Chapter 96: He Even Reconstructs Wrists [3] Heo Jun stared at Kanghyeok with his eyes wide open.
And no wonder, because quite a lot of what Kanghyeok was saying sounded rather absurd.
A person's ligament was not some piece of cloth.
How was one supposed to stretch it?
Even if the director heard this, he probably would've called it ridiculous.
Even in modern medicine, which had advanced enough compared to Joseon that it would not have been wrong to call it nearly miraculous, people still did not use the phrase "stretching" a ligament.
That was because it was practically impossible.
But if the ligament in question was the wrist ligament, then that was not necessarily true.
In theory, it's entirely possible. And…
Kanghyeok calmly looked down at his own hands.
The hands that had successfully carried out even the most difficult surgeries until now.
With these hands, I can do it.
Had he not just cut out exactly the amount of ligament he wanted from that narrow tunnel?
This was not the kind of thing that could be taught.
After all, it was not a technique Kanghyeok himself had ever properly learned.
There was no other way to describe it except to say that he had simply been born with it.
"Dolseok. You can stop lifting now."
"Ah, yes. Whew. This is harder than it looks."
Dolseok let go of the cut edge of the wrist he had been pulling up this whole time.
He had been pulling with such force that even after he let go, the cut surface still remained tilted upward for a while.
If Gwanghae had not still been young, it almost looked as though permanent wrinkles might have formed.
"Yeoni, pull downward."
"Yes, young master."
"Dolseok, just pull upward. You don't need to lift it. Just spread it apart."
"Yes. That part's easy."
Dolseok and Yeoni spread the wound wide according to Kanghyeok's instructions.
As a result, even the structures above and below the transverse carpal ligament were clearly exposed.[2]
"Heavens."
Heo Jun muttered with a face full of wonder.
How many chances would one have in Joseon to witness such a sight?
Of course, on a battlefield, one might see something similar.
But one would never see anatomical structures so cleanly arranged.
"My goodness."
Perhaps because of that, Heo Jun seemed determined to see the cross-section even if he had to twist his neck to the side.
He really was doing his utmost.
This is nothing, though.
Kanghyeok smiled faintly as he looked at the intensely absorbed Heo Jun.
To be so amazed just from seeing the structure of a wrist.
He wondered what expression Heo Jun would make if he were shown internal organs.
No, really. Would he?
Was he not planning to stay in Hanyang for a while and teach Heo Jun anyway?
If so, then even if it took some effort, it would be better to try cadaver dissection.[3]
No matter what, actually doing it yourself is best.
Even for Kanghyeok, the most memorable practical training from his student days had still been anatomy lab.
The practice room heavy with the smell of formalin, under dim and somewhat eerie lighting.
The corpses laid out one by one on twelve iron tables.
At first, he had been too frightened even to go near them.
Their blood had already been drained, and they had been fixed in formalin and dried out.
Even so, they were still corpses with their faces uncovered.
That only lasted a moment, though.
The excitement of finding with his own hands the structures he had only seen in textbooks, and the anatomical knowledge that came naturally in the process.
For the young Kanghyeok, who had dreamed of becoming the greatest surgeon someday, it had been a tremendous stimulus.
Good. Once this matter is over, Teacher Heo gets anatomy lab. The others too.
Harboring a thought that would have been utterly unacceptable in Joseon, Kanghyeok resumed the surgery.
He grasped the wrist ligament with forceps and pulled it upward. About 0.5 centimeters.
Normally, by the time one pulled that much, there should have been a gap.
But Gwanghae's wrist was not like that.
That was because the other severely swollen structures had immediately crowded into the empty space.
"Does anyone know what the problem is here?"
Kanghyeok asked without much expectation.
As expected, Dolseok and Yeoni stayed blank and silent.
Makbong had long since fallen asleep, so there was nothing to say about him.
Yeoju seemed too busy drawing for dear life to pay attention.
"Well… it's too tight."
"Oh."
As expected, Heo Jun really was different.
Even without proper anatomical knowledge, that was quite an answer.
If he were a medical student in lab, that'd be an automatic A+.
