Chapter 83: Lung Operation [1]
Translator: None Editor: One Mountain Guy
When blood pressure becomes lower, there are a few possibilities.
First, blood is flowing out.
It might be not the case of this patient, as he did not bleed much.
Second, the patient might have damages on the head and could not coordinate the blood circulation.
Ganghyuk could not make sure because there was no CT or X-ray, but the probability seemed to be low.
There was no wound on the head.
“His eyes are ok.”
There is a saying that eyes are the windows of the mind.
It is clinically true. Many doctors say that they can identify the brain status of the patient through the patient’s eyes.
Ganghyuk agreed to some extent, so the first thing he did was to see the patient’s eyes.
‘He does not have papilledema and his pupillary reflex is normal. So it must not be the brain damage.’
Third, there is direct or indirect effect on the heart.
It seems this patient may fall under this category.
Ganghyuk thought so…
‘The right lung does not breathe well. His heart beat is biased to the right.”
Then tension pneumothorax can be thought of.
Ganghyuk did not know the cause but it seemed that he had the tension pneumothorax.
When Ganghyuk diagnosed in his mind, Dolseok gave him a syringe.
“Sir, here it is.”
“Good. Yeoni? Oh, you did a good job.”
It is said that practice makes perfect.
They knew what they should do.
Yeoni cleansed the right chest of the patient with brown betadine liquid.
Although strange looking tools came out, nobody asked questions.
Makbong and Heo Jun had already expelled people who could not understand Ganghyuk.
In the room, there were Ganghyuk and his fellows, Heo Jun and his follower.
The follower had heard of Ganghyuk from his teacher a lot and he was watching Ganghyuk closely to learn new things.
“Now, I will stab it.”
Ganghyuk removed the back part of the syringe and stabbed it on the top of the right side of the chest.
-Pushushuk
There was a sound of being deflated and then the air in the right thoracic cavity came out.
At the same time, the same sound came from the patient’s mouth.
‘Heooo.”
He looked around blinking his eyes.
He might feel that he came back from the hell.
Actually, he almost died.
Heo Jun came to him hastily.
“Stay still.”
“Ah, Heo Jun…”
“Do you remember that you were treated here?”
“Yes, I do. I think I lost my mind after that.”
Ganghyuk inferred the situation.
Perhaps, this patient was conscious even after he fell from the stairs.
He was transferred to Naeeuiwon and had treatment.
Then at a certain point, he lost consciousness.
‘It is the characteristic of the tension pneumothorax.’
At first, the patient looks ok, but he suddenly dies without any other signal.
Because of such characteristic, many doctors lose their patients without good treatment.
In traffic accidents, one of the victims who had light injury suddenly dies while he has been helping more seriously injured victims.
“Eum. He was good when he first came, but some time later I could not feel his pulse and then he became unconscious. How do you feel now?”
Kim Kyehan frowned with the remark of Heo Jun.
He might feel some pain in his chest.
He tried to get up.
But Makbong and Dolseok stopped him, so he stayed lying down.
“I have pain in the chest. Who are they, by the way?”
Makbong and Dolseok did not look like men working in the palace.
They wore clean clothes made of good cotton, but the clothes could not hide their status.
They looked like commoners in the marketplace.
“Ah, they are the servants of Scholar Baik I mentioned before.”
“Ah”
Kim Kyehan tried to remember his old memory.
It was the time that Heo Jun was appointed as Cheomjeong (Grade 4) by saving Prince Imhae.
He attributed his merits to Baik Ganghyuk, when King Seonjo praised him.
At that time, Kyehan thought Heo Jun tried to be humble, but now he could see the very person that Heo Jun had praised.
“Is he here?”
“Yes. It is Scholar Baik who has just saved your life.”
“Heo.”
When Kim Kyehan noticed the presence of Ganghyuk, Ganghyuk finished the examination and could identify the status.
The tension pneumothorax does not simply arise when someone falls from the stairs.
There must be another reason.
‘His rib is broken, and it teared his lung.’
It means that there is not much time.
He will die in two hours if Ganghyuk does not make any treatment.
Ganghyuk thought that he must save Kyehan.
If he could not, Heo Jun might have disadvantages and his pride would be hurt.
Ganghyuk cared the latter more.
‘If I saw him, he must live.’
If it is the case that nobody can help, he might give it up.
But in this case, there seems to be chance to save him.
Then Ganghyuk must save him, as he must be the best doctor.
“Heum, what is his name?”
Kim Kyehan answered hastily.
“My name is Kim Kyehan.”
Kim Kyehan.
Ganghyuk thought he might have heard his name.
It seems that he had read his name in a column in that world.
‘Aha. This one carried Seonjo on his back and ran when there was the war. I believe he became a meritorious retainer subject for that contribution.’
Ganghyuk might forget his name, if he did not have questions on this case.
Ganghyuk was not interested in other things than medicine.
