After enjoying some delicious pork belly at the village chief’s house, I came back home and went back to sleep, and the morning of July 3rd, 2001 dawned.
Taking a day off made going back to work even more bothersome.
“Woof!! Woof!!”
After boiling the glutinous corn I brought yesterday, I gave a few kernels to Baekgu.
The dog happily ate them while wagging his tail and barking joyfully.
I, Kim Cheolsu, popped a few corn kernels into my mouth and watched the morning sun rise.
“Maybe I’ll leave today to Lieutenant Shin Seyoung and rest a bit…? I’ve been working too much lately; I’m exhausted.”
Honestly, I had enough sleep, but for some reason, I just didn’t want to go to work.
Lounging around under the blanket again, I eventually crawled out after a while.
No matter how much I tried, I couldn’t sleep well thinking about the patients I had admitted.
Scratching my head, I put on my military uniform.
“Can’t be helped. I’ll at least go to work. I can rest once I’m there.”
There wasn’t much to do at the hospital anyway. No consultations, and things were relatively slow.
Reluctantly, I headed toward the military hospital.
*****
General Surgery Chief Lee Youngcheol was furious.
He had just heard about Kim Cheolsu’s exploits during the morning chief meeting.
Of course, given the conservative nature of the military, it wasn’t praise. The question was why Major Kim Cheolsu from General Surgery was rampaging around, ignoring the other departments.
Especially the Trauma Surgery chief, whose territory had been infringed upon, was the angriest.
He was so outraged that Orthopedics Chief Jang Kihoon tried to subtly side with Kim Cheolsu, but it was no use.
When Chief Jang retorted, “But he did save a life, didn’t he?” the Trauma Surgery chief foamed at the mouth and lunged forward, and poor Chief Lee Youngcheol lost face.
He was furious at being told he couldn’t control a rookie military doctor properly.
He came to the orthopedic ward where Kim Cheolsu was and shouted at him at the top of his lungs.
“Hey, you bastard! What the hell are you doing? Why do I have to get cursed out by Trauma Surgery because of you?”
“Why are you saying that…?”
Kim Cheolsu looked bewildered as if he didn’t understand the reason, which made Lee Youngcheol even angrier.
But he didn’t want to resort to violence and get hit back like last time.
He grabbed Kim Cheolsu by the collar and dragged him outside the ward. Then he unleashed a torrent of curses.
“You piece of trash. You saved a civilian patient while on ER duty? This is a military hospital! Military hospital!! You’re not a civilian; you’re a soldier! Do you understand?!”
“Yes, I understand.”
Kim Cheolsu’s eyes narrowed in response, his gaze rising.
He wanted to slam the chief to the ground right then, but he held back.
He didn’t think he was wrong, but he did partially understand the chief’s position.
Whether it’s a military hospital or even a civilian one, interfering with other departments is unacceptable.
Doctors live by pride and stubbornness. Touching that pride causes conflicts.
If a general surgeon saves an emergency patient who should have been handled by trauma surgery, it causes an uproar.
I knew that from my time at S University Hospital, but I operated anyway.
I didn’t care about a little bit of criticism.
“Soldiers must obey orders! Didn’t I tell you not to cause trouble? Yet you keep messing up! Why did you touch an emergency patient that Trauma Surgery was supposed to handle?”
“Was there a trauma surgery specialist in the hospital that day? I believe I did my best to save the patient. The golden time for a patient in cardiac arrest is only a few minutes… If I hadn’t performed the emergency thoracotomy, the patient would have died.”
“Who cares if the patient dies or not? That woman’s not your family, you bastard! You just take care of general surgery patients…”
Lee Youngcheol’s rant was interrupted by Kim Cheolsu’s sudden ferocity.
The chief was surprised to see him snap like a beast, as he had expected him to listen quietly.
“No matter how much of a chief you are, I think your interference has gone too far. That patient is not my family, but I am a doctor. Should I just let a patient die because of hospital politics when I can save them? I can’t accept that!”
Kim Cheolsu passed by, proud and defiant.
He really could not tolerate the chief’s words.
There isn’t a single life in this world that deserves to be lost. Wasn’t he someone’s family too?
Of course, Lee Youngcheol didn’t understand this and got even more infuriated as Kim Cheolsu walked away, speaking only for himself.
“That bastard’s leaving while I’m still talking? Arrogant punk. If he crosses me again, I won’t let it slide.”
Lee Youngcheol’s chance for revenge came sooner than expected.
Ten minutes later, during the general surgery rounds, he widened his eyes in front of Private Hong Jino’s bed.
“Private Hong Jino’s diagnosis is hilar ductal cholangiocarcinoma? A patient admitted by Kim Cheolsu? Is that guy crazy? If he has cancer, just discharge him with a medical discharge. But he insists on surgery? This is really nuts… Ugh!”
Kim Cheolsu wasn’t there, but Lieutenant Shin Seyoung, who was on rounds with him, looked pale as she tried to calm the chief down.
I had expected trouble once the chief found out, but his reaction was overly negative.
“Chief, removing hilar ductal cholangiocarcinoma is a difficult surgery, but Major Kim Cheolsu can do it. He has already successfully performed this operation several times at S University Hospital. The patients at Hampyeong say he’s a ‘genius doctor’ in general surgery. His trauma surgeries and recent emergency thoracotomies were excellent as well.”
