Women in patriarchal societies have always been representatives of weakness and uselessness. They are beautiful, but also very fragile, just a vase that can give birth to children. A girl with such a petite body can actually defeat two men, which itself is more story-telling than a cesarean section.
Carvey was surprised to find that these surgeons had been skeptical or negative when faced with reasonable disinfection models. But after hearing about the successful deeds of a woman who defeated two men, they all agreed that all these were real facts.
In the end, they just believe what they want to believe.
As a witness, Kawei briefly described the process of Nora's "murder". The exaggerated range of movements and rhythmic stabbing process gave this cesarean section a legendary color.
"Is she really only less than 1.6 meters tall?"
"Well, I'm a little over 1.5 meters tall."
"It's so strange. Unless a girl of such a height has muscles all over her body, she is seriously lacking in strength. Moreover, she is wearing a skirt, which makes her movement very inconvenient. Even if it is a sneak attack from behind, without receiving strict military training, there is no way to do it at the same time. Deal with two men."
"Is she a veteran?"
"She's a girl! A girl!!!"
"You are too ignorant. It's not like there is no precedent for women dressing up as men and sneaking into military camps."
"Would the Austrian army want a soldier under 1.6 meters tall?"
After their analysis, Kawei suddenly realized that he seemed to have unknowingly helped Nora create a space for revenge: "I think the anger of being oppressed is her best source of strength, and the rest is classified as the blade being sharp enough. Bar."
"In a small space, if the gap between weapons is too large, it is not impossible."
"Wait a minute, are you ignoring an important issue?"
"what is the problem?"
"No matter how sharp the knife is, it has to be cut before it is right. She has just had a cesarean section and is very weak. She is so short. Why should she cut someone? Especially that part..." The man tried to follow Kawei's instructions. What he said imitated the process of Fuleny turning into a sieve. "With such a large movement of the upper and lower waist and abdomen, the longitudinal incision on the abdomen can easily collapse."
It is said that interest is the best teacher of learning, and soon their interest in Nora slowly shifted to surgery.
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Because this result is the product of various coincidences, Kawei still needs to explain: "The incision is actually not bad. The person who sutured the incision himself was Dr. Herman of our hospital. The operation was stable and delicate, and the alignment was no problem. After the operation, there was no problem." I cleaned the incision and put a lot of bandages around my abdomen to prevent it from opening."
"Dr. Hermann? I remember that his suturing skills are only average. He probably hasn't reached this level yet."
Herman's seams were certainly not great, but they underestimated the role of facilitators. As long as he helps to close the incision, determine the needle insertion position, and stabilize the suture knot, even an intern who has just learned how to tie knots can be lifted directly to the standard level of surgical suturing.
What's more, Herman has performed many surgeries, so he already has a good foundation, but he is far from being in a bad situation.
Kawei naturally omits these processes and instead emphasizes the high concentration of alcohol used:
"One thing that deserves our attention is that incision dehiscence is not only a suture problem, but also a healing problem. Under the interference of miasma, the incision will soften and ulcerate, so I will use high-concentration spirits before the operation. After two The sub-distilled brandy isolates the miasma."
This is an attempt by Kawei, hoping to use Nora's bravery to help him open up the situation.
The effect was pretty good, and some doctors finally became interested: "Can alcohol block miasma?"
"right."
Kawei smiled and told the reason he had made up before: "Miasma and ulcers have unpleasant odors. Alcohol has a fragrance and can resist the invasion of miasma. If everyone can put aside their prejudices and take a look at Liszt The carbolic acid my husband used actually had the same original intention as the alcohol I used, because carbolic acid also has an aromatic smell."
"..."
There was silence in the audience.
They are all old diehards who grew up in the Austrian conservative quagmire and are unwilling to easily believe in all new theories and discoveries that go against "common sense."
But their profession is to be surgeons who must be at the forefront of technology. Compared with internal medicine where the effect is unclear and obstetrics where the data is not clear enough, surgery where the surgical effect is immediate is more likely to expose problems and needs to be solved more.
These surgeons say that ulceration of incisions is a matter of probability and related to piety, but they still hope to change the status quo. Who wants the surgery they worked so hard to perform and the incisions they worked so hard to sew to turn into a large piece of rotten flesh in the end?
Kawei gave them an opportunity to re-understand surgery.
Of course, this also includes Nightingale’s bold attempt, Dr. Lister’s innovation, and Waterman’s persistence. Coupled with the less than 20% incision infection rate and 0% mortality rate in Kawei's hands, it is enough to illustrate the problem.
