Nineteenth Century Medical Guide

Chapter 120 117. Professional Ethics
Medical trouble seems to be a relatively modern term.

The massive amount of information brought by the high-speed Internet has made many things more and more transparent.Coupled with the rapid increase in human life expectancy, people's expectations for medical treatment have also increased.Under the infusion of a large amount of medical information + high expectations + some media hype + a relatively complete medical compensation system, the contradiction between doctors and patients has become more and more irreconcilable. 【1】

In the 19th century, there were not so many troublesome things in medicine. There were not many diseases that could be diagnosed, and there were very few medicines available. Basically, they could be found from the periodic table of elements.

The more poisonous the "drug", the easier it is to become the magic medicine in the mind of the patient, because the body reacts violently, and the response is effective.If the toxicity is too high and the patient accidentally dies, it is also caused by serious illness, and has nothing to do with doctors or drugs.

It seems that surgery does not use much medicine, and the results of surgery are often either dead or disabled, but the people on the operating table are all dying people. If you die, you will not lose, but if you are disabled, you will earn, so there is nothing to complain about.

In the Municipal General Hospital, Kavey sees patients covered with white cloth every day, but crying is not common, and there is no troublemaker.Losing a loved one can bring a lot of inheritance besides making people feel a little sad. Medical failure itself has no legal support for compensation, so there is nothing to fuss about.

Looking at the knife in this guy's hand, the first thing Karvey thought of was not medical trouble.Because even death can be tolerated, what else can't be tolerated?
"That quack doctor took my love away!" The man who was crushed under Hills roared, "He took my love away! Reinette is going to marry someone else!"

Carvey:? ? ?
Sears broke his palm and kicked the knife away: "If you have anything to say, you can talk to the patrolmen when they come."

"There is nothing to say." The man suddenly laughed, "As long as Olgi is dead, hahaha, as long as he is dead!!!"

"madman."

The doorman was in place quickly, replacing Hills, and the patrolmen were on their way.But the matter is not over yet, and now there is still a doctor in urgent need of rescue lying in the surgeon's office.

Carvey came very suddenly. If it was normal, Sears would not drive him away, but he would never be very enthusiastic.He is not a saint, he can't distinguish between public and private, and he can't even achieve perfect emotional control on the operating table.

However, the situation is different now, and Hills felt a little "happy" in his heart, and ran to the office as soon as he pulled Carvey.

He didn't know that this was actually a kind of dependence hidden deep in his heart, because Olgi was indeed seriously injured in the murderer's mouth.

Many people surrounded the office, and besides doctors and nurses, there were also many patients who came to "join in the fun".The patients who were originally on the operating table for people to watch became spectators, and the doctors who operated on the patients became commodities to be watched.

"Don't look, there's nothing to see, go back and lie down." Sears separated from the crowd and asked as soon as he entered the office, "How is Mr. Olgi?"

"The situation is not very good, there is too much bleeding." Doctor Locard, who attended the regular meeting of the School of Surgery together, was doing first aid in the office. "The shoulder and arm injuries are not bad, but the most troublesome thing is the stabbing in the stomach at the end." For this cut, it is impossible to stop the bleeding alone, the teacher needs to operate immediately."

Carvey walked behind Hills, a little slower.

In addition to coming here to see Olgi's injuries, he also wanted to see if there were any suitable women in the ward.After all, Olgi is a doctor at Graze Hospital, and Graze Hospital has to save lives by itself. Kavey is not easy to presume, and the purpose of coming here is to solve the problem of the curative effect of oxytocin.

The office was full of bloody footprints, and the amount of bleeding was not small.

The vest on Olgi's body was unbuttoned, and the white shirt turned bright red. Carvey couldn't see clearly from a distance, and he could only vaguely see that he was holding a coat by his hand.From the looks of it, he should have been attacked while changing clothes and getting off work.

"Teacher, teacher~"

Olgi closed his eyes, he could hear the voice in his ears, and there was a reaction on his face, but he was completely speechless: "."

Hills was very worried, stepped forward to look at the injury, then turned around and called Karvey's name: "Doctor Karvey!"

"I am here."

Carvey stood at the outermost edge of the rescue crowd, and was closer than the surrounding patients.He didn't talk nonsense, because when he did he would count Dr. Olgi among his patients.Since it is his own patient, the nature is different, and all subsequent rescue measures must be under his own command.

