In the 19th century, the understanding of tumors was still at the stage of the Four Liquids Theory, which believed that tumors were caused by the accumulation of black bile in the blood. Breast cancer that swells or even festers outwards, as a relatively serious surface tumor, will bring a very irritating visual experience, often stimulating doctors' strong desire for treatment.
Internal medicine obviously cannot limit the growth of tumors, and this burden has been borne by surgery from the beginning. 【1】
It coincides with the golden age of surgical development, and the recurrence rate of breast cancer after surgery is very high. Breast cancer resection has gradually evolved from local excision at the end of the 18th century to total mastectomy.
The surgery is very aggressive, and the success rate is steadily increasing. Several surgeons who regularly perform breast cancer resections are able to reduce the mortality rate to less than 50%. However, the recurrence rate after surgery remains high. Even if they escape the risk of surgery, nearly 90% of patients who undergo breast cancer resection cannot escape the bad luck of recurrence.
Very few people can truly survive the surgery and survive for more than five years.
The main reason is that the examination is lagging behind. The early diagnosis is unclear, but the later diagnosis is clear, but the tumor has already metastasized throughout the body. Surgical technique is also a reason. Many rough techniques will also increase the risk of tumor metastasis during surgery and provide an environment for tumor recurrence.
Since the treatments that cause such embarrassing surgical incisions cannot completely cure breast cancer, patients will do the opposite and think of some strange ideas. Even if these ideas go against medical concepts and may not be of much help to breast cancer, they are at least decent enough for patients.
This is especially true when the other person's status is higher than that of the doctor.
"I personally think that breast cancer removal is inherently difficult, far from the level where we can talk about the aesthetics of the incision."
The operation was over, and Kawei stood beside Fernand's bedside waiting for him to wake up. Next to him was Waterman, who just wanted to join him: "This request is of course based on the ability of the operation. on the basis of successful completion.”
"Then let's discuss the surgery itself first, and leave the "aesthetics" to the subsequent secondary surgery," Kawei suggested.
Waterman certainly knows that in this situation it is difficult to solve all the problems at once, and he also suggested this before today. But after seeing Kawei's small incision mastectomy, he had a bold idea: "Do you think it is possible to save your breast after breast cancer removal?"
"Dean Waterman, even if we perform a complete breast resection now, we can still prevent the recurrence of breast cancer." Kawei was a little surprised. "It is right to pursue beauty, but health is the most important thing."
"It's because the recurrence rate is too high..."
Waterman has his own difficulties.
The patient was brought here by Charles, the Royal Dentist of the United Kingdom. He admired Waterman's special plastic surgery techniques and hoped to save his breasts while removing his breasts. This is obviously an idea that is ahead of its time and very unrealistic.
But considering that Charles brought him new materials and that the other party was a respectable nobleman, Waterman did not dare to refuse easily.
Of course Kavi has his own ideas.
Cancer is the king of all diseases. Any treatment for cancer requires an accurate judgment of the spread of the disease before a more complete and effective surgical plan can be specified. The extent of tumor spread cannot be judged by just looking and touching, so the current treatment effect on tumors is very poor.
Fernan's cancer was really not comparable to breast cancer. All Kawe could do was to cut out the lesions and check whether the inguinal lymph nodes on the body surface had metastasized.
As for whether there was metastasis to the retroperitoneal lymph nodes and lymph nodes in other locations, or whether there was hematogenous metastasis, he could only leave it to fate.
Moreover, Kawei's ability is more on the front line of trauma, and he does not have much experience in tumor surgery. Now all the energy is being prepared for rescue operations on the front lines of the war, and it is really difficult to be distracted from studying tumor surgery plans.
"Then it seems that this operation can only be postponed." Waterman was helpless. "What a pity. This is an important operation that King Franz is also paying attention to. Now we can only give up."
Kavi:? ? ?
"Doctor..." At this time, Fernan slowly regained consciousness. The effect of the ether was gradually lost, and the pain in his chest and lower body slowly came to him: "Ah, it hurts, it hurts so much!"
