Nineteenth Century Medical Guide

Chapter 405 Chapter 401. "Outsiders"

Mayer has indeed had good luck these past two days.

Not only did he discover problems in the police deployment, but he also quickly caught the news of Carvey's kidnapping. At the same time, he was not satisfied with the petty spirit of "Nouveau Paris" and boldly embraced the competing "Le Gaulois", starting a career that became famous. First shot.

If he wants to truly succeed in becoming a celebrity, the first shot has very limited effect. What he has to do is to quickly fire the second and third shots, beating his competitors until they can no longer get up.

On a morning that witnessed the miracle of newspaper sales, Mayer's face was still full of stress. He needs to face a major choice, how to proceed with the topic of kidnapping. Because only by continuing to report on this topic can we be remembered by people, not just "Le Gaulois".

The incident has been exposed, and now any experienced reporter will choose the police station. Instead of trying your luck like a headless fly outside, it would be more efficient to interview the police chief.

Considering the relationship between Helmut and himself, Mayer would naturally choose this way.

However, the [Love Alliance] completely disrupted his plan, and of course the plans of other reporters, as well as Morazo's plan. The police station has become a place for those girls to vent their emotions. Let alone interviews, even entering the door is a luxury.

In this situation, some people choose to collect local materials and interview those girls. Some people actively changed their positions and changed their destination from the police station to the garrison headquarters. And some, like Mayer, chose to give up.

His giving up did not mean that he really gave up, but that he took a breath and rested for a while.

The only drawback was that he couldn't enter the ward and could only barely hear the outline of the conflict between Carvey and Landreth outside the door.

The two had coffee before 9 o'clock, and within half an hour, the carriage carrying Kawei arrived in front of them.

He seized the opportunity well and happened to be following Kawei's group.

He never thought that buying a friend a cup of coffee would get such a high reward. What he had to do now was to seize the time and get first-hand information before others came to the hospital. No one is willing to accept more than two interviews. By then, what they have in their hands will be the only information in Paris.

When a reporter like Mayer noticed Carvey's presence, there must be a group of reporters on their way behind the scenes.

Dinner turned into breakfast. The two found a cafe, ordered sandwiches and coffee, and prepared to watch the main palace hospital across the street and talk about Kawei's kidnapping.

Some people sometimes appear to be extremely lucky, but the main reason that makes them appear extremely lucky is often not the luck itself, but a decision to rest unwilling to accept mediocrity, a gentleman's agreement that ignores fame and fortune, or a certain decision to seize luck. "Take a step back" in the hope of a bright future.

After a great success, people's desire for success will become stronger. With the current development of the situation, no matter what kind of manuscript I write, I will not be able to reach today's height.

He found his old friend Théophile Gautier to fulfill the meal he had missed the night before.

Mayer took out a 20-franc note, held it down on the dinner plate, stuffed the remaining half of the sandwich into his mouth, chewed it for a few times, and drank it down with two large gulps of coffee. Then he put on his coat and hat and ran quickly to the Main Palace Hospital.

Compared with the uproarous front-page news of "Le Gaulois", the appearance of Kawei himself seemed to be less thunderous and less rainy. But in an era when there was no Internet or even telephones, newspapers were the best way to quickly deliver news on a large scale.

“This is not Vienna”

“It’s okay not to participate in the treatment.”

Landreth obviously didn't like Carvey's wording, so he asked resident doctors Payon and Albaran to send the little girl to the debridement room first, prepare a stretcher, and then continued to explain: "The surgical theater in Paris is where doctors and medical students work. A place for learning cannot be used to make extra money, and it is not an entertainment tool, so outsiders are not allowed to enter the theater.”

The two sides struggled with each other for two or three minutes. Kawei offered to be an assistant, but was still rejected. Mayer was asked to leave when he heard this, but the dispute between the two did not stop, and even intensified.

Kawei's heart is far from as calm as it seems on the surface, but the first thing now is to ensure that Bertha can receive treatment. No matter who performs the surgery, as long as he can open her belly and find the location of the internal bleeding: "But I have to enter the surgery theater, or at least go to the audience to watch you do the surgery."

"Thanks."

"Go quickly." Gautier smiled and took a sip of coffee, then looked at the menu again, "But you have to settle the bill first."

