Kawei has indeed passed the age where he needs to show off his abilities excessively to show his value. Years of experience in clinical work have allowed him to develop the habit of doing risk assessments in advance. Faced with the inguinal hernia in Morasso's right lower abdomen, after repeated evaluations, he chose to remain silent.
This is the result of the superposition of many factors. From the moment he stood on the operating table, this question was swirling in his head: Should he suture Ignatz's hernia?
The first thing that came to his mind was the purpose of the surgery.
Surgery is an act of destroying the patient's body tissue. Every cut must have a purpose, and the benefits of each cut should exceed the cost of destruction. The nature of the operation in front of me has changed since Ignatz's scalpel opened Morasso's groin.
There are essential differences between ordinary irreducible inguinal hernia and intestinal incarcerated necrosis.
The intestines of the former are in good condition, and only need to loosen adhesions to return the protruding intestines to the abdominal cavity. The focus is on tightening the hernia sutures, with the goal of restoring the patient to health. The latter's intestinal tube has become necrotic, and the necrotic intestinal segment must be cut, focusing on anastomosis of the broken ends of the small intestine, with the goal of keeping the patient alive.
Morasso's situation was the latter. Even if the intestinal anastomosis was eliminated, the surgical goal was basically achieved. The hernia itself was not life-threatening, and if it was sutured incorrectly, it would just recur.
The second thing he has to consider is the suturing technique required for the surgery.
The reason why Kawei was able to put forward his own opinions on intestinal anastomosis was because the intestinal anastomosis technology had matured twenty years ago and had been recorded in various surgical books. His assistant certainly couldn't perform the surgery, but it wasn't surprising that he had read a few books.
The reason why Ignatz made mistakes in suturing was because of his condition, proficiency and the cooperation of his assistants.
Compared with intestinal anastomosis, the hernia gap suturing technology in this era is completely blank. Regardless of the technique or the needle insertion position, it is very different from the repair method created by Dr. Bassini more than ten years later with a recurrence rate of less than 15% [1].
There is definitely no problem with Kawei's ability, but the time is not yet ripe.
It was really shocking that an assistant who had never even read a book and had only been on the operating table for the first time could so casually explain a set of suture techniques that could be applied to modern times. He must go through a process of practice and summary so as not to arouse suspicion.
The last and most troublesome point is disinfection.
Even if Kawei really took the risk and proposed the Bassini repair, and Ignaz really adopted his opinion, the patient would still have to face a lottery-like wound infection. Bacteria do not choose where to gather based on surgical suturing techniques. Infections will occur regardless of suturing technique.
Instead of fighting for a while now, it is better to let it go first and wait until the surgical disinfection is completely resolved before performing a second operation on Morasso.
Of course, all this has to wait for Morasso to fully recover. All Carvey has to do is to do his best and obey fate.
After considering these factors, he chose to shut up.
...
With the help of Kavi, Ignatz was in great condition and quickly completed the gap stitching, which took less than 15 minutes.
"...The suturing is over." Ignatz, like a solemn king, narrated the last step of the operation to the surrounding audience, "Then just put the skin on both sides of the gap, and it's over!"
At 15:45, the operation, which lasted nearly two hours, finally came to an end in Kawei's shock.
Ignatz naturally received cheers and applause from the audience, and became the focus of everyone's attention. Even those colleagues who criticized each other, looked down upon and envied each other, all left the table one after another and politely expressed the most basic congratulations that a gentleman should have.
"This surgery definitely has special significance!"
A loud shout from the audience shocked everyone present: "Not only did the suturing speed of the second intestinal anastomosis break the record, but the length of the operation itself also broke the record in the Austrian surgical community. "Vienna Daily" will publish it tomorrow The whole process, readers who are used to your amputation reports, will definitely be interested in this operation!"
The speaker was a reporter from the daily newspaper, and Ignatz had always been a frequent headliner of this newspaper.
