Nineteenth Century Medical Guide

Chapter 169 166. Postoperative Aftershock (2)

Kamiyi's request was strange, but understandable.

According to the general situation, the doctor defaulted that the excised tissue was discarded by the patient, so the excised breast and muscle would be sent to the upstairs laboratory, soaked in carbolic acid for embalming and preserved as a display specimen.

The tissue specimen excised from the first radical mastectomy belonged to a French countess, which is exciting to think about.

But when Kamiy asked to take it back for his own use, it was impossible for everyone present to refuse.After all, it was cut from his wife, and there is no pre-operative signature to authorize the hospital to dispose of it. In addition, the other party is a French nobleman, so they have spoken, and they must return it.

As for whether it will really be made into a book cover in the end, it is no longer the point. Watman can only give up this "valuable" specimen material.

"The Countess's breasts and musculature are placed in the upstairs laboratory." Bergett is the youngest local doctor here, so he naturally assumed the responsibility of leading the way, "Count Camille, please follow me."

Kamiyi was not very sure about this matter at first, but he was relieved when he saw that none of the doctors refused: "By the way, I don't know much about making leather, can you teach me?"

"Actually, it's similar to ordinary tanning. You can ask those tanning masters for advice."

"Oh, thank you."

After Kamiyi was sent away, the microscopic examination of tumor slices was still in full swing. Whether it was for Watman or Ignatz, the operation was far from over.

Judging from the shape of the resected tumor, the boundary was blurred, no obvious capsule was found, and it showed obvious infiltrative growth.The discovery of tumors has been accompanied by the entire history of human development. Even without a pathological microscope, everyone present would know that it must be a tumor after seeing this shape.

But microscopic examination still has its necessity.

It is not to clarify the diagnosis of the tumor, but to clarify the relationship between the tumor and the lymph nodes that Carvey said before, and also to determine whether there is a tumor in the excised armpit tissue.

"It will take some time for the examination." Ignatz looked at the tissue that had just been immersed in the xylene clearing agent, and said, "You have had a two-hour operation, so you should sit down for a while."

"I am fine."

Only then did Ignatz look at his father: "I think you couldn't hold on just now."

"What's the matter, it's only past three o'clock, and I feel pretty good." Watman leaned against the desk, looking not tired at all, "Even if there are two more surgeries, it's fine."

"Ok."

Ignatz took advantage of the gap between the preparation of the section specimen, picked up the sentinel lymph node tissue section just now, put it under the microscope and looked at it: "The stain given by Carvey is quite easy to use, not worse than that eosin."

Watman turned his head and looked out the window. There were crowds of people at the gate in the distance. The first batch of doctors who left the surgical college bumped into the reporters who had been waiting for a long time: "A surgery has attracted so many people. I am afraid that the warm-up articles can On the headlines of tonight's evening paper"

At this time, a voice came from outside the door: "Who made the object, technology and completion of the whole operation far beyond usual."

"Varela? Why are you here?" Watman looked back at his "old friend" and said without waiting for him to ask a question, "The operation was a success. We are 70% sure to prevent the Countess' tumor from recurring. If we don't Unexpectedly, the second remodeling can be done in three months. Well, you can go back to writing.”

Varela: ? ? ?

"Huh?" Seeing him surprised, Watman was also surprised, "Aren't you here for an interview?"

"Of course I'm here for the interview."

"So I said all I could."

Varela glanced at Ignatz, who had become a pathological examiner, pulled up a chair and sat down, then took out his notes and said, "There is no need to ask these questions. I know the operation will be successful."

"Then what do you want to ask?"

"I heard that the operation uses a brand new method?"

"A radical operation cuts off the pectoralis major and minor muscles."

Varela froze for a moment, then immediately frowned.

He did not expect the conservative Austrian surgery to be so radical this time, and his mind was filled with various questions: "Do you think the tumor will invade the muscle?"

Working in the surgical field for so many years, Watman has long been familiar with his way of asking questions, which is obviously a trick, and then step by step to find out the loopholes in the surgeon's operation.Unlike his son, he has always been tough on such aggressive questions: "Of course."

