Chapter 102: Touch the Eye [2] "Heo."
Heo Jun tossed back his surname-like exclamation and nodded.
And understandably so, since Kanghyeok had just said he was going to cut into the eye with a knife.
This truly was no ordinary matter.
In contrast, Kanghyeok appeared quite calm.
At least on the surface.
Ah, I'm fucking terrified.
But Kanghyeok was only human, so how could he not be nervous?
He had never put even a needle into an eye, let alone a knife.
He was merely holding himself together with the poker face he had developed over his long years at a university hospital.
If the chief surgeon trembled, everyone else would become even more anxious.
"All right. Yeoni, you still have the hooks I gave you earlier, right?"
"Yes."
"Hand them here for a moment. I'll hook them onto the eyelids... then hold them open above and below."
"So you're forcing the eye open... I thought so."
If he was going to operate on the eye, he had to be able to see it first.
Yeoni nodded at once, looking as though she understood.
Kanghyeok put on an unbothered expression as he set the hooks in place.
Of course, he was thinking something quite different inside.
When I did my rotations... I feel like there were more than just one assistant surgeon.
Back then, he had never really understood ophthalmologists.
No, seriously, why did they need two assistants, sometimes even three, for such a tiny eye surgery?
Meanwhile, the bold surgeons in general surgery opened abdomens and necks with just an intern assisting them.
But now that he was staring at someone else's eye right in front of him, he felt a little differently.
If I keep it pried open like this, it feels like the cornea is going to be ruined.
Surprisingly, the cornea was one of those body parts that was not very durable.
If it was not constantly moistened with tears and periodically protected by closing the eyelids, it could easily be damaged.
That was exactly why eye patches were prescribed to patients with facial paralysis whose eyelids did not close properly.
If he forcibly kept it open like this, it would almost certainly be damaged.
I'm doing this to save his vision... so that won't do.
Kanghyeok handed the hooks over to Yeoni and looked at Heo Jun.
Had he not spent all this time at the Royal Medical Bureau training him up as a useful hand?
If he did not make use of him at a time like this, he would be a fool.
"Teacher Heo."
"Yes. I'm listening."
"Would you perhaps be able to assist with the surgery today?"
"What? Oh my. Of course."
"Then put on a mask and gloves. There are clothes here too, so change into them."
Kanghyeok pointed to the clothes he had unpacked from the bundle.
They were Joseon surgical garments he had designed himself, and the sleeves were so short that no one could possibly wear them outside.
No matter how hot it was in summer, this was still an age where yangban had to wear long sleeves.
But Heo Jun did not complain or ask questions. He quietly changed clothes.
"Huh."
Life at the Royal Medical Bureau must truly have been demanding.
The sharply defined abdominal muscles he had once developed through training taekkyeon had disappeared somewhere along the way.
Heo Jun seemed to notice Kanghyeok's gaze and gave an awkward smile.
"Haha. State service is no easy thing."
"Still, I suppose the salary must not be bad. Ha ha."
"It's enough to put some belly on me."
Heo Jun pointed at the flesh on his stomach that his surgical robe failed to cover completely.
There was even a strangely proud smile hanging on his lips.
This was not twenty-first century South Korea. This was sixteenth-century Joseon.
When starving commoners were everywhere, living richly enough to grow a belly was clearly a blessing.
"All right, then what should I do?"
Heo Jun finally approached after fully getting himself ready.
He sat facing Kanghyeok, which was also the best position for a first assistant.
"First... make sure the eyeball doesn't dry out by sprinkling water on it regularly."
"Yes, that's not difficult."
Heo Jun answered while looking at the syringe Kanghyeok had handed him.
Was he not someone who personally performed hemorrhoid surgeries at the Royal Medical Bureau?
Something like this would indeed be nothing to him.
"And if there's bleeding, wipe it with this."
Kanghyeok placed a cotton swab in Heo Jun's free hand.
