Chapter 87 – Future plans of a general hospital (4)

Dowook walked down the hall on the fifth floor of the hospital and toward the annex where the cancer center was located.

‘Full of enemies, huh….’

The chiefs from the internal medicine departments were hoping to take a place in the integrated outpatient clinic during the second quarter.

The strong incentives proposed by the vice dean must have been a clear motive.

However, this part was not of great interest to Dowook.

He was always tired just by training to master the senses he received through his special sense, and thanks to numerous surgeries that followed intensively for months, performance-based bonuses were already piled up in his bank account.

It was a waste to work more tenaciously here at a time when he didn’t have enough time to spend the money he’d already earned.

However, the opening of an integrated outpatient clinic itself was welcoming.

It didn’t even start properly, but he couldn’t believe that he already got access to such a rare case.

There was also a situation in which internal medicine chiefs were working together to keep him in check. The conflict of energy between those who followed the dean and those who followed the director.

It was just a trivial problem in front of this specific case patient, whose resistant tumor had spread to the brain.

‘…Hold on. Why do I feel like my thinking circuit has been so weird lately? Is it because I’m so focused on Chief Ji’s senses these days?’

It was a tiring desire to have a mindset of wanting to save every serious patient somehow. A person must know when to give in order to have time to breathe. Dowook tapped his cheek and recalled the moderately selfish mind of ordinary people.

He arrived at the annex and got on the elevator.

Dowook squeezed through the crowd of visitors and pressed the eighth floor and had to fix his eyes on the advertisement on the wall because he could no longer move his body.

[Myeong Sae Hospital Cancer Center]

[Challenge cancer with 30 years of know-how, excellent treatment technology, and development of new treatments]

Shin Yae Seung, the dean of the hospital, looked very bright. He didn’t know when he’d come back, but Dowook wanted him to be so bright even when he returned.

Ding.

After getting off the elevator, Dowook approached the glass door engraved with the phrase “High Difficulty Cancer Surgery Team.”

This was a department with only talented doctors who dealt with multiple cancers requiring complex surgeries. When it came to cancer, it was a kind of special team that was already attempting integrated outpatient treatment.

knock, knock

“Excuse me.”

With the appearance of Dowook, the heads of doctors sitting in the inner office moved.

Since his department and position were kindly written on the plaque on the desk, Dowook was able to find the person who requested for cooperation in the middle of the room.

After passing through professors in the Department of Anesthesia Pain, Pathology, and Radiation Oncology, he stood in front of a man who looked exceptionally young to be here.

“I’m Park Dowook.”

Min Bo-Hoon, who was looking at the monitor, turned to look at Dowook.

“Welcome, Dr. Park. Please sit there.”

Min Bo-Hoon, who looked closely while sitting down, was handsome and had very thick eyebrows. His eyes were clearly focused on him, so he felt a subtle pressure just by looking at him.

“I was looking at a case of Dr. Park right now. You removed primary tumors recommended for chemotherapy through surgery due to their small size.”

Looking at the monitor, it was a recently written surgical report about Tom Brand.

“That’s right.”

“This part here. Did you not know before surgery that a single tumor was deeply rooted in the blood vessels?”

Min Bo-Hoon had asked at once, pointing to the hardest part of the surgery. The report did not say, ‘This part was very difficult.’ If he figured it out at once, it meant he had a good sense of vision.

Dowook answered.

“It was an area where normal tissue and abnormal tissue could not be distinguished by deep scan. I saw it with my eyes, touched it with my hands, and figured it out.”

“I see.”

Min Bo-Hoon looked for related data on the diagnostic medicine server and entered the figure by launching a program called “biomarker.”

“If you had asked our team to do so, we could have pinpointed the tumor before the surgery. The latest liquid biopsy uses secretive baggage loaded with cancer cells for cross-analysis.”

The location of the tumor was gradually revealed above the 3D image. Min Bo-Hoon pointed to the screen.

“What do you think?”

Dowook looked closely at the form indicated by the marker on the screen. And he had no choice but to admit it. The fact that hidden tumors could be predicted with cutting-edge diagnostic tools.

“It’s very sophisticated. It’s almost the same as the actual extracted form.”

Min Bo-Hoon, who was glancing at the admiring Dowook, opened his mouth.

“This would have been enough to introduce my diagnosis level. Did you visit here because you thought you could help me more than this?”

“You’re suddenly getting to the point.”

“I didn’t invite you to make friends. If you are burdened, I recommend you to step down from here. A lot of invisible eyes are focused on this collaboration.”

Min Bo-Hoon gently revealed that he had received a hostile request. It was not a cold tone, but there was an atmosphere that aroused tension momentarily.

“I’ll ask you one thing before I tell you my judgment.”

“Say it.”

“Those invisible eyes. Professor Min, how much do you care about them?”

Professor Son Chang-man of the oncology department next to him glanced at Dowook, and when they met eyes, he quickly turned away.

Min Bo-Hoon answered Dowook.

“As much as needed.”

“It seems like if it helps with the patient’s situation, you’ll ignore it.”

“I won’t deny it.”

Dowook pointed to the monitor.

“Will you post the MRI on the screen?”

When he checked in the outpatient clinic, the tumors in question appeared.

There were a total of three resistant tumors located in the brain. The tumor located in the liver existed as a single but extensive mass. Even if you looked at it separately, it was serious.

“Here. No. 1 and No. 2. I would have extracted the two largest brain tumors first and tried to extract the remaining one. That way, we can shorten the operation time.”

“Do you think you can handle the bleeding if you extract 1 and 2 at once?”

“It’s possible. If you finish in three hours.”

Professor Son next to them sarcastically said while eavesdropping.

