Surviving as a Rogue Hospital Director - Chapter 68

—————
This chapter was translated by Lunox Novels. To support us and help keep this series going, visit our website: LunoxScans.com
—————

Episode 68.
The Angiography Room resembles an operating theater.
The difference lies in the presence of a monitoring space outside.
Like detectives watching an interrogation from an adjacent room. Like a singer in a recording booth.
The Control Room outside the Angiography Room peers inward and communicates via intercom.
— Click.
“C-arm Left Anterior Oblique 30 degrees locked.”
As the technician in the Control Room pressed a button and spoke, the interior of the Angiography Room filled with the converted mechanical version of that voice.
The C-shaped mechanical arm enveloping Kang Woo swiveled left and right, back and forth, until it tilted thirty degrees from the left.
Kang Woo’s torso then appeared on the monitor in grayscale, as though a full-body X-ray had been taken.
“We’ll hold it steady here for now.”
Sung-hyuk spoke into empty air, but the bidirectional microphone transmitted his words to the Control Room as well.
“You’ve confirmed the sedation, yes?”
“Yes, we’ve used three cycles of Midazolam and Ketamine.”
He also confirmed with Min-ho that Kang Woo was soundly asleep. It wasn’t full general anesthesia—they were proceeding with local anesthesia but had sedated the patient to prevent movement.
“Three cycles? That’s heavy.”
“Yes, we were planning to try up to three times, then switch to something else, but he fell asleep on the third attempt.”
Midazolam and Ketamine weren’t weak drugs by any measure. Kang Woo must have been resistant to medication.
“Keep the oxygen going. Watch the SPO2 carefully.”
“Ha, I’ve already got the nasal prong in place.”
The most common side effect of sedating a patient with medication is hypoxemia—shallow or slow breathing that deprives the body of oxygen.
A transparent tube was wound tightly around Kang Woo’s oxygen meter, a thin cannula designed to deliver oxygen through the nose.
Upon seeing this, Sung-hyuk’s expression softened. He had been intensely focused and on edge right before the procedure, and now, seeing the patient and operating room so meticulously prepared, his burden eased considerably.
“Oh, Min-ho! Perfect!!”
Hyun-ji gave Min-ho a thumbs-up, keeping her voice low enough not to grate on Sung-hyuk’s ears. Min-ho made a V-sign with his thumb and forefinger, pressing it beneath his chin.
Sung-hyuk shook his head at the sight of the two of them, as if to say he couldn’t control them.
‘They’re in high spirits, those two.’
Noticing this, Hyun-ji sent Min-ho a signal, pressing her temples gently as though transmitting telepathy.
Seeing this, Min-ho quickly moved to stand across from Sung-hyuk.
“We’re using the femoral artery today, correct?”
“That’s right. Stability is what matters now.”
In truth, using the radial artery in the wrist would be easier for patient recovery than the femoral artery.
But this procedure was new to Sung-hyuk as well, so choosing the femoral artery was a decision to minimize risk.
The femoral artery had a larger diameter and fewer curves, allowing a straight path all the way to the heart.
Sung-hyuk brought the tips of his fingers to the inner pelvis and thigh of Kang Woo, locating the artery.
After confirming the precise location, he made a quick puncture with the needle.
“Puncture complete.”
He informed the Control Room of his progress, then advanced the guidewire to create a pathway for the other instruments.
— Whoosh, whoosh.
Under Sung-hyuk’s hands, a thin, long catheter slid steadily into Kang Woo’s body.
— Gulp.
Min-ho held his breath, worried even that swallowing might disturb the moment. He took in every movement Sung-hyuk made.
“Lower the C-arm a bit more, please.”
“How is this angle?”
“Good.”
“Switch to Right Anterior Oblique here. I’ll freeze it.”
“Roger, locking it in place.”
Sung-hyuk and the Control Room conversed in real time as they navigated through Kang Woo’s vasculature. When overlapping vessels obscured the path, they adjusted the angle, paused, and continued.
To maintain the same position, Sung-hyuk tensed his entire body and moved his fingertips in microadjustments. Even the lead apron hanging from his waist remained discretely still.
“Magnify the septal branch, please.”
“Got it now.”
Thus the catheter reached Kang Woo’s heart.
‘Wow, we’re already here?’
Min-ho once again held his breath, watching Sung-hyuk work.
The septal branch, with its complex network of vessels, was a critical gateway determining the success of the Alcohol Septal Ablation. The number of branches varied by patient, they often overlapped with other vessels, and they didn’t always show up clearly on X-ray.
Yet this was the only passage through which they could reach Kang Woo’s surgical site.
“Should we take a quick breather?”
“No need. Let’s keep going.”
Min-ho gripped his own chest as he spoke, but Sung-hyuk remained unflustered.
Having ascended from the pelvis to the heart in one continuous motion, Sung-hyuk now gently penetrated deeper.
When the vascular pathway ended, the C-arm, its job done, ceased its movement, and the echocardiogram took over, displaying Kang Woo’s heart’s interior.
In the grayscale image appeared four chambers divided by walls and the valves connecting them, which beat ceaselessly.
It also revealed the thickness of the myocardium and how rapidly blood passed through.
The origin of all life.
An organ that never rests from birth until death, that moves of its own accord without the brain’s permission.
— Thump-thump, thump-thump.
Min-ho gazed at the heart in wonder, spellbound. He couldn’t tell whose heartbeat he was hearing—Kang Woo’s or his own.
But Sung-hyuk’s expression was troubled. For the first time, he tilted his head slightly, and his hand stilled.
“I’m feeling resistance.”
This was a sign the vessel had ended. With the heart mere inches away, he had reached a dead end.
