Nineteenth Century Medical Guide

Chapter 52 51. An Ordinary Transaction
Cleft lip repair is a complex surgical project.

In addition to the lower triangular flap method shown by Carvey, there are also rectangular flaps suitable for bilateral cleft lip, upper triangular flap suitable for complete cleft lip, and the more difficult rotary propulsion method [1].Coupled with many situations that require secondary surgery, cartilage restoration, nasal deformity repair, and various plastic surgery, there are many things that can be obtained.

Carvey learned a lot when visiting the plastic surgery department in the operating room. This time, he only gave an entry-level procedure. Compared with straight-line suture, it definitely has many advantages, but at the same time, it also inevitably has a lot of disadvantages. 【2】

It is difficult to reproduce the surgery on a cadaver. The stiff body surface will make the lips lose the beauty they should have after suturing.But relying on Ignatz's many years of surgical experience, he quickly realized that this is a brand-new method different from straight sutures, and it is an innovative method that can make headlines at any time.

Immediately, three options appeared in Ignatz's mind:

Denies the technology and secretly appropriates it;
Acknowledge this technology, but still choose to give up, the beauty of adults;
Acknowledge this technology, choose to join by force, and those who see it will have a share.

He first ruled out taking it for himself, not because he didn't want honor and praise, but because his status was not enough to grab the idea of ​​an assistant.But after seeing all the surgical methods, and even telling myself the basis of the creativity, it feels really uncomfortable to hand it back to Carvey.

Ignatz desperately needs a chance to prove himself

Remove the two extreme items, and the only option left is to split.

There have been so many such cases in history, and it is not uncommon for teachers and students to publish the same research together.But it is indeed embarrassing to ask such a request. Ignatz hesitated for a while before finding some "appropriate" reasons for himself.

"If you use the triangular flap you mentioned, I'm afraid the simple figure-of-eight anastomosis with needles will be very clumsy, and it won't fit the wound well. I think it still needs to be sutured with silk thread."

He first affirmed Carvey's contribution, and then slowly tested the share he could get in this innovation: "For the angle of taking the triangular valve, the cutting size, the method of silk suture, the choice of suture needle and silk thread, I think All of them still need further experimentation and practice, and follow-up after surgery is also required.”

To put it simply, the idea is yours, and further improvements belong to me.As for when the research results are actually released in the future, the teacher's name will naturally come first.

Carvey knew what he meant, anyway, this entry-level technology was just a bait.

Now that the tide of opinion has shifted toward Ignatz, those reporters and editors have found that belittling a once-great man seems to sell more, which is an opportunity for Carvey.

If Ignatz can really refuse like a saint, then Carvey can just use the triangle valve technology to continue to gain popularity.

If Ignatz is determined to grab the technology and release it as his own innovation, then Carvey will not need to have scruples in the future.Whether it is to store good evidence to refute, or to publish updated technology, it is not difficult for him, and by the way, he can also get a wave of media support.

But now the other party has chosen a compromise solution, planning to use his fame, technology and experience to share half of the credit. It seems that he is preparing to throw the problem back to Kawei.

Unexpectedly, this is what Karvey was waiting for, so instead he pushed the boat forward: "What do you think of the triangular flap technique, teacher?"

"If you take into account the postoperative scar contracture, this solution is really good, and it will be more suitable for cleft lip than straight suture." Ignatz has a very keen surgical intuition, "If you take this into account, straight suture may only be suitable for A very short kind of cleft lip, like Mrs Gale and her baby."

"Teacher, that's not what I mean." Carvey asked with a smile, "I'm asking, as an innovation in surgical procedures, what about the triangular flap technique?"

Ignatz has to admit that this is a brand-new attempt. The concepts of "curved surface" and "triangular flap" have opened a new door for Ignatz to repair cleft lip.

In the eyes of ordinary people, this may be an innovation, but for surgeons who have been involved in this type of operation all year round, this innovation may bring unlimited imagination and creativity.

He turned back and walked to the equipment table, struggling with his thoughts for a long time, but he couldn't tell the white from the black, so he could only bluntly say: "This is a very good innovation, but it still needs time to prove it slowly."

