Prof. Lee, coming out of the hallway with Suhyuk, opened his mouth,
“Do you know what peripheral occlusive vascular disease is?”
Suhyuk answered simply, “It’s a disorder of the blood supply.”
Prof. Lee smiled pleasantly. If he had asked other interns, they would have paraded boring medical terms one by one… But Suhyuk was different. His answer was short, concise and to the point.
“Why does it happen?”
“It’s caused mainly because of atherosclerosis.”
Atherosclerosis is a vascular disease in which endothelial cells proliferate and cholesterol is deposited and atheroma is formed in the endocardium enclosing the blood vessels as if an old pipe has rusted and foreign matter gotten stuck in it. Accordingly, it is mainly senior people who are afflicted with this disease. Blood clots are formed and hemorrhage occurs in the atheroma, narrowing the diameter of the blood vessel and clogging it. This leads to peripheral obstacles.
“Does the patient need any amputation surgery?”
Prof. Lee, smiling at his remarks, showed a surprised look.
If one’s body does not show any disability, one can end treatment with medication. On the contrary, surgery is essential if serious conditions are unavoidable with just medication. Amputation is necessary to preserve the healthy part of the limb.
“You’re right. He needs to have his left leg amputated.
At his reply, Suhyuk made a regrettable expression.
What kind of a patient were they? In his 60s or 70s?
Why did he not do anything about his legs before getting to the point where he needed such a surgery?
He must have come to the hospital when he could not bear his condition anymore, though he took it lightly and left it untreated. Also he wanted to save some money and did npt want to make his children worry. Most senior patients came to the hospital that way. Suhyuk could learn this after he started his internship.
With a little sigh he got on the elevator. When the elevator stopped at the destination, Lee and Suhyuk came out. Then, Lee picked up the phone, saying, “I’m going to the surgery. Are you ready?”
Lee knitted his brows slightly.
“Prof. Lee has arrived?”
Actually the patient was not someone Lee Mansuk was in charge of. Another professor was supposed to perform the surgery, but some urgent business made Lee Mansuk take his place. Then, the professor in charge just arrived at the surgery room.
Looking at Suhyuk, Lee opened his mouth, “So? Prof. Lee said he would perform the surgery as planned?”
Suhyuk’s expression was tinged with regret. Hearing the conversation, he could know the surgery cancellation by Prof. Lee was a done deal.
Prof. Lee Mansuk, who fixed his gaze on Suhyuk, turned around, saying,
“No, no, let me do it this time.”
A resident’s tiny voice came from the cellphone.
“Oh, Lee went into the surgery room already…”
The phone was hung up like that. Prof. Lee could not ask Lee to come out as he was in the surgery room… He turned his head to Suhyuk.
When he felt Suhyuk was certain to be disappointed, he could not just let the surgery pass.
Then something came to his mind like a lightning bolt.
He said, with a grin, “Let me go into the surgery room a bit later.”
“Didn’t you say the operation would be performed by another doctor?”
He nodded his head.
“Well, things happened that way. But I have many patients for surgery. At 5pm, I have another patient due for surgery. You can come then.”
Hearing his explanation, Suhyuk’s hardened expression became a bit bright.
“What kind of a patient?”
“Disc problem in the neck.”
Suhyuk was sitting inside Prof. Lee’s office quietly. Asking him to take a break, Prof. Lee went out for some business, and then one hour passed. Suhyuk rose from the seat.
He used a computer and browsed some books. There was nothing he could do in the office.
Suddenly it came to his mind when he first saw Prof. Lee: ‘If you become my disciple, I’m going to guarantee your break time.’ Was this out of his concern for me from back then?
Suhyuk’s educated guess was exactly right. Prof. Lee wanted to get some break time for him.
Any medical staff knew how hard the internship was.
So, Prof. Lee gave him break time at his own discretion. When Suhyuk was down in body and mind, he wanted to show favor to him with comfort like this.
However, Prof. Lee’s wishes like that were completely crashed.
Suhyuk, leafing through books, murmured, “I’d rather stay at the emergency room.”
It was too boring. The reason he came to the hospital was to take care of patients.
Just idling away time, confined to the office like this was not in his element, and made him feel heavy. He looked down at the floor.
‘How much are the patients suffering when I’m idling away here?’
It was just regrettable for him not to see the patients as much as he wanted.
He looked at one of his hands, and thought to himself: When an opportunity comes along, I won’t hesitate. When I show to them what I can do, and get the real results, can it lead to some sort of change in the authoritarian system of the hospital? Change in a way that a capable doctor could see the patients as much as he or she wants?
While Suhyuk was thinking like that, the time was passing.
Finally it was the operation time Lee mentioned.
