Nineteenth Century Medical Guide

Chapter 69. 66. Metamorphosis: Prelude

For this urgent temporary operation, the theater staff also worked hard.

They called up the operating venue at Graze Hospital at night, cleaned the venue in advance, and doubled the number of candles inside the theater.The venue was brightly lit, and the smell of burning wax overwhelmed the smell of blood.

In addition to the venue, they also need to deal with the embarrassing operation time.

Ticket sales began after 5 o'clock, and the start and duration of the operation were uncertain.In order to grab tickets and watch the entire operation, the audience needs to give up the time for dinner and enter the venue first.

There are some dried fruit snacks and drinks in the audience lounge of the theater, but the amount is very small, and it can only satisfy the gluttony and cannot be full.

It is obviously inhumane to let them starve to see a pregnant woman cut open. If there is inhumanity, it means that there is still room for improvement.

After a short thought, the theater temporarily opened the trading channel, allowing those street food stalls to enter the venue to sell their own things.Of course, entry also requires an entrance fee, and there are a bunch of troublesome rules to follow.

Immediately, the hands of the audience were filled with all kinds of food, such as small sausages, barbecue slices, bacon, cheese and bread cubes, together with the original grapes, figs, plums, pears, and cherries on the dinner plate. Many British eat mussels and conch, Italians eat pizza, and French eat oysters and squid.
The theater turns into a buffet scene in seconds.

Before the operation officially started, the place was already filled with the noisy sound of wine bottles, wine glasses, fruit forks and dinner plates colliding with each other. 【1】

The theater was full of seats, and the audience was full of enthusiasm for the performance, especially when the so-called "National Top" surgical team entered the arena, the high emotion of wanting to watch the operation immediately was peaked.

"Ignatz! Ignatz!"

"Cesarean section! Cesarean section!"

"Get started, I can't wait."

Carvey was last, with two nurses and a theater employee.

Now he is still an assistant, even if Ignatz is absent, as long as Hills and Herman do not express their views, he can only be an assistant.Because a young man who has only been in the practice for more than half a month can't be the chief surgeon without the nod and approval of the master and the hospital.

Anyway, for him, he is used to being an assistant these days, and he just sees the tricks.

No matter what went wrong with the surgery later on, and whether Hills and Herman were willing to take over or not, he needed to do one thing before the operation: disinfection.

It is also a very personalized four washbasins, which are filled with two parts of water, one part of bleach and one part of soap.

"Wash your hands first, Mr. Ignatz's rules."

Carvey told a lie that anyone could expose, but gave the extremely nervous Hills and Herman a buffer time.The time squeezed out by repeatedly washing their hands can let their brains relax and sort out the operation process to be done next.

It's a pity that this kind of time didn't last long, and people soon discovered that something was not quite right.

First of all, Ignaz’s fans were the ones who misfired in the auditorium. Ignaz was not in the three-person team that entered the arena. After waiting for a long time, no one showed up. sense of anticipation.

People were surprised, why didn't the chief surgeon come?
"Where's Ignatz?"

"Where did the surgeon who performed the surgery go?"

"Don't just wash your hands, say something, it's too boring."

Among the three, Hills is the first to bear the brunt. He is considered to be an official assistant. When Ignatz is away, he will naturally take charge, and the pressure will naturally be placed on him: "Doctor Hills, where is Dr. Ignatz going?" gone?"

The accusation was replaced by a directed question, and Hills had to answer: "Ms. Ignatz has something to do. The operation is urgent. We will do it first for the time being."

"Cesarean section is a major operation, can you do it?"

"What if you don't come back?"

"Yeah, what if Ignatz doesn't come back? Can you finish the operation?"

"Cesarean section is not limited to your City General Hospital. We spent a lot of money to see Ignatz perform the surgery, not you!"

"Now you don't even have a chief swordsman, so what do you think?"

The lack of a surgeon not only affects the operation, but also brings about a serious problem that only existed in the 19th century, that is, there is no commentary.

No one introduced the patient, no one described the progression of the disease, and no one clarified the purpose of the operation.Although the audience doesn't care about these things, not listening and not speaking are two concepts. Without the introductory introduction, it will always make people feel that something is missing.