But he remembered the name very well, because he wondered how a desexualized man could carry the king on the back and ran the long way.
Now Ganghyuk saw the person with his eyes, and the question became bigger.
‘He does not have good muscles.’
Comparing to the muscles, he had quite much fat.
It was no wonder why he fell down from the stairs.
“What will you do?”
While Ganghyuk was thinking of the treatment, Hoe Jun asked.
Heo Jun had no idea how he could treat such a trauma.
Although he had some knowledge on anatomy because he learned from Ganghyuk while they stayed together, it was not enough to apply to the field.
He did not have any practical experiences.
“The ribs broke, and they went into the flesh. One of them tore the lung.”
“Heo.”
“As the air came out of the lung, he could not breathe and his heart could not function properly.”
“Ah, I see.”
It might be difficult for Joseon people to understand but Heo Jun followed the explanation very well.
It was because he had learned modern medicine through correspondence with Ganghyuk.
He had medical knowledge enough to understand Ganghyuk’s explanation.
“Therefore…”
Ganghyuk looked at the patient but hesitated to speak.
Kim Kyehan became breathless.
It was no wonder for him to be breathless because his lung was torn.
The treatment was temporary only.
“I need to open the chest, return the ribs to original place and remove the torn lung.”
“What?”
Kim Kyehan could not listen to what Ganghyuk said because he was busy with breathing.
Even though he had heard, he would not be able to understand it.
Therefore, the question was asked by Heo Jun.
He looked at Ganghyuk with eyes wide open.
“As I told you. I must cut the chest to open, return the ribs and remove a part of the lung.”
“Is it possible?”
“Yes.”
Ganghyuk nodded his head looking around his people, his home visit bag and other carriers.
If it was the time when he came to Joseon first, he could not do this operation.
But now he had good assistants and anesthetics.
“Oh, then, go ahead.”
“I need to make the patient sleep.”
“Ah, did the herbs I had mentioned work?”
“Yes, of course.”
While Ganghyuk was talking with Heo Jun, Dolseok took out various medicine from the carriers.
It was anesthetic made of Seomsu and Chooh.
“Excuse me, could you drink it?”
“What is this?”
“It is good for you. Take it.”
Ganghyuk poured the medicine to Kyehan pulling the lower chin down.
Kyehan swallowed the medicine half reluctantly.
“Keo”
It seemed it did not taste bad. He made some sound of satisfaction.
“How is the effect?”
Heo Jun became an observer.
Ganghyuk touched the patient’s pulse and answered.
“He will fall asleep before I count seven. His heart beat has already slowed down.”
“Oh.”
As Ganghyuk mentioned, Kyehan fell asleep soon.
He made mumbles and then fell asleep.
His last word was regarding the King. It seems that he had a strong loyalty.
‘He is a blessed king.’
He was loved and respected by many great men in his times comparing to his personal ability.
‘Ok, now it is time.’
As the patient fell asleep, Ganghyuk could make an operation.
It would be better to finish the operation quickly.
“Makbong, stay beside the patient holding the balloon.”
“Yes, sir.”
Anybody can blow the balloon made of bull scrotum.
But there is nobody who can blow continuously and persistently.
Makbong came to the head side of Keyhan and stayed there.
When the operation would start, he would blow the balloon.
“Dolseok, go to the opposite side. Yeoni, come beside me.”
“Yes, sir.”
The operation was a quite big one.
It was difficult to operate with only an assistant.
“Yeo…. No, you must draw everything. Do not miss any scene. If needed, please help Makbong, too.”
“Yes, sir.”
Ganghyuk almost called the name of Yeoju.
Of course, Heo Jun would not disclose it to others even though he knew the things regarding Yeoju.
But it would be better not to disclose it to him.
There is a saying that walls have ears.
“Ok. I will start.”
Ganghyuk simulated the cut with his fingers.
It would help him to know the exact place where he should cut.
“Analgesic injection.”
“Yes.”
Dolseok gave him the syringe with analgesic.
Ganghyuk injected along the line that he would cut.
It was not only to reduce the pain.
It is principle to perform local anesthetics even when the patient is under the systematic anesthetics.
‘It will reduce bleeding.’
He heard that his seniors used to use lidocaine only.
But at his time, epinephrine complex was widely used.
It reduced bleeding and had better anesthetic effect.
“Ok, give me a scalpel.”
“Yes.”
Ganghyuk cut the line with the scalpel.
At the same time blood came, and Yeoni wiped it out.
“Eum, Dolseok, pull it.”
“Yes.”
As Dolseok pulled it, Ganghyuk could see where he should cut in a glance.
Ganghyuk put the scalpel on the muscle covering the thoracic cavity.
He opened his mouth making his face very serious.
“Makbong, are you ready? Remember, you are doing the most important thing. I will try to finish it as quickly as possible. Keep blowing the air to him.”
“Yes.”
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