Nineteenth Century Medical Guide

Chapter 389 385. A messy day

January 1, Vienna City General Hospital

The winter sunlight shines through the glass into the office of the Chief of Surgery in the early morning, illuminating the desk and waking up Ignatz's face.

"You shouldn't have slept at night, right?"

After the breakup, Alina couldn't worry about him. She didn't know how many times she said it: "You are going to the operating table today. With your mental state, what if something goes wrong on the operating table?"

"What could go wrong?" Ignatz yawned impatiently, "If it weren't for the surgery today, I wouldn't have slept so late. Besides, the time hasn't been decided yet."

Alina was very excited: "I don't care what happens to you, what I'm worried about is the reputation of the hospital!!! Failure in the operation will damage the brand of our hospital!"

"Okay, okay." Ignatz waved his hand, "Everyone is very tired this morning, and it's not like anything big happened. Why are you yelling so loudly?"

"you"

Alina threw the personnel file on him: "It's been almost a week since we arrived, but you haven't filled in the file, you haven't filled in the working hours and income distribution table, you haven't given the hiring time, and you don't even have a name! It's just like that What do you mean by giving it back to me? If you were serious about this matter, why would I need to come here to talk to you?"

When Jack saw this, he didn't dare to be idle. He immediately got up and moved in several important cases today, ready to be dispatched to make case reports at any time.

What's more, many new people have come to the hospital recently. Whether it is out of respect for teachers or because of Heman's own status, it is obviously inappropriate for him to continue to be responsible for chores.

"Okay!" Ignatz wanted to send her away, "Didn't Herman say I'll give it to you tonight?"

In the eyes of outsiders, he lived a very monotonous life, with no entertainment at all. The romantic places he went to before were also discontinued. He never saw the woman again, and he seemed to be very decadent.

The more Alina looked at him, the more uncomfortable she became, as if she was a different person: "You are the director. The news has been coming for half a month. Is it difficult to fill it out? Besides, I have to arrange work according to personnel. Do you think it's casual?" Can anyone just come to work?"

But this life was fulfilling in Ignatz's own eyes.

"No, I'm sorry, I forgot." Shanwang stood up, scratched his head, and said in French, "I'm going to take a dip right now."

Ignatz watched Alina slam the door and leave, sighed softly, and his eyes returned to their original appearance. He put down the newspaper and tapped the coffee cup with the tip of his pen: "Herman, where is my coffee?"

"I heard that he recently stayed in a nursing home with several big businessmen." Herman didn't know much. "I don't know exactly when he will come back."

The reason for working hard is to fill the emotional emptiness. Secondly, Kawei and Zeng Jin’s subordinates are not here. With the size of the municipal general hospital, even if a few more new people are hired, there is still no chance to rest. .

"Forehead"

Unexpectedly, Ignaz did not rush to ask about the medical history, but suddenly said: "This Kawei, why hasn't he returned to the hospital yet? He didn't ask anyone to send a message. Reporters from several newspapers came to inquire about it many times. Yes, there is gossip everywhere.”[2]

"Look, you should have waited for him to come back and handed it over to him from the beginning. Why do you need to come to me?"

Herman used to work for him as a handyman. He left for half a year and is still familiar with these trivial matters: "Oh, I understand. I'll give it to you tonight."

Hermann is no longer the same as before. After returning from the Austro-Prussian War, his skills have become increasingly mature. Kawhi has always said that he lacks sufficient innovation ability, and that's because his basic skills are already impeccable.

"Humph!!!"

Since breaking up with Alina, Ignatz has plunged into work, spending time in the hospital every day and rarely going home. Even if I go home, it is only to wash up, change clothes, and change a few books before returning to the hospital. He stayed in the operating theater and ward during the day, and in the anatomy room at night. When he was tired, he would sleep on the floor in the office for a while, and his life gradually became Kawei.

"I know, I know. It's not like you sent her off too early. Herman hasn't arrived yet." Ignatz looked behind her and said, "Herman, come here."

"Of course I know that he is with the profiteer Laszlo, and I heard that there is also an Italian and an American." Ignatz pointed to the newspaper in his hand, "This kind of thing has been written in the newspapers. Everyone knows it in Vienna. I asked about the specific address, don’t you have it?”[2]

Of course, he also knew that he didn't need to be like this. He was so old and could just leave the work to his subordinates. There was no need to work so hard.

