What Kiryu Kazusuke had been referring to was the concept of "damage control surgery," something that had only gradually become widespread in the trauma emergency field in the early 21st century.
Most physicians at this time still subscribed to the philosophy of "it is what it is," or took the risk of cutting open the retroperitoneum to ligate blood vessels.
He looked at the monitor. "If Doctor Namura still doesn't act, the patient's heart will stop within three minutes."
To Namura Shoji, this kind of direct and crude "packing hemostasis" was often viewed as a sign of incompetence, or a stopgap measure used by battlefield doctors.
If he performed it and the patient died, he would bear primary responsibility for medical malpractice.
If he didn't perform it and the patient died, it would be because the patient's injuries were too severe; he had tried his best but was powerless to save him.
Namura Shoji knew very well that as long as he set down his scalpel, stepped back, waited for the EKG to flatline, declared death, and wrote up a death case discussion, tonight's nightmare would be over.
But…
His hands were shaking. Truly shaking. Shaking violently.
Before him was a human life—a man in his thirties, in the prime of his life. Perhaps he had a wife and children at home waiting for him to return.
A doctor's instincts and lingering conscience were wrestling against his own self-interest.
"Damn it!"
Namura Shoji cursed through gritted teeth.
Whether he was cursing this damned world, that loudmouthed resident, or himself, he didn't even know.
"Give me large gauze pads! Prep for incision!"
He thrust out his hand and seized the scalpel passed by the scrub nurse.
Even if the professor chewed him out mercilessly afterward, even if his career was stained because of it, he couldn't just stand by and watch someone die on the operating table.
At this point, it was a desperate, last-ditch effort.
"Incision site: midline lower abdomen!"
Although Namura Shoji's hands were still shaking, the blade tip was already pressed against the patient's skin.
Just as the blade was about to slice through the skin—
Ssss—
The sound of the airtight door sliding open suddenly came from the operating room entrance.
Everyone instinctively turned to look.
Imagawa Ori walked in with large strides, her arms raised, freshly scrubbed and disinfected, clad in a sterile surgical gown.
"I'm taking over this surgery."
"Doctor Imagawa!"
Namura Shoji's blade hung suspended a millimeter above the skin.
His voice even trembled. Honestly, the moment he saw Imagawa Ori, he felt an unprecedented sense of relief.
A savior had arrived.
Someone else would shoulder the responsibility now.
"Doctor Imagawa?"
Although Doctor Inoue belonged to the Second Surgery Department, he had also heard of this genius female board-certified specialist from the neighboring department.
"What's the current situation?"
The moment Imagawa Ori entered, the circulating nurse immediately stepped forward to help her into a surgical gown and gloves.
Kiryu Kazusuke reported concisely: "Comminuted pelvic fracture with massive retroperitoneal hematoma; stabilized with a C-clamp; ruptured spleen already resected."
"Currently suspecting rupture of an internal iliac artery branch. Blood pressure 60/40. Preparing for preperitoneal packing."
After hearing his report, Imagawa Ori nodded.
"Then I'll stand opposite as first assistant to help expose the field for you."
Namura Shoji very consciously stepped back, yielding the lead surgeon's position, and prepared to move to the opposite side.
Although he couldn't be the lead surgeon, serving as first assistant to Imagawa Ori during a major resuscitation like this was a good opportunity to make an impression before the professor.
However, just as one of his feet stepped onto the footstool—
"No need." Imagawa Ori directly cut him off.
"You go be second assistant with the retractors, or go write the medical record."
"Kiryu, you'll be first assistant."
Namura Shoji froze, one foot still suspended in midair. "Huh?"
Imagawa Ori glanced at him coldly. "Your hands are shaking like you have Parkinson's. Are you trying to cut the patient's bladder?"
Namura Shoji's face flushed to the color of a pig's liver.
But he didn't dare talk back.
He was a fellow; she was a board-certified specialist. Rank crushed people. Moreover, Imagawa Ori was exactly the kind of fearsome figure who, when displeased, could verbally tear someone apart until they withdrew into their shell.
And so, Namura Shoji slunk off to the second assistant's position at the edge and picked up the retractor.
"Yes."
Kiryu Kazusuke stepped forward and took the first assistant's position.
Imagawa Ori also stepped up to the operating table.
Her gaze swept coldly across the surgical field. Seeing the C-clamp and the abdominal incision site, her brows rose slightly.
"Scalpel."
Imagawa Ori reached out, took the scalpel, incised, dissected, and exposed the prevesical space.
Kiryu Kazusuke's hands quickly matched her rhythm—retracting, cauterizing, suctioning.
He was somewhat curious.
It was three-thirty in the morning.
Even for an emergency page, a specialist rushing from home would need at least half an hour to arrive.
But Imagawa Ori had appeared too quickly. It was as if she lived in the hospital, or had received advance notice.
Moreover, with her extremely pragmatic—that is, money-loving and life-valuing—disposition, she would usually avoid such a high-risk mess where the patient would probably die on the table; she would never voluntarily jump into something like this.
Unless this patient could bring her benefits that far outweighed the risks.
"Gauze pads."
Imagawa Ori took the large gauze pads passed by the scrub nurse, clamped them with long forceps, and stuffed them directly into the space anterior to the bladder.
The prevesical space, also known as the space of Retzius, was filled with loose connective tissue and was the main site of venous plexus bleeding following pelvic fractures.
"Press."
Kiryu Kazusuke pulled the retractors forcefully to the side, creating operating space for her.
The two of them coordinated with seamless precision.
One piece. Two pieces. Three pieces.
The white gauze pads were forcefully packed in, using the pressure created by their physical volume to firmly compress the shattered pelvis and torn vascular network.
This procedure looked incredibly crude, utterly devoid of elegance.
But it was the only life-saving measure available.
"Left side packing complete."
"Continue on the right."
Fine beads of sweat seeped onto Imagawa Ori's forehead, but her eyes remained focused.
Just then—
Ssss—
The airtight door slid open again.
A slightly portly middle-aged man with a somewhat receding hairline walked in, wearing green scrubs that looked rather old.
He slowly swept his gaze around the operating room. "Why does this look like a vegetable market?"
His voice wasn't loud, and it carried no anger, yet everyone present felt as though a mountain were pressing down on them.
This was Professor Nakamura Hiroshi, chair of the Second Surgery Department.
A major figure who normally only appeared at important academic conferences or when operating on government dignitaries had actually come personally to the emergency operating room.
"Professor, why have you come?"
The suction tube in Doctor Inoue's hands was shaking so much he could barely hold it.
In the dead of night, for emergency surgery like this—forget a full professor, even those associate professors normally couldn't be called in no matter how hard you tried.
The circulating nurse didn't dare breathe too loudly and quickly helped Professor Nakamura into a surgical gown.
Nakamura Hiroshi snorted irritably. "If I don't come, should I wait for you to kill the patient, then have me go apologize to the board chairman tomorrow?"
Saying this, he walked to the operating table and personally took over the abdominal exploration.
Kiryu Kazusuke's hands never stopped moving.
That Imagawa Ori, a board-certified specialist, would rush over in the middle of the night to salvage the situation, and that the full professor of the Second Surgery Department would personally make an appearance.
Moreover, the two of them had arrived almost back-to-back.
What did this indicate?
It indicated that someone had directly called the highest levels of both departments and applied pressure.
Then, this patient's identity absolutely belonged to the top echelons of Gunma Prefecture.
A prefectural assemblyman?
Or the president of a major conglomerate?