Trauma Center : Golden Hour - Chapter 106

“Then…….”

The person responsible for the overall condition of the patient was not the lead surgeon, Baek Kang-hyuk, but the anesthesiology resident.

At Baek Kang-hyuk’s words, the resident slowly began adjusting the amount of drugs and anesthetic gas being administered to the patient.

If you suddenly forced a stopped heart to beat and then turned off the [extracorporeal circulation machine], the patient would obviously die.
( T/N: “extracorporeal circulation machine” is a device used to circulate blood outside the body during surgery. )

That was just another word for murder.

“Now, slowly raise the temperature near the heart.”

“Ah, should I?”

At the resident’s words, Baek Kang-hyuk removed the ice water that had been placed near the heart.

It wasn’t as if the [coronary artery] had been completely blocked, anyway.

The heart is an organ that also receives some nourishment from the blood that fills the ventricles and atria.

Therefore, if you relied only on the [coronary artery] and did nothing else, it could result in [myocardial] damage.
( T/N: “[myocardium]” refers to the heart muscle itself. )

If overall [myocardial] damage occurred in a patient whose heart had already ruptured, what would happen?

That was something that absolutely had to be prevented.

“Please release the clamp as well.”

“Already?”

“Yes. I’ve been preparing for it, so it’s fine.”

The resident pointed to the patient’s blood pressure.

He remembered the systolic blood pressure being 90, but before he knew it, it was above 130.

The device settings hadn’t changed.

‘When did he do that…….’

The resident looked back and forth between Baek Kang-hyuk and the patient, showing signs of inward admiration.

Here, the role of the device was essentially to act in place of the heart.

The fact that the settings hadn’t changed meant the heart rate was the same.

‘He’s constricted the peripheral blood vessels…….’

By doing that, even if the heart was beating somewhat weakly, it could maintain blood pressure for a while.

Of course, if that period became too long, it could actually burden the heart.

The resident was sure that Baek Kang-hyuk wouldn’t make that kind of mistake.

“I’ve released it.”

“Okay, changing device mode now. [Help mode].”

As soon as Baek Kang-hyuk released the clamp, the resident changed the device settings.

It was a slightly different mode from before, when the device was automatically circulating blood through the body.

It calculated the pressure at the [aorta] and supplied just enough additional force to make up the difference.
( T/N: “[aorta]” is the main artery carrying blood from the heart to the body. )

Of course, since the heart still wasn’t beating, only the setting had changed—the actual function was the same as before.

Gush, gush, gush.

The only difference now was that blood was finally pouring into the heart.

“Phew.”

Jaewon let out a sigh of relief at the sight.

It was because nothing was leaking from the area where the heart had ruptured.

‘Well, who do you think sutured it…….’

If anyone other than Baek Kang-hyuk had sutured the heart with a 7-0 suture, he would have been so anxious he’d be driven mad.

But the lead surgeon for this operation was Baek Kang-hyuk.

He’d already experienced just how skilled his suturing was, more times than he could count.

No matter what happened, it wouldn’t burst again.

“Okay, let’s try getting it to beat slowly.”

Baek Kang-hyuk didn’t bother to check for bleeding.

That was only natural, wasn’t it.

“Yes.”

As soon as the resident heard Baek Kang-hyuk’s words, he stopped the drug that had halted the heart.

Even then, his expression was tinged with doubt.

The patient’s heart had already stopped before the drugs were administered.

‘The professor was definitely squeezing it by hand…….’

Would the heart that had stopped really start beating again after this surgery?

It was uncertain.

No, it was extremely unlikely.

At least according to his medical knowledge, it was impossible.

‘But somehow, I feel like it’ll come back…….’

But the resident had already seen more than a few miracles while working alongside Baek Kang-hyuk.

So, he looked at the patient’s heart after completely stopping the drugs.

This time, with a glimmer of expectation.

Twitch.

Soon, a faint movement appeared in the heart.

It was still only a slight twitch.