The media is the most powerful weapon in spreading prestige, and Ignatz knows this: "Thank you, Mr. Varela."
"Tomorrow's daily newspaper will be a big seller again... I will take the first step. See you next time, hahaha..."
After watching such a thrilling operation, no reporter could stop the storm of words in his mind. Every finger of Varela wanted to vent them on the buttons of the typewriter as soon as possible.
"He's such a guy who doesn't get up early for anything. I thought he almost fell asleep in the first half."
"It makes sense for him to be excited."
"Tomorrow's newspapers will deliver this grand operation to every citizen of Vienna, and then word of mouth will spread throughout the country and even Europe, and even the other side of the Atlantic will know about it."
Several colleagues focused their attention on Ignatz again. Their faces looked calm, but their hearts were equally excited. Because this operation indicates that as long as the suturing speed can catch up with Ignatz, today's anesthesia technology will be able to support surgeons in completing complex abdominal operations.
Regardless of postoperative infection, at least the surgery can be completed successfully.
"Thank you for coming." Ignatz leaned forward again and thanked his colleagues and spectators around him. "Next time I will show a set of long metal tubes [2] that I designed to treat refractory urethras. It’s narrow, it should be able to help solve it…”
"New equipment? Where is it?"
"The design drawings were just completed a few days ago, and I'm already looking for a company to produce them."
"So it's not finished yet." These people didn't have much enthusiasm for the unknown equipment and quickly changed their focus, "By the way, what's the name of your assistant?"
"Oh, my name is Kavi, Kavi Hines, my new apprentice." Ignatz answered casually.
"A graduate of medical school? Why have I never seen him before?"
Ignatz glanced at Elena, who was still caring about her son on the sidelines, and just smiled without answering directly. However, this brief escape soon pushed the problem into a direction beyond his expectation.
"How much do you pay him every month?"
Suddenly a strange question popped up, leaving Ignatz confused: "Why do you ask this?"
"Just asking, apprentices in our hospital receive a weekly salary, 3 crowns per week in the first year, and then increase year by year. What about you?"
Ignatz was stunned for a moment, then looked back at Kawei who was packing surgical instruments in the preparation area, and suddenly found that two guys had already secretly left him and found him. The two people asked about trivial matters in daily life, such as whether there was a place to live, how the food was, and then about wages.
Asked about wages again...
What on earth are they going to do! ?
Suddenly Ignatz realized the true purpose of these people: "Don't go too far, he is my assistant!"
These people were peers and Ignatz’s competitors. They responded unceremoniously: “You are so stingy, you exploit young people like this. At 7 crowns a month, this income is comparable to that of maids who provide food and accommodation. Even lower [3]!”
"It doesn't matter, Mr. Kawei, your hard days are over." A surgeon wearing a gorgeous long cloak took Kawei's arm and said with a smile, "Since you have not officially signed a labor contract with the Municipal General Hospital, Contract, Groz Hospital is willing to pay double the salary to invite you to work in the surgical ward."
How could Ignatz bear to poach someone in front of him: "Hey, I haven't left yet, don't you take me seriously?"
"No, double is not enough. St. Mary's Hospital is willing to pay three times the salary to invite you to work in the surgical ward."
"Harrods Hospital is willing to..."
"That's enough for you!!!" Ignatz suppressed his anger, "Please allow me to reiterate, he is my assistant, the surgical talent I discovered! And he is under 21 years old and not an adult. There is nothing we can do about it. Sign a labor contract.”
"No, no, you forgot something."
"Something? What's the matter?"
"According to the newly promulgated "Underage Labor Protection Law", as long as he is over 15 years old, even if his parents are not around, Mr. Kawei has the ability to sign a labor contract. Since he has not signed it now, we have the freedom to invite him. At the same time, He also has the right to participate in the selection."
"Indeed, everyone should compete reasonably."
