The main purpose of Kawei's amputation was to allow Li Ben to live well. It didn't matter whether it hurt or not, at least he was still alive.
It also makes me sick of the theater.
With the hardware configuration of the surgical theater, there was only a wooden table and a rest and preparation room, which was not worth the part of the ticket money he took away. Modern hospitals can provide sterile operating rooms and all kinds of cleaned surgical instruments. There is nothing here, which is equivalent to empty gloves.
But all Kawei can do is disgust people. What really needs to go against the theater is the hospital.
As long as the expansion of the surgical department is completed and a venue is available, the hospital will be able to get back the right to perform its own surgeries. By then, Kawei will definitely be a signature and have the power to negotiate prices with the hospital. There is room for discussion in the future on how to renovate, how to add equipment, and how to select patients and audiences.
Of course, this kind of thing can only happen slowly...
He was now more interested in Hills' patients than reforming the operating room.
The original chronic abdominal pain seemed very strange.
Chronic abdominal pain is often not severe and will pass after a while, but the patient still agrees to the operation, indicating that the symptoms have reached an intolerable level. Now that he had a severe cough before going on stage, Kawei had a bad premonition.
"The patient is in the preparation room?" Kawei asked, "Can you take me to see him?"
Hills has been Ignatz's assistant for so many years, and finally he is in charge of his own affairs, and he certainly doesn't want outsiders to interfere. So when Kawei wanted to intervene, he decisively refused: "No, Dr. Kawei, that's my patient."
"I know, I was just looking."
"There's nothing to see." Hills' words on the stage were fair, but once he met Kawi, his words were full of hostility, "You'll see after the operation starts."
"Oh well."
Taking into account Hills' ability, Kawei wanted to help make a diagnosis first, and did not want the patient to be stabbed for no reason. Since the other party refused, he would not force it. He quickly put away the cleaned tools and left the surgical theater with Berget and the others.
He needed to go back to the hospital first to explain the key points of care to the nurse to prevent Li Ben from getting infected with his postoperative incision, and then go back to the theater to watch the operation with Ignatz.
Regarding Li Ben's physical condition, Alphonse was most concerned about him: "Is it intercepted?"
"Yes, it must be intercepted, otherwise you won't survive." Kawei saw that he was worried and said, "Don't you have a grudge against him? Why are you so worried?"
Alphonse said: "I'm just worried that he won't survive. After all, amputation can kill people. If the person is gone, who should I fight with?"
"We're still dueling, but my legs are gone." Kawei said with a smile, "You'd better stop thinking about dueling as soon as possible."
"Huh? It's enough to have hands in a duel. It has nothing to do with legs." Alphonse didn't take it seriously at all. "The weapons for dueling are not only swords, but also knives and guns. When his wounds heal, Put him in a wheelchair, and we'll fight it out one by one!"
Kawei was stunned for a moment, and then he realized that he had a large-caliber percussion gun on his waist when he first arrived.
It's hard to persuade him with words, but now he didn't want to waste his words. He patted Alphonse on the shoulder directly and said: "By then I will no longer be your assistant. You'd better hire someone else."
"No, if you want to duel with a gun, you need two assistants."
"If you slip away, I'll still have to pay for it. I won't do this kind of thing." Kawei removed himself completely, but he still maintained the responsibility that a close friend should have. "When the time comes, I will be a field doctor. Watching the show nearby, no matter who is injured, they can be taken to the hospital in a carriage."
"This is a good idea." Alphonse looked at Li Ben, who had just been woken up by the nurse and grinned in pain, "Can he really survive?"
"Don't worry, it's okay."
...
At ten o'clock in the morning, the audience began to enter the theater one after another.
For non-medical professionals, the name and purpose of the surgery are secondary, and fun and exciting are the most important. Hills' abdominal exploratory machine gave them the feeling of opening a blind box, so even though they were queued in the morning, there were still many people who cheered.
There were more surgeons, apprentices and medical students at the scene. In addition to wanting to see Hills' debut after going to Glaze Hospital, they were mainly greedy for the morning ticket price.
Half an hour later, the host of the theater came on stage and began to briefly introduce today's surgeon: "Ladies and gentlemen, the next person to come on stage is the representative of the younger generation of Austrian surgeons, Professor Ignatz the Fast Surgeon. Protégé, now the pillar of the Department of Surgery at Graz Hospital: Dr. Hills Guderian.”
