Trauma Center : Golden Hour - Chapter 104

“H-here!”

Realizing the mood was turning tense, Jang-mi quickly handed over the scalpel, already fitted with a no. 15 blade—the kind Kang-hyuk usually used for incising arms or legs.

“Hmm.”

Thankfully, Kang-hyuk seemed satisfied with the blade and nodded.

Meanwhile, Jaewon, face tense, stretched out the patient’s left outer thigh.

“Yeah. Pull it tight like that. Anesthesia…”

Kang-hyuk started to give an order but fell silent.

Gyeongwon was already deepening the anesthesia.

It looked like he’d given a bit more [muscle relaxant], too.

All five fingers indicating anesthetic depth were extended.

“Huh?”

“Never mind, you’re doing fine.”

“Yes, Professor. Let me know if there’s too much bleeding.”

“Okay.”

Kang-hyuk, looking satisfied, made the incision.

By the book, you’d draw the surgical line with a marker first, then cut.

If you messed up with a marker, you could erase and redraw.

But with a scalpel, there was no fixing it.

You had to get it right in one go.

Screee.

Kang-hyuk made about a 15cm incision along the outer left thigh, accounting for the underlying [quadriceps muscle].

(T/N: [Quadriceps muscle] is a large muscle group at the front of the thigh, responsible for extending the knee.)

It wasn’t a straight line.

‘How does he just cut like that…? It’s not something you do every day.’

Jaewon was awestruck at the incision, which seemed perfect no matter how many times he looked.

It would be understandable if Kang-hyuk were an orthopedic professor who did this constantly.

But he was a general surgeon—well, trauma surgery sometimes required limb incisions, but it wasn’t his main field.

“What are you gawking at? If the skin is cut, what does the assistant do next?”

Kang-hyuk scolded Jaewon, who’d been momentarily dazed.

He always wanted everything handled quickly in surgery.

If you could keep up, he didn’t care if the assistant joked or hummed—just get it done.

The problem was, hardly anyone could keep up.

Kang-hyuk was too fast.

“Uh, yes. Yes!”

Jaewon nodded, looking at the incision through both skin and about half the underlying [subcutaneous fat].

(T/N: [Subcutaneous fat] is the layer of fat just beneath the skin, important for insulation and energy storage.)

With uncanny skill, the blade had gone just deep enough to avoid significant bleeding.

‘He’s a monster, really.’

Jaewon stuck the [retractor] into the incision, not just opening it wide, but lifting it slightly.

(T/N: [Retractor] is a surgical instrument used to hold back tissue and expose the surgical area.)

The split skin was lifted upward, but the subcutaneous fat beneath was still attached and sat lower.

The gap between what was cut and what needed to be cut was much wider now.

“Hand me the [Bovie].”

(T/N: [Bovie] refers to an electrosurgical knife that uses electric current to cut tissue and cauterize blood vessels.)

“Yes, here it is.”

“And the [tip]…?”

“I put in the sharp one.”

“Good job.”

Kang-hyuk nodded at the razor-sharp tip—sharp enough to pierce a glove with a single poke.

Usually, for large areas like the leg, where there aren’t many vital organs, a broad [blunt tip] was preferred—it could cauterize bleeding by burning the sides.

But Kang-hyuk hardly ever used the blunt tip.

In fact, neither Jang-mi nor Jaewon could recall seeing him use it.

“Suction here. You know a lot of [fine dust] comes out, right?”
(T/N: [Fine dust] refers to smoke and tiny particles produced when the electrosurgical knife burns tissue.)

Kang-hyuk said as he brought the Bovie to the yellow fat.

Jaewon hurried to place suction close by.

“Fine dust? You get that here too? I thought it was just from factories…”

“Sheesh.”

Kang-hyuk gave Jaewon a look of disbelief.

No wonder there’s a saying about “specialist idiots.”

“Why…?”

“Don’t you read the news or newspapers? There are in-depth columns about this stuff.”

“I’ve just been busy with patients…”

“This guy acts like he’s the only one seeing patients. What about me?”

“Well…”

Jaewon wanted to say something but couldn’t find the words.

This crazy professor spent even more time on patients but still kept up with this sort of thing.

‘And when does he even have time to shower and press his clothes?’

Now only Kang-hyuk called Jaewon “Slave.”

You might think that was a good thing.

But it wasn’t.

‘They call me a bum now…’

People called Jaewon a bum.

It sounded absurd at first, but now he was used to it.

His stained gown, bloody Crocs, and flipped-up hair all looked the part.

“Anyway, when you hit fat with this, it burns and cuts at the same time.”

“Yes.”

“Huh? Never mind. There’s always a ton of [fine dust], so keep suction close. You saw that recent study, right? Surgeons who spend longer in the OR don’t live as long.”

“Oh… right. I did see that.”

Kang-hyuk constantly reviewed weekly journal articles, especially if he found something important or interesting, he’d share it with the team.