“This tricky tumor in 3 hours? Which hospital has this concept of surgery?”

Dowook looked at Professor Son without any indecision.

“Really?”

“Isn’t that obvious? Even if you try to remove just one of these tumors, five to six hours is a given.”

It would be reasonable for Professor Son. However, Prof. Choi never performed surgery with common sense.

“I exaggerated the estimated time a little bit.”

“Taking a step back since you made a mistake, huh. This is not a place to say things recklessly. You have to give your best opinion.”

“That’s right. If you train enough in advance, you’ll be able to do it in two hours. I actually inflated the time.”

“If you knew it was bloated, you’d regret… Huh? What did you just say? Two hours? You want to shorten it? You’re kidding, right?”

“If you go into the operating room with Prof. Choi, you’ll be in trouble if you joke around like this.”

Professor Son’s eyes shook significantly as if he had not expected that he had Prof. Choi behind him.

“If you want to check if this is an exaggeration or fact, you can come observe. Professor Choi and I are almost always in the office except for surgery.”

Professor Son knew that no matter how hostile a relationship may be, there was something he should not touch. He never said he would go to verify.

“Then, when will you come?”

“Hmmm…”

“You don’t have a cold, but you’re just coughing.”

With that rebuttal, Dowook turned back to Min Bo-Hoon and continued to talk.

“With the smallest number 3, I cannot guarantee a reduction in surgery time. It’s located quite deep. It will take at least three more hours to extract completely. In the end, you need up to 5 hours.”

“The last one is small in size, we can leave it and respond with medication. What is the total loss of normal tissue if you use a knife to a non-fatal area?”

Professor Son, who retreated after hearing Choi Hoo’s name, regained his energy and paid attention once more.

Dowook said.

“This patient, after liver extraction, won’t be able to withstand chemotherapy.”

“Do you mean to say you can manage tumor patients better than oncology?”

They’d have to see, but he was confident.

Since he had dealt with severe symptoms so much, it was now clear what kind of burden a patient after such major surgery could endure.

However, in order to understand this fact, he could not take out the charts of critically ill patients he had managed one by one and talk for a long time.

“If you have a short knowledge of tumors, you should know how to admit it.”

When Dowook did not respond, Professor Son raised his voice as if he had waited.

‘Ugh, such a bother.’

He was about to move on as he shook his head.

“Professor Son.”

“Huh?”

Min Bo-Hoon, who was quiet, turned his head.

“It’s not the right choice to leave a tumor no matter how small it is. If it metastasizes during the recovery period, the patient will have to live a limited life from that day.”

“What’s the probability?”

“Is there a high probability that cancer cells in the liver have been delivered to the brain? Dr. Park’s logic, which assumes a complete enumeration, should be seen as the obvious choice, not because he has a short insight.”

Professor Son, who was suddenly scolded, gave a silent wink, saying, “What’s wrong with you?” Min Bo-Hoon said to Dowook, ignoring the signal neatly.

“Keep talking.”

Even when on the same side, Min Bo-Hoon, who was relentless, had the air of a leader. Principled. Harsh. It was not yet known whether there was a spirit of sacrifice in it.

“This is all I can surgically respond to. To take a step forward from here, I think I need to hear how Professor Min Bo-Hoon will perform liver cancer extraction surgery.”

Tingle.

Min Bo-Hoon’s sense immediately entered through Dowook’s special sense.

‘He’s strong. He’s only 36 years old, but he’s already at this level.’

There was a reason, he was the youngest assistant professor at the Department of Pancreatic Surgery.

Dowook heard a brief explanation of the surgical outline of the liver area with Min Bo-Hoon’s senses.

“……so, the top priority is to resect right to the middle, but to defend 65% of normal liver tissue.”

He asked a question because he felt something but he didn’t know it.

“Why don’t you try to resect vascular complications when resecting cancer tissue in the posterior region? The safety will be low.”

“Because you can’t use a microscope.”

“Oh.”

This was a combination surgery. Since neurosurgery, which would operate the brain, would be exclusively using the microscope, there was no room for separate pancreatic parts in the middle in the same operating room.

“There is a blind spot like this when high-level surgery is performed at once.”

Tingle.

Dowook felt the urge of what Min Bo-Hoon actually wanted in this situation and opened his mouth without realizing it.

“If the neurosurgery part replaces the vascular anastomosis at this time, the surgery will work much smoother.”

Min Bo-Hoon hesitated.

“What did you just say?”

“The hepatic pancreatic part should pay attention to resecting the tumor to the lower vena cava inlet, so I thought it would be better for a third party to help the blood vessels exposed in the meantime.”

Min Bo-Hoon, who was surprised, asked again, perhaps because he pointed out something that could not be mentioned unless he was a surgeon.

“No way. Did you understand this resection process just by outline?”

“Professor Min explained it well.”

Dowook continued to respond calmly because he had often experienced these reactions.

“I think this is a case where the patient’s survival cannot be guaranteed unless all metastatic tumors are extracted in a single attempt. None of the neurosurgery books would have experienced such surgery, so I think they must have had a lot of worries within the high-level cancer surgery team.”

“I agree with you”.

Dowook considered the degree of cooperation he could perform in line with the surgical process of the paroxysmal pancreatic part. Then he relayed the conclusion he had reached.

“If I participate, the main surgeon of each part is Professor Min Bo-Hoon and Professor Choi Hoo. I’m the only assistant. You can proceed with this configuration. It’s going to be much more efficient and faster.”

An unconventional proposal from a neurosurgeon to assist in both surgeries.

Not only Min Bo-Hoon but also the oncology professor, who had been listening to this conversation, looked at him with wide eyes.