Nineteenth Century Medical Guide

Chapter 76 73. Qualified Surgeon——LoveMIkeG Han Zong Jiageng (25)

Surgical theater is actually a very small entertainment project, and its appearance comes from people's desire for blood, screams and other sensory stimulation.

Going forward, it can actually be traced back to the Roman duel field. Although one witnesses the redemption and the other watches the killing, you can get a glimpse of it from the layout of the surgical theater.The same ladder circular layout, the same bloody scene, the audience can hear the horrific screams, and can also smell the unique smell of blood.

But after entering the nineteenth century, surgery became more and more professional, and barbers gradually withdrew from the stage of history.

With the successive emergence of mature hemostasis and anesthesia, the chance of massive bleeding on the operating table is getting smaller and smaller, and the patient no longer screams like a dead pig, and the operating time given to the surgeon is further lengthened.

These changes in just a few decades have greatly reduced the excitement that laymen can watch, and greatly diluted the concentration of "stimulation".

It's no fun, so fewer and fewer people see surgery.

As for why Ignatz's operation is still hot at the box office, the reasons are nothing more than the support of colleagues and the study tasks of medical students.

In the era when medical education was still poor, the chances of medical students getting started with anatomy were very low, and they could only rely on watching to make themselves memorize anatomical structures and anatomical techniques.And when it comes to work, the source of illness for surgeons is also a problem, and few people are willing to lie on the operating table that is comparable to killing pigs.

If you want to improve your surgical ability, watching anatomy and watching surgery is an important way to learn.

The Vienna Municipal General Hospital was established early. At that time, the wards were all internal medicine, and the arrangement of the operation theater was not considered.

In the days when barbers were surgeons, putting the operating theater in the hospital would also cause dissatisfaction among the gentleman doctors, so the theater was thrown into a small theater next to the nearest theater on Lake Wien.

The original surgical theater was not popular, until many hospitals signed merger agreements for the audience gathering effect, and then the surgical theater flourished.As the popularity gathered more and more, the small theater evolved into a big theater, and this tradition was completely preserved.

Once it became a tradition, the old-school conservative Austrian Empire was unwilling to make changes.

The annual ratio of cents is the focus of the hospital and the theater pulling each other.

It's not that the Municipal General Hospital didn't think about splitting up the family, but there was only one Ignatz in the department of surgery, and the hospital couldn't afford enough money to build a brand new theater, so the dean could only delay after seeing this.

Now that Laszlo has the money, there are people who share the pressure for Ignatz, which provides strong conditions for the relocation of the theater.

"Now that the audience is used to going to the theater to see surgery, will there be loss if they suddenly change direction?"

"The loss of viewers is inevitable." Carvey has his own opinion, "Surgery is becoming more and more professional, and the interest of ordinary people will continue to decrease. From the perspective of ordinary people, will Teacher Elina pay a lot of money to see a surgery? ?”

Alina shook her head, the answer was naturally no.

"However, there is still a group of people in the market who need to watch the operation, that is, medical students and fellow surgeons. Since Earl Morazzo's operation was stretched to more than an hour, the audience who came to watch our operation Although the number of people is not small, the structure has undergone great changes.”

Carvey explained: "The ratio of medical students to doctors is very high. I think it would be a good choice to contact the medical school and give discount tickets to the theater. If it is a complicated operation that only we can do, maybe the fee can be raised even higher Some. Because this family has no semicolon, if you want to see it, you can only come to our hospital to see it."

After listening to these analyses, Alina realized that things were not simple.

It was just a caesarean section and the injection of Laszlo's charity funds, and the hospital has undergone such earth-shaking changes.At that time, the hospital will monopolize all the income. Not only will the working capital of the hospital increase, but the income of the surgery department will also increase.

There are more successful operations, and those outstanding medical talents will come in droves.

This constitutes a virtuous circle.

"This seems to be a big deal, I'm going to discuss it with the dean now"

The administrative matters were handled by Alina, and Carvey and Ignatz still focused on the operation itself.

The huge success of the cesarean section had a far greater impact than Carvey expected.Just this morning, Graze Hospital, Hartman Hospital, and St. Mary's Hospital "donated" women who needed cesarean sections in their wards.