It was not a tool used in hemorrhoid surgery, so it must have seemed rather unfamiliar.
As expected, Heo Jun tilted his head and asked, "You wipe it with this, not gauze?"
"If enough blood comes out during eye surgery that you can wipe it with gauze, then it's a major disaster."
Kanghyeok smiled, recalling memories from when he had been a clinical student.
He could still vividly remember a professor making an enormous fuss over two drops of blood.
Anyway, those minor departments are all so fainthearted.
From the perspective of surgeons who would not even blink unless the patient was actually dying, the fuss ophthalmology or ENT professors made seemed laughable.
"That makes sense too."
Heo Jun smiled along with Kanghyeok.
"All right, then let's begin."
"Yes, Scholar Baek."
The surgery began in a much more relaxed atmosphere.
That atmosphere helped Kanghyeok a great deal too, because first of all, his hands stopped shaking.
And his dizzy mind settled somewhat as well.
Thanks to that, details from textbooks he had skimmed only a few times back when he was a student began resurfacing.
Not perfectly, though.
He would have to make up the rest with anatomical knowledge.
After all, surgical procedures were not rigid things assembled like machines.
First, I should make a circular incision along the cornea.
After swallowing dryly, Kanghyeok began making the incision with the scalpel.
His expression was more cautious than ever.
About 2 to 3 millimeters deep... if I go deeper than that, it'll be a real disaster.
It would not do to destroy the eyeball itself.
One fortunate thing was that Heo Jun and Yeoni were quite good assistants.
Yeoni held the eyelids open without the slightest tremor, and Heo Jun wiped away blood with uncanny timing whenever it looked like bleeding might obscure the field.
If it looked like the cotton swab would get in the way, he instead sprinkled water to secure visibility.
Good. Very good.
Thanks to that, Kanghyeok was able to fasten the first button properly.
He had successfully finished the incision, the foundation and most important part of the operation.
It was neither too deep nor too shallow.
And it formed a perfect circle along the edge of the cornea.
"Good... now I need to spread this incision apart."
"Uh... I can barely even see it in the eye."
Just as Heo Jun said, the incision between the cornea and the white of the eye was too small to see clearly.
Kanghyeok tilted his head for a moment, then quickly arrived at an answer.
At times like this, his long experience as a surgeon was a great help.
"First, hand me the suturing instrument."
"What? You're closing it right after cutting it?"
"No. Thread isn't used only for suturing wounds."
"Oh. Is that so?"
It was the same in every profession, but especially for surgeons, rigid preconceptions were dangerous.
Otherwise, there would be no chance of performing little tricks like this.
—Poke.
Kanghyeok passed thread through each cross-section of the incision.
"Let's see..."
He very carefully grasped the thread and pulled it to either side.
Then a gap so tiny it was almost invisible began to open.
It was thanks to using the thread like a hook.
"Ah. So that's how you do it."
"Yes. It's a useful method when opening a small gap like this."
"So the incision is done now... what do you plan to do next?"
"Cut again. At this point, only the outer gate has been opened. Mm. Like I said, I think that's a very fitting comparison."
"Ah, yes."
Thinking, as usual, that it was quite an excellent description for something he had come up with on the spot, Kanghyeok picked up the scalpel again with his usual narcissistic satisfaction.
Neither Heo Jun nor Yeoni reacted much. They were already used to that side of him.
Only Dongpa, crouched in the corner, let out an uncomfortable groan.
"Ugh."
Unfortunately for him, that groan did not end there.
Makbong kicked him at once from the side.
Makbong was the kind of fellow who never forgot this sort of punishment, even while continuously blowing air into the patient.
Meanwhile, Kanghyeok was staring at the opened gap with the scalpel held upright.
If I miss the direction here, I could damage the iris or the lens. Then it really would be a disaster.
In other words, he had to insert it at the proper angle and to the proper depth.
"Properly" is always the hardest part.
