Nineteenth Century Medical Guide

Chapter 307.
The failure of the operation in the afternoon made Cedieu have been in the dissection room for four full hours.

In fact, regardless of the surgical concept or cutting-edge surgical technology at the time, the tumor could be completely resected and a pathological biopsy was performed, the intestinal tube was anastomosed, and the patient survived the operating table. The operation was undoubtedly a success.

But since the appearance of Carvey, some strange changes have taken place in the mind of this famous French professor of surgery.

Man is an extremely greedy creature, and doctors are also human, so there is no exception.

When it is discovered that there is a better treatment for the same disease, quite a few doctors will not be content with the status quo and will force themselves to improve their skills.In the process of upgrading technology, it is inevitable to pay the price of forced upgrading.

The patient's incision swelled and oozes blood, and a large amount of bloody fluid oozes out of the suture site, which is difficult to heal, which is the price.

Some patients are in good physical condition and may have a chance to grow well under the premise of adequate nutrition, but cancer patients are often elderly, and the chances of this are very small. The same is true for bed 13. He is in his 60s and is thin. The free food provided by the hospital cannot achieve adequate nutrition, and there is no continuous supply of antibiotics.

In the 19th century, the occurrence of intestinal fistula and anastomotic leakage was basically a death sentence.

Of course, Cedieu also paid the price of being called "fame".

The failure of two operations in a row gave the abdominal surgery, which has just started, a blow. Although the colleagues and students who came to watch the operation did not say anything, they would talk about it behind their backs. It is inevitable that there will be some afterthoughts. view.

The most common question is "Why do you take such a risky surgery?".

There is also no lack of rhetoric such as "the local excision should only be done through the gang from the beginning", "rather than resecting the sacrum and coccyx, it is better to do it through the abdominal cavity".Some reporters even stated that abdominal surgery is a killing technique, no different from killing a pig and digging out its internal organs.

Although the surgical theater no longer welcomes outsiders, it still has a performance nature. Cedieu has experienced many failed scenes, and he has long since ignored these.

The only thing he cares about now is why the intestinal anastomosis that can be done on the corpse becomes so troublesome when it comes to the patient.The blood supply has been controlled, and the alignment has been done well. The intestines of this two-day-dead corpse can prevent leakage. Why can’t the intestines in the patient’s body?
"Peon."

Cedieu looked at his newly sewn rectum, sat on the small chair next to the corpse, and said, "Go, get me a cup of coffee."

"Good teacher."

Paion was the first assistant in that operation, and now he is also the first assistant in the autopsy. The other two are interns and another nurse who have just arrived in the hospital.After Paion left the room, the atmosphere became even more awkward. The two of them didn't dare to vent their anger, they just stood blankly waiting for the order.

Cedieu looked at the blood stains on the ground and the greasy traces of various tissues dragging, and sighed: "How many sutures did we do in total?"

"Eight times."

"How many times have I failed?"

The intern looked at the notebook in his hand and replied, "I failed three times, but I succeeded the last three times."

Cedieu is still constructing in his mind the anatomy around the rectum during the surgery, hoping to find where the surgery differs from the anatomy.At the same time, he also needs to consider the time of the second operation. Whether to wait a few days or do it immediately will have a huge impact on the success rate of the operation.

After all, he is over 60 years old, and his energy is not as high as that of young people, and he gets tired soon.

A series of three yawns seemed to have shoveled a few more handfuls of dirt on the frustration after the operation, making his body heavier, and he lost his strength as soon as he sat down, and he couldn't stand up anymore: "What time is it now?"

"It's past ten o'clock."

"You haven't eaten yet?"

"Eat before coming here."

"No time." Cedieu couldn't help yawning again, "It's getting late, and there's still surgery to be done tomorrow, so go back when you're tired."

Just as they were about to leave, they suddenly felt that something was wrong, so they stood still: "The equipment will be used tomorrow morning, and the corpse must be disposed of. Let's pack up before leaving."

Cedieu nodded, wiped his greasy hand on the leather skirt a few times, then turned to look at the gate: "Why hasn't Peon come yet?"

