In the past two months, Kawei's status has begun to rise, which is of great benefit to spreading his medical claims and bringing chaotic surgical procedures into formality. But at the same time, this status also brought him many responsibilities that he could not refuse like shackles.
The impressive achievement of zero mortality in nearly ten cesarean sections in two months has allowed Kawei to easily exceed the limits of existing surgery. At least in the field of pure cesarean section, Kawei is the absolute authority in Vienna.
Now only limited by the speed of news spreading, Kawei's reputation is limited to the surrounding Vienna.
However, as time goes by, the surgical procedures and key points of cesarean section will eventually be spread overseas through papers and letters.
Since it is the absolute authority, sometimes it is necessary to give others some guidance without hesitation. Ignatz, Waterman, and Orji have all received his guidance, and now Besim and Denev are no exception.
From a personal personality point of view, Kawei does not like to communicate, but the profession of surgeon inherently requires communication. Interpersonal relationships influence the cooperation and work efficiency of the surgical team, as well as his reputation among colleagues, and are an indispensable part.
In front of him was a new gynecological surgery with no visible results. Looking at Besim who sincerely invited him, Kawei still wanted to refuse first and test the other person's attitude: "There are still things to be busy with at the Municipal General Hospital, besides gynecological surgery I haven’t done it either, otherwise I would still..."
"Gynecological surgeries are also performed in the abdominal cavity. I just hope you can give me some reference advice."
"Then..." Kawei looked at the time, "When does the operation start?"
"Coming soon, one o'clock in the afternoon."
"Then I'll go and have a look." Kawei is still modest and cautious about his surgical abilities. "We can't really discuss our opinions. Let's learn from each other."
Besim never expected that he could invite Kawei. In the past month, the only people who could invite him were Waterman and his son. Orji's cesarean section was just a coincidence. If she really had to go to her door to ask for one, she didn't know what the result would be.
First, he wanted Kawei to guide him in gynecological surgery, or give him more advice during the surgery. At the same time, taking into account Orji's surgery yesterday, Besim also wanted Kawei to give himself and Denev a thorough explanation.
After all, the operations they performed in the gynecological ward were minor operations, requiring only some sewing and mending [1]. They basically did not use ether, and they had never been to an operating theatre. With such a skilled surgeon present, Besim felt much more at ease.
In comparison, Denev, who was in the preparation room at this time, showed more excitement: "What? Dr. Carvey Hines is here too???"
"I guess he came to see the mother who had surgery yesterday, and then asked about the gynecological examination and treatment she had done before." After Besim sent Kawei to the surgical theater, he also entered the preparation room early, "Wear rubber gloves. What?"
"I have brought it, and I am soaking it in disinfectant." Denev pointed to the basin in the corner, "There is also ether, anesthesia mask, sterile gauze, alcohol...Teacher, do you want to use the infusion bottle? ?”
"It's just a gynecological surgery, not a cesarean section, and there won't be much bleeding." Besim hesitated as soon as he finished speaking, "Forget it, maybe I'd better be prepared."
"Then prepare the sodium citrate." Deneve took out the prepared medicine bottle from the box, then pulled out his notes from under the open anatomy diagram and found the person who had the cesarean section at that time. Record: "The dosage is 2.5g per L of blood."
Besim asked: "Do you remember where the surgery was?"
"Remember, considering the lower position of the uterus, we chose the transverse incision in the lower abdomen that Dr. Carvey has always advocated." Denev looked at the anatomy diagram of severe uterine prolapse [2], then looked at his notes, "It should be fine. "
“Ever thought about the bladder?”
"Well, the bladder needs to be avoided carefully. We can't make the same mistake as Dr. Orji." Deneve had indeed made adequate preparations for the operation. The notes were densely filled with key points. At the same time, he also kept several of Carvey's machines. I watched the cesarean section again and said, "The money spent on surgical theater is not in vain."
Besim looked at the various anatomy and surgical atlases placed on the table in front of him. Looking back on the past, he realized that his students had indeed worked hard enough.
He took out a bottle of red wine from the cupboard and filled two glasses: "I wish our operation a success, and that we can impress everyone including Dr. Orji and Dr. Kavey, and at the same time, we can silence those who gossip." .”
"Don't worry, teacher, I'm confident!"
...
Denev's academic career was indeed not easy.
He came to Austria from Belgium to study five years ago. Because he did not have a local high school diploma and failed to pass the Vienna University entrance exam, he had to work to make money while spending time re-learning the content of Austrian high schools.
After entering Vienna Medical College, he finally showed his amazing learning ability and received his doctoral diploma five years later.
Before graduating, he entered the Graz Hospital where Besim was working as an intern. Compared to Berget, who was still an "apprentice", he was now a full-fledged gynecologist at Graz Hospital.
If nothing unexpected happens, he will be able to successfully enter the Gynecological Medical Association in half a year and receive all the patients on his own.
"He is indeed very talented." Kawei didn't know how to evaluate this newly graduated doctor, "But Dr. Orji, I just entered medical school, so I don't seem qualified to evaluate this doctor of medicine."
"You are different, how can you compare with them." Orji said with a smile, "You can still work even if you don't go to medical school."
"That's not necessarily true. Herbalism and zoology are quite difficult at the undergraduate level," Kawei said. "I have to spend a lot of time on these two courses, and by the way, there's also philosophy. It's really troublesome."
"That's not the point. The focus of medical school is on anatomy, physiology and pathology. I heard that you were exempted from these three items."
"Well, Dean Meadows helped."