"Enough people have been rescued, and I can't help much if I come in." Carvey said, "Actually, no matter what the injury is, you have to perform an operation to stop the bleeding first."

"Kavi?"

"Yes, it's me."

Locard also participated in the regular operation meeting and reported on the iliac vessel occlusion technique during amputation, so he naturally knew him.Like Hills, he is not in the mood to chat now: "There is too much bleeding, go get some gauze!!!"

"By the way, push a stretcher, and get the theater ready for surgery, hurry up!!!" Hills also joined the ranks of first aid, "The location of this knife is too bad, I'm afraid the intestines have been cut, and even the spleen has been cut , otherwise there wouldn’t be so much bleeding.”

"This guy is too ruthless, he just wants the teacher's life!"

Hills took Locard's gauze, pressed the wound on his stomach, and asked, "How is the shoulder injury?"

"I checked it, it's okay, no major blood vessels were injured, and a temporary bandage has been done just now."

"What about the arm?"

"It's just a skin injury."

"The most troublesome thing is the stomach."

"I think we need to open the abdomen and do intestinal anastomosis immediately." Locard didn't know much about the spleen. "But what should we do if the spleen really ruptures? Do splenectomy directly?"【2】

"I don't know." Hills has almost no experience in trauma management, and has only learned one or two cases of splenectomy in textbooks. "If the bleeding is serious, it can only be removed."

Seeing that the atmosphere was not right, Carvey asked abruptly, "Haven't you all had a splenectomy?"

"."

"Look? You haven't even seen it, have you?"

"."

These two sentences made the atmosphere of the entire office extremely oppressive. Olgi's face was pale, and the two young surgeons were even paler. They had no confidence in the upcoming operation.

If one of the two fell in a pool of blood, Olgi, the director of surgery, might have already had an accurate surgical plan.Whether right or wrong, it is better to do something than to do nothing before one is about to die.

As for confidence, it is something that a mature surgeon must have, and it has nothing to do with the difficulty of the operation.

After the two nurses left, Carvey's vision finally got better, and he could see clearly the abdominal wound they were dealing with: "That much bleeding?"

"Yeah, I can't stop."

Carvey felt strange: "Wait, don't you think there is a strange smell in the office?"

"odor?"

"What smells?"

"gunpowder."

Carvey shrugged his nose, walked back following the faint smell of gunpowder, found the door of the office, and quickly picked up a pistol from the door: "I just fired a gun, didn't you hear the gunshot?"

"I did hear a noise before, but I didn't expect it to be a gun."

"That guy is still carrying a gun!" Hills looked at Olgi, his heart was full of anger, "The teacher is the best surgeon in Graze Hospital, and he is also the one who guarantees me to be the chief surgeon. If something happens to the teacher .”

"Don't think too much." Lockard comforted, "In fact, the teacher's approach is not appropriate."

"What's wrong?" Hills was a little excited, "He just did what a kind and normal person should do."

"But he violated professional ethics after all."

"Should I be axed for violating professional ethics?"

Carvey didn't know what the two were talking about, and he wasn't interested in this complicated medical trouble.The appearance of the pistol made him see that Olgi's injury was strange. After all, a ruptured spleen was internal bleeding, and even if there was blood gushing out from the body surface, it would not flow everywhere under the pressure of so many gauzes.

He walked up to Hills, and finally saw the problem: "You are in the wrong position."

"What do you mean?"

"You only saw the knife wound, not the gunshot wound." Carvey moved Sears' hand to the right, "You have to press here."

Hills' fingers felt the heat of blood again, and the gunshot wound was in the middle of Olgi's abdomen.The gushing blood and several knife wounds made them ignore the small hole in the shirt: "This position, not even the liver is that hateful guy, he must be hanged!!!"

"do not talk"

Lockard is different from Hills. He is a student brought up by Olgi from the medical school, and his relationship will only be deeper than Hills.But he still couldn't agree with the teacher's approach: "This can't be blamed on Mr. Nuo Dier."

While the two were discussing the motive for the murder, Carvey looked around and found Olgi's surgical instrument box: "If you have time to talk about this, you might as well perform the operation as soon as possible."

"We're waiting for the stretcher."