Peon was not lazy. After leaving the dissection room, he did go to Cedieu's office, preparing to make a cup of strong and refreshing coffee for his respected teacher.It's just that there was a small episode in the process, and a variation made the idle and lazy rest time immediately tense.

Different from the layout of the Municipal General Hospital, the main palace hospital is good at surgery, with sufficient surgical beds and more wards.From the anatomy room to the office, you need to go through a whole corridor with wards on both sides.

Not long after leaving the dissecting room, the nurse holding the oil lamp stopped him: "Doctor Paion, you came just in time!"

Peon usually doesn't stay that late and doesn't have any night shift experience.However, the doctor's intuition told him that the nurse's complexion was very bad and she looked out of breath, maybe something happened in the ward.

"What's wrong? What happened?"

"Hurry up, hurry up and prepare for the surgery theater, people are dying!"

Peon was a little confused.

Ready for surgery theater?People are dying?Who is dying?

One night of rectal resection + anastomosis, all he could think about was the 13-bed rectal cancer operation.So when I heard this sentence, my brain didn't think about it seriously at all, and gave the answer directly: 13 beds are not enough.

Coffee and 13 beds, he will definitely choose 13 beds, and immediately turn around and go to the ward.

"What are you doing?" The nurse was also stunned, "The surgery theater is outside!"

"I want to see"

Seeing that he was still explaining at this time, the nurse was impatient: "Dr. Carvey is watching inside, and he said he wanted the theater. What's the use of you going to see it. Hurry up and prepare for the theater, he's going to have an emergency operation!"

"Now?"

Pai Ang, who usually followed other doctors, was confused for a while, thinking that Bed 13 should not die and must be rescued, so he rushed out without looking back.

The chance meeting between the two came and went quickly, and both thought and behavior were serious and responsible.But like the advantages, their disadvantages are also obvious. The most important checks are missing between information exchanges, including the most basic patient information checks.

The bed number was not confirmed before the operation, which is unimaginable in modern times, but it was very common in the 19th century.

This difference is based on more than a hundred years of accidents, reflections, and institutional regulations. If you just say it casually, there will be no change.

It is undeniable that the poor information between Paion and the nurse drove Shebasto's rescue on the fast track.Moreover, the lax management of the operation theater, or it can be called no management, also saves a lot of trouble in the whole rescue. With just one sentence, all the equipment can be taken at will.

It took a total of three to four minutes from Carvey's order to pushing the person into the surgical theater, which is unimaginable in modern times.

There is no need for consultation, no clear diagnosis, no coordination of various links in the operating room, no need to report to the superior, and no pre-operative talk and communication. It only needs a word from Kawei, and everything can be done.

Of course, the premise is that he has enough prestige.

"This..." Peon looked at the fat Shebasto, and even suspected that he had misheard just now, "This is not Mr. Lennon in bed 13."

Carvey rummaged through the surgical equipment box with a strong smell of blood, and replied: "13 beds? He is Mr. Sebasto Marcelino, the chief of the Paris Police Department. How could it be 13 beds!"

"Then what did you say just now?" At this moment, Pai Ang realized that he hadn't heard the nurse's words clearly, and asked quickly, "It turned out that he was the one who was about to die, right, how is bed 13 now?"

"I don't know, but his family is with him, so it should be okay." Carvey only cared about his patient, and asked casually, "By the way, where's your skull drill? Just this one?"

Paion has almost never had brain surgery, and the last time he saw someone do it was several years ago: "It's just this one, and no one usually uses it."

"It's too dirty." Carvey picked up the drill bit and looked at it under the light, feeling really confused, "There are blood and rust spots everywhere, I think you usually wash the equipment after use, why don't you wash the drill bit? ?”

"They do cleaning now, but that was a few years ago."

It was only then that Carvey clarified their thinking on equipment maintenance: as long as they are not in use, there is no need to wash them.

The incident happened suddenly, and he didn't bring his own equipment box, so he could only use this skull drill to make ends meet: "Go and wash it, and then soak it in brandy for a while, I will use it later."