“How many branches do you count?”
“I see three on the monitor now. What if we try advancing into the branch deeper inside?”
Sweat trickled down Sung-hyuk’s spine. His sterile cap was damp along his forehead.
Yet unlike the stiffened Min-ho and Hyun-ji, Sung-hyuk showed no sign of panic.
He withdrew the catheter slightly, exiting the vessel he had just entered.
Right beside it lay the Atrioventricular Node. One mistake in position and alcohol injection could stop the heart instantly.
‘I never expected this to be easy from the start.’
Sung-hyuk steadied himself inwardly. This lay within the anticipated range. He had prepared contingencies not just for Plan B, but all the way to Plan Z.
For this moment, he had combed through Jason Lee’s papers,
revisited every procedure he’d performed so far,
and convinced Kang Woo himself.
‘Director, you should rest a bit.’
‘This isn’t a burden you carry alone. This is the work of all of Korean University Hospital.’
Sung-hyuk recalled the conversation with Beom-jun.
When the director said “all of Korean University Hospital,” he was really speaking of himself.
He could never shift responsibility to that man. He wouldn’t disappoint him either.
‘I’ll do it. I absolutely must see it through.’
Focused, Sung-hyuk fixed his gaze on the echocardiogram, moving his hand with such minute precision that anyone unfamiliar with ultrasound would have thought he was perfectly still.
Without an open thorax, unable to use both hands or to manually manipulate the heart’s interior with instruments, he could only adjust the catheter incrementally as he navigated the vessels.
Again, sweat beaded and ran down his spine.
‘That’s it.’
At that moment, he felt the catheter slip smoothly forward into the heart’s interior, resistance-free.
And at that same instant, welcome news came from the Control Room.
“Septal entry confirmed!!”
One weight lifted.
Yet Sung-hyuk did not let his guard down. The real work was only beginning.
Having entered through the septal branch, the catheter now arrived at the passage through which blood flows from the left ventricle into the aorta, with the ventricular septum below and the aortic valve above.
The target site for today—the Left Ventricular Outflow Tract.
Sung-hyuk and Min-ho simultaneously checked the ultrasound. Indeed, the cardiac muscle had thickened excessively, obstructing the blood’s passage.
Now it was simply a matter of injecting strong concentration alcohol to kill the muscle tissue.
And as a moment of breathing room appeared, Sung-hyuk offered Min-ho an opportunity.
“Want to give it a try?”
Min-ho, who had been drawing 98% Ethyl Alcohol into a syringe at his side, dropped it.
“Me, really?”
“Just inject the alcohol very gradually. Push 1 milliliter over the course of one minute, slowly.”
Min-ho nodded, trembling. He understood that such opportunities didn’t come around easily.
Under Sung-hyuk’s watchful eye, Min-ho carefully attached the syringe to the catheter’s tip. In his mind, he repeated Sung-hyuk’s instruction: 1 milliliter over one minute.
‘Is this pace right? But why isn’t it going in?’
But it proved more difficult than expected.
“If blood flow is slow, resistance builds up, and if it’s fast, it goes in easily. The resistance you’re feeling is actually good for slow injection,”
Sung-hyuk said to Min-ho. It wasn’t mere reassurance. A stiff brake would be easier for a novice driver to manage.
Encouraged by Sung-hyuk’s words, Min-ho focused on the sensation in his hands.
Meanwhile, Sung-hyuk’s eyes were fixed on the Electrocardiogram.
The graph, which normally showed five sharp peaks with each heartbeat, now fluctuated erratically as the alcohol entered.
His heart rate, which had been 80 beats per minute, climbed steadily, triggering an alarm.
— Beep, beep, beep.
Sung-hyuk narrowed his eyes to gauge the timing, while Min-ho tensed his hand to keep it from shaking.
When the heart rate finally spiked to 110 beats per minute, Sung-hyuk commanded.
“Hold it! Stop.”
At his word, Min-ho relaxed the hand holding the syringe.
— 100, 90, 85.
The moment Min-ho ceased the alcohol infusion, the heart rate quickly returned to the 80s.
“Keep the heart rate below 110. Don’t let tachycardia develop—keep a close eye on it.”
“Yes.”
Sung-hyuk spoke calmly, but this had been a moment where tachyarrhythmia could have taken hold.
Min-ho was well aware of it. Had the professor not been watching, disaster could have struck.
This time, as Min-ho felt the resistant syringe, his eyes also tracked the patient’s condition.
Even to his own assessment, he was doing better than at first.
‘Phew, is this enough? Should I do more?’
As he reached for the third syringe, Min-ho glanced at Sung-hyuk. The professor’s eyes remained locked on the monitor.
His hands were beginning to cramp. The tension had locked his muscles tight. Yet he couldn’t slow the pace of the alcohol injection. He couldn’t stop here either.
Sung-hyuk remained motionless in his position, reading Kang Woo’s vital signs.
‘Has the cardiac muscle shrunk compared to before? Or has it not?’
Min-ho followed Sung-hyuk’s gaze to the monitor, but he couldn’t quite discern the difference.
With trembling hands, he continued the alcohol infusion while awaiting Sung-hyuk’s instruction.
Then came the words he’d been waiting for.
“Okay, that’s enough.”
At Sung-hyuk’s word, Min-ho carefully set down the catheter and syringe, then stretched his fingers long to ease the tension.
“That’s it, right? We’re done?”
“Yes. All set. Worked perfectly. Good work.”
With Sung-hyuk’s understated words, Kang Woo’s procedure ended.
Despite this being the first time, not a single complication had arisen.
And at that moment, the speaker connected to the Control Room came to life.
— Click.

—————
This chapter was translated by Lunox Novels. To support us and help keep this series going, visit our website: LunoxScans.com
—————