The train traveled faster than the news, and Elisabeth left Zurich half a day after receiving the letter. As soon as the train arrived at the station, without even having time to announce the itinerary, Kawei got off the train inexplicably, parted ways with the accompanying surgical team, and left alone.

"No."

"Damirgaon?"

"Me? I don't even know."

At this time, Shanwang brought the coffee over, and was immediately tortured by Ignatz's eyes: "Shanwang, I heard that you and Kawei are very close. When he went to the Drouot auction house in Paris, he also brought you Looking at you, you should have his current address, right?"

"Me?" Shanwang smiled fakely, "Of course I don't, I'm just an outsider."

Ignatz's anger surged, and he slapped the newspaper on the table: "Well, Kawi, I'm about to retire. It's not even a matter of leaving the entire surgery to me. Not even these little bastards." Leave it to me and let me discipline you. How old are you? You have become a lord and become a shopkeeper."

"Isn't it me?"

Sediyo, who was sitting next to him, also holding a newspaper in his hand, suddenly said: "But the newspaper in my hand didn't say anything about him. It even praised him for being personally invited by the French Emperor to participate in the World Expo." 【3】

"Humph, what's the use of a doctor going to a place like that?"

Ignatz no longer worried about where Kavi was, and waved to Jack: "Jack, you are in charge of this morning meeting, right? Let's discuss the surgical patients."

"it is good."

杰克简单汇报了四个病人的情况，需要做的分别是开腹探查、剖宫产、阑尾炎和腹股沟疝，时间安排分别在上午的8点30分、下午1点、3点和晚上6点。

Laparotomy is the most troublesome and urgent. The time cannot be determined according to the theater and is completely decided by the doctor.

The doctors basically all came out, and the chief surgeon must be Ignatz, with an assistant Cediyo, and then Herman and Damirgaon. The main point of conflict is how other surgeries are allocated.

"Professor Sediyo, according to the previous agreement, appendicitis is yours." Sediyo's arrival did relieve Ignatz of some of the pressure, but at the same time, the power and the surgeon were also taken away. "I choose inguinal hernia, but the problem is how to do a cesarean section?"

"Let's do it together." Sediyo only obeyed Kawei. He was definitely dissatisfied with Ignatz, but on the surface they still treated each other as equals. "Didn't we agree before?"

"If we do it together, who will be the chief surgeon?" Ignatz just drank coffee and did not look at him.

"You've had so many cesarean sections in Vienna, but I haven't had one yet." Cediyo knew what he was thinking and demanded directly, "I've been in Vienna for almost a week and have done a lot of anatomy exercises. I have gained a lot of experience in performing cesarean sections in Paris, so I am almost ready to perform the surgery today, right?”

"Then don't I become Ichisuke?"

"I have been your assistant for a week, and I will also be your assistant for the one you will do in the morning."

"That's different." Ignatz put down the coffee cup, "You came to Vienna to learn new technologies. This is not the Palais-Dieu Hospital in Paris, but the surgical ward of the Municipal General Hospital, my ward."

Cedillo couldn't stand his attitude and stood up to leave as soon as he heard this. Ignatz knew that he had gone too far, and quickly explained: "Forget it, I'm afraid of you, everyone has such a hot temper. I'll leave the cesarean section to you, okay? But don't look for me, Issuke?" Someone else."

The final surgery schedule board, with the specific details and time of the surgery written in crooked French, was hung at the entrance of the theater.

[8:30, exploratory laparotomy on bed 11, Yi, Sai, He, Da/Jie, Shan]

[13:00, 14-bed cesarean section, Sai, Jie, Shan]

[15:00, Appendicitis removal in 3 beds, Sai, He and Jie]

[18:00, bed 63 with inguinal hernia, Yi, Da, Shan]

The morning meeting ended at 7:20, several people checked the ward at 7:50, and left the ward at 8:8. At the same time, Amor and Kallen were called in for preoperative preparations, and the operation started on time at 30:.

The patient came to the hospital yesterday, a 45-year-old male, who kept complaining of stomach pain. According to the abdominal physical examination left by Kawei, it was found that there was extensive tenderness on the right side of the abdomen, without rebound tenderness or guarding. The initial diagnosis was appendicitis, but the symptoms were not typical.

So just in case, they chose to have a caesarean section for investigation.

During Kawei's absence for half a year, the operating income of the surgical theater was very average, and it was even more empty in the early morning with no one around. They carefully made a slightly larger incision at the McBurney's point of the appendix. They immediately discovered that the appendix was obviously swollen and there was an obvious ulcer. If it were a step later, an abscess cavity might form.