Since Kanghyeok was the sort of professor who was both extremely demanding and stingy, this much praise meant Heo Jun would have gotten an A+ anywhere else too.
Wearing a satisfied smile, Kanghyeok nodded.
"That's right. Exactly. Even with this much extra room, everything is still crammed tight, so no matter what medicine we used, it would have hurt terribly."
Kanghyeok looked at Gwanghae with a somewhat regretful expression.
At the moment, he was sleeping peacefully under the effect of the medicine.
But the face Kanghyeok had seen when he first entered the room had truly been awful.
For someone so young, he really endured it well.
As someone who needed to use every possible means to calm even a cut finger, Kanghyeok found that hard to understand.
Heo Jun also looked regretful.
Since Gwanghae was a prince he served with genuine loyalty, that was only natural.
"So that was the case. I even hold the post of Chomjeong, yet I have not been able to help much. I feel ashamed."[4]
"Well… structural problems are difficult to deal with, are they not? Even so, you prescribed the medicine well, and that's how he managed to endure until now."
"Even so… really now. It only makes me feel I must learn much more from Scholar Baek."
"I'll teach you as best I can, so set your worries aside."
It would be a rather shocking course of instruction, though.
Kanghyeok deliberately left the rest unsaid.
Surprises worked better when they were left as surprises.
I can't exactly go around the palace saying I'm going to perform cadaver dissection.
Cadaver dissection, of all things.
Was there not even a punishment in this era called bugwanchamsi?[5]
If other people heard about it, they would probably faint.
There was also a real chance he could be dragged off to the Uigeumbu and put through all kinds of suffering.[6]
Anywhere but the Uigeumbu.
Had he not seen it for himself during the Gichuk Purge?[7]
Perhaps because this was an era that did not even have the concept of human rights, the severity of the torture had been truly horrifying.
A person was not some peanut to be roasted and crushed.
Burning, roasting, beating…
"Anyway, there is an easy way to solve it."
Kanghyeok might have been a surgeon who was hardly worthy of being called a veteran, but Heo Jun was someone who had not even reached beginner level yet.
If he wanted to teach him, he had to pitch things properly to his level.
If he started by teaching techniques that even most professors could not dream of doing, the only result would be despair.
"Oh. And what would that be?"
"You simply cut here."
Kanghyeok pulled the transverse carpal ligament even harder.[2]
Only after he had dragged it more than 1 centimeter did a slight gap finally appear, and Kanghyeok immediately pushed the scissors into that opening.
"Like this."
Kanghyeok moved the scissors with great boldness.
With a slicing sound, the transverse ligament that had been tightly holding the wrist structures together was cut halfway through, and at the same time, the compressed structures bulged out through the gap.
Among them were extremely important structures like the median nerve, the finger ligaments, and the arteries.[8]
"This… is it really all right to leave it like this?"
"Usually, yes. Usually."
"Mm. Won't it tear?"
Heo Jun pointed at the transverse ligament, now only about half intact.
And his concern was not entirely groundless.
There really were cases where it tore.
"As long as he doesn't overdo it, it'll be fine. If he goes back to exercising like before, then… yes, it'll tear."
If Gwanghae avoided overexertion from now on, he would be able to live much more comfortably.
The problem was that Gwanghae was someone who, whether he wanted to or not, would have to keep overexerting himself.
Whether he went to war or wrote, he would have to keep using his wrist.
Heo Jun clearly understood that as well.
That was why his expression did not look good.
"He will not listen if told not to exercise. And he will keep painting too."
"That's what I think as well."
Kanghyeok answered while looking at Gwanghae's sleeping face.
He had never formally studied physiognomy, but he knew enough to tell what kind of person someone was at a glance.
After all, when one worked as a professor at a university hospital, one saw countless patients.
On some days, just seeing a patient open the examination room door and walk in was enough to give a rough idea how long the consultation would take.
If I had to classify Gwanghae, he's the type of difficult patient…
The kind who stubbornly refused to listen to the doctor.
The kind you ended up seeing two or three times for the same illness.
And then they came back again after that.
That was the sort of person Gwanghae looked like to Kanghyeok.