It just doesn't taste right.

The audience who were still feasting just now put down their knives and forks one by one, and there was a moment of silence, hoping that Hills could give them a reasonable reason to continue watching.After all, I have watched surgery in the surgery theater for so many years, and I have never seen any messy situation. The temporary absence of the chief surgeon will not make them leave angrily.

However, Hills froze in front of the wash basin and said nothing.

Carvey was surprised that a guy who wanted to reach the pinnacle of surgery had no desire to show off in front of such an opportunity.What surprised him even more was that even Herman, who was standing by the side, didn't say a word. The two of them just washed their hands silently, watching the audience get up one by one and walk out the door.

Ignatz's absence is in the hands of Carvey, but the audience cannot be absent. Without the audience, how can this operation be done.
Carvey suddenly found that he seemed to have merged into the vicious circle of abnormal surgical development in the 19th century, and regarded surgery as a performance show of personal skills.

To be honest, although it is inhumane to the patient and the privacy is destroyed, it is quite touching from the perspective of the chief surgeon.

Looking back, there is a reason for such a strange theater of surgery.In the absence of large-scale international medical conferences, it just filled the gap caused by the unsound medical system, and also gave surgeons a chance to make their mark.

If you want to stand out, you have to win the hearts and minds of the audience, even Kavey, who has mastered the skills for more than 100 years, is no exception.

"Everyone, please stay!"

The first thing he has to do is to keep people first.Whether it's drawing big cakes or bragging, retaining talents will lead to follow-up, and those who cannot retain have nothing.

So after attracting everyone's attention, Kavey stood in the center of the field and decided to brag, bragging about the operation before saying: "If you choose to leave now, you will not only lose one or two hundred crowns of ticket money, And a perfect victory that only a patient audience can witness."

Money is not important to these viewers, what is important is to be able to see a wonderful operation.

Even knowing that Kavey was probably bragging, they still chose to be tolerant, and stayed in their seats to see the situation first.It's just that doubts still exist, especially the daily reporter, Varela, who was moved by the news.

"How perfect? ​​I don't think even Ignatz himself can boast of such a sea."

Carvey put his finger on his lips and warned: "If Mr. Varela has any comments, we can talk about it after the operation. Now is our time."

"."

Temporarily dispelling the audience's idea of ​​leaving, Carvey prepared to divert their attention from the chief surgeon first, to stabilize the wave of people: "Let's invite the pregnant woman, Miss Nora, to enter the venue first."

Hearing that there was finally a reaction in the theater, the host outside the door quickly coordinated the delivery workers, and under the protection of two midwives and Marcus, pushed the pregnant Nora into the door.

Marcus is in his 40s and has been working for nearly 20 years. This is the fourth time he has had the honor of stepping into the theater of surgery.The first three times were also for cesarean section, but he had never seen such an exaggerated number of spectators. He was very impressed by the hot scene of the operation.

He looked at Kavey standing on the field, and then looked at the eyes cast around him, thinking that he couldn't do this.

It is obviously very inappropriate for a gentleman of high birth to display his knowledge like a theater actor.

But Marcus still gave Carvey a rare encouragement.

"Now the fetal heart rate is between 130-140, and Nora's heart rate has been stable, around 85." He patted Kavey on the shoulder, leaned forward and said, "I won't stay here anymore, a midwife will help you, Come on!"

Carvey nodded, sent Marcus away, and asked the nurse holding the air storage bag to connect Nora with a new type of anesthesia device【2】.

Then, while disinfecting Nora's stomach with alcohol, he introduced the whole story of the operation: "The incident happened suddenly today. Ms. Nora went into labor suddenly. At 4:48 in the afternoon, maybe you are still admiring the operation in the afternoon, but I As an assistant, she looks after patients in hospital wards.

Just at this time.
slap~
Nora's stomach burst, and all the amniotic fluid in the enlarged uterus flowed out, and the entire Municipal General Hospital's obstetrics department was in a mess. "

Kavey was talking about the story before the operation, and his hands were not idle. Alcohol, gauze, bandages, and Ignatz's cesarean section equipment box were placed in the preparation area:

"Nora is only 19 years old. This is her first pregnancy and it has been 9 and a half months. According to obstetric practice, no surgery is performed unless necessary. However, Nora is thin and has a small pelvis, and the birth canal conditions are not suitable for normal delivery. Teacher Ignatz As early as a month ago, the cesarean section had been scheduled, and the time was set for next week.

