Nineteenth Century Medical Guide

Chapter 149 146. Trouble
In the past two months, Kavey's status has started to rise, which is of great benefit to spreading his medical opinions and bringing the chaotic surgical operation into the normal.But at the same time, this status also brought him many responsibilities that he could not refuse like shackles.

The impressive achievement of nearly ten caesarean sections with zero mortality in two months made Kavey easily exceed the limit of existing surgery.At least in the field of simple caesarean section, Carvey is the absolute authority in Vienna.

Now it is only limited by the speed of news dissemination, and Karvey's reputation is limited to the surrounding area of ​​Vienna.

However, as time goes by, the procedures and key points of cesarean section will eventually spread overseas with papers and letters.

Since it is an absolute authority, sometimes it is necessary to give others some guidance without hesitation.Ignatz, Waterman, Olgi have all received his guidance, and now Besim and Denever are no exception.

From the point of view of personal personality, Carvey does not like to communicate, but the profession of surgeon is inherently social.Interpersonal relationship affects the cooperation and work efficiency of the surgical team, and also affects his reputation among colleagues, which is an indispensable part.

In front of him was a new type of gynecological surgery with no visible results. Looking at Besim who sincerely invited him, Kawei still wanted to refuse first, to test the attitude of the other party: "The Municipal General Hospital still has things to do, and the gynecological surgery I haven't done it either, or else"

"Gynecological surgery is also performed in the abdominal cavity. I just hope you can give me some reference."

"Then" Carvey looked at the time, "What time does the surgery start?"

"Soon, one o'clock in the afternoon."

"Then I'll go and have a look." Carvey is still modest and cautious about his surgical ability, "It's really not an opinion, let's learn from each other."

Besim never thought that he could invite Carvey. In the past month, only Watman and his son could invite him.Olgi's cesarean section was just a coincidence. If you really want to come to ask for it, you don't know what will happen.

First, he wanted Carvey to guide the gynecological surgery, or to give some advice during the operation.At the same time, taking into account Olgi's operation yesterday, Besim also wanted Kavey to give himself and Denever a complete explanation.

After all, both of them had minor operations in the gynecological ward, and they only needed needles and threads to do some mending[1]. They basically didn’t use ether, and they had never been in an operation theater.With such a skilled surgeon present, Besim felt much more at ease.

In comparison, Denever, who was in the preparation room at this time, showed more excitement: "What? Dr. Kavi Hines is here too???"

"I guess I came to see the woman who had the operation yesterday, and then asked about the gynecological examination and treatment she had done before." Besim also entered the preparation room early after sending Kawei to the operation theater, "the rubber gloves brought Is it?"

"I've brought it, it's soaking in disinfectant." Denever pointed to the basin in the corner, "There are also ether, anesthesia mask, sterile gauze, alcohol. Teacher, do you want to use the infusion bottle?"

"It's just a gynecological operation, not a cesarean section. There's not much bleeding." Besim hesitated as soon as he finished speaking, "Forget it, why don't we prepare it."

"Then prepare the sodium citrate as well." Denever took out the prepared medicine bottle from the box, and then pulled out his notes from under the open anatomical diagram, and found the record of the cesarean section operation at that time. Record: "The dosage is 2.5g per L of blood."

Besim asked: "Do you still remember the location where the operation entered?"

"Remember, considering the lower position of the uterus, we choose the transverse incision in the lower abdomen that Dr. Carvey has always advocated." Denever glanced at the anatomical diagram of severe uterine prolapse [2], and then looked at the notes, "It should be no problem. "

"Ever considered the bladder?"

"Well, the bladder needs to be avoided, and you can't make the same mistake as Dr. Olgi." Denever did make enough preparations before the operation, and the notes were densely filled with key points. I watched the cesarean section once, "The money in the surgery theater is not wasted."

Besim looked at the various anatomical and surgical atlases on the table in front of him, and recalled that his students really worked hard enough.

He took out a bottle of red wine from the cupboard and filled two glasses: "I wish our operation a success, let everyone, including Olgi and Dr. Carvey, be impressed, and at the same time stop the mouths of those who gossip .”

"Don't worry teacher, I have confidence!"

Denever's academic career was indeed not easy.

Five years ago, he came to Austria from Belgium to study. Because he did not have a local high school diploma or pass the entrance examination for the University of Vienna, he had to earn money while working while spending time re-learning the contents of Austrian high school.

After entering the Vienna Medical School, he finally showed his amazing learning ability, and got his Ph.D. diploma five years later.

Before graduating, he entered the Grace Hospital where Besim worked as an intern.Compared with Bergett, who is still working as an "apprentice", he is now a certified gynecologist at Graze Hospital.

If there is no accident, he will be able to successfully enter the Gynecology Association in half a year and receive patients in the clinic alone.

"It's really talented." Carvey didn't know how to evaluate this newly graduated doctor, "But Dr. Olgi, I just entered medical school, so I don't seem to be qualified to evaluate this doctor of medicine."

"You are different, how can you compare with them." Olgi said with a smile, "You can work even if you don't go to medical school."

"That's not necessarily the case. Herbology and zoology at the undergraduate level are still quite difficult." Carvey said, "I have to spend a lot of time on these two courses. By the way, there is also philosophy. It is too troublesome."

"That's not the point. Medical school focuses on anatomy, physiology, and pathology. I heard that you are exempt from these three."

"Well, it was Dean Meadows who helped."