After removing the abscess cavity, cutting out the appendix, and embedding the broken end, they began to examine other intestinal tubes. After no other problems were found, the abdominal cavity was cleaned and closed. The whole process took 2 and a half hours. There was nothing wrong with the process itself, but it was very rough. There was definitely a clear gap compared to Kawei's neatness.

"It would have taken me an hour and a half to finish it!" Sedieu handed over the final suturing work to Herman, secretly arguing with Ignatz, "Have you regressed? You used to be considered the number one person. , does Kuai Dao’s name have to be taken off and given to others?”

"You probably haven't read the request left by Kawei."

Ignatz took off his mask and hat. He couldn't stand his habit of finding faults: "There are so many procedures to follow, and cleaning and suturing must be done. Every step must not be missed. It's not as easy as amputation. Besides, "Nothing's wrong with the patient."

"It's okay. He was very insensitive to anesthesia and woke up twice." Cediyo continued to attack, "If Amor hadn't reacted quickly, this operation would have been ruined."

The two surgical geniuses who used to dominate each other never imagined that they would work together on the same operating table in the same hospital. Their director-level pride did not allow them to compromise with each other.

The quarrel went up and down from noon until the start of the next operation. It was Sediyo's first real cesarean section.

In the afternoon, the number of people in the surgical theater gradually increased. In addition, it was the first time for Sedillo to perform an operation on stage. Many viewers wanted to see the style of the surgical director of the French Palais-Dieu Hospital.

After all, a senior director is a senior director and has more experience than a young doctor. If he has solid basic skills, he will learn techniques very quickly. In fact, Cediyo has already had the ability to perform a cesarean section, but he has never had the chance. This time, the pregnant woman was in good health and had no other complications. He performed the cesarean section quickly.

The only flaw is probably that the suturing of the uterus was not delicate enough, which may have some impact on the next child.

"It wouldn't be like this if I sewed it. It would affect the population development of Vienna too much. And I also have time requirements. It would not be good for pregnant women if I delayed it for too long."

Ignatz choked back at the reporter's question, but Cedillo had no time to argue with him, as the third appendicitis followed.

Unlike the first one whose diagnosis was unclear, this one’s diagnosis is clear. The pain site was in the right lower abdomen, there was obvious tenderness and rebound tenderness, there was no muscle guarding, and the body temperature was always at a high level, so the diagnosis was appendicitis.

This was not the first time for Cedieu to undergo appendicitis surgery. He was a fan of appendectomy in Paris and had done many of them. But the surgical style was much rougher than what Kawei advocated, even rougher than Ignatz just now, and there was no way to study the details in detail.

But these are only related to the patient's postoperative recovery and do not belong to the operating table. The real trouble for Sedieu was that the appendix couldn't be found.

There is a variation in the location of the appendix. Unless you are a true expert in this field, it is not that easy to find.

So, just like Kavi helped Ignatz, Ignatz came off to help Sediyo. Of course, the process couldn't be as beautiful as Kawei's. The two directors dug through a narrow appendix incision for more than half an hour before finally finding the appendix.

The appendix was only slightly swollen, and there was no pus around it. They couldn't help but wonder if there was something wrong with the preoperative diagnosis.

This is quite common in daily clinical work. Preoperative and postoperative diagnosis can sometimes be very different. In the absence of imaging tests in the 19th century, this disparity was only more pronounced, and there was no way to remedy it.

Unless another laparotomy is performed.

But when the surgery reached this point, it took more than an hour just to find the appendix. The audience on the stage was very agitated, and it seemed difficult to end the surgery without cutting something out.

"cut?"

After all, it was not his own territory. Cedieu hesitated: "But it looks like the shape and color of this appendix are quite normal."

"It doesn't feel good." Ignatz gave himself an excuse, "Tick it and see if it's very hard."

"Nonsense, isn't that what the appendix is ​​all about?"

Before Sediyo could finish his whisper, Ignatz turned around and faced the audience and said: "There were some minor accidents during the operation. The patient's appendix was hidden very deep. But the result is good, we still found it." This 'bad' appendix hiding in the dark."

At this point, even if the appendix is ​​clean, it still needs to be cut out. Fortunately, it is a useless organ, so the two of them have less psychological burden.

Even if the appendix was found, it was mostly successful. Within half an hour, the operation had entered the stage of closing the abdomen. But whoever it was, broke the silence around me before Ignatz announced that the operation was over: "Two professors, are you ready to intubate?"

(End of this chapter)