“Kim Cheolsu succeeded at gallbladder cancer surgery at S University Hospital? What’s the success rate?”
“That’s…”
The success rate for the hilar ductal cholangiocarcinoma surgeries Kim Cheolsu performed wasn’t high, since it’s an extremely difficult operation.
Lieutenant Shin hesitated to say more, and Lee Youngcheol smiled smugly.
“No matter how great a genius surgeon Kim Cheolsu is, he can’t save all hilar ductal cholangiocarcinoma patients. Ha ha—Lieutenant Shin!”
“Yes, Chief.”
“Tell Major Kim Cheolsu to come to the general surgery chief’s office immediately. I have something to say.”
“… Understood.”
The red light for Private Hong Jino’s surgery, whose condition was improving, was now flashing.
After the chief left the ward, Lieutenant Shin’s face darkened, and Hong Jino looked worried.
“Nurse officer, won’t this prevent the surgery? I have to have the operation inside the army! You know my family’s poor! If I go outside, I won’t get surgery and I’ll die. Then my mom…”
“… For now, let’s trust Major Kim and wait. He’ll figure something out.”
“I believe in our doctor. He will definitely do the surgery!”
*****
Only thirty minutes after their morning fight and separation, Kim Cheolsu was called back to the chief’s office, looking unhappy.
He thought they would just bring up the ER surgery again, so he was upfront from the start.
“I no longer want to justify saving the female patient. Did you call me again?”
His insolent tone made Lee Youngcheol angry again, but he calmed himself and threw a challenge.
“Why did you admit patient Hong Jino?”
“… Excuse me?”
Kim Cheolsu’s face paled, realizing what the chief was thinking.
Seeing this, Lee Youngcheol eagerly launched his attack.
“A patient with hilar ductal cholangiocarcinoma can’t continue military service properly. Sick soldiers should be discharged quickly. That’s better for Hong and for me. I just called the medical command and submitted a medical review for Hong Jino, so postpone the surgery. If the review passes, he’ll be discharged medically.”
“What… What did you say?! Hong Jino got sick in the army. Isn’t it the country’s responsibility to provide treatment until the end? Isn’t that right?! This is nonsense…!”
“Listen, hilar ductal cholangiocarcinoma isn’t a simple disease to be treated in a military hospital. Besides, soldiers want to get discharged. I’m just doing what everyone wants. Got anything else to say?”
“I won’t accept this. If he gets discharged like this, Hong Jino will die. I will never let that happen!”
Kim Cheolsu slammed the chief’s office door and stormed out.
Lee Youngcheol muttered in disbelief,
“That bastard has such a temper. Hmph! But I’m still the chief of general surgery. He can’t operate without my permission. What a ridiculous guy.”
*****
That night at 11 p.m.
After 10 p.m., while everyone was asleep, the operating room at Hampyeong Hospital was lit.
The medical staff carried in Hong Jino on a transport stretcher and prepared for surgery before anyone noticed.
The surgical team supporting the operation mostly consisted of those who had become familiar with Lieutenant Shin while performing emergency thoracotomies on traffic accident victims.
The staff’s morale was high, but there was tension because hospital patrols came regularly.
Kim Cheolsu, with a calm expression, looked down at Hong Jino’s face, already under general anesthesia and asleep.
The timing for surgery was perfect. The jaundice was almost gone…
But it was unfortunate that such a life-or-death surgery had to be done in secret.
“Phew…”
Kim Cheolsu exhaled a long sigh, then flashed his eyes and said to Lieutenant Shin,
“Lieutenant Shin, hand me the scalpel.”
“Yes, Major.”
Grasping the scalpel, Kim Cheolsu began cutting Hong Jino’s abdomen.
He made a clean L-shaped incision, reversed left to right.
Looking inside, he inserted his hand to palpate and check the tumor’s metastasis.
Fortunately, the cancer had not spread further.
The expanded right hepatectomy for hilar ductal cholangiocarcinoma is a very difficult surgery, but he judged it could be successful.
“From now on, I will begin the extended right hepatectomy to remove the tumor invading the hilar area! First, I will dissect the lymph nodes around the superior duodenal ligament and common hepatic artery.”
He carefully incised the serosa of the superior duodenal ligament with the scalpel, then dissected and removed the lymph nodes and soft tissues within.
Next, he dissected the lymph nodes around the celiac artery and common hepatic artery, placing them behind the portal vein.
Having finished the lymph node dissection around the common hepatic artery, he took a brief breath.
But the expanded right hepatectomy was only beginning.
Looking at the clock, ten minutes had already passed. He had to finish the entire operation and leave the OR before someone showed up…!
“Before cutting the distal common bile duct, I’ll secure the surgical field.”
Before dividing the bile duct, it was time to mobilize the duodenum.
He needed to dissect the duodenum, which obstructed the view of the distal common bile duct where it enters the pancreas.
He performed the Kocher maneuver, separating the duodenum from the retroperitoneum and lifting it.
Kim Cheolsu made a small incision on the peritoneum at the proximal lateral side of the duodenum with the scalpel, then inserted his left index finger into the opening.
Using the fingertip, he pushed and dissected the retroperitoneum.
Now the surgical field around the distal common bile duct entering the pancreas was secured. This area had to be cut.
A bead of sweat rolled down Kim Cheolsu’s usually unflappable forehead.
A soldier’s life depended on this surgery… and it was just beginning.
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