"You didn't earn it by yourself." Orji also taught in a medical school and knew the examination process very well. "The requirements for undergraduate graduation are not high. Just pass the usual assessments and exams. You will be fine."
Compared with academic problems, Kawei is more worried about this operation now: "In fact, in my opinion, Dr. Deneve is already quite good if he can think of this operation. There is no need to go on stage to do it himself. There are many operations." There are all kinds of traps, and you can’t just do them if you think you can do them.”
Orji also holds the same view, but he is more concerned about more basic things: "I don't think too much. Whether it is necessary to use surgery to solve the problem is naturally decided by the gynecologist. The reason why I don't I agreed to the operation just because the gynecologist was not qualified to go to the operating table."
Bessim was not around and his words were clear.
There are many surgeries in modern gynecology, and there is no such thing as a surgeon performing all surgeries. But in the 19th century, invasive procedures were often the job of surgeons, and other doctors did not touch blood.
"Personally, I think that if the operation is indeed feasible, there will be no problem for a gynecologist to go to the operating table."
Orji looked very surprised: "Yu Gong, they have not received professional training, and there will definitely be problems on the operating table. Yu Si, I am a surgeon myself, so naturally I don't want others to take away my job."
"I don't think it's okay. There will be more and more surgeries in the future. A single doctor has limited energy and cannot handle all surgeries." Kawei said, "If we take a longer-term view and want surgery to flourish, Inclusion is important.”
"...It's so courageous of Dr. Carvey to think like this."
"Think about the future when medicine develops to a certain scale. We will be able to detect more and more diseases, human life expectancy will be greatly improved, and surgery will develop to an unprecedented level." Kawei said excitedly about the current status of medical care in the 21st century, "Doctors will not There are only internal medicine, surgery, obstetrics, and gynecology, and they will be divided into more departments due to various systems.”
"More departments?" Orgi had never thought about this question.
"Looking at the development of medicine to this day, medical division is an inevitable result. The more we know about the human body, the more professional medical talents are needed. When such professional talents gather together, a brand new department is formed... ..."
Kawei's "conjecture" was too advanced, making it difficult for Orji to digest.
Just at this time, the door to the operating area was pushed open, and Besim and Denev pushed the patient into the theater.
The surgical theater at Glaize Hospital is different from the Lakeside Theater. Tickets are not sold to the public. The operations are only for the doctors and medical students in the hospital to watch. If the patient has a special status and spends a little more money, these viewers can be rejected.
Since the venue is full of people, the host and the ticket window are omitted.
The disadvantage is that the lively atmosphere in the theater is missing, but the advantage is that the operation will be quieter and the viewers will be more professional.
But today's surgery is very special. As Orji said, the doctors who visited here thought that the surgery was too casual from the proposal to the execution, and the surgery should be stopped in time. So when Besim entered the venue, you could hear them talking.
"The patient is a 53-year-old middle-aged woman who has given birth to six children. Her uterus is severely prolapsed and she cannot live a normal life at all." Besim said, "It must be difficult for you to understand why we want to perform this surgery. Determination, because you simply cannot understand the pain of uterine prolapse patients."
Someone on the stage soon came forward to refute: "It's not that we don't understand the patient's pain, we are just skeptical about whether the operation itself can be successful."
"In the previous discussion, we have already stated our point of view. If the operation was proposed and put into practice by Dr. Orji, no one would gossip. But now it is performed by two gynecologists. Isn't this too much? It’s child’s play.”
Orji shook his head: "I don't have the ability to do it, and I don't have the time."
At this time, Denev stood up. As a young doctor who had just graduated from medical school, he shouldn't have said anything. But seeing his teacher being beaten down by the number of people made him a little angry:
"Teacher Besim and I have studied many cesarean sections and have our own unique understanding of reducing and fixing the uterus. We have done a lot of autopsies and similar surgeries on pigs, and the results are good. Please Please give me your understanding, as for your support, we don’t care.”
"No matter how much you object, the surgery has been approved by the director..." Besim didn't have much to say, "Let's get started."
"According to Dr. Carvey's preoperative preparation workflow, we will disinfect the abdominal incision while anesthetizing with ether." Deneve said, picking up the alcohol gauze and "wiping the abdomen repeatedly to keep the surgical area clean. .....”
Although these processes were carried out according to the process described by Kawei, even the surgical incisions were the same as the cesarean section incisions he advocated.
However, the uterine prolapse repair advocated by Denev is definitely not a reconstruction of pelvic function in the modern sense. Simple reduction of the broad ligament may be able to lift the uterus, but this kind of lifting will not work when the surrounding tissues are weak. The effects were not lasting, and in Carvey's mind the surgery was doomed to fail.
However, he still ignored a key factor. Neither Bessim nor Denev had ever actually been on the operating table.
Even though the ether anesthesia was successful, the patient had no accidents; the surgical incision was made beautifully, and a small amount of subcutaneous tissue bleeding was harmless. But the two of them didn't really understand the anatomy of the abdominal cavity. Even if they memorized all the contents in the book, the stomachs of dead bodies and living people were completely different things.
Under the not-so-bright oil lamp, the bright red made it impossible for the two of them to tell which part was the appendage and which part was the uterus.
"We're looking for the broad ligament, the broad ligament..."
Denev held the crow's beak pliers in his hands, trying to find the broad ligament he wanted so much, and then cut it off to reduce its length. But his hand could only stop in mid-air, and the big beads of sweat on his cheeks kept rolling. Finally, it flowed to the corner of his mouth and he said: "Teacher, where is the broad ligament..."