Paion took the drill, looked back at Xie Basto who was lying on the bed, and was about to ask what surgery he was going to do next, when he suddenly remembered that he seemed to have forgotten a big event: "Ah, I Forget Professor Cedieu's coffee!"

"Coffee? What coffee?"

"Professor Cedieu just asked me to make coffee"

Carvey quickly interrupted him: "Are you kidding me? I'm about to start a show here. Who will be my assistant if you run away?"

For a moment, Paion didn't understand the severity, and wanted to use the nurse at the side as a shield. It wasn't until Carvey emphasized the skull drill again that he realized that what was going to be performed here was a craniotomy.

Craniotomy was not uncommon in the past, especially in the 17th and 18th centuries, doctors were extremely lacking in knowledge, and everything was based on hearsay and so-called "inheritance".Skull drilling, together with amputation, has become an important means of life-saving when the injury is critical.

It wasn't until later that doctors discovered that simply drilling holes in the head didn't seem to cure the concussion.It has only two effects, one is to make the headache more severe, and the other is to bleed.

The rich blood supply of the scalp and the rupture of intracranial blood vessels caused by improper drilling will well explain what is the real bloodletting before the doctor tries to open it.Over time, few doctors dared to drill the skull.

Although France is very liberal in medical treatment, even though the death rate of diphtheria and tracheectomy is as high as 75%, some people are still willing to try it.

But when it comes to drilling holes in the skull, French surgeons are very cautious.This is also an important topic that must be carefully treated and examined when the world's medical care enters the "modern" threshold.

"Cranial drilling? Now?" Paion was stunned again, "To the Chief of Police?"

Carvey is still rummaging through the equipment box for the tools that will be used later: "Do you want to do it? If you don't do it, forget it, I can do it by myself."

Peon picked up the skull drill that had just been put down again, his hands trembling slightly: "Doctor Carvey, can you tell me why you chose to drill his head? I remember that the scope of skull drilling is very narrow, and there are extremely serious cases. Complications, most patients will die on the operating table."

"Are you asking why?"

"Correct."

"The reason is that if you don't open your head, he will definitely die. If you open it, you may still have a chance."

"Didn't he drink too much? He smelled of alcohol."

"Look at his head." Kavi turned Shebasto's face sideways, exposing the back of his head, and then called him twice, "There is no response to such a big wound on the head, this state has continued It's been more than an hour, and if we go any further, something will happen."

Paion had no concept of cerebral hemorrhage and cerebral herniation, nor did he know the principle of craniotomy, but he knew that this must be a rare opportunity, at least more rare than offering a cup of coffee.

Seeing that he was interested, Carvey picked out some tweezers, hemostats, and a long and thin metal urethral probe: "These also need to be washed, the rust and blood stains on the drill bits must be cleaned, and then a charcoal brazier is prepared. "

"it is good."

At this time, the dissection room had been cleaned up. Although there was still a bad smell in the air, at least it looked much cleaner.The interns and nurses bid farewell to Cedieu, but his coffee was delayed.

Cedieu was unhappy: "What is this kid doing?"

Fortunately, he didn't want to make trouble with his subordinates for a cup of coffee, he just made some complaints secretly, and then put the matter behind him.The most important thing now is the timing of the second operation on the 13th bed. It is best to decide as soon as possible, but unfortunately he has no spare time to continue thinking.

Going home and resting became Cedieu's only option
Until he left the dissecting room and walked up the corridor that Paian had walked through just now, he found that not only the ward was brightly lit, but also many strangers at the door: "What's wrong? What happened? Who are you??? "

Those men and women were well dressed, and when they saw Cedieu, they all rushed forward and asked, "Professor Cedieu, are you doing the operation?"

"Isn't the surgery already done?"

"How is my husband now? Where is he? Can I see him?"

"Oh, God, Marcelino has to lose several laps every Ramadan. He is your devout believer. Why do you punish him like this? What did he do wrong?"

Cedieu was already tired enough, and was dizzy by this news: "Who are you? And who is Marcelino?"

(End of this chapter)