"The operation was successful." Kawei did not call his name, but simply gave a brief overview of the operation process and diagnosis. "It is indeed a gallbladder tumor, but the focus is limited to the vagina, and there is no sign of spread for the time being."
"Then, those two swollen ones..."
"It's been cut off." Kawei lifted the blanket covering him, revealing his flat chest wrapped in bandages. "You look exactly the same now as before."
Fernan had a headache, but he still insisted on looking up at his body, and finally smiled with satisfaction. The operation took a lot of energy from him, and now his body is very weak, but Fernand still raised his arm and held Kavi's hand: "Thank you, doctor, thank you so much."
"The next three days will be more difficult. You need to change the incision and dressing, and the pain will not disappear so quickly." Kawei had to take out a few bottles of ya tablet tincture even if he didn't want to, "If you can't help it, just take a few sips. , if nothing else happens, I will come see you again the day after tomorrow."
"Thanks."
Fernand's operation came to an end, and Carvey and Waterman left the surgical theater. Because the king's name had just been mentioned, the conversation between the two returned to breast cancer removal.
"The patient is a French aristocrat, and her father can speak at a high level." Waterman generally described the triangular relationship between France, Prussia, and Austria. "You also know that the current situation is tense, and Prussia will declare war anytime and anywhere. If at this time, If we can win over France, the situation will be very favorable to us."
Medical diplomacy was something Carvey could not have imagined, because French surgery has always been at the forefront of the world.
"It depends on what kind of surgery it is." Waterman is very proud of his technique. "If it's breast cancer, it's definitely not as good as the UK and the United States. When it comes to plastic surgery, it's far behind Professor Corigo and me. .So she found Charles and took the train to Vienna together, hoping to seek my help."
Since there is such a relationship, Kawei has to pay attention to it: "It's not that I don't want to help, but the surgery is too risky, and it is likely to become a double-edged sword in this delicate international relationship."
"The king has also thought about this problem, but when things have reached this point, the risk does not only stop at the success of the operation." Waterman wants to see more clearly, "The mortality rate of breast cancer is very high, and not having surgery is equivalent to Send your allies away.”
"This is so weird..."
Carvey didn't believe that a single operation could influence the country's decision-making, and neither did Waterman. But as long as there is a possibility, the king is still willing to let the two people serve the future of the empire. Anyway, it is not Franz himself who is on the operating table.
According to his words, as long as people are still alive and well before the end of the war.
"Domestic investment in surgical research is getting less and less, which is also attracting sponsorship for the College of Surgery." Waterman walked on the garden path leaving the hospital and said, "I don't know whether the successful operation can bring more benefits to the College. With so much money, not having the surgery will definitely make the king lose confidence...",
Once Franz loses confidence, the domestic economic downturn will inevitably affect surgical capital investment.
Kawei knew this very well. Considering the previous surgeries, he was indeed seeking too much stability: "Okay, I can consider joining, but I have to see the patient first. I have to know the location and size of the tumor, as well as the It has not spread to other places.”
When Waterman saw that he had finally convinced him, he couldn't help but patted him on the shoulder: "What a good boy! Ingnatz did not misjudge the person!"
...
The patient was over forty years old and was wearing a very exaggerated yellow-green dress. He was having afternoon tea with Franz and Elizabeth Yin.
Vienna's desserts, like its music, never disappoint, but the worries about her body are still beyond her control. Her mouth is full of sweetness, but her heart is particularly bitter: "Your Majesty the King, when will Professor Waterman be able to Come?"
"We agreed it would be three o'clock in the afternoon, so it should be soon." Franz explained, "After all, he is the dean of the School of Surgery and has a lot of work on his plate."
The female patient put down the tea cup in her hand: "Please forgive my presumption, since I met Dean Waterman two days ago, I always feel that he doesn't know much about breast cancer, and he doesn't want to treat me."