Hills pushed open the door and stepped forward quickly with a smile on his face:
"Thank you host. Today I want to bring you a strange patient with abdominal pain. He has had abdominal pain on and off for more than three months. He has constipation from time to time and has a particularly poor appetite. After receiving treatment from a physician in our hospital, his symptoms improved. There was no relief at all. I considered the possibility of intra-abdominal tumors and prepared to do an abdominal exploration.
Now for today's patient: Mr. Edward Sterling. "
As soon as he finished speaking, two assistants pushed the wheelchair and sent the patient into the theater.
"Mr. Edward is 32 years old. He is a conscientious and good tailor. The clothes I am wearing are from his craftsmanship." Hills said, "Unfortunately, he is suffering from abdominal pain for a long time and is in pain. In addition, he has recently suffered from abdominal pain. Coughing and phlegm, I don’t even touch my pipe.”
After that, he lifted the blanket from the patient, revealing Edward's thin body.
The 1.8-meter-tall man had long curly brown hair, but his torso and limbs were extremely thin. He actually needed the help of an assistant to get onto the operating table, which made the audience sigh. But if you record this sound and listen carefully again and again, you may be able to hear a suspicious sound with an opposite tone in it.
Others couldn't hear clearly, but Ignaz, who was sitting next to him, could understand clearly. He looked at Kavi at his hand and asked, "What's wrong with you?"
"Teacher, I think there is something wrong with this patient."
Ignatz was puzzled: "Of course there is a problem, otherwise I wouldn't have been sent here for laparotomy."
"No, the problem I'm talking about is not that problem, but this..." Kawei was thinking about a bunch of differential diagnoses for abdominal pain. When he realized that his words were a bit riddle, he quickly changed his words, " The patient is about the same height as me, but he is very thin. The teacher can look at his belly. Isn’t it a little strange?”
"Belly?" Ignatz narrowed his eyes slightly and understood what he meant, "It seems a little strange."
Edward's arms and legs were very thin, but his belly was a little bulging.
I couldn't see clearly in the wheelchair just now, but when I stood up straight, I felt a sense of incongruity.
Unfortunately, it was short-lived and he soon lay on the operating table. His supine position and loose abdominal skin hid all the bulge. Looking back now, Edward's belly is just like that of ordinary people, nothing special.
Kawei had a bad premonition after hearing the symptoms before, but now that he saw the patient's appearance, he was thin, had a sallow complexion, had a cough, abdominal pain, and a distended abdomen, and his premonition was basically confirmed.
At this time, I don’t know who started first, took out a 10-kronor note, and said with a smile: "Since it is an abdominal exploration, why don’t we guess what is inside before starting the operation?"
This suggestion played into the hearts of the surrounding audience, and suddenly several voices came out: I guess it must be a tumor, a huge tumor... The location should be the colon, colon cancer! "
"I guess it's an intestinal obstruction."
"I guess it's chronic appendicitis, which has suppurated and formed an inflammatory mass."
"...Don't worry, don't worry, let me write it down." At first, the man took out a pen and paper and scrawled a few words on it, "10 crowns per person, and the winner will share the prize pool equally."
"Interesting! I guess hepatitis!"
"Here, 10 crowns, I guess cholecystitis!"
"Gastroenteritis!"
"I also guessed it was a tumor, but it should be a small intestinal tumor..."
More and more people are participating. Some give answers after careful consideration, while others just join in the fun out of boredom. It doesn’t matter whether they win or lose, they just think it’s fun.
They respected the rules in the theater and upheld the proper gentlemanly etiquette, keeping their voices as low as possible. But there were too many people discussing at the scene, which finally aroused Hills' dissatisfaction: "Everyone, the operation has begun. Please try to restrain your impulses and stay quiet."
Everyone finally calmed down a bit, but only in terms of volume, and the blind box guessing became more intense.
"My 10 crowns, I think it's stomach cancer."
"I bet on hepatitis!"
"Where do so many tumors come from? I choose gastroenteritis."
"Chronic diarrhea..."
"What kind of diarrhea! He is obviously constipated, you are talking about diarrhea?"
"Um, sorry, then it's intestinal obstruction!"
Ignatz did not participate in it, and sneered at this groundless and playful speculation: "What time has it been? Can you be more serious!"