With an unhappy expression, Kanghyeok adjusted the hand gripping the scalpel.
No matter what, this was the moment he had to stab.
I have to trust the feeling in my fingertips.
If he was inserting it correctly, at some point he would feel empty space.
The moment that happened, he had to stop.
That would be the place full of aqueous humor.
The very thing that was causing the patient pain.
—Thrust.
Kanghyeok could not thrust the blade in with his usual decisiveness.
Instead, he inserted the tip softly and slowly.
Compared to a single decisive thrust, that might cause more damage to surrounding tissue, but it could not be helped.
He had to protect the more important structures.
—Thunk.
At a certain moment, the resistance against the blade's tip suddenly gave way.
"Hup."
With a short gasp, Kanghyeok barely managed to stop his hand.
When he withdrew the blade, aqueous humor slowly began to leak out through the wound he had just made.
"That did it. Hm?"
"Why? If fluid is coming out, then it worked... Hm?"
Heo Jun uttered a similarly puzzled sound.
Because some strange reddish tissue had blocked the hole through which fluid had been spilling out eagerly.
"What is that?"
The question came from Yeoju, who had silently been sketching from behind.
Thanks to the natural pigments Gwanghae had given her, the drawing was very colorful.
"This is..."
Kanghyeok kept pointing helplessly into the air.
What is this? Did I stab the wrong place?
Cold sweat was pouring down his back.
It was one of those eternal truths: one should not perform a first-time surgery without a teacher.
That thought flashed through his mind.
But another thought quickly rose up.
No. I stabbed it correctly.
The sensation at his fingertips was always honest.
Especially for a highly skilled surgeon like Kanghyeok, that tactile sense was exceedingly sharp.
Sometimes one had to trust touch more than sight.
What was more, the fluid that had leaked out had definitely been aqueous humor.
Then what on earth was that red tissue?
After pondering for a long while, Kanghyeok's face finally began to brighten.
"This is the iris."
"The iris?"
"Yes. Judging by the location, it can only be the iris."
"What is that?"
At Heo Jun's innocent question, Kanghyeok was once more keenly reminded that this was Joseon.
A famous physician of the era was asking what the iris was.
Suppressing a bitter smile, Kanghyeok answered, "To put it simply, it's the part that regulates how much light enters the eye. The reason we can quickly adapt when we go somewhere dark or somewhere bright is because of this fellow."
Strictly speaking, the iris was not the only reason.
But there was no need to start talking about photoreceptor cells.
Even Kanghyeok had forgotten half the details himself.
Fortunately, Heo Jun understood to some extent.
"I see. So it works by changing size?"
"Exactly right. Well, it won't cause a problem if I cut a little of it away, so I'll do that now."
His eyes might become a little dazzled in bright places.
But compared to blindness, that was nothing.
Kanghyeok cleanly snipped off the protruding iris without hesitation.
With that, one hole was completed.
Watching the aqueous humor stream steadily out through the hole he had made, Kanghyeok smiled in satisfaction.
Now three more, I suppose. This part isn't hard at all.
Was the first time not always the hardest?
Starting from the second hole, Kanghyeok opened them skillfully, as if he had been doing it for decades.
Heo Jun was the first to click his tongue in amazement at that skill.
He had never seen anyone improve so quickly in real time.
"Scholar Baek truly is extraordinary."
"Ha ha. It's nothing. First we should see how the patient does."
Kanghyeok looked down at the patient lying there with four holes made, and several knots tied into the wounds around the cornea.
At that point, Makbong, who had been blowing air all this time, asked with a rather tired face, "Is it over now?"
"Ah, yes."
"Then shall we wait until he wakes up?"
"Mm? No. Why wait and make things harder? Wake him right away. I noticed his eyelids twitching earlier. The effect of the pufferfish poison must have worn off."
"Aha. Yes, understood."
Makbong looked delighted to hear that and rolled up his sleeves.
The patient woke only seconds later with a short scream.
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