Chapter 126: He Even Does Facial Surgery [3] Artery.
A blood vessel that supplies oxygen to the many organs of our body. In other words, a vessel that extends directly from the heart.
Naturally, the blood pressure in it was tremendous, and the danger if it was mishandled was incomparable to that of a vein.
And right now, Kanghyeok was about to cut that vessel and reconnect it.
On a wooden table.
Without a single piece of modern equipment.
This is absurd.
Now that he was facing it in reality, it truly felt ridiculous.
Calling it merely a difficult and demanding operation did not even come close.
It's dangerous. Extremely dangerous.
Kanghyeok hesitated for a moment as he faced the heavily throbbing vessel.
The others, who through their prior training now roughly understood what sort of structure this was, reacted much the same way.
"Can this really be cut?"
Yeoni asked with a worried look.
In truth, this was not Kanghyeok's first time handling an artery.
Though before, all he had done was tie off one that had already been severed.
Even so, they had all experienced to exhaustion just how frighteningly blood could spray out of a structure called an artery.
"If I don't cut it...."
Kanghyeok gently moved aside the swollen blood vessel.
Beneath it, a flattened white structure came into view.
"That's a nerve."
Dolseok, who had been doing an excellent job playing the role of the top disciple, recognized it immediately.
There was no way he could know exactly which nerve it was.
Still, the fact that he could distinguish a nerve from other structures was greatly encouraging.
"That's right. A nerve."
Kanghyeok nodded, once again thinking how excellent his teaching methods were.
Then he pointed at the badly compressed nerve.
"This one handles sensation in the face. Since it's being pressed like this, it receives abnormal stimuli. That's why the pain comes, as though he's being cut by a blade."
"So that's why this elder keeps grimacing."
"His pain must have been terrible. Someone like him endured it, but...."
If it had been an ordinary person, he would likely have broken down long ago.
The sharp pain that came at any time was not merely a problem because of the pain itself.
Did patients with panic disorder not become socially withdrawn and find it difficult to function normally because they never knew when the next panic attack would come?
This damned trigeminal neuralgia was the same.
The fear of pain often destroyed the patient.
"Then we'll have to do something about the artery pressing on it."
"That's right. It's dangerous, but it's a risk worth taking. Just finding this alone means we're already halfway there."
It would not have been an exaggeration to call it a stroke of heaven-sent luck.
When he had gone in blindly with a blade knowing almost nothing, he had truly wondered whether this was even the right thing to do.
It was one of the few times in Kanghyeok's career as a doctor that he had made an incision without certainty.
At least I found it. That much is fortunate.
It was fortunate, but the fact that the cause was an artery was unfortunate.
Ordinarily, this was the kind of structure one avoided touching altogether.
Yet here he was, having to cut it with a blade.
It was practically a killing technique, not surgery.
So it took several rounds of self-justification.
Let's think back to what Dolseok said.
Kanghyeok looked at Dolseok, who these days was so excited that he followed Kim Simin everywhere.
He shot the bow so much that his fingers had all split open.
Only now were calluses beginning to form, so he was getting hurt less often.
At first, Kanghyeok had to tend Dolseok's wounds for dozens of minutes every day.
It had almost become hard to tell who was master and who was servant.
In any case, because of that, he had heard endlessly about Kim Simin's archery.
The title of famed archer really wasn't wasted on him....
He did not even need Dolseok's testimony.
A glance at the sparrows scattered in the yard made it obvious.
Seeing how they had all been pierced on the right side, he almost felt that the praises sung of Taejo Yi Seonggye might not merely be legend.
And yet this illness makes him loose absurd arrows from time to time. It's possible he died pointlessly after leading the Battle of Jinju because of this.
After all, when sharp pain struck, concentration was bound to waver.
And then even a bullet fired by a defeated enemy might hit its mark.
If I think of it that way... then this surgery isn't just a surgery for pain.
It might be somewhat exaggerated, but one could even regard it as a life-saving operation.
In other words, Kanghyeok's surgery might allow Kim Simin to live longer.
And not just anyone, but the famed commander who led the Battle of Jinju to victory.
If so, there was no more reason to hesitate.
This might even make the Imjin War end sooner.
At any rate, judging by the way the court was now functioning, the possibility of preventing the war was virtually nonexistent.
They were too madly busy fighting among themselves, so how could they possibly suppress Japan?
Even at this very moment, Toyotomi Hideyoshi was likely watching with burning eyes, searching only for a pretext to invade.
What was more, the yangban of this age were trapped in an inexplicable sense of superiority.
They believed that the Great Ming Empire was the center of the world, and that Joseon, as its tributary state, naturally stood above Japan.
Since their superiority came not from objective comparison but from delusion, it was as obvious as fire that war would break out.
That doesn't mean I can step forward too openly either.
Surely everyone had thought it at least once.
If I went back to Joseon, never mind the Imjin War, I'd absolutely solve that first.
And then I'd make Joseon the strongest nation in the world and maybe even unify the world.
Kanghyeok had not been an exception, but once he actually arrived here, that illusion vanished.
For one thing, if I weren't a yangban, I'd already be dead by now.
In an age with a rigid status system, what one individual could do was extremely limited.
That was true no matter how brilliant a modern person might be.
And had Kanghyeok not seen with his own eyes how the State Tribunal tortured people?
If he stepped in carelessly and got caught up in factional strife, there was no knowing when or how things might go wrong.
So let me just work hard at the things I can do.
They might not seem like great things, but perhaps they could still bring about great changes.
Things like fixing Yi Sun-sin's leg more perfectly, treating Ryu Seong-ryong, treating Gwanghae-gun, and now treating Kim Simin.
"All right. We finish this as quickly as possible. Hand me the suture."