"The teacher is being suppressed by others, and he urgently needs to prove himself." Carvey put down the scalpel and looked at Ignatz. "This new technique is given to you. You can use it to study, improve, and even publish it in medical journals. If The effect is good, and maybe Britain, France and Germany will imitate it.”

Ignatz turned his back to Kavey, his face didn't show any changes, but he was very excited inside: "This"

Carvey doesn't care what mood he is in now, he just wants to get what he wants: "Of course I also hope that the teacher can bring my name when publishing it. After all, this is a new technique created by the two of us."

"."

Ignatz thought over and over with the scalpel in his hand, but couldn't think of a reason for his refusal.He looked back at Carvey, and there was no trace of bad intentions in his extremely sincere eyes, as if to say, "Teacher, don't worry, I'm here to help you."

".Can."

Taking the bait, Kavi began to slowly tighten the fishing line: "At that time, I will be your right-hand man in creating a new technique. This title sounds pretty good."

"Well, it's not bad." Ignatz echoed.

"But it's just good, not really good."

Ignatz heard a dissonance and realized that Kawi's stuff wasn't free.But at this time, he has already chosen this path, and there is nothing to hesitate: "As a right-hand man who creates a new technique, he should be rewarded."

"Teacher, I need your recommendation."

What Carvey wanted was not a practice certificate, which he found out these days did not exist, and was replaced by a badge of membership of the Physician Association [3].In fact, this kind of badge has no substantive effect, and is more of a status symbol.

Membership must be nominated by at least three members. At the annual election meeting, their academic qualifications and outstanding contributions in medicine will be listed one by one, and then the membership list will be announced after the election.

Internal medicine has requirements for a diploma, and the minimum is a bachelor's degree, but it is just a start.

If you want to join the association, you must know the members of the Medical Association, and then you must first work in a large hospital.However, the threshold for large hospitals is much higher, and they must have a master's degree, which directly isolates ordinary civilians and even some middle-class people.

Although surgeons are recognized as doctors and can join the Physician Association in name, in fact very few surgeons can successfully pass the election to join the association.

To this end, the Department of Surgery established its own Institute of Surgery.

The admission standard of the institute is also an undergraduate start, and Ignatz is the vice president of the researcher.The old dean is 56 years old this year. As soon as he retires, Ignatz can easily take over.

All Carvey wanted was the key to graduate school, a college degree.

If you want to get a diploma, you have to enroll first. Enrollment is not based on a selection test, but on personal application and recommendation from professors.If you just recommend this column, you can't think of success without a deep family background and connections.

"You want to go to medical school?"

"Yes." Kavey nodded.

Ignatz wants to object, because it runs counter to his teaching philosophy of bringing Kavela into the hospital, and he also doesn't understand this kind of behavior: "Surgery doesn't actually need this kind of thing, as long as you do it well, both Not in a year! Maybe in just one year, you can become a surgeon."

"I know."

"Then why do you have to go to medical school?" Ignatz was puzzled.

"I know for surgery a diploma or something doesn't affect the job, but I still want to fight for it."

What Carvey gave was a superficial reason, but behind the scenes his purpose was to get close to those professors who were doing research in medical schools.They have complete research equipment, which is very suitable for him to "create and invent" some high-end products that are not in line with the current era.

Ignatz sighed: "It's not easy. My recommendation alone is not enough. You have to have a high school diploma. I remember you said before that you dropped out of school because you were helping in the barber shop."

"I really don't have a diploma now." Carvey suddenly thought of someone, "What if I have one?"

"With a high school diploma and my recommendation, it shouldn't be a problem." Ignatz said, "But it will take some time. The end of the summer vacation will be in October."

"Can't advance? There should be a chance in March."

Of course, Ignatz didn't want to advance, because the longer Carvey stayed in the hospital, the more he could show his excellent teaching quality: "Although I have some connections, I can recommend it, but it's too much to jump in the line halfway, and I'm afraid it won't be possible."

"I still hope that Mr. Ignatz can help me think of a way as much as possible. After all, I am also a helper in creating new techniques." Carvey re-covered the corpse with a white cloth, "Oh, by the way, how much does it cost to enroll?"