One such article was about the link between surgeon operating times and life expectancy.

Operating rooms were much more hazardous than people thought.

“That’s all because of this. If you want to live long, use suction.”

“Yes, Professor.”

Jaewon wanted to live long, too.

He quickly brought the suction close to the burning fat.

‘Honestly, if I wanted to live long, I should quit trauma surgery…’

Watching the white smoke sucked away, Jaewon thought it looked more toxic than ever.

Still, nothing seemed more toxic than daily life in trauma surgery.

It was a job where you burned up your own life to save others.

Sizzle, sizzle.

Kang-hyuk’s Bovie burned through the fat and reached the muscle below.

The Bovie didn’t just produce heat—it used electricity, so any touched muscle would contract violently.

Fortunately, Gyeongwon had raised the anesthesia depth, so the response was subdued.

“Hmm.”

Kang-hyuk, unusually, let out a small groan as he continued to burn through the muscle.

Thud.

Thud.

The patient’s thick thigh kept shuddering.

If someone unfamiliar walked in, they’d think a madman was playing with the patient’s leg.

‘He’s probably not messing around.’

Jaewon thought it was ridiculous, but with Baek Kang-hyuk, nothing could be certain.

He’d more often done the unexpected than the expected.

So Jaewon decided to wait and watch.

Thud.

Thud.

But as it went on for more than five minutes, Jaewon grew uneasy.

‘Is he really not just messing around?’

But Kang-hyuk’s face was too serious.

‘Well, he could joke with that face, too.’

Jaewon mustered his courage and spoke.

“Professor, what are you… you’ve been doing this for a while…”

“Hold on. I’m looking at the [muscle fibers].”

(T/N: [Muscle fibers] are the individual contractile cells that make up muscle tissue; the direction and type are important for surgical reconstruction.)

“Muscle fibers?”

“Yeah. The grain. You see it too, right?”

“Oh… yeah, I do.”

Jaewon noticed the muscles twitched in different ways, depending on where the Bovie touched.

Some areas were wide, some narrow.

The contraction strength also varied—not necessarily stronger just because the area was bigger.

‘So what does it mean?’

Jaewon thought maybe it was just Kang-hyuk’s sharp observational skills at play.

It was interesting that stimulation produced different contraction sizes and strengths, but he didn’t see any greater medical significance.

But Kang-hyuk stopped at a certain spot.

He stimulated it several more times.

Thud.

Thud.

A wide swath of muscle contracted powerfully.

Kang-hyuk pointed at it and asked Jaewon:

“What do you think?”

“Huh?”

“What do you think? Here.”

“Uh… it’s big.”

“You…”

Kang-hyuk looked at Jaewon with deep disappointment.

Jaewon realized something was wrong and stared harder at the muscle.

But nothing obvious came to mind.

Just then, Jang-mi tapped his arm.

He turned to see Jang-mi pointing at the patient’s heart.

The [cardiopulmonary bypass machine] was running fully now, and the [cardioplegic agent] had stopped the heart completely.

(T/N: [Cardiopulmonary bypass machine] is a device that takes over the function of the heart and lungs during surgery, circulating and oxygenating blood. [Cardioplegic agent] is a solution used to intentionally stop the heart during surgery to allow for repairs.)

“Whew.”

It wasn’t the first time, but seeing a stopped heart never got easier.

Jaewon involuntarily sighed and checked the heart.

Th𝚤𝘴 𝐜hа̄pţ𝑒r ıʂ pⲟ𝙨ṯᥱđ b𝓎 Ƙ𝚤𝗍𝗲ṉ𝟬𝕧𝓮𝗅

Soon he nodded.

“The size… it’s almost identical to the [right ventricle] defect…”

“Exactly. So, what now?”

“We cut this and attach it to the heart.”

“Then what are you waiting for? Pull it up!”

“Yes!”

“Gangster, scalpel instead of the Bovie.”

“Yes!”

Kang-hyuk switched from the electrosurgical knife to a scalpel and began cutting out the muscle from the thigh.

It was a huge amount for the heart but only a small piece for the thigh—especially in a patient with such thick legs.

Screee.

Kang-hyuk carefully cut along the [muscle fiber] direction to avoid damaging the contraction capability.

Jaewon assisted with forceps, making sure not to grab the muscle in a way that would harm the graft.

After all, it was going into the heart.

‘But can you just stick muscle in like that…?’

It was nothing like the transplant operations Jaewon had seen during his residency.

He’d only been in on abdominal organ transplants—liver, kidney, etc.

It was strange to see tissue moved from one part of the body to another like this.

“Good.”

Whether he knew Jaewon’s doubts or not, Kang-hyuk nodded repeatedly.

Once cut, the graft was a perfect match for the heart’s defect.

Of course, the cut muscle came with some bulky blood vessels and tissue, but those were unavoidable—otherwise, you’d just be attaching dead muscle.

“Good. Clamp the bleeding here. Let’s attach it to the heart right away.”