Cleft lip repair is a complex surgical procedure.
In addition to the lower triangular flap method demonstrated by Carvey, there are also rectangular flaps suitable for bilateral cleft lip, upper triangular flap suitable for complete cleft lip, and the more difficult rotational advancement method [1]. Coupled with the many conditions requiring secondary surgery, cartilage reduction, nasal deformity repair, and various plastic surgeries, there is a lot to offer.
Kawei learned a lot when he visited the plastic surgery department in the operating room to chat. What he was given this time was just an entry-level surgery. It definitely has many advantages over straight sutures, but it also inevitably has a lot of disadvantages. 【2】
It is somewhat difficult to reproduce the surgery on a cadaver. The stiff body surface will make the lips lose the beauty they should have after being sutured. But relying on Ignatz’s many years of surgical experience, he soon realized that this was a brand new method different from linear suturing, and it was an innovative method that could make headlines at any time.
Suddenly three options appeared in Ignatz's mind:
Deny the technology and secretly appropriate it for yourself;
Acknowledge this technology, but still choose to give up, the beauty of adulthood;
Recognize this technology and choose to join it forcefully, and everyone who sees it will have a share.
He first ruled out keeping it as his own, not because he didn't want honor and praise, but because his status was not enough to steal an assistant's ideas. But I had seen all the surgical methods, and even told myself the basics of creativity, and it felt really uncomfortable to return his hands to Kawei.
Ignatz needs a chance to prove himself so much
Remove the two extreme terms, and the only option left is a tie.
There are so many cases in history that it is not unusual for teachers and students to publish the same research together. But it was really awkward to make such a request. Ignatz hesitated for a while before he found some "appropriate" reasons for himself.
"If we use the triangular flap you mentioned, I'm afraid that a simple needle-punch figure-of-eight anastomosis will look very clumsy, and the wound will not fit well. I think we still have to use silk sutures."
He first affirmed Kawei's contribution, and then slowly tested the share he could get in this innovation: "As for the angle of the triangular flap, the cutting size, the silk suture method, and the selection of suture needles and silk threads, I think All require further experimentation and practice, as well as follow-up after surgery.”
To put it simply, the creativity is yours, Kawei, and the right to further improvements belongs to me. As for when the research results are actually released in the future, the teacher's name will naturally be ranked first.
Kawei knew what he meant. Anyway, this entry-level technology was just a bait.
Now that the tide of public opinion about Ignatz has changed, those reporters and editors have found that belittling a once-all-powerful man seems to be more likely to gain sales. This is an opportunity for Carvey.
If Ignatz can politely refuse like a saint, then Kawi can use the triangular flap technology to continue to gain popularity.
If Ignatz is determined to seize the technology and use it as his own innovation to release, then Kawei will no longer have to worry about it. Whether it is storing good evidence to refute or publishing updated technology, it is not difficult for him, and he can also gain a wave of media support.
But now the other party has chosen a compromise plan, preparing to share half of the credit with its own fame, technology and experience. It seems that it is preparing to throw the problem back to Kawei.
Who knew that this was what Kawei was waiting for, so he followed suit and said, "Teacher, what do you think of this triangular flap technique?"
"If you take into account the scar contracture after surgery, this solution is really great. It will be more suitable for cleft lip than straight-line sutures." Ignatz has a very keen intuition about surgical operations. "If you take this into consideration, straight-line sutures may only be suitable for cleft lip surgery." A very short type of cleft lip, like that of Mrs. Gale and her child..."
"Teacher, that's not what I meant." Kawei asked with a smile, "I was asking, as an innovation in surgical techniques, how about the triangular flap technique?"
Ignatz had to admit that this was a brand new attempt. The concepts of "curved surface" and "triangular flap" opened a new door to cleft lip repair for Ignatz.
In the eyes of ordinary people, this may be an innovation, but for surgeons who have been involved in this type of surgery all year round, this innovation may bring unlimited imagination and creativity.