Mayer had seen Carvey twice from a distance, and yesterday he had seen the photo of the editor of "Le Gaulois". He felt familiar at first sight. It was just common sense that kept telling me that I might have seen it wrong, until the waiter not far away suddenly said:

"Doctor Kawei? Isn't this Doctor Kawei? The newspaper also said that he was kidnapped. Now he is willing to write anything to attract attention."

Since he couldn't achieve it, Mayer chose not to write. It’s not too late to sort out the ins and outs of things, and then write again when new material is available.

Kawei asked to be the surgeon because Bertha was still too young and the operation was quite risky. No one could do it better than him. Landreth naturally disagreed, because he was the current chief surgical director of the Diocesan Hospital, and there was no reason to leave the French matter to an Austrian.

Kawei agreed with the first half, but reforms need to be followed up with corresponding rules, and forced changes will only cause more trouble.

The key is that in the second half, Kawei was called an outsider by other surgeons for the first time.

In the past, no one dared to say that he was an outsider, whether he was visiting the operating room of his own hospital or going to other hospitals for study and exchange. After coming to Vienna, I have been visiting the operating theaters of various hospitals. If I want him to be the surgeon, I have to send an invitation letter. Why is he now an outsider?

"An outsider? I am also a doctor and a surgeon who once worked here. How come I am an outsider?"

"Once upon a time, if it weren't for your previous help to the Main Palace Hospital, you wouldn't even be qualified to enter the surgical ward dressed like this, so how could you enter the theater?"

Landreth looked at Kawei's coat that had not been washed for a long time, and then glanced at the two dirtier women behind him: "I'm not discriminating against you, but the surgical ward needs to be clean, and I don't want the postoperative wounds of the patients. There is ulceration.”

Apparently he was confusing sterility, cleanliness, and elegance, but Carvey had no problem with that. He let Martha and Fran leave first and stayed in the ward.

"I told you that you are an outsider too."

"I don't touch patients, I just ask to be an audience in the surgical theater."

At this time, Peang, who had previously served as Kawei's second and third assistant, came over with the vital signs chart he had just recorded: "Director, the injured person's heart rate is 124, and his blood pressure is not stable. The just measured 75/40, Bika Dr. Wei spoke a little lower, and his breathing was a little weak."

Landreth did not refute Carvey's judgment. After taking the form, he carefully looked at the values: "Send the person over and ask the theater to prepare anesthesia and equipment, and prepare for large-scale disinfection of the abdomen. Then briefly explain to her mother Let’s talk about the condition and treatment. We need to do laparotomy to rule out visceral bleeding.” “Okay.”

This is not the technical reserve that a 19th century director of general surgery should have. He was obviously deeply influenced by Carvey's surgical rules and copied most of the first aid measures and preoperative regulations.

Landreth also admitted the importance of these measures generously: "Don't worry, your rules have always been the guidelines for surgical operations at the Palace Hospital. I attach great importance to it and agree with it. But this does not affect your An ‘outsider’ fact.”

After speaking, he took out his newly drafted rules and regulations for the surgical ward and pointed to one of them:

"It is clearly written here that 'Only doctors and interns from the Palais-Dieu Hospital, medical students from the School of Medicine of the University of Paris, and members of the Paris Surgical Association can enter the auditorium of the surgical theater.'"

"Just because of nationality?"

"It's strange to think that the most authoritative hospital in France that treats the most patients will eventually let young doctors from other countries lead surgical operations. I don't care how much Professor Sedieu trusted you at the beginning, how much that guy Holt relied on you, now It’s my responsibility, I have the final say.”

Landreth took off his coat and began to prepare for the operation: "If Dr. Carvey is interested in the results of the operation, you can wait outside the theater. It won't waste too much of your time."

Kawei's principles may seem selfish, but he is more concerned about the patients and wounded because he believes he can give the best and most appropriate treatment.

Before traveling through time, Kawei encountered others trying to steal the source of his illness. Although Kawei felt uncomfortable, he endured it and got over it. At least the level of doctors in the hospital is pretty much the same, and everyone else is well aware of their own capabilities. There are almost no warriors who "rise to the occasion", and patients can still receive appropriate treatment.

But it was different now. He had no trust in Landreth.