But Kawei knew that even in the face of so much evidence, they still couldn't get over the hurdle in their hearts.
So he didn't force it, put aside the anti-infection, and first introduced his new oxytocin drug: "Forget it, let's talk about surgery first. At that time, the patient's uterine bleeding was severe, and we could only rely on crow's-beak forceps and hands to stop the bleeding. .”
This is a problem that occurs with all cesarean sections.
In the 19th century, cesarean section was difficult to remove, and the uterus was a long vertical incision similar to the abdomen, making it difficult to stop bleeding. The vast majority of cesarean sections that died on the operating table were related to heavy bleeding, and most of the women who died after surgery also suffered from heavy bleeding.
"Several seniors present must have gone to the surgery site at that time. I used a new obstetric medicine from the East." Kawei dug into his pocket and took out a tube, "This colorless and transparent liquid can be used in the original On the basis of uterine contractions, further violent contractions allow the uterus to stop bleeding on its own within a short period of time.”
"how to use?"
"Use a syringe to penetrate into the uterine muscle layer."
"Is it really that magical?"
“It’s really amazing and the effect is remarkable”
A person's boasting always seems weak. The surgeons who had been to the scene had to admit the effect of oxytocin after seeing Kawei's eyes: "It is indeed a very useful drug. I forgot how many injections were given." , but the swollen uterus quickly doubled in size, and the bleeding quickly stopped."
"I can also testify that the hemostasis effect is almost like magic. Although as a good surgeon, I shouldn't describe it like this, but I really can't find a suitable metaphor to describe this matter."
"The hemostatic effect is indeed good, but the side effects still need to be verified in the long term."
Kawei heard a different sound and immediately followed up and said: "I have given medicine to voles, and there is probably only one side effect, which is increased blood pressure."
"Blood pressure? How did you measure your blood pressure?" [1]
"You have to know that even with the most advanced blood pressure monitor, there is no way to accurately record the reading. Blood pressure is a very vague concept. Please be sure to be more detailed."
There was indeed no convenient blood pressure monitor at the Municipal General Hospital. In order to test the limits of oxytocin, Kawei sacrificed many voles. Now he needed an old concept to explain the new concept of increased blood pressure. The first thing Kawei thought of was the four-liquid theory: "In other words, it probably means increasing blood."
Hearing these words, the doubtful eyes in the audience instantly understood everything.
"The old blood pressure measuring machine in the general hospital is too big and ineffective for hamsters, but I chose an older method, such as the carotid artery puncture blood column method in the 1930s."[2]
Kawei sighed: "Later I learned that there is no need to record any detailed readings at all, because as long as a large dose of oxytocin is injected, it will cause a sharp increase in blood pressure. If the dosage continues to be increased, the vole will die within a short time. causing severe internal bleeding."
The four-liquid theory, which has been passed down for thousands of years, can indeed justify itself under certain circumstances, and now it has finally become an important tool for Kawei to promote his medicines.
Compared with "helping shrink the uterus" and "stopping bleeding in a short time", the increase in blood is not a particularly harmful side effect. For women who have lost a lot of blood after cesarean section, adding extra blood and raising blood pressure is not a disadvantage.
"Dr. Carvey, have you ever tried to put the drug into production?"
"It will take some time to officially put it into production," Kawei said. "But considering that there are still several women who need cesarean section sleeping in the ward, I made another batch of medicine for subsequent use."
"Have you ever considered the price of the medicine after it was put into production?"
"Due to problems with the production process and raw materials, the cost of drugs is quite high, so the pricing will naturally not be too cheap."
The current rudimentary level of the chemical industry makes Kawei very helpless. The production of natural leaching takes a long time and is cumbersome to operate, which is much more difficult than the synthetic method in the future. But there is only one way to do it: leaching, and the only way to reduce the cost is to use pig brains later.
"On the premise of protecting the patent, I will try to reduce the cost as much as possible, so that at least all mothers who need cesarean section can use oxytocin."
After talking about oxytocin, Kawei started to walk them through the details of the operation from beginning to end, including abdominal incision, uterine incision, fetal removal method, how to remove the placenta after fetal removal, how to further stop bleeding, how to suture the uterus, and final abdominal cavity exploration, etc. wait......
Although Waterman added the adjective label "nearly perfect" to this cesarean section, in Carvey's eyes, it was not perfect because the power to perform the first half of the operation had always been in the hands of Hills. Moreover, obstetrics itself is not Kawei’s strong point, and there is definitely room for optimization in the process.