"You didn't fight for it yourself." Olgi also taught in the medical school and knew the examination process very well. "The requirements for undergraduate graduation are not high, as long as you pass the usual assessment and examination, you will be fine."

Compared with academic problems, Carvey is more worried about this operation now: "Actually, in my opinion, Dr. Denever can think of this operation is already quite good, there is no need to go on stage to do it himself. Many operations have There are all kinds of traps, and you can’t really do it if you take it for granted.”

Olgi also holds the same point of view, but he cares more about more basic things: "I don't think too much about it. Whether it is necessary to use surgery to solve the problem in gynecology is naturally decided by the gynecologist. The reason why I don't Agreeing to the operation is only because a gynecologist is not qualified to be on the operating table."

Besim was not around, and his words were very straightforward.

Modern gynecology also has many operations, and there is no saying that surgeons arrange all operations.But in the 19th century, invasive procedures were often the job of surgeons, and other doctors were bloodless.

"I personally think that if the operation is really feasible, there is no problem for a gynecologist to go to the operating table."

Olgi looked surprised: "Gong Yu, they haven't received professional training, and there will definitely be problems on the operating table. Privately, I am a surgeon myself, so naturally I don't want others to take my job away."

"I don't think it's nothing. There will be more and more surgical operations in the future. A single doctor's energy is limited, and it is impossible to handle all the operations in his hands." Carvey said, "If you take a long-term view and want to carry forward surgery, Inclusion is important."

"Doctor Carvey is really brave to think so."

"Think about the development of medicine to a certain scale in the future, we will be able to detect more and more diseases, the life expectancy of human beings will be greatly increased, and the development of surgery will reach an unprecedented level." Carvey said excitedly about the current status of medical care in the 21st century, "doctors do not Only internal medicine, surgery, obstetrics, and gynecology will be divided into more departments because of various systems."

"More departments?" Olgi never thought about the question.

"Looking at the development of medicine to the present, the division of medicine is an inevitable result. The more we know about the human body, the more we need professional medical talents. This kind of professional talent gathers together to form a new discipline."

Kavey's "guess" was too advanced, making it difficult for Olgi to digest.

Just at this time, the door of the operating area was pushed open, and Besim and Denever pushed the patient into the theater.

The surgical theater at Graze Hospital is different from the lakeside theater. Tickets are not sold here, and the surgery is only watched by doctors in the hospital and medical students.If the patient has a special status and spends a little more money, these audiences can also be rejected.

Since everyone in the arena is their own people, the host and the ticket window are omitted.

The disadvantage is that it lacks the lively atmosphere in the theater, and the advantage is that it will be quieter during the operation and the viewers will be more professional.

But today's operation is very special. As Olgi said, the doctors who visited here thought that the operation was too random from proposal to execution, and the operation should be stopped in time.So when Besim entered the venue, they could hear them talking.

"The patient is a 53-year-old middle-aged woman who has given birth to 6 children. Her uterus is severely prolapsed and she cannot live a normal life at all." Bessim said, "It must be difficult for you to understand why we want to perform this operation. Determined, because you can't understand the pain of patients with uterine prolapse."

Someone on the stage quickly retorted: "It's not that we don't understand the patient's pain, but we are skeptical about the success of the operation itself."

"In the previous discussion, we have already stated our point of view. If the operation was proposed by Dr. Olgi and put into practice, no one would gossip. But now it is performed by you two gynecologists, isn't it too much? It's child's play."

Olgi shook his head: "I don't have the ability to do it, and I don't have the time."

At this time, Deneve stood up, as a young doctor who just graduated from medical school, he shouldn't talk too much.But I was a little annoyed seeing my teacher being counted down:
"Mr. Besim and I have studied many cesarean section operations, and have our own unique understanding of the uterine reset and fixation. We have done a lot of autopsies, and we have also done similar operations on pigs, and the results are good. Please Everyone understands, as for support, we don’t care.”

"No matter how much you object, the operation has been approved by the director." Besim didn't have much to say, "Let's start."

"According to Dr. Carvey's preoperative preparation workflow, we will disinfect the abdominal incision while ether anesthesia." Denever said while picking up the alcohol gauze, "Wipe the abdomen repeatedly to keep the surgical area clean."

Although these processes are carried out according to the process that Carvey said, even the surgical incision is the same as the cesarean section incision he advocated.

However, the repair of uterine prolapse advocated by Denever is definitely not the reconstruction of pelvic cavity function in the modern sense. Simple broad ligament reduction may play a role in lifting the uterus, but this lifting is done when the surrounding tissues are weak. The results were not sustainable, and in Carvey's view the operation was doomed.

However, he still ignored a key factor. Neither Besim nor Denever had actually been on the operating table.

Even though the ether anesthesia was successful, the patient had no accidents; the surgical incision was beautifully done, and a small amount of subcutaneous tissue bleeding was harmless.But the two of them didn't really understand the anatomical structure of the abdominal cavity. Even if they recited all the contents in the book, the stomach of a dead body and a living person are two completely different things.

Under the oil lamp, which was not too bright, the bright red made it impossible for the two of them to tell which was the annex and which was the uterus.

"We're looking for the broad ligament, the broad ligament."

Denever clutched the raven's beak pliers, trying to find the broad ligament he wanted, and cut it to reduce its length.But his hand could only stop in mid-air, despite the bean-sized beads of sweat rolling on his cheeks, and finally trickling down to the corner of his mouth, he uttered a sentence: "Teacher, where is the broad ligament?"

(End of this chapter)