"Why wait?" Carvey moved the equipment box over, "Whether to go there or not, can the surgery be done differently? Or do you want to follow my pre-operative disinfection?"

There were fewer things in the equipment box, not as miscellaneous as Ignatz's, but it was still enough for simple hemostasis for laparotomy.Although the amount of Olgi's bleeding seems exaggerated, it has not yet reached the point of a direct death sentence. At least Carvey can barely feel his pulse.

He took out the scalpel from the box and didn't have time to argue with them, so he asked directly, "Will you do it or I will do it?"

Sears and Lockard glanced at each other: "You do it."

"Come a nurse to drive away the people outside and keep them quiet." Carvey immediately took over the power and directed the improvised team in the room, "Come two more to pull the desk over, as a temporary The operating table. Hills went to prepare ether, Lockard went to find the instrument box for laparotomy, and the set in my hand should be used for amputation."

"it is good."

In just 2 minutes, the chaotic ward gradually became orderly.

The onlookers were sent back to the hospital bed, but the office at the scene of the crime became a temporary operating room, and Carvey's scalpel had already cut Olgi's stomach: "This knife feels pretty good."

"After all, the hospital has spent a lot of money, and it has never been stingy in terms of equipment." Hills took the skin that Kavey cut open with crow's beak forceps and tweezers, "What kind of surgery are we going to do this time?"

Carvey shook his head: "I don't know."

"do not know???"

"How would I know what to do if I didn't cut open to see what's inside my stomach."

In the nineteenth century, one of the criteria for evaluating the quality of doctors was the speed of diagnosis.

The less questions you ask, the better. It is the most correct way to make a judgment with a very positive tone after just two glances, because in this way the patient will believe you.But Carvey has long developed the habit of not making conclusions easily, and it is the attitude that a doctor should have towards a patient.

Hills took out the needle and thread from the equipment box: "Here, the suture."

Carvey's amputation left a deep impression on Sears, but this time Carvey's choice was different: "With such a serious knife wound, the bleeding around the incision is ignored. We will enter the abdomen as soon as possible."

The cutting of the scalpel is faster and more rough than before in the surgical theater. After cutting the muscles in twos and twos, Kavey quickly opened the peritoneum, and there is a scene that can only be seen when making blood sausage: "No blood coagulation."

"A lot of blood clots."

"Where is the attractor?" Carvey looked around, "I want the attractor!"

"Here we come, the suction device is here!" Lockard was carrying two equipment boxes and a long suction device tube, and knocked open the door. "Everything is here."

"Hurry up and get on stage." Carvey dug out several crow beak pliers from the box, "Hills drew blood, and the nurse reported his heart rate."

"Heart rate."

The nurse in the ward was unskilled and couldn't keep up with Kavey's rhythm. When she looked down for the stethoscope, Kavey had already pinched Olgi's right hand: "110, up to 120, it's a bit troublesome. "

Hills kept shaking the handle of the suction device in his hand, and the semi-coagulated blood was quickly drawn out of Olgi's abdominal cavity, and a glass bottle was quickly filled.

The stab wound to Olgi's left abdomen had unfortunately cut part of the bowel and then touched the lower border of the spleen.

"There is a tear in the spleen." Kavey's eyes were sharp, he pushed his intestines away slightly and opened up his field of vision to see a small incision on the spleen, and there was a hematoma under the capsule, "There was only a small incision, not much bleeding, abdominal The blood clot in it should not have caused it."

"Where is that? Is it really a liver?"

"Don't worry, you have to take your time to find the blood spot." Kavi didn't say much, and pulled the skin on the other side with a retractor: "There is indeed a tear on the lower edge of the left lobe of the liver, and there are scorching marks."

"If the spleen is ruptured, it can be cut, but if the liver is ruptured, the liver must also be cut?"

"Who said that a ruptured spleen should be cut?" Carvey moved the nozzle of the aspirator in Hills's hand toward the liver, "There is very little bleeding in the spleen, it's just a hematoma, and a simple suture will be enough later. The trouble is the liver"

Being born in a safe country is a lucky thing, but it also makes Carvey less experienced.He did not deal with many gunshot wounds, most of which were injuries to bones, muscles, and blood vessels. It was the first time he had seen the liver punctured.

This time is also a challenge for him.

(End of this chapter)