With their big bellies out, they gathered in the No. [-] Maternity Ward.

The two were similar to Nora, with obvious bony birth canal stenosis; one was difficult to give birth because of a huge cyst in the YD that blocked the birth canal; the other was more serious, with placenta previa at 36 weeks of pregnancy.

"The woman with placenta previa has been admitted to our surgical ward, and the other three are still staying in the obstetrics department." Ignatz has been staying in the office, and he accepted them during the rounds this morning, "Patient Temporarily stay on the bed managed by Sears, and transfer her over when your bed is allocated."

Carvey knew that on the bright side, he was already on an equal footing with Sears and Herman, and became a doctor who could really perform the surgery.

Ignatz sent the medical records to him: "You are familiar with obstetrics, do you have any suggestions for placenta previa?"

Carvey looked at it twice, but didn't see anything substantial, and asked, "The danger of placenta previa is massive bleeding. Is the bleeding serious?"

"It looks a little bit, Marcus checked and said it's not much."

"Well, 36 weeks is a bit tight. If the bleeding is not serious, we can delay it as long as we can."【1】

"Severe bleeding requires immediate surgery?"

"Yes, once the bleeding is severe, you must operate immediately." Carvey sighed, not too sure about this operation, "I need to do as much oxytocin as possible, and the amount of this operation may be much higher than that of Nora. many."

Ignatz nodded, unwilling to miss this opportunity again: "Then I won't go home."

Carvey smiled, "The next one, it should be Mr. Schmidt with 9 beds, the church priest."

"I saw it with Sears in the morning, and the old man still has severe abdominal pain." Ignatz was still a little confused about the differential diagnosis of abdominal pain, "You said it was something bad from eating, or abdominal distension, or something else reason?"

"That's not right."

"I touched the priest's stomach, and the tenderness is obvious, and the location is here." Ignaz said, clutching his lower right abdomen, "There is no lump, I guess it is appendicitis, and it needs to be removed as soon as possible."【2】

Carvey took Schmidt's medical records and said, "It's a pity that the priest doesn't want to have an operation. He made it clear when he first came here."

"Then why is he here?" Ignatz didn't understand, "Hurry up and go back to the internal medicine department to take medicine."

"Well," said Carvey, "he wouldn't even take medicine, saying that buying medicine and swallowing any kind of preparation would be considered a lack of faith and an interference with God's divine arrangement."

Ignatz took a deep breath and complained: "I thought he would use the medicine as 'Satan's bait to lure him to hell'."

"How to do?"

"Go and see him first, I'll figure out a way."

Carvey has encountered patients of all religious beliefs before.

But in modern times, the wisdom of the people has been developed, religion is just belief and science does not conflict, and the influence of religion is not so deep-rooted, so he doesn't know how to deal with it.In comparison, Ignatz's experience is much richer.

"Father, how are you feeling today?"

Schmidt is nearly 50 years old, with a fat body and half of his hair is white. He is wearing a priest's white robe and sitting in a wheelchair.Holding the Bible in his hand, he murmured words, which probably meant that he hoped that his prayer and repentance would be forgiven by the Lord.

So he didn't respond to Ignatz's question. It was his son Schmidt Jr. who stepped forward to answer: "Father's stomach hurts."

"How much does it hurt?"

"It hurt so much that I almost passed out at noon." The son was very worried about his father, "but he still insisted that it was intestinal gas and refused to even take the medicine."

"It's not a question of whether to drink medicine or not." Ignatz immediately made a decision, "Your father's condition requires surgery. If you ignore the inflamed appendix, your father will die when it ruptures. The time is still according to It was set before, tonight, at the surgery theater."

"But he hasn't let the doctor touch him since noon." Little Schmidt said, "It is said that surgeons are very dirty, and he needs to keep himself pure in body and mind."

Ignatz had already prepared: "So let's talk to you."

"What do you want me to do?"

"Give him some wine, say it will relieve the pain, and then use this when he is in a daze after dinner." Carvey took out a handkerchief and a bottle of ether from his pocket, "drop some, cover it gently On his nose, fell asleep in a while."

