Nineteenth Century Medical Guide

Chapter 41 40. The Hand of God

Although Kawei had a lot of titles before time travel, he was an ordinary uncle in the eyes of outsiders, and he was also an ordinary young man after time travel.Whether he has money or not, he has always enjoyed a regular, monotonous and boring life, and has no intention of changing it, as long as there are no sudden changes, he will keep it going.

Only in this way can he devote all his physical and mental energy to his work without reservation.
Of course, this will also bring about a small problem, because he also brought those almost crazy ideas, pursuits and a little bit of mental cleanliness in his mind.

This small flaw in his concentration made him look very different from other doctors.

For Carvey, who is obsessed with medicine, there are only two types of patients, those who are his own and those who are not.

He doesn't care if it's not his own patient. There are tens of thousands of patients in the world. God can't save all of them when God comes.But once it is in his hands, it will be different. The health, life and death of these patients are directly linked to his ability to work.

Failure is not allowed, let alone death!

If they happen to meet, Carvey will lock himself in the office and dig out all the diagnosis and treatment records until he finds a way to break the situation, except for those who are already unable to recover.

One minute ago, Laszlo was not his patient, but Ignaz's. Before making a shot, he would consider the gains and losses, the benefits, and how to end up after failure.But now Ignatz suddenly fainted. As the first assistant in the tracheotomy just now, in Kavey's established thinking, he has become Laszlo's doctor
At least half a doctor.

At this time, the gains and losses and benefits of money and status have become indifferent things.

This time Laszlo's hypoxia came quietly, far less violently than before.There is no restlessness, nor is there any struggle, even for him, this chaotic feeling is particularly subtle.

It is indeed a little uncomfortable, there is still resistance when breathing, but the existence of resistance is not so thorough, and some air can still flow into the lungs to some extent, it is nothing more than a little effort.
Inhale and exhale
The wound still hurts, but it's bearable
Inhale. Exhale.
very laborious.
Laszlo thought he was just tired, so he closed his eyes cooperatively, and prepared to give a big gift to the surgeon who insisted on operating on him when he woke up.

Just when everyone's attention was diverted from Laszlo and turned to Ignaz, the god of death who had hovered in the sky for a long time finally waved its sickle lightly.The only one who saw the sickle's trajectory and blocked it at the first time was Kawei.

Carvey reached out and placed his hand on the opening of the newly inserted catheter. The airflow driven by breathing was very weak, and the chest heaving that should have appeared basically disappeared.Laszlo's hypoxia did not improve at all, his lips were cyanotic, and his newly awakened consciousness was gone.

There is no room for overthinking about unexpected situations, but Carvey still has to figure out why first.

Why is there still hypoxia after endotracheal intubation?

Allergies can only cause tissue edema, the most typical ones are skin mucous membrane and laryngeal edema [1].The main components of the trachea are cartilage and muscle, and the trachea should not be swollen anywhere.Besides, Laszlo's trachea was right in front of him, and when the tube first went in, it did relieve part of the hypoxia.

But now I'm hypoxic again, and it's only been less than half a minute!

is blood?

Maybe the bleeding from the wound flowed back into the trachea, but after a few minutes, it has begun to solidify.However, the anterior jugular venous plexus was injured during the stoma, and the bleeding was not much, even if there was regurgitation, it was not much, and it was not at all to the point of completely blocking the trachea.

Could it be the hemorrhage just now?

Carvey knew very well that he stopped the bleeding very quickly, and the blood vessels were spraying outwards, and did not stop at the wound.There will definitely be backflow of blood, but Laszlo also coughs, so logically there shouldn't be a problem.

what else?Food scraps from a party?

But the residue is generally only blocked in the subdivided bronchi, and basically will not cause blockage of the entire large airway, and Laszlo is not a newborn child.Moreover, the person has been fine before, and there is no possibility of sudden obstruction.

If you think about it further, you have to ask about underlying diseases and the like, which is obviously meaningless here.

Carvey took a deep breath, gathered his thoughts and re-examined the entire tracheotomy process.

Ignatz's knife edge is a bit problematic, but it's only a small problem. For those who get started for the first time, he has done a good job.Although there was a lot of bleeding throughout the process, it was all under control.

Where exactly is the problem.
In the whole room, except for Kavi who was still thinking about Laszlo's trachea, almost everyone surrounded Ignatz.

