Nineteenth Century Medical Guide

Chapter 211 208. Alternatives to the Death Penalty
Another nearly 4-hour operation.

Kavey's body and energy are fine, and when he left the bedroom, except that his legs were a little sore, he looked like a normal person.Hills is also considered young, and has done a lot of odd jobs, and his physical strength can keep up.

The other three older ones were not so relaxed.

When standing on the stage, all I could think about was how to do my job well, and I didn't feel anything.But once they got off the operating table, the pressure disappeared in an instant, and the fatigue that they had forgotten swept up in an instant.

Standing for a long time and high concentration, coupled with the lack of oxygen caused by the mask, drained their energy.

When Carvey screwed all six screws into the pit, inserted silver rods up to fix it, and then covered it with a thin layer of bone for fusion and fixation, Watman was already exhausted【1】.

The monocortical fixation of the vertebral body and the bicortical and tricortical fixation of the sacrum mentioned by Carvey just went through the scene in his ear, and didn't enter his mind at all [2].This is the disadvantage brought about by his gradual distance from the front line of surgery. Of course, the distance from himself is also due to his increasingly unsatisfactory physical condition, and the two complement each other.

And Olgi, who was standing opposite, was even more tired.

He suffered a gunshot wound to his abdomen. Although he is in good health and has recovered well, it can't be reflected in ordinary surgery.But when faced with really high-intensity surgery, the shortcomings are infinitely magnified.

The post-operative recovery has greatly weakened his physical strength, and his strength and endurance for visual exposure cannot keep up. In the end, it all depends on perseverance.

But compared to the two of them, Massimov was the one who suffered the most.

He has never been injured, and his physical strength is actually not bad. The only discomfort is cervical spondylosis and lumbar muscle strain.Bowing his head, bending over to exert force, and limited back movement have greatly restricted his surgical ability, which can be regarded as an opportunity for him to retire early.

All three are old people standing on the edge of the retirement line, or have already stepped into the retirement area with one foot.Now, in order to learn the new operation, he endured physical discomfort and persisted until the end of the operation.

Carvey is also old, so he naturally knows that the taste is not good.

This kind of blow is not only physical, but also mental. This feeling of powerlessness will make people lose their enthusiasm for work and force old doctors to leave the front line of love step by step.

Because they are already at the forefront of today's surgery, as the difficulty of Kavey's surgery continues to increase, they will find themselves more and more powerless.

In stark contrast to them is Sears.

In his 30s, he is at the peak of his physical energy. Although his basic skills are not as solid as Damirgang, he has enough experience in big scenes and a very strong desire to learn. He even asked Kawei with his notes after the operation. Quite a few questions.

He was playing with his hands the whole time, so there were so many details that he didn't see that he couldn't even sort out the anatomical structure where he was after entering the spine window.That is to say, the three quality questions that newcomers to surgery often encounter when they first come into contact with surgery:

What is in front of me?
What anatomical position am I drifting into?

What am I going to do next?
"These are the problems you will encounter when you first come into contact with spinal surgery." Carvey asked the three elderly people to rest aside, and finally explored the epidural space again to remove the remaining bone fragments, "write down the operation steps , and then practice more on the corpse. If you don’t understand anything, you can come to me at any time.”

After a cesarean section and several successful celiac surgeries, Sears slightly changed his role, and his relationship with Kavey.

Kavey is still a strong rival in the peer competition, and he can only be regarded as a challenger. In fact, in most cases, he is not even a challenger, and he needs to continue to learn.But the tone of the challenge must not be changed. Even learning is for the sake of the challenge. Once the tone is changed, he may not find the motivation to continue chasing.

"Okay, I hope Mr. Ignatz won't get mad at me the next time I come to the Municipal General Hospital."

"He made the decision out of anger." Carvey handed over the final finishing steps to him. "During the operation just now, there was a lot of bleeding in the epidural space, so a drainage tube still needs to be placed."

