Trauma Center : Golden Hour - Chapter 113

Bang bang bang bang bang!

Soon, the loud noise of the MRI machine began echoing through the MRI room.

Anyone who hadn’t heard it wouldn’t be able to relate.

But after hearing it just once, they’d definitely hate it.

‘Damn…….’

It had been a long time since Jaewon was inside an MRI room like this.

It was only natural, since you usually only did this as an intern.

Bang bang bang bang bang!

Because it was a magnetic resonance machine, the sounds changed periodically.

Of course, none of those sounds were pleasant to the ears.

They were just different types of torment.

“Hmm.”

While Jaewon was suffering through the auditory torture,

Baek Kang-hyuk was looking at the Brain CT they had just taken.

There was no point in watching the MRI scan too closely, no matter how hard you tried.

And besides, the one inside wasn’t an intern—it was Jaewon.

He had enough skill to notice anything unusual immediately.

“This can happen…….”

Kang-hyuk circled the dark shadow in the middle part of the brain on the CT image with the mouse cursor.

It was an area usually filled with cerebrospinal fluid.

Normally it was clearly visible, but now it was much smaller.

Part of it was the brain tissue swelling and pressing down.

But some of it was also because Kang-hyuk had drilled a hole in the spinal cord.

‘There’s absolutely no bleeding.’

There was a small amount of bleeding near the skull.

But it was nowhere near enough to be a problem.

It was at the level of capillaries—if it weren’t Kang-hyuk, another doctor might not have noticed at all.

‘I’ve never seen something like this…….’

When doing CT and MRI, they had assumed there might be brain bleeding invisible to the naked eye.

If they found anything during the scan, they planned to remove it.

Th𝙞𝑠 ƈh@pτꬲr 𝙞𝕤 p𝑜𝗌τ𝘦∂ b𝙮 𝒌𝐢ṯꬲп◎𝙫𝘦𝗅

But nothing appeared on the CT.

Maybe, since MRI is a more expensive scan than CT, it would show up there.

But CT was overwhelmingly better at detecting things like bleeding.

Tap tap.

Kang-hyuk unconsciously began drumming on the desk with his index fingernail.

It was a long-time habit, but almost no one had ever seen it.

It only happened when he couldn’t find an answer right away.

That’s how rare the situation was.

‘If only……. If only we’d been a little faster.’

If they’d reduced intracranial pressure before brainstem herniation started.

What would have happened then?

In this situation, regret and self-blame, with nothing that could be done, swirled in his mind.

“Scan’s done.”

While he was lost in thought, the tech announced over the mic.

At that, Jaewon, who’d been in the scan room, let out a sigh of relief and removed his earplugs.

Even with them in, it was still loud.

At least the plugs prevented hearing loss.

“The images come up right away, right?”

Kang-hyuk called out to the tech running to the scan room.

The tech nodded hurriedly.

“Yes, Professor. It’s transmitted in real-time, so you can see it on this machine right away.”

“Okay. Please handle moving the patient.”

“Yes.”

While the tech did that, Kang-hyuk opened the transmitted images.

MRI, unlike CT, is taken in multiple stages.

So the number of images is enormous.

But that wasn’t a problem for Kang-hyuk.

He quickly scrolled through the images with the mouse.

‘Well, if it didn’t show up on CT, it won’t show up here…….’

The point of checking the MRI wasn’t for things like bleeding.

It was to look at the brain tissue itself—something CT couldn’t show in as much detail.

‘It’s really swollen……. From the cerebral cortex on…….’

Apparently, when the patient fell, their head whipped back and forth.

It was the kind of damage you see as a sequela of a car accident.

Only much worse.

‘Even the brainstem……. Hmm…….’

It felt different from just inferring with changes in vital signs.

It was also completely different from when he’d seen it on CT.

The patient’s brainstem was being pushed down into the narrow spinal canal.

On the MRI, you could see it clearly.

Without realizing it, Kang-hyuk muttered, ‘Can they survive?’ and was startled.

No, more than startled, he felt guilty.

He realized he’d just imagined the patient’s last moments.

“Professor! How does it look?”

“Hmm?”

When he turned his head, Jaewon was still pumping breaths into the patient’s tracheostomy tube.

That’s why he hadn’t dared enter the MRI control room—he stood outside.

He looked rather awkward.

“Uh…… it’s not good.”

“Ah.”

Jaewon found it harder to speak because of Kang-hyuk’s expression than his words.

Wasn’t this the same Kang-hyuk who always seemed so brimming with confidence, even arrogance?

But now he was clearly deflated.

‘No, forget it.’

Jaewon stopped himself from trying to say something comforting and shook his head.

Not only was it presumptuous, but he also didn’t know what to say.

Besides, if anyone needed comforting, Jaewon was no exception.

This patient wasn’t just Kang-hyuk’s.

“Let’s get to the ICU. Neurology should be on their way.”

“Ah, yes, Professor.”

So Kang-hyuk and Jaewon slowly pushed the patient toward the ICU.

The professor watched the monitors attached all over the patient’s body as he pushed the bed.

