To Hell with Being a Saint, I’m a Doctor - Chapter 219: Pneumothorax

Leaving the unsuitable forest for surgery behind, Ray found a clearing with a large rock and gently set down the Holy Commander he had been carrying.

He took a dagger from the multi-purpose pocket on his thigh and sliced the rock cleanly.

Swooosh-

The giant rock was cut as if it were tofu.

Having created a makeshift operating table, Ray lifted the Holy Commander onto it.

The Dark Elf, watching this, murmured in admiration.

“Such impressive swordsmanship.”

“Thanks, but can you find some clean cloth? As clean as possible.”

“…Understood.”

She nodded reluctantly, her voice betraying her lack of enthusiasm.

Though unsure why she should help, her curiosity compelled her to observe closely.

“What should we do?”

“Tell us anything we can help with!”

The two priests approached with their hands clasped together.

Ray looked at them and asked,

“Ever cut open a person?”

“What?”

“You’ve at least seen someone dying, right?”

“Yes… I mean, I have, but…”

“Then help me. Once the Dark Elf brings some usable cloth, put it where I direct you.”

“Ah, okay. We can definitely do that!”

They would be in trouble if they couldn’t even manage that.

In the past, even the finest medical teams of the modern era didn’t meet his standards.

But now, he missed them deeply.

A bilateral sternocostal thoracotomy isn’t something one does alone.

Typically, one needs at least one knowledgeable surgeon, an anesthesiologist, a surgical assistant, and two other assistants.

The thought of performing the surgery alone, giving detailed instructions at every turn, was already exhausting.

He released divine power into the surroundings.

A special purification gift from the gods began to cleanse the area.

Underneath the hard surgical table, where the Holy Commander lay, he placed his robe for cushioning.

Before starting the surgery, he needed to create an electrosurgical unit.

He rubbed the blade of the small dagger with his finger.

The sharp dagger quickly transformed into a blunt stick.

“This should work as a cautery. Just heat it up when needed.”

He nodded to himself, checking everything was in order.

The time had come to begin the surgery.

“Everyone, gather around. We’re starting now.”

The Dark Elf approached with a cloth in hand.

It seemed she had found a relatively clean corpse somewhere and torn its clothes for bandages.

“This was all I could find.”

“We need as much as we can get, but if this is all there is, we’ll make do.”

He cast a spell on the Dark Elf and the priests.

“Clean.”

Whoosh—

In an instant, monster blood and various impurities washed away from them.

“Just a heads-up, don’t be surprised by anything I do. As long as you follow my instructions, we can definitely save him.”

“…Understood.”

“Yes…”

“Hmm.”

Leaving behind their diverse responses, Ray created a scalpel.

Wooong—

Mana converged in his hand, forming a tiny sword.

“That’s quite a significant amount of mana.”

“From now on, try not to talk. Even a droplet of saliva during surgery would be disastrous. If you must speak, turn your head away.”

“……”

“Sleep.”

He used magic to put the Holy Commander to sleep as a precaution.

Shaking off the tension in his hands, Ray prepared himself.

‘It begins now.’

He undressed the Holy Commander’s upper body and drew a long incision line along the lower part of the chest.

The two priests gasped at the sight but managed to stay silent, fortunately.

He cut along the chest line, slicing through the adipose tissue and muscle beneath.

Next, he cast a spell on the blunt dagger.

“Heat.”

He applied the heated tool to the incision, causing the skin to sizzle and seal the bleeding.

This should halt most of the bleeding.

Lacking rib spreaders, he had to manually cut the 5th and 6th ribs.

Turning to one of the priests, he instructed,

“See the part I just cut? Grab and spread it open.”

“What?”

“Make sure the inside is visible.”

“But even if you say so, how can I… If I do, the Holy Commander might die…!”

Time in surgery is more precious than gold.

Especially in a situation like this where they can’t even monitor the heartbeat.

“If you can’t do it, step aside. Can you?”

Turning to another priest, she hesitated but then nodded.

“I’ll try.”

“Please, gently lift and spread this side of the bone. Be careful not to touch the organs.”

“Yes…”

She followed his instructions perfectly.

Crrrack—

The Holy Commander’s chest opened wide.

This provided enough visibility for the surgery.

He turned his head again and said,

“Keep holding it like that, controlling your strength. This might take a while.”

Ray moved his hands.

‘First, I need to check the hole in the lung.’

A pneumothorax occurs when air leaks into the pleural cavity due to a hole in the lung, causing air or gas to build up.

Before closing the thoracic cavity, it is necessary to re-expand the lung and install a chest tube to drain secretions from the pleural cavity.

Given the significant size of the pneumothorax, over 20%, and the presence of disease in the opposite lung, chest tube insertion was appropriate.

Inspecting the lung, Ray frowned.

‘The lung is too collapsed.’

It seemed more air had escaped than he had thought.

He needed to quickly expel the air and re-inflate the lung.