"A year's tuition fee is about 500 crowns."【4】

Speaking of money, Ignatz suddenly thought of his wife: "I forgot, what did the dean ask you to do?"

"Oh, it was Mr. Laszlo who was looking for a family doctor, and found it on my head." Carvey walked to the sink, picked up the alkaline soap on the side and began to wash his hands, "He really takes me seriously , thinking that I could bring him health and good luck, but I refused anyway.”

Ignatz looked at the lye soap in his hand, and didn't know when he put it there, but continued: "Their family is so rich, you really don't want to go?"

"Sorry, don't go."

Carvey's handwashing method is particularly weird. From the crevices of the nails to the elbows, soap is all smeared, and the process is extremely cumbersome.He not only washed it by himself, but also gave it to Ignatz: "Teacher, don't you wash it? Some flower essential oils are added in it, which is very fragrant."

Ignatz's hands were really not clean after touching the corpse, and even after wiping it with a wet rag, there was an uncomfortable slippery feeling and peculiar smell.

Thinking that he had just taken away Kavey's innovative technique and wanted to ask about his salary, he tried to wash his hands for the first time: "It's just a corpse. I didn't expect you to be so disgusted."

"It's my father's habit, and I get used to it as I learn."

Carvey passed over the alkaline soap with floral fragrance: "Try it, teacher, it feels very comfortable after washing."

It was impossible for Ignatz to learn Carvey's surgical hand washing method, but just rubbed his hands casually.His main concern was still Carvey's income: "How much is Alina paying you now?"

"30 crowns a month."

"How do I pay for tuition with this little money?"

"And 1% of theater revenue."

"Sills is only 6%, and the theater is willing to give you 1%?"

"It should be the effect of that edition of the evening paper."

Ignatz said: "In fact, the ticket price for surgery is very unstable. There are completely different prices with me and without me. The boss probably saw that I will always take you to the stage. Today's ticket price is higher than usual. 20%."

Carvey nodded with a smile: "Indeed, there is still an advertisement posted at the door."

"After this operation, you should be able to earn forty or fifty crowns."

Carvey also chose to ask Ignatz for a recommendation after he got the news of his salary increase.According to this income, as long as you are lucky, you can earn enough for one year's tuition by working for one month.

The next thing to wait for is Ignatz's recommendation letter.

"Teacher, why don't you have a meal together?" Carvey invited with a smile, "After all, I got a raise, so I'll treat you to this meal. By the way, I can talk about Mr. Alphonse's hemorrhoids."

The two struck a deal in silence, without the presence of a third person, in the autopsy room of the Municipal General Hospital.

According to Ignatz's character, since he promised, he would not go back on his word.As a leading figure in Austrian surgery and a professor of anatomy and surgery at the Medical School of the University of Vienna, he has a very loud voice in the school.

Of course, if you really regret it, Kawei is not afraid, it's just a little troublesome.

At three o'clock in the afternoon, Alphonse was wheeled into the operating room.

According to the requirements of hemorrhoid surgery, he quickly took off his pants, covered his body with a white sheet, and lay on his side on the bed.The buttocks are the surgical area, becoming the second exposed part besides the face. 【5】

As usual, Ignatz introduced the patient's situation before the operation as usual:
"Ladies and gentlemen, after a thrilling duel, Monsieur Alphonse, head chef at the Rochesuart restaurant, has received a sword wound on his ass.

Fortunately the sword wound did not touch the anal canal and my assistant Kavey made a perfect cotton packing.Such a sword wound does not require surgery, but unfortunately, Mr. Alphonse's hemorrhoids are very serious, and he has already had symptoms such as profuse bleeding, blood clots, and prolapse.

Considering his profession and his dignity as a French chef, surgery was necessary.

My assistant Carvey and I have done sufficient research and study on the most cutting-edge hemorrhoidectomy, so we are confident that we can finally achieve the goal of successful operation and give Chef Alphonse the most perfect gang door. "

At the end of the introduction, Kavey already has a pair of hemorrhoid clips in his hand [6]: "Teacher, clip~"

(End of this chapter)