“It, it’s beating…….”

Jaewon swallowed dryly as he watched the heart.

The heart that seemed like it would never return was beating.

It wasn’t yet strong enough to circulate blood throughout the body.

Thump.

But soon, the heart began beating powerfully.

“Oh…….”

The resident couldn’t help but exclaim.

He had expected the heart to beat.

But he hadn’t expected such a perfectly formed beat.

‘The muscle transplanted into the right ventricle…… is synchronized with the original myocardium.’

What kind of magic was this?

The muscle from the thigh was now beating.

It was a muscle that, at best, only moved the leg by contracting and relaxing.

But now, it was beating in perfect sync with the surrounding heart muscle.

“No, how is this…….”

It was astonishing.

Even Jang-mi, who had remained silent and assisted so far, couldn’t keep her mouth shut.

“Oh.”

She soon realized her mistake and closed her mouth.

But it didn’t really matter.

Everyone in the operating room was making similar sounds.

Even the new nurse who was hiding in the corner with a pale face.

Without realizing it, she had come closer and was now standing behind Jang-mi.

‘She doesn’t even know where she is.’

Judging by her expression, she seemed unaware of where she was standing.

That’s how astonishing Baek Kang-hyuk’s surgery was.

It felt more like magic than surgery.

“Hmm.”

But the person who actually performed the surgery, Baek Kang-hyuk, didn’t look very satisfied.

‘I definitely can’t completely substitute that for a heart muscle.’

He was someone who could see what others couldn’t, using his miraculous skill to connect even the muscle fibers.

His extraordinary vision didn’t just shine during surgery.

If anything, it shone brighter after surgery.

‘The contractile ability is still lacking. I didn’t see it when it was normal…… This is about 50% capacity, at best.’

It was beating similarly.

But the structure of thigh muscle and heart muscle couldn’t possibly be the same.

No matter how perfectly he connected them, there were clear limits.

Others might not notice, but Baek Kang-hyuk could see those limits.

‘It can’t be helped. If the same thing happens to the left ventricle, a support device will definitely be needed.’

It was pure luck that the patient had injured the right ventricle.

The right ventricle only had to send blood to the lungs, not the whole body.

That still required considerable force, but it was nothing compared to the left ventricle, which had to pump blood throughout the body.

‘He should be able to last several months like this.’

Baek Kang-hyuk briefly placed his hand on the heart that he could almost say he had recreated for the patient.

It felt different from just looking at it.

The heart was truly beating.

“At this rate, you really won’t need a [pacemaker]…….”
( T/N: “[pacemaker]” is a medical device that regulates the heartbeat. )

Jaewon finally spoke up after standing in shock for a while.

Baek Kang-hyuk looked back at him with his hand still on the heart.

“Have I ever said anything wrong?”

“No……. But according to the textbooks, you’re supposed to put in a [pacemaker].”

“The textbooks won’t mention reconstructing a heart with thigh muscle, either.”

“Ah.”

He was right.

No matter how thick the medical textbooks were, not all of Baek Kang-hyuk’s operations would be in them.

“It’s not something I just thought of now.”

“Excuse me?”

“It was published in a Paraguayan paper two years ago. Technically, it was an experiment on pigs, not humans.”

“Why would they do such an experiment?”

“I have no idea. But thanks to that, this person survived.”

Baek Kang-hyuk tapped the area where the thigh muscle fragment had been grafted.

Jaewon, rather than Baek Kang-hyuk, was more startled and shouted.

“Whoa!”

“It’s fine. I didn’t make it that thin.”

“Still. It was ruptured not long ago.”

“Not anymore.”

“But…….”

“But what?”

Baek Kang-hyuk seemed more relaxed than before.

He was pretending it was no big deal.

But it was actually the first time he had saved someone whose heart had ruptured so severely.

It would have been strange if he didn’t feel relieved.

Thanks to that, Jaewon could finally ask with a more relaxed expression.

‘He’s not going to call me an idiot, right.’