At that moment, Prof. Lee opened the office door and came in, saying, “Let’s go.”
Suhyuk’s eyes were shining. They arrived at a patient’s room.
They came to see the patient before surgery. A 41-year-old man.
The man had been afflicted with a disc problem in the neck for ten years.
Though he was treated with physical therapy and medication at other hospitals, his condition got so bad that he was hospitalized at Daehan Hospital.
He was suffering from severe trembling in his hands and some paralysis.
“Please take care of him well, doctor,” his wife earnestly requested to Prof. Lee.
“I’ve been in this speciality for several decades. Those patients I treated were discharged with smiles. Some of them were lawmakers. So don’t worry.”
After saying that, he slightly looked at Suhyuk, because his remarks were intended for him to hear them.
“Then, I’ll see you later.”
When Lee and Suhyuk went out, the medical staff were pushing the patient’s bed and followed them.
Both of them, standing side by side, were disinfecting their hands.
“The world has become so much better. Nowadays, disc patients can be treated with laparoscopy or laser surgery quickly. By the way, why does the current patient need to have this surgery?”
At Lee’s asking, Suhyuk answered shortly,
“Isn’t it because the disc has been fragmented, not prolapsed?”
Saying so, Suhyuk changed into surgery gowns as if it were natural to him.
Prof. Lee looked at him blankly. How did he know the answer?
He felt as if he were facing a fortune teller. And then he made a feigned smile.
‘That’s possible because he would be my disciple.’
The two went into the surgery room right away.
The medical staff looked at Suhyuk with a suspicious expression.
“He’s an intern who came here to observe the operation.”
At Lee’s remarks they were back to their busy preparation for the surgery.
When anesthesia was done, the medical staff checked the patient’s condition.
Blood pressure, pulse, breathing, and brain oxygen saturation, etc.
All indicated a normal condition, and soon the patient was in deep sleep.
The nurses brought a thin green cotton sheet to cover the patient from head to toe.
The sheet had a hole around the neck area only.
“Now we’re starting anterior cervica discectomy fusion.”
It was a surgery to remove the bursting disc after cutting 3-4 cm of the neck area.
When Lee held out his hand, an assistant gave a scalpel to him.
During typical thoracic surgery, assistants gather around the patient to help the surgeon, but for a fine incision like this, only the surgeon is in charge. Assistants hand over surgery tools or check the condition of the patient through a medical device.
Prof. Lee looked at Suhyuk before incising the patient’s neck and gestured with his eyes toward a monitor on the side. The view of Lee’s microscope was openly projected on the monitor. Lee indicated to him that he should look at it. Soon Lee moved a scalpel with his eyes into the microscope. The skin was cracked and the scalpel reached the cervical spine at once. Because the incision was so microscopic, it was an operation that did not require blood transfusion. But as he had to touch the sensitive parts during surgery, there were many risk factors. The lesion should be removed in a way that the scalpel would not touch the nerve and muscle attached to the target point.
Suhyuk was watching the monitor silently. Though it was regrettable that he could not participate in the surgery, it did not matter. It was way better for him to be in the surgery room than being confined in the office. Above all, Prof. Lee’s way of using his fingers was excellent.
His nimble fingers slowly removed the disc protruding between the cervical vertebrae with a forceps. The technique was very smooth, and he smiled unwittingly. It resembled the face of the teacher who pleasantly watched a child who painted a picture.
He pulled the tissue out with his tongs and went further into the neck. Then a white film covering the central nervous system was revealed.
Suhyuk, watching the screen, looked at Lee.
Suddenly the nurse, coming to Lee, was wiping his sweat.
"Huh ..." Lee sighed deeply and took his eyes to the microscope again.
It was really important from now on.
As his hand was deep into it, the nerves became closer. It was possible that the nerves could be ruined with his mishandling. Suhyuk’s sharp eyes were fixed on the screen.
It was not that short an amount of time.
Lee, removing all the lesions, said, "This is the cervical width of the patient with the disc.”
The cervical vertebrae seemed to have a mouth full of liquid. The width was about 3mm.
"The width narrows if the nerves are pressed, and the body is obstructed."
Then he opened the cervical spine with his tongs.
The distance between the cervical vertebrae was widened to 6mm.
"Only when the patient keeps this condition, his nerves will be cured without being squeezed."
The medical staff stared at the screen, and were all ears not to miss even one word.
On the other hand, Suhyuk just nodded his head calmly.
Now all he had to was to insert a cage that is as big as one’s thumb nail.
The assistant handed over the cage filled with bone marrow.
And a ballpoint pen and a hammer.
Lee seemed to be moving as if he were knocking on a gong.
At first glance, it was as if he was sculpting a person.
He was nailing down a cage.
Then, Suhyuk's eyes frowned.