He pulled out a baton from his back waist.

The hollow silver baton was a military control baton given only to adults.

The priests looked puzzled as he suddenly took out the baton, and they were shocked when he cut it without hesitation.

What was that thing!

“As an adult, receiving this also grants the right to control the military, a symbol of leadership.”

To damage it, what was he thinking!

Regardless of their thoughts, Ray didn’t care.

“Clean.”

He neatly cut the ends of the baton and inserted it into the Holy Commander’s chest as a tube.

Ray inserted the baton into the air and gas-filled area, simultaneously pushing air out of the other end with mana.

In this way, the outside of the baton became a relative vacuum due to the lower air pressure.

The air inside the pleural cavity was then forced out because of the pressure difference.

Hiss—

As he had expected, a faint sound of air escaping was heard, and he could finally breathe a sigh of relief.

As the air and gas exited through the chest tube, the collapsed lung began to re-expand.

While waiting for all the air to escape, he checked the lung and found no abnormalities such as ruptured alveoli.

It was a fortunate situation amidst misfortune.

Normally, he would proceed with pleurodesis, but with a priest present, there was no need for chemical pleurodesis.

Why bother when there was the excellent magic of divine healing?

After removing the baton, now a makeshift pipe, he beckoned to the fidgeting priest.

“Do you still have some divine power left? Please heal.”

“Yes…”

As she extended her hand, she said,

“Cure.”

The divine power, activated by the incantation, healed the Holy Commander’s injuries.

The holes in the lung, the cut ribs, and the incised chest all mended.

However, it seemed to require significant divine power to mend bones, as she was heavily panting afterward.

“Huff… Huff…”

She appeared exhausted.

Well, she would soon be able to relax by absorbing the divine power scattered around.

With everything seemingly over, Ray also let out a breath.

“Phew…”

It had been a long time since he had performed surgery, especially challenging without modern medical equipment.

Having to detect changes in heart rate manually was like performing a high-difficulty trick.

Sitting beside the rock, Ray was approached by the Dark Elf.

“What was that just now?”

Thinking briefly, Ray casually replied,

“A magic to save lives.”

“It didn’t look like magic… That scene just now was more akin to murder or torture.”

“But he’s alive now.”

“He wasn’t dead, to begin with. Humans, you are quite interesting.”

“I get that a lot.”

“May I ask how you got that mark on your hand?”

She pointed to a spot, and upon looking, I saw Aira’s special mark.

“Hmm… Proof of being caught?”

“…? I don’t understand what you mean…”

“The truth is, I don’t really know either.”

“An interesting human who knows High Elves. This is somewhat surprising.”

“It’s not that big of a deal.”

Responding nonchalantly, the Dark Elf then spoke with gravity,

“Elves are a greedy race. Beauty isn’t all there is, so look broadly and deeply. Elves can reveal ugliness in what seems precious, and it’s better to give up if you don’t understand that.”

His words were enigmatic.

Was there a hidden meaning?

The Dark Elf turned away after imparting those words.

“My husband is waiting; it’s time for me to leave.”

Muttering, she vanished into the forest.

‘To think there was a Dark Elf here.’

I had heard that Elves and Dark Elves didn’t get along well.

That was probably why she lived in such a secluded place.

The two priests, seeing Ray resting, offered him a cloak.

“We, we are sorry, but please use this…”

They still had difficulty grasping his surgical methods, which seemed as horrifying as torture, but he was a Saint chosen by the gods.

There had to be reasons unknown to them.

Convincing themselves of this, the priests began to attend to the Saint.

Ray chuckled, noticing their trembling hands.

“Don’t be too frightened. This is my version of divine magic.”

“…Yes.”

He sighed.

Though he did not seek their understanding for his medical methods, such reactions after surgery were still disheartening.

Draped in a cloak that was heavy with the scent of blood, he casually sat down on the grass.

The surgery was a success.

The Holy Commander had likely used divine magic on himself to eliminate the abnormality in his body.

However, the reason it had not healed was probably the air that had filled the pleural cavity.

Once the lung had collapsed and was filled with air, casting divine magic to seal the hole wouldn’t expel the trapped air from the collapsed lung and the pleural cavity.

‘Now that the air and gas have been expelled, it’s healed.’

There were significant diseases that divine power couldn’t fully cure.

More than 40% of patients with an initial spontaneous pneumothorax experienced a recurrence on the same or the opposite side.

Furthermore, among those treated for recurrent pneumothorax, the chance of another recurrence was over 80%.

But now, after removing the air and repairing the lung, it was completely healed with divine power.

He couldn’t be certain, but it was unlikely to recur under normal circumstances.

There should also be no side effects or after-effects from the treatment.

All that remained was waiting for the Holy Commander to wake up.

But what about this emptiness in his heart?

He never thought he’d feel a day of sadness from a lack of acknowledgment.

He looked up at the night sky and murmured.

“Lately, I find myself looking up at the sky often.”