"it is good."

"Don't suture the muscles of the paraspinal muscles. Just let them close after returning to their original position. Suturing will aggravate the muscle edema, and the pain will die after the operation."

"it is good."

Hills simply sewed on the fascia layer with a needle and thread, and then closed the incision on the old marshal's back waist, and then disinfected, draped, and bandaged again.

Until here, the operation can be called the end.For Carvey and Ludwig himself, the operation itself is over, and the really difficult postoperative recovery has just begun.

First of all, the paraspinal muscles above the spine were stretched for more than three hours, and then I would definitely encounter stubborn low back pain.Pain relief must be prepared at all times. If it becomes unbearable, Carvey will choose to inject methylene blue to temporarily demyelinate the pain-sensing nerve.

Take care of the pain, and then the infection.

Although the routine use of antibiotics after surgery does not reduce the risk of postoperative infection after spinal surgery, in principle, the more beautiful the operation is, the lower the chance of postoperative infection [3]. Carvey is confident in his technique.

But that's just a technical level, and technology alone is not enough to prevent infection.

What Carvey used was not a sterile operating room, but the bedroom of a 60-year-old retired marshal.The physiological saline used is freshly boiled and cooled water + salt, without the blessing of modern aseptic modern technology, it is only better than drinking water.

The disinfection of the equipment is not in place, especially the leather skirts they use during the operation, which are only subjected to simple steam fumigation + alcohol spraying.Even if the ground is disinfected with alcohol and the air is sprayed with low concentration carbolic acid, there is still a great risk of infection.

Therefore, for two days after the operation, methylene blue must be used every day to fight the infection in the body.

After these two days have passed, evaluate the drainage effect and the recovery of the incision and make changes. The best case is that the incision is normal, and the worst is that the infection dehisces.

Carvey also does not know whether the old marshal can avoid postoperative infection, because there are many factors to prevent infection that could not be developed in the 19th century [4].He can only be as perfect as possible in terms of equipment materials, surgical techniques and drug selection.

"To strengthen nutrition, don't touch the bandages and gauze on the incision. I will come here every day for inspection." Carvey said to the housekeeper.

After knowing that his master had survived the long operation, the old butler finally showed a smile on his face: "I've made a note, do you have any other orders?"

"Don't touch the incision with water, observe the liquid in the drainage syringe, and record the amount of liquid at any time." Carvey taught him how to use the drainage syringe, "Pay attention to protecting the drainage tube mouth, and don't touch dirty things "

The housekeeper was a little confused looking at the series of operations: "This thing is a bit complicated, I can't do it."

Carvey put down the syringe and support frame in his hand: "Forget it, I will call a nurse to help at night. I will tell her the main points of postoperative care. She is as demanding on details as I am , I hope you can cooperate with her work as much as possible."

"Please rest assured, Dr. Carvey." The butler put away the pen and paper for recording, and said respectfully, "As long as it helps the master's health, we will fully cooperate."

Carvey stretched his waist and picked up the equipment box that he had organized: "Well, I will come again tomorrow."

"Are you going back?"

"Yeah, the operation is over, so it doesn't make sense for me to keep it." Carvey thought he was asking about the anesthesia recovery, and explained, "The anesthesia time should be less than half an hour, and the vital signs are stable now. And Hills is watching, there will be no problem."

The housekeeper quickly explained: "No, no, that's not what I meant."

"What's the matter?"

"A lot of people came to the living room downstairs, and some of them want to see you right away." The butler pointed to the stairs and said with a smile, "And it's getting late, it will take time to go to the city from here, why not Have lunch here before leaving."

Clinical medicine has nothing to do with the military and politics, and the military medical office has little to do with Kavey, so he doesn't want to stay here for a long time.As for lunch, he has always been a very modest eater, so he just needs to find something in the kitchen to eat on the road.

But when he heard that Franz was coming, Carvey could only change his original plan and choose to stay.