He turned around and walked to the equipment table. He struggled with his thoughts for a long time. He really couldn't turn white into black. He could only say bluntly: "This is a very good innovation, but it still takes time to prove it slowly."
"Teacher is being suppressed now and needs to prove himself urgently." Kawei put down the scalpel and looked at Ignatz, "This new technique is given to you. You can use it to research, improve and even publish it in medical journals. If The effect is good, and maybe Britain, France and Germany will also imitate it.”
Ignatz turned his back to Kawei, his face showed no change, but he was very excited inside: "This..."
Kawei doesn't care what his mood is now. He just wants to get what he wants: "Of course, I also hope that the teacher can bring my name when publishing. After all, this is a new technique created by the two of us."
"..."
Ignatz held the scalpel and thought over and over again, but he couldn't think of a reason to refuse. He looked back at Kawei, with no trace of bad intentions in his extremely sincere eyes, as if to say, "Teacher, please don't worry, I'm here to help you."
"......Can."
Taking the bait, Kawei began to slowly tighten the fishing line: "Then, I will be your right-hand assistant in creating a new technique. This title sounds pretty good."
"Well, that's good." Ignatz agreed.
"But it's just good, not really good."
Ignatz heard some dissonance and realized that Kawei's things were not free. But at this time, he had already chosen this path, and there was nothing to hesitate about: "As a capable assistant in creating a new technique, you should be rewarded."
"Teacher, I need your recommendation."
What Kawei wants is not a practicing certificate. This thing does not exist after he has inquired about it these days. Instead, it is a medical association membership badge [3]. In fact, this kind of badge has no substantive effect. It is more of a status symbol.
Those who want to join must be nominated and recommended by at least three members. Their academic qualifications and outstanding contributions to medicine will be listed one by one at the annual election meeting, and then the membership list will be announced after the election.
Internal medicine requires a diploma, and the minimum is a bachelor's degree, but that's just the beginning.
If you want to join, you need to know the members of the Medical Association, and then you have to work in a large hospital first. However, the threshold for large hospitals is much higher, and one must have a master's or doctoral degree, which directly excludes ordinary civilians and even some middle class people.
Although surgeons are recognized as doctors and can nominally join the Medical Association, in fact very few surgeons can successfully pass the election and join the association.
To this end, the Department of Surgery established its own surgical institute.
The admission standard for the graduate school is also an undergraduate degree, and Ignatz is the associate dean of the research institute. The old dean is 56 years old this year. As soon as he retires, Ignatz can easily take over.
All Kavi wants is the key to the academy, a college diploma.
If you want to get a diploma, you must first enroll. Admission does not depend on a selection test, but on personal application and professor's recommendation. In the recommendation column alone, it is impossible to succeed without deep family background and connections.
"You want to go to medical school?"
"Yes." Kawei nodded.
Ignatz wanted to object, because this was contrary to his original teaching philosophy of bringing Kavila into the hospital. At the same time, he also did not understand this behavior: "Surgery does not actually need this kind of thing. As long as you do it well, both sides will be fine." In a year... no! Maybe in just a year you can become a surgeon."
"I know."
"Then why do you have to go to medical school?" Ignatz refused.
"I know that in surgery, diplomas and things like that don't affect the job, but I still wanted to fight for it."
Kawei gave a superficial reason, but secretly his purpose was to get close to the professors who were doing research in the medical school. They have complete research equipment there, 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: "This is not easy. My recommendation alone is not enough. You must have a high school diploma first. I remember you said before that you dropped out of school halfway because you were helping in the barber shop."
"I really don't have a diploma now..." Kawei 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 summer vacation will end in October."
"Can't it be brought forward? There should be a chance in March."
Of course, Ignatz did not want to go ahead of schedule, because the longer Kawei stays in the hospital, the more excellent his teaching quality will be shown: "Although I have some connections and can recommend him, it would be too much to jump in the queue halfway, and I'm afraid it won't be possible."
"I still hope that Teacher Ignatz will try his best to help me think of a solution. After all, I am also a helper in creating new techniques." Kawei covered the body with a white cloth again, "Oh, by the way, how much does it cost to enroll?"