What's more, the other party is a little girl who is only 6 years old. The anesthesia, preoperative preparation and intraoperative support are different from those of adults. The gap in the operation itself is even greater. The belly of a 6-year-old child may only be as big as an adult male's liver. Finding bleeding is the next step. How to suture to stop bleeding is the key.

Anyway, he had to be there.

Kawei opened the suitcase covered with mud print dust and took out a crumpled folded piece of paper: "I definitely don't have a member of the Paris Surgical Association, but I have this."

"what?"

"That day after Mr. Bizet's surgery for laryngeal cancer, I received the Legion of Honor Officer's Medal awarded to me by Mr. Holt, ordered by the Three Emperors. That medal made of pure gold was too precious, so I kept it at home with only this Go out with a certificate." [1]

Since the Second Republic, the Legion of Honor has been awarded not only to soldiers but also to civilians. At the same time, the number limit and nationality requirements have been relaxed, and you can get it as long as you make outstanding contributions to France. Coupled with the fact that there were no noble characteristics in the first place, the number of people granted the grant increased much more than before.

But even so, it still represents France's highest honor.

If surgeons with the French Legion of Honor cannot enter the surgical theater to observe, then I am afraid that not many in France can.

Faced with this piece of paper, Landreth had to compromise.

Starting from February this year, the surgical theater of the Diocesan Hospital is strictly open to the public and is completely free of charge. A surgical show in the eyes of Viennese people has been directly elevated to the level of medical education. Whether it meets the expectations of the reform is a matter of opinion.

There were only a few people sitting sporadically in the theater. Kawei randomly found a seat near the front and thought over and over in his mind about the possible surgery scenes.

The surgery officially started at 10 a.m.

"A 6-year-old girl was hospitalized after being hit by a carriage and then trampled for 3 hours." The medical history reported by Landreth was very standardized and even had a modern flavor. "The wheel rolled over her arm, and the horse's hoof trampled her. Passed through her abdomen and the child fell unconscious on the spot.

The child developed high heart rate and low blood pressure 2 hours ago. It was considered that the arm wound had not lost much blood and there was a possibility of internal bleeding. The child was awake 1 hour ago. After questioning, no headache, dizziness or difficulty breathing was found, and damage to the brain and lungs was temporarily ruled out.

Preoperative diagnosis revealed abdominal visceral injury, liver and spleen rupture, and exploratory laparotomy was performed. "

The preoperative disinfection was done by Peon, and Albaran, who had finished his internship in urology surgery, helped. There were no problems with the steps and scope. The problem was that the diagnosis was too hasty and no abdominal puncture was performed to confirm whether there was blood accumulation. Moreover, they did not prepare blood well in case of massive bleeding and shock during the operation.

Kaweike doesn't care whether the operation starts or not, as long as he enters the theater, it is equivalent to entering the home court. If he feels there is a problem, he has to raise questions. There is no room for bargaining: "Peang, how did I teach you before? When you encounter emergency trauma For patients with severe bleeding and unstable blood pressure, what else should be done besides diagnosis and preoperative preparation?”

"This" Peang was excited, seeming to recall a long-sleeping memory.

Landreth knew that Kawei would be like this, and quickly warned: "Dr. Kawei, only one voice is allowed in the surgical theater, and no one else is allowed to make noise."

Kawei didn't care about this: "Peyon, tell him what step he missed."

Peang glanced at Kawei, then looked at the little girl's belly, but her mouth was like a locked safe door, unable to say, "Yes."

"Don't worry, what is it?"

Peang replied: "We need to prepare blood. We didn't prepare blood."

"Prepare blood?" Landreth frowned, "Didn't I prepare rehydration fluids?"

Peang quoted Kawei's original words: "This kind of patient may bleed at any time. He needs fluids and blood transfusions at all times. If it is too late, it will be too late. Because the blood type must be matched before blood transfusion, which is very time-consuming. If the blood type is wrong, ,That is"

"Okay, I get it!"

As soon as Landreth picked up the scalpel, he was captured before he could cut the skin. His mood was definitely not much better. However, out of respect for the patient and the most basic professional ethics, he still asked Payon to prepare blood, and the original first assistant position was replaced by Albaran.

It's a pity that Albaran, the intern, is definitely not good at assisting, especially in such a complicated and stressful emergency surgery. So Carvey proposed again: "Dr. Landreth, I think it's better for me to be your assistant."

(End of this chapter)