Physicians were all talking about "Barber", and they still had a little respect for Ignatz in their hearts. The fact that they just undertook the pressure and completed the tracheostomy already explained the problem.At this moment, what Ignaz represents is no longer a single surgery, but the cards of all Austrian doctors.

Especially the doctors from the Municipal General Hospital stepped forward to help him out of the room immediately.Ignatz is the hospital's signature, and his occupation is a bit humble, but his earning power is not small at all.

Alina had been guarding the door the entire time, but when she heard voices inside the room just now, she thought something went wrong with the operation.Looking at it again now, it turned out that it was my husband who fainted: "What happened to him? What happened?"

"I must have been too tired after tossing around all night." Fatolad looked around and found the butler, "Are there any dried peach slices in the house?"

"Yes, Monsieur Count."

"Boil a glass of cognac and a tablespoon of sugar, and pour them into wine glasses containing three slices of chilled dried peaches [2]. Give each of them a glass, which is very useful for restoring strength," Fattorad finished For the recipe, I don’t forget to add, “If the dried peaches are not chilled, remember to put an ice cube to prevent your mouth from burning.”

"Okay, Monsieur Earl, I've made a note."

Several physicians praised this classic prescription. Two of them helped to send Ignaz to the bedroom next door to rest, and the rest stood beside Fatorade and directly fast-forwarded to the part of rewarding for meritorious deeds. .

"Count, Ignatz has won again this time."

"There's nothing to do about it." Bosa was still calm, and didn't take this kind of credit seriously. "Actually, it just happened to fall within the scope of surgery."

"But he took all the credit for the previous three hours!"

Fattolad felt helpless, but he still said decently: "He has won for more than ten years, and this time is not bad. Everyone, the most important thing is to save the life of Mr. Laszlo. He is very important to the entire Austrian Empire." It's too important."

"really."

"I see a lot of people gathered at the door. I'm afraid the news of Mr. Laszlo's sudden illness has already reached the ears of those newspaper reporters."

"Well, you go to deal with these flies, and I have to make a detailed report to the Duke."

Fattorad sighed, and continued: "Remember not to exaggerate Mr. Laszlo's condition, especially the news that he was suffocated, otherwise the headline of the evening newspaper in the afternoon will become "The new president of the Credit Bank has just arrived in Vienna and suddenly "Sick Disease" and other titles, this is the last thing the Duke wants to see."

"understood."

"Everyone~"

After the housekeeper ordered the dry peach wine, he returned to the physician and said with a smile: "You must be tired after a busy night. If you don't mind, just have some breakfast. We have prepared Schlierbach cheese ham sandwiches and salsa. Huh Chocolate Cake."

"Then, do you want to eat first?"

"By the way, where is Miss Naya?"

"Those who were still here just now should be with Mr. Laszlo."

Just when everyone thought of Naya, Naya's voice came out, but the young lady lost control of her emotions again: "What are you doing??!"

In fact, Naya didn't leave the room at all, and turned around and walked back after Ignatz was helped out.As the only family member around Laszlo, her father's health is closely related to her.But in fact, there was another person who returned to the bed earlier than her, and that was Bergett.

Bergert is a student of Ignatz, and the teacher must be by his side when he falls to the ground, but when he was about to step forward to help, he looked back at the patient in a strange way.This glance not only saw Laszlo, but also saw Kawei nailed to the bed like a log.

what is he doing

Why is there no response to the teacher's fainting?
And the operation has been done, why is he still looking at the patient?

In the past, Bergert would not have cared, but the ligation technique Carvey showed just now took him by surprise and became an important weight when making a choice.And Ignatz has colleagues around him, and his wife when he goes out, so it doesn't make much sense to go there by himself, it's better to stay here.

After weighing the pros and cons, curiosity prevailed and brought him back to the bedside.

"Ms. Ignatz fainted, how can you return?"

"Shh~ the operation was not successful."

Kavey's voice is very soft, but the weight of these words is extremely heavy.Bergett was startled when he heard this, and did a little inspection like him before realizing something was wrong.

He has no clinical experience, and his anatomical knowledge is in a mess in his head, and he is not prepared for it at all.I have been in the Municipal General Hospital for a few days, and the only things I have learned are two things, "suppress the patient" and "call my teacher".