"The tuition fee for a year is about 500 kronor." [4]
Speaking of money, Ignatz suddenly thought of his wife: "I forgot, what did the dean ask you to do before?"
"Oh, it was Mr. Laszlo who wanted to see the family doctor, and then he found my head." Kawi walked to the sink, picked up the alkali soap on the side and started to wash his hands. "He really took 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 it was put there. He just continued: "Their family is so rich, you really don't want to go?"
"No fun, I won't go."
Kawei's way of washing his hands was particularly weird. He was smeared with soap from the gaps between his nails to his elbows. The process was extremely cumbersome. Not only did he wash it by himself, he also didn't forget to give it to Ignatz: "Teacher, don't you wash it? Some flower essential oil is added to it, it's very fragrant."
Ignatz's hands were indeed not clean just after touching the body. Even after wiping with a wet rag, there was an unpleasant greasy feeling and odor.
Thinking that he had just taken away Kawei's innovative technique and wanted to ask about his salary, he tried to clean his hands for the first time: "It's just a corpse. I didn't expect you to dislike it so much."
"It's my father's habit. I learned and got used to it."
Kawei handed over the floral-scented lye soap: "Try it, teacher. It feels very comfortable after washing."
It was impossible for Ignatz to learn Kavi's surgical hand-washing technique, so he just rubbed it casually on his hands. His main concern is Kawei's income: "How much money does Alina give you now?"
"30 crowns a month."
"How can I pay for tuition with this little money?"
"And 1% of theater revenue."
"Hiles also takes 6%, but the theater is actually willing to give you 1%?"
"It should be the effect of the evening newspaper."
Ignatz said: "Actually, the ticket price of surgery is very unstable. The price is completely different with and without me. The boss probably knows that I will always take you to the stage. Today's ticket price is higher than usual. 20%.”
Kawei smiled and nodded: "Indeed, there is still an advertisement posted on the door."
"After this operation, you should be able to earn forty or fifty crowns."
It was only after Kawei received the news of his salary increase that he chose to ask Ignatz for a recommendation. According to this income, as long as you are lucky, you can earn enough tuition for a year by working for one month.
The next thing to wait for is Ignatz’s letter of recommendation.
"Teacher, why don't we have dinner together?" Kawei invited with a smile, "After all, I got a raise, I'll treat you to this meal, and by the way, we can talk about Mr. Alphonse's hemorrhoids."
...
The two made the deal silently in the autopsy room of the Municipal General Hospital without a third person present.
According to Ignatz's character, once he agreed, he would not go back on it. As a leading figure in Austrian surgery and a professor of anatomy and surgery at Vienna University School of Medicine, he has a very loud voice within the school.
Of course, if he really regrets it, Kawei is not afraid, it will just be more troublesome.
At three o'clock in the afternoon, Alphonse was wheeled into the operating room.
In accordance with the requirements for hemorrhoid surgery, he quickly took off his pants, covered himself with a white sheet, and lay on his side on the bed. The buttocks are the surgical area and become the second exposed part besides the face. 【5】
As usual, Ignatz introduced the patient's condition before the operation:
"Ladies and gentlemen, after a thrilling duel, Mr. Alphonse, the chef of the Roche Shuart restaurant, received a sword wound on his buttocks.
Fortunately the sword wound did not touch the anal canal, and my assistant Kavi did a perfect cotton padding. Such a sword wound did not require surgery, but unfortunately, Mr. Alphonse's hemorrhoids were very severe and had symptoms such as heavy bleeding, blood clots, and prolapse.
Considering his profession and his dignity as a French chef, the surgery was necessary.
My assistant Kavi and I have fully researched and learned about the most cutting-edge hemorrhoidectomy surgery, so we are confident that we can ultimately achieve the goal of successful surgery and give Mr. Chef Alphonse the most perfect gang door. "
After the introduction, Kawei already had a hemorrhoid clip [6] in his hand: "Teacher, clip~"