Varela scribbled a few words on the paper and continued to ask: "Without the pectoralis major and minor muscles, what will happen to the function of the upper arm?"

"It doesn't have much impact, and the countess doesn't need to work."

"But those are two big muscles after all, isn't it too much?"

"Not rashly!" Waterman held back his words, "This is the School of Surgery, not your lakeside theater, so don't ask unnecessary questions."

Varela nodded: "Okay, then I will change the question."

"please say."

"I heard that the armpit tissue was also removed during the operation?"

"Because we judged that the Countess's tumor has metastasized through dye tracing."

"Dye trace?"

"It is a brand-new technique for checking whether there is tumor infiltration in the pathological section during surgery."

The pen in Varela's hand rarely stopped, and he needed to clear his mind, because now he is like a middle school student with good grades who suddenly comes into contact with university knowledge, and he is facing a gap in education and learning.

Pathological slides can still be understood, what is dyeable tracer?
Because he did not watch the operation on site, it was difficult for him to understand the specific function of this technology: "Dean, can you introduce this new technology to me?"

The tone and title have become much more solemn, but Watman doesn't like him: "Sorry, I don't know much about this. This is the method that Dr. Carvey came up with after research. If you really If you want to know, you can go to him."

"But you're right there."

"I only care about surgery, so I don't have the time to learn this new technology in such a short time."

The reason why Ignaz was able to stand on the apex of Austrian surgery was nothing more than proficient technology.But this does not mean that Watman has lost the wind. In the eyes of those who really care about surgery, the identity of the dean of the School of Surgery is much more important than that of Ignatz's deputy dean.

Taunting Watman for not being interested in new technologies?

But what he was doing was a brand new surgical technique, and the other party was already an old man in his sixties, so it was inappropriate to be too harsh.

Is it possible to mock the Austrian surgery with only Watman?
That's even more impossible, because the youngest surgeon, Carvey, is on the operating table.There was a cesarean section before, and there was a radical cure for breast cancer later, and there were a bunch of messy abdominal operations in between.Adding this dye tracer of unknown use, it is a joke to say that there is no one in the surgery.

Today's surgery gradually abandons timing, and also loses the screams of patients and the heated discussions in the auditorium.If it was Carvey's main operation, the audience would even have to wear those ridiculous masks. The operation time became longer and longer, but the process became more and more boring, and the report lost its original sales.

In fact, since the cesarean section, the reported operations have become more and more professional, and more and more out of the public's taste for excitement.

As a senior surgical reporter, Varela can only rely on some complaints to catch people's attention like his own editor to maintain sales.But after a quick scan of the two options, it seems that neither of them will work. This operation may have been done too perfectly, and he couldn't find an angle worth complaining about.

"Then can I see the surgical incision?"

Watman drew a general area on the chest: "From the front of the armpit to the inner side of the costal arch, roughly like this."

"Such a big gap?" Varela lacked knowledge of the local anatomy of the shoulder and chest, and immediately asked, "The surgical trauma is so large, there must be a lot of bleeding during the operation."

"No major blood vessels were damaged, and the bleeding did not exceed 100ml."

"Stop joking, Dean, since the operation is successful, there is nothing to hide about such a trivial matter."

"It's impossible for you not to know that the suturing skills of two young doctors, Kavey and Damirgang, are at least among the top five in Austria, even if they are not perfect." Watman turned his old face coldly: "It's about France. The safety of the countess, do you think I'm joking?"

Varela lost his voice and could only divert the contradiction: "I was not allowed to enter the theater this time. I lack material to report."

"I've said it before."

"That's not enough, I paid for the front page of the daily newspaper"

"Come on, Varela." Watman was in no mood to chat with him any longer, "For the sake of your many years of reporting on surgery, the School of Surgery has always been open to you. This is done out of surgical development considerations, We are not a tool for newspapers to make money."