Little Schmidt was only in his early 20s, and he never thought that there would be such a method in the hospital, so he was even more worried: "Are you sure the operation will be successful?"

Ignatz stood up straight, puffed out his chest, and made it clear: "Although appendectomy deep into the abdominal cavity is still in its infancy and the process is very dangerous, it is for most surgeons. For me , the success rate is at least [-]%."

Little Schmidt looked back at his father, still hesitating: "Because several elders in the family died due to the operation, perhaps because of their influence, my father has always been unable to accept surgery."

"We deeply regret this." Ignatz said helplessly, "I believe that all surgeons choose to operate only as a last resort."

At this time, the priest who was still praying by the bed suddenly interrupted their conversation and shouted: "Don't waste any more time, the Lord told me that there is only a bad smell in my stomach, I will not agree to the operation! It's better now Just let me go home from the hospital, I want to go home!"

"We are just asking about the situation. For safety reasons, we will not let you go back until tonight."

Carvey feinted and shoved the vial and handkerchief into his son's arms.

Little Schmidt hesitated for a long time before accepting the job reluctantly: "I really don't understand why you can face bloody wounds and patients who died of surgery so calmly every day."

"That just happens to mean we're all qualified surgeons."

Ignatz replied without hesitation: "Remember, child, that one of the essential qualities of a surgeon is a mind accustomed to necessary cruelty."

There were not many patients in the ward. After the rounds, Carvey went directly to the maternity ward. He needed to see how Nora was recovering.

The obstetrics department is still the same, the bed is always full, and at first glance, it is full of pregnant women with big bellies, in a mess.Nora was lying on the bed, quietly looking at her sleeping son, without much expression on her face, and she didn't show a smile until she saw Kawei.

"doctor."

"Well, you don't need to get up."

In Carvey's hand is the medical record given by Marcus, which records in detail Nora's postoperative treatment methods and process【3】.This is what Carvey asked the obstetrics department after surgery, including uterine palpation, heart rate, bleeding volume, wound, urine output, body temperature and mental condition.

The content of the writing cannot be said to be bad, but the hospital does not have a portable thermometer, so it is very inconvenient. It is not clear whether Nora has an incision or puerperal infection. 【4】

When Kawei came up, he touched her forehead with the back of his hand: "It's still a little bit warm, but it's not a big problem, it's a normal situation after giving birth."【5】

Nora was used to the postoperative examination, so she pulled off her clothes consciously, revealing the bandages covering the wound.The wound was the same as that written in the postoperative records, except that Herman's suture level needs to be improved, there is no serious problem.

"Let the child drink more milk, which can stimulate the contraction of the uterus and prevent inflammation and swelling here."

Seeing that she was recovering well, Carvey didn't have much to talk about: "You should rest first, and see a nurse if you have any discomfort. The main concern is a lochia, a wound, and finally body temperature."

Nora couldn't understand these, and only remembered the last sentence, so she wanted to say something to Carvey: "Doctor."

"Huh? What's wrong?" Carvey asked.

Nora looked at Carvey's face, then at the child, hesitated for a long time and finally said nothing: "Forget it, it's nothing."

Carvey felt that she seemed to have some postpartum depression. After all, a poor family had an extra mouth, and her husband was a bad gambler. It was easy for her to understand her mood problems.But just when Carvey wanted to say something, a nurse came outside the door: "Doctor Carvey!"

"Huh? What's wrong?"

Before the nurse stepped forward to explain the situation, a man appeared behind her, wearing a brown coat, with an expression as if he owed him hundreds of crowns.Regardless of the nurse's objection, he went straight into the ward: "Dr. Carvey, we meet again."

"Yo, isn't this Mr. Varela?"

Varela's complexion was indeed very ugly, but he lowered his posture for work purposes: "I am here this time to represent the Vienna Daily"

Carvey greeted him with a smile, and before he finished speaking, he pulled his clothes and walked out of the ward: "This is the obstetrics department, and you are not a family member of the maternity. Why are you running in? Go out and talk about something!"

　A day's meeting was held, and there was an update (2/20), and there was another update in the middle of the night

　　
　
(End of this chapter)