The next step was placenta previa, which caused even more dangerous bleeding. Kawei still had a long way to go before having a cesarean section.
"At the end of this cesarean section report, I still want to talk about another patient in advance."
Cavett carefully prepared the negative teaching material of Li Ben: "He was a survivor of that murder. If you have the program list, you should be able to see that he was the patient with compound trauma at the end of the regular meeting.
I didn't mean to disrupt the flow of the meeting, I just wanted to use him as a negative example when it came to preoperative preparation and postoperative care.
Among the surgical patients I took over, he was the only one who did not receive preoperative preparation and postoperative care. The other one is Count Morazo. Everyone has listened to Teacher Ignatz’s previous report, and it is clear to what extent his large wounds have festered.
However, Li Ben's wound was more serious! "
Li Ben's bed had poor ventilation conditions and he did not receive strict nursing care. All four stab wounds were infected.
Especially the long oblique wound on the leg had become swollen and ulcerated, with yellow-green pus leaking out every day. According to Ignatz's method, in this case, the leg must be amputated immediately, otherwise it will kill him in a few days.
But Kawei still wanted to wait a little longer and do a thorough debridement to see if it was possible to save her.
Of course, when facing Li Ben, he would definitely not have this attitude towards experimental rats. Xiao Zhi moved with reason and emotion, and in just a few words, Li Ben was filled with hope for conservative treatment.
After all, no one wants to live with prosthetic limbs and crutches for the rest of their lives.
"Mr. Li Ben was stabbed four times. Because there were no qualified instruments at the scene, I could only help him with hemostasis and sutures immediately."
Kawei avoided all the details of the operation and went straight to the theme of anti-infection: "It has only been a few days now. All the incisions have ulcerated, half of the sutures on the legs have collapsed, the wounds are open, and there is a stench every day. Considering Mr. Li Ben's strong Based on my conservative treatment attitude, I decided to use Mr. Lister’s carbolic acid to give the most thorough debridement..."
Just when he was about to continue speaking, Hills' voice suddenly sounded from the audience: "Kavi, don't waste any more time."
Kawei was stunned, glanced at the others who had been silent until now, and asked, "What's wrong?"
"First of all, let me make it clear that I am not jealous that you snatched that cesarean section. I know that I am not strong enough. If I persist, it will definitely lead to disaster, and Nola's mother and child will not be as safe as now."
Hills said: "It is not easy in Austria to prove whether your and Mr. List's methods work. Your approach will not work."
"Why doesn't it work?" Kawei wondered, "Just because I haven't been to medical school? I don't have a diploma and a corresponding degree?"
"This is one." Hills said helplessly. "The other is that you are at best a qualified young surgeon with no experience, no qualifications, and no social status. Except for one or two successful operations that were inexplicably performed. , nothing. Even if you had the same thing, I wouldn’t talk to you like this."
"I am telling the truth!"
"Why do you make us believe it is true? Just rely on a dozen safe and sound patients?"
"Isn't this enough?"
"There are so many surgeons here who haven't succeeded? It's just the result of God's temporary gift!" Hills continued to advise, "Wait until you are the surgeon in the surgical theater for a whole year, taking care of the postoperative recovery of hundreds of surgical patients. Come back here with the data and brag about that care process. Maybe then, some people will believe you."
Carvey sighed, gaining a more direct understanding of contemporary class concepts.
No wonder Waterman, who is in a high position, does not dare to mess around. With the conservative style and internal power struggle of this group of people, if they are a little tougher, they will inevitably divide the college into two factions: disinfection and non-disinfection.
It would be much easier for Kavi to bring it up, and no one would take him seriously. Even if there is a split between the two factions, it will not be too late for Waterman to show up to mediate.
Thinking of this, Kawei did not get angry with Hills. On the contrary, Hills' words saved him a lot of unnecessary saliva: "I would like to ask everyone here, if I were replaced by Professor Ignatz, what was the content just now? Isn’t the reliability much higher?”
"Of course."
"At least there is a need to try."
"It won't work even if it's Vice Dean Edinson. Who makes Ignatz a baron?"
"Baron... In the end, you still have to show your origin." This is what Kawei wants. "If I am also a baron, will it be okay?"
"Stop joking, how could you be a baron?"
"Isn't your father a barber? How could he have a title?"
I saw Kawei take out a certificate that had been prepared for two days from his pocket. It looked wrinkled, but the royal seal was stamped on it: "I am the eldest son of Baron Anderson Edmund, and this is my hereditary certificate. "