"No, Justina, you are wrong." Franz still hoped to stabilize her first. "Although Dean Waterman is the most famous surgeon in Austria, the operation is indeed very complicated. He just needs Just some time.”
"But my body can't wait any longer! And I heard that he went to see an operation, if my information is accurate enough." Justina sighed.
"Well, I know about this matter. It is a very meaningful operation related to the breast." Of course Franz also knew about it, "But I know very little about surgery, and I can't comment on the rapidly developing medicine. , I’d better wait until he comes and explain it to you slowly.”
After speaking, Franz glanced at Yin Elizabeth beside him.
Franz didn't care what kind of disease the French general's daughter in front of him had, or whether Waterman could cure her. What he was most concerned about was France's attitude in the upcoming Prussian-Austrian War. Whether it was pro-Prussian or pro-Austrian was crucial to the direction and final outcome of the war.
But as a king, he couldn't act too selfish, so he could only hope that Yin Lisabai would ask around the corner.
"Dean Waterman will definitely not go see other people's surgeries for no reason." Yin Lisabai smiled and comforted, "He must also be looking for a perfect way to treat the disease, so you can relax."
"Alas..." Justina shook her head helplessly, "My grandmother contracted this disease and died on the operating table. Although my mother survived, the wounds left by the operation were really terrible. I don’t want to be like them, I want to live well and live like a woman!”
"You will, believe me." Lisa Bai held her cold hands, "Are you really determined to have the operation in Vienna?"
"Who asked the best plastic surgeon in Europe to live in Vienna?" Giustina said without hesitation. "In fact, at first I wanted to go to the UK, where there is a breast cancer research center. But you also know that my father is very fond of The attitude of the UK, if those newspaper reporters knew that I went to the UK to receive treatment, my father would definitely be furious after reading the newspapers."
Yin Lisabai took every step and tentatively said: "I think you still have to send a telegram to General McMahon to report that you are safe."
"I will, but I have to wait until I get the exact news of the operation before I send a telegram." Justina finally felt better. "I am only 42 years old this year. I just hope that I can live a good life and look at me." My son is slowly growing up, but this is too difficult for me."
"It'll be fine..."
With her mood so low, Lisa Bai Yin could only use her own personal experience to comfort her as much as possible: "My health was also very bad some time ago, and I almost thought I was going to die. In the end, I received treatment in a nursing home before slowly recovering. .”
"real?"
"Really, Franz has always been by my side, he can testify." Elizabeth Yin said very realistically, with happiness on her face, "If possible, why not ask your lover to come to Vienna to accompany you."
"Forget it, Douai is just like my father. He runs to the military camp every day and is a war maniac."
Upon hearing this, Franz suddenly asked: "Oh? Is the old general preparing an army?"
"This...I don't know about this."
After that, the couple asked her a few more tentative questions, but they didn't get any definite answers. In Justina's eyes, only Waterman's surgery could make her feel better. But all good things are hard to come by, because after chatting with Cavey for a while longer, Waterman didn't arrive at the palace until 3:30 in the afternoon.
"Your Majesty, Professor Waterman has arrived."
“It’s finally here!” Franz seemed more excited than Justina, “Why are you still hanging around, let him in quickly!
! "
The captain of the guard glanced at Justina on the side and whispered: "By the way, he seems to have brought Dr. Kawei with him."
"Kavi??? The Kavey who saved the little boy by the river?"
"Yes, that's him." The captain of the guard glanced at Justina on the side, looking a little embarrassed. "Dean Waterman insisted on bringing him in, but his noble status was bought and he was not eligible to enter." The conditions of the palace. Therefore, it is up to you, Your Majesty, to decide this matter."
Outside the palace, Franz may be more easy-going, but once he enters the inner courtyard of the palace, even he must abide by the millennium-old rules of the Habsburg Dynasty: "Let Dean Waterman come in first, as Kawei said. .....Just ask him to wait at the reception desk."
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156. Surgical diplomacy? Free to read.