But people are not as good as heaven, and when the amniotic fluid breaks, we are forced to take measures. "

First catches the eye, then introduces the audience's emotions, and now that their emotions have returned to their previous state, it's time to explain the operation:

"The three teachers, Ignatz, Hills, and Herman, have been preparing for this operation for two whole weeks, and have also fully studied the successful cases of cesarean section in Britain, France and Germany. We already have the necessary conditions for a successful operation. The speed of cutting and suturing has also gradually approached the accuracy required for successful surgery.

We all have the confidence to complete this operation. "

The content of the speech was very plain, basically the same as what Ignatz usually said, but the audience could still see the confidence in the operation from Kavey's tone and eyes.

Just like Ignatz himself standing there.

This kind of self-confidence also misled the nurses, making them think that Carvey would be the surgeon today: "Mr. Carvey, the patient's anesthesia was successful."

Karvey nodded, and sent Hills and Herman to the operating table.After the nurse put the required equipment in place, he whispered to the two of them, "The scene has stabilized, what should we do next?"

This is undoubtedly giving Hills and Herman a choice, and it is still too late to give up the opportunity now.

As long as the two nod, Carvey will take over.

But after the opening introduction just now, Hills regained some confidence, and still reached out for the scalpel: "Follow my rhythm, I will do it, and you will explain. Herman, I will leave it to you to stop the bleeding. "

On weekdays, Hills performed amputations, excision of superficial tumors, lithotomy and lithotripsy, and sometimes he took orders to do bloodletting for high-class people because there were no patients.

He lacks the confidence to be the chief surgeon, and also lacks the ability to control the field for major surgery, so Ignatz has been reluctant to give him the opportunity to be the chief surgeon.

This just shows that Sears' surgical skills are not weak.

But it is a pity that he is facing a cesarean section, surgery is surgery, and obstetrics is obstetrics.Obstetrics can become an independent department, and cesarean section can become a second-level obstetric surgery. Naturally, it has its own way, and it is not something that a novice who has just studied for a few years can deal with it all.

"Everyone, please pay attention. Teacher Hills is judging the orientation of the fetal head in Nora's body, which is very important." Carvey is half explaining and half teaching, "The incision of the cesarean section needs to be aligned with the position of the fetal head. After the uterine incision, the midwife can directly ask the midwife to help remove the fetus."

Hills: Fetal head? ? ?

He was holding a scalpel, and he didn't start for a long time. In fact, he was just measuring with his fingers, looking for the incision position that he and Ignatz had made together.

But listening to what Carvey said, it seems to make sense.

Just where is the fetal head?

"Speaking of this, everyone will definitely be puzzled. The baby is in the womb, and our eyes can't see it. How can we judge the position of the fetal head?"

Carvey smiled, looked at the position of Sears' palm, and continued: "Mr. Sears' palm is touching the child's buttocks, and it feels very soft. And the child's head is on the other side, because there is a skull The reason, the texture is hard”

Hills followed his instructions, moved his palm to the other side, and indeed found a harder fetal head.

The next step is to choose the entry point.

"Generally, considering the position of the placenta in the uterus, the incision will be moved down as much as possible, and it is best to make the incision in the lower part of the uterus." Carvey interrupted Hills's train of thought again.

Of course, Hills knew that the downward incision could avoid the placenta and reduce the amount of bleeding during the operation, but an incision that was moved too downward would block the doctor's line of sight, which was not conducive to hemostasis and removal of the fetus.

But the right to speak is now in the hands of Carvey, and the words have already been spoken. For the sake of theatrical effect, it is impossible for him to refute.

"Ms. Hills' scalpel landed on Nora's navel, and made an incision [3] next to the rectus abdominis muscle. The length is about 10cm." Carvey helped pass three crow's beak forceps and two balls of gauze In the past, "we had to remove the fetus very quickly because that was the only way we could focus on stopping the bleeding."

(End of this chapter)