He was a little worried.

But he couldn’t just let his curiosity go unanswered.

There wasn’t much point in suffering under Baek Kang-hyuk if he didn’t try to learn what he didn’t know.

“Will that muscle stay like that?”

“What muscle? Oh, this?”

Baek Kang-hyuk tapped the thigh muscle graft again.

Jaewon gathered his composure and nodded.

“Yes, that. It seems to be working fine now, but thigh muscle isn’t designed to move continuously, right?”

Baek Kang-hyuk answered with a faint smile.

“Right. Just looking at this patient’s muscle, you can tell the proportion of [fast-twitch fibers] is about 30%.”
( T/N: “[fast-twitch fibers]” are muscle fibers designed for short bursts of power rather than endurance. )

Jaewon wondered how he could possibly know the proportion of [fast-twitch fibers], but he didn’t ask.

It wasn’t an important issue anyway.

“Exactly. It seems like it would get tired or worn out under stress…….”

“For now, it will. That’s why we need to strictly limit physical activity.”

“For now……?”

Jaewon unconsciously tilted his head.

Baek Kang-hyuk’s tone suggested that it would be fine later.

And it wasn’t just the tone.

“It’ll be fine later.”

“How, exactly?”

“You really don’t know? Wait, is this your first time seeing [free flap surgery]?”

“Yes.”

Jaewon thought, ‘What’s free flap surgery?’ as he nodded.

“Muscle tissue adapts well to the environment it’s transplanted into. The muscle cells themselves are [pluripotent], meaning they can differentiate. In about a year, this will transform into [myocardium].”
( T/N: “[pluripotent]” means cells capable of becoming various other cell types. )

“Wow…….”

Pluripotent.

It was a term Jaewon had learned more than ten years ago.

Th𝚤𝙨 ςhа̄pƚ𝙚r 𝐢𝕤 pՕ𝐬𝘵𝑒𝙙 b𝖞 Ⱪ𝗶ƚꬲṉ𝐨νᥱ𝑙

Just something you briefly learn in physiology class.

“Why are you standing there with that blank look? Aren’t you coming?”

“Huh?”

“Oh, you’re not going to close up? Leaving it like this?”

“No, I’ll close it up.”

Jaewon hurriedly followed Baek Kang-hyuk.

Baek Kang-hyuk took a much larger suturing device from Jang-mi and began closing the wound.

The resident adjusted the amount and speed of anesthetic gas and medication to match Baek Kang-hyuk’s suturing speed.

It had been quite a process.

But another patient had survived today.

It wasn’t just Baek Kang-hyuk’s group that had spent such a busy day.

After all, at a university hospital, the word ‘busy’ didn’t mean much.

It just meant everyone else was busy too.

So were the Director and the Chief of Administration.

“Oh my. You really have to be careful when you play golf.”

Director Choi Jo-eun spoke with a worried expression.

The middle-aged gentleman sitting on the hospital bed let out a hearty laugh.

Even while laughing, he frowned in pain, so it seemed he was still hurting.

“Indeed. When I was young, carrying someone on my shoulders was nothing…… Now even swinging a little golf club is difficult.”

The gentleman was none other than the current Fire Chief, Oh Hyung-seok.

At his words, the Chief of Administration burst into laughter as if he’d heard something funny.

“Oh, come on. I heard your drives go over 300 meters, Chief.”

“That just happens occasionally. I hurt my shoulder showing off.”

“Luckily it’s not a serious injury. For now, just leave it to Professor Jin Tae-rim. After some injections, you’ll recover completely.”

“Thank you for your concern. Haha.”

Hyung-seok smiled graciously.

The Director then gave him a meaningful smile and took his hand.

“Never mind all that…… Please just take care of those two I mentioned earlier.”

“Ah, don’t worry. Since it’s a promotion, no one will complain internally.”

“Thank you.”

“Not at all. I should thank you for letting me know there are so many complaints coming into the rescue team. Haha.”