Ignatz lost his voice. At this moment, he thought back to Kavi's assistant's work just now. It was indeed done very beautifully, and he didn't feel like a novice at all. He had no reason to give up this good idea, not to mention that he had spent hundreds of kronor on getting Kavila to his side, and that was all money.
But the situation is not optimistic.
The lack of a contract was a flaw, and it required the dean's review beforehand, so there was only a verbal agreement with Kawei. Oral agreements have no legal effect. Faced with the temptation of money, he would also be swayed. The salary of 7 crowns is indeed too unreasonable.
Just when Ignatz regretted it, Kawei did not hesitate, as if he didn't care about the income: "I just want to find the best surgeon in Austria. Is the best surgeon in Austria Mr. Ignatz? "
This is a very pointed question.
In modern times, the quality of a doctor depends on his scientific research strength and some prestigious titles, but at the beginning, surgical technology and speed were the best criteria.
Whether it is the number of surgical records set or the survival rate of patients after surgery, Ignaz has surpassed them all. Coupled with the two new records in the abdominal field today, it all proves that he is the best surgeon in Austria.
Seeing everyone's silence, Kawei smiled and said: "I just want to be with the best surgeon. The 7 crowns just mentioned is actually just the starting salary. It will be adjusted later based on performance."
"So that's it."
"What you just did is worth 20 crowns."
"Oh, there's no chance, let's all disperse..."
As soon as these doctors left, before Ignatz could open his mouth to explain, Elena came over: "Doctor Ignatz, you succeeded again. Congratulations, and I also wish my poor brother the best." It can survive the ulceration period of the postoperative wound.”
"I come to check every day. The count is strong enough, so there should be no problem."
"I hope so."
Elena was very angry at Berget's resignation. While she was angry with him, she was also angry at Ignatz's verbal stimulation. But no matter what, this operation that no one in Austria was willing to touch was successfully completed. She must thank him on behalf of her brother: "I also hope that Dr. Ignatz can give more guidance to my son in the future."
"That's natural."
Elena sighed, and then looked at Kawei who was standing next to her: "How old are you?"
"Me?" Kavi replied, "17."
"You are really young, younger than my son." Elena said nothing more, her eyes returned to her son, "Beget, remember to go home early."
"Well, I'm afraid I won't be able to go home on time tonight." Berget accompanied Morasso's bedside and said awkwardly, "Hans invited us to a banquet to appreciate his latest masterpiece and maybe have some fun. later."
"Hans? Hans Schriati?" Elena asked.
"Yes, he is now the most famous painter in Austria."
"All right......"
...
As the crowd slowly dispersed, cleaners came in one after another and began to wash away the blood stains on the floor.
The sound of the brush scraping against the wooden floor made Ignatz calm down completely, and he recalled his painting album. It was an introductory book on anatomy, with a lot of surgical content but very simple, and it did not record the key points of Lembert suture at all.
It may be that my memory overlapped and I confused the contents of other books with my own.
"Kavi, why don't I remember writing this passage in my painting album?"
"Huh?" Kawei was stunned and asked, "What are you talking about?"
"The seromuscular layer needs to be aligned during intestinal anastomosis."
"Haven't you written it before?" Kawei started to pretend to be stupid, as if he didn't care about the matter. "Maybe it's connected with previous memories. I do remember that this content was written in a surgery book."
"Have you read surgical books before?"
"Oh, my dad was working as a surgical assistant in Lombardy at the time, and there has always been this kind of book at home... Well, now it belongs to Italy [4]." Carvey was a little embarrassed, shook his head and said, "Damn Italy people."
Kawei never mentioned his life experience, and Ignatz did not want to delve into it.
Kawei's strength far exceeded his expectations, and he was half of the credit for the successful completion of the operation. Thinking of Kawei's words just now and the extremely shabby 7 kronor, Ignatz was really embarrassed: "You should be praised for your performance on the first day today."
"Thank you, I will continue to work hard."
"No, I'm not talking about superficial praise, but real material rewards." Ignatz asked, "What do you want?"