Bergett reacted quickly, and was about to go out when he turned around, but was immediately stopped by Kawei: "What are you doing?"

He pointed to the door: "Of course it is to call the teacher"

"Are you stupid? Teacher Ignac has fainted. Do you think he will wake up because of you yelling twice? Then pick up the surgical instruments and immediately revive this Hungarian rich man who is about to suffocate?"

"What then?"

"We'll figure it out ourselves."

Bergert was in a daze: "Are you kidding me? How do we deal with patients who can't handle this new type of surgery? It's very difficult for the top French surgeons to guarantee the success rate of the operation. 40% is the best. God knows if something went wrong with the operation just now!"

Carvey shook his head, completely treating him as his little brother: "The surgery itself is fine."

"What's the problem?"

"I'm still looking."

The whispered conversation between the two attracted the attention of Naya who had just returned to the room: "Father, oh, my poor father, I didn't expect such an accident to happen to you when you first came to Vienna. The oysters are really terrible, but luckily I didn't eat them."

Half pain and half joy on her face, she looked at Laszlo whose neck was stained with blood, and kept stroking his sweat-soaked hair: "It seems that you are really tired, go to sleep."

Bergert was very nervous, he didn't even dare to look at his former dance partner, and he didn't know how to explain this matter to this wayward rich daughter.

The strongest surgeon in Austria screwed up the operation?

Ignatz fainted from exhaustion after failed surgery?
These words will definitely damage the status of my teacher in the surgical field.

However, at this time, Carvey said self-consciously: "Your father is very weak and needs to rest now."

The implication is obvious that Naya's stay here will only affect Laszlo's rest, which is a very tactful "guest" order.But Naya ignored the poor boy: "No, father needs me by his side. If he wakes up and sees that I'm not there, he will definitely be angry. If it really doesn't work, I'll just keep silent."

She is indeed a troublesome woman!
Carvey murmured secretly in his heart, and looked at Bergett.

Bergett was not stupid, and soon realized that only he was qualified to speak to this young lady on an equal footing, and Carvey was not qualified: "Miss Naya, he is actually right, your father is very weak now and needs to An environment as quiet as possible.”

"I said I won't talk!" Naya was very stubborn, and turned defensive into offensive in an instant, "But you, the operation has been completed, why are you still in the room?"

"We are doctors and we need to observe Mr. Laszlo's condition at any time."

"Isn't he breathing again? What else needs to be observed?"

Bergett was not Naya's opponent at all, and he was beaten back in a few words.And Kavi on the opposite side didn't mean to help him at all, because he suddenly thought of an important thing, that is why Laszlo suffocated for the second time.

"Wait. Could it be that the original problem is here!"

He always attributed the cause of the second suffocation to the patient's body, but ignored that in the 19th century, surgery itself was also a high-probability external cause.

It wasn't Laszlo's trachea, or blood, or anything else, but the artificial airway that had just been placed through the incision.

The airway tube will definitely not be a problem. This is a valuable item that Ignatz got from France.Not only is it made of sterling silver, but the shape and style are also reproduced according to the catheters of French surgeons.

There is no problem with the person and the catheter, so the problem lies in the interface.

The interface must be misplaced!
Although it is outrageous in modern times, the incidence rate can never exceed one in a thousand, but it is not difficult to understand in the 19th century.What's more, it was Ignatz who put in the catheter just now, the sharp knife hand who cuts legs like vegetables, it's normal that his hands are not accurate.

It stands to reason that in Kavi's capacity, without Ignatz by his side, he has no right to touch Laszlo at all.But now there is no time to explain, Kawei didn't say hello to Naya, just reached out and grabbed the artificial airway that had just been put on the incision.

"what are you doing?"

"I'm saving your father." Carvey said his purpose in a flat tone.

Naya originally wanted to give Kawei the most basic respect. After all, he also participated in the entire operation just now, and he deserves credit even as a civilian.But it wasn't until Kavey pulled out the artificial airway that she realized that she was wrong. This is not a doctor at all, but a devil!

"What the hell are you doing??!"

With the departure of the artificial airway, Laszlo on the bed suddenly coughed twice, his chest rose and fell, and then he gasped for breath.

"So I said, I'm saving your father." Carvey breathed a sigh of relief, leaned over and said with a smile, "Mr. Laszlo, welcome back."

(End of this chapter)