Franz no longer sat and chatted with Carvey as before, but stood up the first time he saw Carvey going down the stairs to show respect.When Carvey walked in front of him, he smiled and said, "Congratulations, Dr. Carvey, the operation seems to be successful again."

"I can only say that the operation went smoothly." Carvey did not dare to speak too much, "But the postoperative recovery still depends on the old marshal himself and some luck."

"Another 4-hour operation." Franz looked at the wall clock and was very satisfied with Carvey's performance. "You should know that there is no surgeon in the world whose operation is so complicated."

Carvey knew that it was not the time to be overly modest, but he couldn't be too high-profile, so he could only change the subject during the conversation: "I heard from the old housekeeper that His Majesty the King wants to see me?"

"Yes, something about the Military and Political Department." Franz did not answer, but handed over the right to speak to Ambassador Edward, and he sat back in the original posture that the king should have. A little Mr. Edward's problem."

When he saw Edward's face, Carvey had already guessed his purpose of coming here, which was to solve Fernan's trouble.

But what he didn't expect was that Edward has come to the position he is today, and he still avoids some dirty tricks, without the demeanor of zz: "It seems that there is only this way to solve the problem you raised. Walk."

"This road." Edward hesitated for a moment, and asked, "Who will handle it? I might not be allowed to go, right?"

Grand Duke Brecht on the side patted him on the shoulder and said with a smile: "It's easy to handle. I have people in the police station and the court. Mr. Edward just let me know."

Edward still hesitated, hoping to get a clear answer from Carvey: "Is he really not going to die?"

"I went to see him before, and checked him." Carvey shook his head, with an extremely complicated expression on his face, "The cardiopulmonary function is a bit worse, but the infection has subsided, and the incision has grown well. The drainage fluid from the previous three days There is a lot, and there is still some bleeding, but after two days, there will be only clear ascites, and the drainage strip should be pulled out today."

Edward couldn't understand these technical terms, but it was not difficult to hear Kavey's "helplessness" from his expression and tone: "It seems that he really survived."

"If there are no accidents, at least he can live for another year or a half. After all, his liver is not very good."

How could Edward wait for that time: "That's all right, just do it according to the method you said."

???

Everyone suddenly shut their mouths and looked at him in unison: "."

Edward realized that he had said something wrong, sighed, and changed his words: "I said something wrong just now, and I did it according to my method."

Only then did they all express their agreement, and at the same time they began to care about another matter: "What are you going to use, Mr. Ambassador? Arsenic?"

"This should be the most commonly used and best. Are there other options?" This is what Edward is struggling with. "But I remember eating this thing. Will it be found out after death?"

"Of course, the current technology can already detect arsenic." Brecht replied, "But don't worry, Mr. Ambassador. After all, he is a death row prisoner, and the prison will not check it. Even the prison will not check it. No one will bother with such nonsense.”

"If possible, can Dr. Carvey come and check?" Edward said, "The main thing is to use your mouth to announce the cause of death."

"Let me admit that I failed the operation?" Carvey laughed angrily, "Although you have a high status, I shouldn't refuse, but this has had a very negative impact on my work. As far as I know, Mr. Ambassador There is also a surgeon by my side who should be able to do it for me."

"This"

The more Edward listened, the more he felt that these people didn't want to wade into the muddy water.

From a rational point of view, no one would investigate the cause of death of a death row prisoner, but the direction of public opinion is unclear, Carvey refused to tell the truth, and Franz was too lazy to care about it, so he really didn't dare to gamble.

"The situation is so special now that many people want to release Fernand. At this time, he died suddenly. Is it possible?" Edward looked at Carvey. There is no other way to replace arsenic? Preferably something else that cannot be traced to the source."

There must be alternatives to the death penalty, and there are many, but Carvey is reluctant to say: "I'm not interested in killing people, so I don't know much about it. I'm really sorry."

(End of this chapter)