The kind who absolutely had to do whatever he wanted to do—or needed to do.
"Then how…?"
"Did you think I removed this piece for no reason?"
Kanghyeok waved the ligament piece he had just taken out in front of Heo Jun's eyes.
Heo Jun's face brightened noticeably.
"Ah-ha. So when you said you would lengthen the ligament, that was what you meant."
"That's right. From here on, the assistant's role becomes important."
Kanghyeok resumed the scissor work he had briefly paused.
A little later, the transverse ligament was completely cut through, and the structures freed from confinement spilled out haphazardly.
If left like this, there would never be any pain again for the rest of his life.
But there also would never be a day when he could move properly again.
"Dolseok, Yeoni. You each have one hand free, right?"
"Ah, yes."
"What's spilling out here now—grab it carefully. Pull it straight up and down."
"Yes, young master."
As expected, Yeoni moved first.
Whether it was because she handled martial arts, or simply because it was natural talent, Kanghyeok did not know.
But her hands were very deft.
Dolseok was not especially slow either, so he managed to hold things roughly to Kanghyeok's satisfaction.
"Good. Hold it just like that. I'll finish quickly."
"Yes."
Kanghyeok attached the ligament piece he had cut from the aponeurosis to the cut end of the transverse ligament.[9]
It was fast and accurate suturing, but unfortunately, there was no one present who could appreciate its true brilliance.
Kanghyeok had no choice but to console himself with self-praise.
If the director saw this, I'd be looking at a raise…
Kanghyeok sighed inwardly and tugged on the ligament.
"Mm. As expected, it's sturdy. All right, now the other side… Pull it well. That makes it easier to attach."
"Yes, young master."
Yeoni and Dolseok pulled the ligament and surrounding structures even harder up and down than before.
Thanks to that, it became easier to attach the graft to the cut ligament end on the other side.
The suturing this time was even finer than before, but again, no one appreciated it.
Eh. How would you people know this is world-class technique?
Kanghyeok comforted himself once more, then set down the suturing tool.
"All right. You two can let go now."
"Yes? Ah, yes."
As Dolseok and Yeoni released what they had been holding, the ligaments and surrounding structures began once again to fill up the space more than they had moments ago.
"Now, let's see."
Kanghyeok lightly tugged the tightened transverse ligament with forceps.
The instant he saw a gap form when he pulled, a wide smile spread across his face.
"Good. Very good. Now the prince has nothing to worry about."
"Really?"
"Yes. Once I close the skin before he wakes up, we're done."
"You've truly worked hard. Ah, I think he may be starting to wake a little."
Heo Jun pointed at the fingertips, which had just begun to twitch.
"Oh. Then I'd better hurry."
Kanghyeok's hands began moving as though possessed.
So quickly that even with both Dolseok and Yeoni assisting him, they could barely keep up.
As a result, by the time Gwanghae's fingers twitched again, the wound was already closed.
And when he opened his eyes, it had even been wrapped in bandages.
"Mm. Mm… Mm…?"
As expected, the effect of the anesthetic also included memory loss.
Gwanghae tilted his head for quite a while before finally remembering what had happened before the surgery.
"Ah. What happened?"
"Your Highness, it went very well."[10]
"Did it?"
True to his impatient nature, Gwanghae immediately moved his fingers.
Then he tried rotating his wrist as well, but it did not work out.
That was because Kanghyeok had wrapped bandages tightly around it and immobilized it so it could not move.
"For now, it would be best not to overdo it."
"Mm."
Fortunately, Gwanghae did not act stubborn.
After all, this was after he had ignored Kanghyeok's words and ended up needing surgery.
"How long must I keep it like this?"
"It would be best to be careful for ten days."
"Ten days. Understood."
"In the meantime, I will come every day and check on you."
"I'd appreciate that."
"Then please get some rest."
Kanghyeok left the room, leaving Gwanghae behind.
Heo Jun hurried right after him.
"It was truly incredible."
"It was nothing."
"I want to perform a surgery like that as soon as possible."
"As it happens, I've been thinking about a new teaching method."
"Really?"
"That reminds me… by any chance, do you know where people in Hanyang usually die?"
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