis is done incorrectly, wouldn’t digestive enzymes, bile, and intestinal fluids leak out?”

“… … .”

“Damage to the anastomotic tissue due to leakage. And sepsis due to infection. I think it would be better for us to finish it.”

Now you’re trying to interfere.

In fact, it was nonsense.

It’s just like dog whining.

so.

“… … .”

“… … .”

“… … .”

“… … .”

There was silence for a long time.

The professors simply looked down at the observation room.

There was no hesitation in the hand movements of Lee Jin-hyeok and Jang Hyuk-jun in the operating room.

Opposite the mesentery.

So, cut the factory wall to the same size as the inside diameter of the common bile duct.

It was connected from the back.

Once, twice, three times.

I think you only need to give it two layers.

After giving it three times, the posterior anastomosis is completed.

This time, anterior anastomosis again.

This also ends in an instant.

And what followed was the remaining skills.

The doctors who were watching this burst into exclamations of admiration.

“Heh heh… … .”

“Here again… … .”

“No, this is… … .”

This is because Jinhyeok and Jang Hyeokjun, who were reconstructing the bile duct and reconnecting it to the factory, sutured part of the factory wall to the connective tissue surrounding the liver.

Immediately someone asked Amilon:

“Why do you think you’re doing that?”

“That, that.”

“They know that too. They took three layers because they thought the joint shouldn’t be torn.”

“… … .”

“And now, look. They are even doing additional traction to prevent the anastomosis from loosening.”

“… … .”

Amilon, who had nothing to say in rebuttal, lowered his head and stepped back.

The traction that will come later.

So, to prevent the anastomosis from being damaged by impact,

Those who do the anastomosis of the connective tissue and the factory that doesn’t need to be done.

There was absolutely nothing to find fault with.

While they were talking like that.

Before we knew it, Jinhyeok and Jang Hyeokjun were touching the pancreas area.

The area that was touched at first.

And finally finish it up.

After washing with saline solution.

Check for bleeding.

That wasn’t all.

Check if there are any parts that are incorrectly connected.

Are the biliary and jejunal anastomoses okay?

Is the severed liver okay?

Let’s check everything carefully, someone watching asked.

“So, is Dr. Lee really such a genius?”

“Yes, that’s what I heard.”

“Then, what about Dr. Jang, who was in charge of the surgery?”

“yes?”

“What on earth is Dr. Jang, who can guess the size of a hematoma just by looking at an X-ray image and solve countless difficult problems we sent him?”

“That, that is… … .”

When Dr. Amilon couldn’t answer properly and became disoriented.

The discussion continued for a long time.

“Isn’t there a reason why Dr. Jang performed the surgery instead of Dr. Lee?”

“Then you’re more of a genius?”

“In terms of skill, Dr. Lee seems to be better.”

“Then Dr. Lee should have performed the surgery.”

“That’s right. They both had general surgery boards. Both were possible surgeries.”

The discussion went on for quite some time.

Although the book was written together, there were all sorts of stories about the identity of Jang Hyuk-jun, whose name was not known.

There was a lot of speculation about why Jang Hyuk-jun performed the surgery.

at last.

“Nakamura, check again.”

When everyone looked at Nakamura again, he, who had lost his soul, gave a very Japanese answer.

“That, that… … . Um… … . Isn’t Doctor Jang a greater genius than Doctor Lee? Why is a genius doctor hiding his powers? Something like that… … .”

Out of breath.

A loner who hides his strength.

No, I’m saying he’s a genius doctor who hides his powers.

It was a typical answer from Japan, the country of animation, but everyone nodded quietly.