As a full-time reporter covering surgery, Varela can really feel that surgery is undergoing earth-shaking changes.

This change does not seem to be as sensational as the entry of ether into the surgical procedure many years ago. Preoperative disinfection, intraoperative bleeding control, greatly prolonged operation time, more and more complicated surgical procedures, and the emergence of various new surgical methods.
Each step is small, but each step is eating into Varela's work space.

Originally, he could figure out the operation process by reading the anatomy book, and he had the illusion that I could do it myself, but gradually the operation became more and more difficult, and he could barely understand the explanation content of the chief surgeon.

But since Carvey had a cesarean section, Varela found that the operation had completely improved and changed.What's more frightening is that this change began to slowly drive other surgeons.

The surgical steps began to increase significantly, from the passion in the eyes of the layman to the painful waiting. Even sitting in the first row of the auditorium could not eliminate this feeling, and it was replaced by a deep sense of powerlessness.

He couldn't see the operation clearly, and he couldn't remember the whole process of the operation.

Now the treatment of breast cancer has changed from simple resection to radical resection. Although it is just a simple change of wording, he can't even imagine the incision after suturing.

"I'm a surgical reviewer anyway, (however, give me some minimum respect)."

This half sentence may be Varela's last stubbornness, but it's a pity that Watman, who has been dealing with surgery all his life, sees farther than him.At the end of his vision, there is no layman's place in the reformed surgical operation, and Carvey's radical mastectomy may be the starting point of this revolution.

"What commentator? You're just a reporter."

A simple sentence broke the final bubble: "The reporter only needs to make the answer public. If it is a mature surgical procedure, you can indeed comment on it based on your experience. But now it is a consensus between doctors and patients." innovative surgery, you, as an outsider with no medical study experience, are not qualified to comment on it.”

"I'm not qualified?" Varela's voice trembled.

At this time, Ignatz, who was checking the sliced ​​specimens with peace of mind, suddenly interjected: "Don't say you are not qualified, even I am not qualified. The reason is very simple, because I don't know how to do it."

"If you don't, you're not qualified. Has surgery developed to the point where it's out of touch with the public?"

"At least its ceiling is out of the way of the general public."

Watman stepped forward and patted his old friend on the shoulder, took half a cigarette from him and took two puffs: "As a columnist for the largest-selling newspaper in the empire, there is nothing wrong with reporting on surgery, and there are usually many minor operations for you to choose from. But when it comes to surgery that is enough to change the surgical pattern and development direction, I suggest avoiding professional content and writing more about other aspects.”

"Other aspects? What aspects?"

"Like a romantic love story between an earl and countess."

At this time, with the blessing of Bergett's superb cutting skills, Kamiy successfully obtained Justina's skin.

"I got it." The earl excitedly opened the burlap bag, revealing the jar inside, which contained a whole piece of skin with your head on it, "Next, I will let the master tanner trim it Well, finally sewn on the cover of my poetry book."

"Is it the most beautiful star in your heart?"

"Yes of course!"

Justina had a terrible headache and churned stomach, and if she hadn't eaten all day, she would be lying in her own vomit by now.But after seeing this scene, after seeing her beloved man tailor-made a human skin book for herself, she still showed a gratified smile.

"Thank you, Camille."

"This is my love, the love that belongs only to you."

Giustina couldn't lift her arm, so she could only tap his palm lightly with her fingers: "Go get a pen and paper."

"Do you want to write poetry?"

"No, I feel so weak that I can barely speak, and I'm not in the mood to write poetry."

"Then you are."

"Father just sent me a telegram yesterday, and I could see his concern, so I needed to write a reply while telegraphing him that everything was safe."【1】

Justina licked her chapped lips, and continued: "The operation was successful, at least it seems to be successful now. Considering the subsequent remodeling surgery, I must also fulfill the promise I made with the Austrian Emperor and write to my father This letter." [2]

Kamiyi was very distressed, and held her hand tightly: "Take a rest for two more days, your body is too weak."

"It's okay, dictation doesn't take much effort."

(End of this chapter)