"Yes."
"Not that one. The thick one."
"This one?"
"Yes. That one. Whenever you cut an artery, you always use the thickest thread. Otherwise it bursts right away."
"Yes, Young Master."
Kanghyeok gave Yeoni a faint smile as she answered briskly.
Whatever the case, it was always gratifying to see the disciples he was teaching grow so quickly.
Maybe these two will also play a major role in the war someday.
As medical practitioners, would they not be hard to match anywhere across the Eight Provinces of Joseon?
Especially in trauma care.
And their swordsmanship was also quite good.
"Young Master, here it is."
"Ah, right."
Kanghyeok returned from his fantasies of the distant future to reality.
To the distorted facial artery in front of him, pulsing like something the size of a five-hwan coin.
"First... let's tie it off here."
"If you're going to cut it anyway, why tie it?"
"If I cut it as swollen as this, it'll be a disaster. Even with Makbong lowering the breathing rate, it's still no good."
When the breathing rate decreased, the amount of air inside the thoracic cavity also decreased.
And a decrease in the amount of air meant a corresponding decrease in thoracic pressure.
In the end, this could also lower the overall blood pressure.
Blood pressure was not created solely by the strength of the heart.
The problem is that the effect isn't all that big.
At best, it would only lower it by about ten to twenty.
That was enough only to lower the spray of blood from reaching the ceiling to about shoulder height.
In other words, if the blood burst out, he would die either way.
So he had to reduce the cross-section of the vessel being cut as much as possible.
And for that, tying it was necessary.
"Look, if I tie it here and here... then I can cut on both sides of this, right? It's obviously much better than cutting through the swollen part itself."
"That makes sense. I see. Then this really isn't that different from cutting a normal artery, is it?"
"Right. Honestly, if it comes to it, I can just cut it and not reconnect it."
"Would that really be all right?"
"Normally, no. But with Brother Kim Simin... it might be possible."
Kanghyeok folded his arms and looked down at Simin's face.
The wound from more than a year ago lay fully exposed.
With the vessel this ruined, there's no way proper circulation was happening.
Of course not.
If the diameter widened at only one spot, the blood would instead swirl around inside that area.
It would not flow well in the direction it was supposed to go.
But the structures behind it were not destroyed.
The artery on the opposite side must have developed more in compensation.
Not because it was Kim Simin, but because that was simply how the human body worked.
When one side failed, the other naturally stepped in to help.
So even if he cut away this facial artery, no major problem should occur.
But... the wound around here is too severe for that. There are almost no blood vessels left here at all.
If he handled it badly, the area that had previously been injured might necrose.
He would not die because there were antibiotics, but it would still be a serious problem.
If possible, it was better to do it properly from the beginning.
"Still, let's proceed with the intention of reconnecting it."
"Yes."
"So you all have to do well. The moment I signal, clamp it right away."
"Yes...."
"Ah, and...."
Kanghyeok turned to Dongpa, who had been standing there uselessly the whole time like a borrowed sack of barley.
Dongpa, who could neither see patients nor assist in the operation, only fidgeted helplessly.
It was not because he lacked skill.
It was because he had lost in the rock-paper-scissors showdown between Makbong, Dongpa, and Dolseok yesterday.
One might wonder what was so bad about getting to rest, but there was another reason.
"Roll up your forearm in advance. Yeoju, get the syringe ready."
"Ugh... yes."
"You drew Makbong's blood before too, didn't you? What kind of person only receives blood? You should give it too."
"Yes, Master."
"We might not need it... but we probably will."
Kanghyeok took his eyes off Dongpa, who was now preparing to become a living blood bag.
Since Yeoju had become highly skilled at drawing blood, there was no reason to worry.
"All right, scissors."
"Yes."
"Makbong, you're controlling the breathing rate properly, right?"
"Yes. I think I'm doing an amazing job."
"Good. Not bad."
In truth, Kanghyeok already knew that Makbong was doing well.
It was not as if Kanghyeok had lost his mind and was deliberately not controlling the bleeding on the surface.
The color of the blood is good.... If oxygen were lacking, it would never look like this. Heart rate is about one hundred beats per minute. It's straining him a bit, but... he should be able to endure this much.
Was he not exceptionally tough?
He could likely withstand almost anything.
As long as they did not drag this out too long.
"Then I'm cutting.... When I signal, block it with your hand first."
"Yes, yes."
Kanghyeok first cut cleanly through the side farther from the heart.
Since it was not the direction from which blood came from the heart, the blood did not spurt upward as violently as expected.
It merely streamed out in a steady flow.
Though even that was by no means a negligible amount.
"Block it!"
"Yes!"
Yeoni moved like lightning and placed her hand over the cut end of the artery.
Just as Kanghyeok had instructed beforehand, she did not try to press it down or anything like that.
She merely blocked the opening.
Surprisingly, that alone was often enough to control bleeding from a vessel.
"Well done. Now... this next part is important. First, Yeoju, start drawing from Dongpa."
"Yes."
"You already inserted it?"
"Just in case."
"Fine. There's no harm in being careful."
As expected, Yeoju seemed to have rather masochistic tendencies.
To think she had already gone ahead and driven a metal needle in beforehand.
Thinking that he really needed to secure another Rh-negative blood bag soon, Kanghyeok moved the scissors.
-Snip.
As expected, the side closer to the heart was different.
Even after lowering the blood pressure that much, blood still shot out in a long spray.
It nearly reached all the way to Yeoni's shoulder on the opposite side.
"Dol!"
"Yes!"
"Yeoju, draw blood as fast as it comes! It's spraying like crazy."
"Yes, yes."
"All right, then let's reconnect it. This gentleman is destined for great things."
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