The fellow was still squeezing the resuscitation bag.

It was a scene unimaginable in any other department.

A stark example of trauma surgery’s chronic understaffing.

Rattle.

Thankfully, the distance from the MRI room to the emergency ICU wasn’t far.

It had been designed so that critical patients could get scans easily.

If you looked at only things like this, Hanguk University Hospital was an excellent hospital.

In fact, if you left out the Severe Trauma Center, it was almost world-class.

“Professor! Neurology is here!”

“What? Already?”

As soon as Kang-hyuk entered, Jang-mi shouted.

He cocked his head in curiosity and looked inside.

Just as she’d said, two neurology doctors had arrived.

With a portable EEG machine.

‘Two of them came?’

It was odd.

Hadn’t the official consult not even been requested yet?

It wasn’t even that Kang-hyuk had called them directly.

And yet, not one, but two came so quickly.

One of the neurology doctors explained.

“Nice to meet you, Professor Baek. I’m Choi Jun-yong.”

Of course, it was a name Kang-hyuk had never heard.

He wasn’t the type to pay attention to people around him.

“Ah…….”

No matter how you looked, he seemed too senior to be a resident.

A glance at the name tag confirmed he was a professor.

“You came yourself, Professor. Thank you.”

“No need to thank me. I was just trying to see if there was anything we could do to help.”

“Help?”

“I’ve been very impressed at every meeting. Our department, outside of the sleep medicine part, isn’t exactly a thriving field either…….”

“Ah.”

Neurology mainly treated strokes, especially cerebral infarctions.

In other words, diseases that could easily kill patients.

Due to the nature of the national insurance system, these specialties couldn’t make money.

If it weren’t for sleep apnea, neurology would be on the deficit list every time.

In other words, they were in the same boat.

“I don’t like how national university hospitals only care about money……. You know how it is. If you get on the wrong side, you lose your post, and sometimes get pushed out to a branch.”

Kang-hyuk hadn’t known, but such things really happened in neurology.

A professor who protested against reducing stroke patients or being forced to do aggressive interventional procedures without indication was now in Gangneung.

It was said to be for “developing regional hospitals,” but anyone in the know knew it was just punishment.

“Well……. I’m just not the type to keep things bottled up inside.”

Kang-hyuk glanced away from Choi Jun-yong’s admiring gaze, a little embarrassed.

Especially today, since the patient’s condition was so poor and there wasn’t much more he could do.

“Anyway, since you’re here, please take a look at this patient.”

He quickly changed the subject.

Jun-yong nodded readily and approached the patient.

There was a hole in the head, a tracheostomy in the neck, and a drain inserted in the back.

‘You really tried everything.’

Anyone could see they’d fought desperately to save the patient.

And that those efforts hadn’t accomplished much.

If they’d been successful, the patient’s vital signs wouldn’t look like this.

“Let’s hook them up.”

Professor Choi hid his pity and instructed the resident.

The resident deftly connected the EEG machine to the patient’s head.

This was mainly to check reactions to sensory stimulation.

Sensory here included vision, hearing, smell, taste, and touch.

Touch was assessed in detail for temperature, pain, texture, and so on.

Beep.

Each stimulus was applied one after the other.

And brainwave patterns appeared on the EEG monitor.

Choi Jun-yong’s expression watching this was not optimistic.

“How does it look?”

Even Kang-hyuk couldn’t interpret EEG at a glance.

He had to ask the specialist.

“Overall, brain function is very low. Well……. It’s always worst right after the injury…….”

The single most important thing for brain injury prognosis was “how were they at the start?”

If the initial state was too bad, the chance of recovery later was much lower.

“How bad?”

“Sensory function is relatively okay. But…….”

“Is the motor function…?”

“Yes. Even if they wake up, they’ll probably need full-time care for life. In fact…….”

They weren’t even sure if the patient would wake up.

The fact that their vital signs had improved a bit suggested the brainstem herniation had stopped.

But once brainstem herniation happens, the brain is damaged that much.

No one could guarantee the patient’s survival now.

“Um, Professor.”

While everyone was discouraged, Jang-mi quietly called out to Kang-hyuk.

“Hmm?”

“The guardian……. They just arrived. What should we do?”

“We have to see them. What else can we do.”

“Should I bring them in?”

Jang-mi glanced at the patient, who hardly looked presentable.

They hadn’t even changed into a hospital gown yet.

Just moving, diagnosing, and treating had eaten up all their time.

“No, not that. I’ll go out and talk to them.”

“Okay, I’ll let them know.”

“No need. I’ll go now. Thank you for the exam. And……. please continue any additional checks.”

At Kang-hyuk’s words, Professor Choi Jun-yong smiled and nodded.

“Of course. There’s no need for an official consult—we’ll keep track ourselves.”

“Thank you.”

Kang-hyuk thanked him again and walked to the ICU entrance.

He felt unbearably heavy.

‘If only we’d been a little faster.’

Even just ten minutes faster.

That thought dominated his mind.

‘I can’t let things go on like this. I have to find another way.’

(T/N: I feel so sad. Damn. This week’s chapter is too heavy.)