"I am idle after all. Professor, why don't you give me a guess?"
"Yeah, let's take a guess."
"We are not good enough. In the end, it still depends on you."
Ignatz was urged to do nothing, so he had to dig into his pocket and handed over a 10-kronor note: "I also think it is a tumor. The specific location is hard to say..."
"You must tell me the location!"
"Yes, there must be a place, otherwise there will be too many people with tumors."
"Must you say it?" Ignatz thought for a long time and finally figured out the answer, "...then the small intestine."
"Okay, small intestine tumor +1!!!"
At this time, Hills had already performed the operation. With the help of his assistant, he gently incised the skin, and followed Kawei's example, performing anatomical separation and hemostasis layer by layer: "Today's surgery, we will start with dividing the epidermis. start......"
This was the first time that Kawei saw his operation being so "delicate" and couldn't help but smile: "Teacher, what happened to Hills today? He cut the skin so carefully."
Ignatz was 10 kronor short for some reason, and felt a little uncomfortable, so he thought about Laqavi and went into the water together: "Stop looking, where is your answer?"
"Huh? What answer?"
"We have already told you what is in this patient's stomach, but you haven't told us yet."
At this time, everyone remembered that it turned out that Kawei had not participated in it, and they couldn't help shouting: "Even Teacher Ignatz participated, and Dr. Kawei had to guess one thing."
"Yes, I have to guess."
"10 kronor?" Kawei couldn't help but take out the money from his wallet, "I guess it's water."
"water?"
"Why water?"
"Can the stomach also hold water?"
The medical level of the audience varied greatly, and only a few doctors who had experienced many clinical cases really understood what he said. Kawei didn't give a reason, because the explanation couldn't keep up with Hills' knife, so he could only give a rough color: "Well, it's just a belly full of yellow-green water."
At this time, Ignatz understood what he meant: "You mean ascites?"
"Yes, ascites." Kawei said, "I have not touched the patient's belly, but judging from the visual volume, it is estimated to be 200-400ml."
Just after I finished speaking, those who guessed the answer were still in a state of confusion. Hills had already cut into the peritoneum. After all, his delicacy was just a show. A knife inserted into his abdomen was like opening a dam on a river, and the gurgling abdominal fluid leaked out from the hole: "Hurry up and get the gauze... Oh, forget it, just forget it." Let’s do this first…”
The amount of ascites cannot be calculated, but the color is very obvious, which is the yellow-green that Kawei said.
"How did Dr. Carvey know it was ascites?"
"Because this kind of thin body inherently means disease consumption, and the bulging belly cannot be protein or fat, it can only be ascites." Kawei couldn't tell them anything about pathophysiology, so he would talk in general terms for the time being. Introducing a concept that is not very accurate, "And these ascites come from a strange place, there must be something else in the stomach."
Hills's surgical skills were passable, but it was a bit difficult for him to make the same diagnosis as the internal medicine department. In the eight years of clinical medicine that I studied for a master's degree and a Ph.D., half was anatomy, and the rest was mostly pathology, and then other basic medical theories. There was very little content that actually taught clinical medical judgment.
In fact, it is difficult for even physicians to judge the condition by inspection. After all, only a very small group of people are at the forefront of frantically submitting articles to magazines.
"Everyone, I made a mistake in my judgment and let everyone see such a joke."
Hills' body was covered with yellow-green abdominal fluid stains, and his cuffs and pants were soaked. He hurriedly corrected the previous accident and quickly revealed the next step of the operation plan: "Next, I will drain the patient's ascites and continue intra-abdominal exploration."
At this time, his assistant suddenly called out: "Teacher Hills, come and take a look."
"What's wrong?" Hills, who was facing the audience, suddenly turned back to look at the patient, "What happened?"
"Teacher, look at the patient's belly. His belly is densely packed..." The assistant swallowed, unable to bear the goosebumps on his body, and avoided looking, "It's all packed with particles..." I really can’t stand the little white bumps on my face.”
"Little bump?"
These are small milky white particles the size of a finger. If you look closely, you will find that they have been densely hidden in the patient's abdominal cavity. They are all on the omentum, peritoneum, and intestinal mucosa.
Just when Hills was in a daze and didn't know what to say, a voice suddenly came from the audience: "This is tuberculous peritonitis!"
