The daily work of an apprentice like Gustav is not easy. He needs to contact customers and appraisers for teacher Bernard, arrange the order of auctions, and prepare auction catalogs.
Only at small auctions with little reputation could he go on stage and bang the hammer under Bernard's care.
If he hadn't taken Bernard's words seriously before and thought that making connections was still far away from him, then after experiencing the auction, he had sorted out all these childish ideas and packed them away. The skull.
Now that most of the auctions of Ingres' paintings have ended, the auction center has entered a period of steady rest, and Gustav, who has been busy for more than half a month, also has a long-lost vacation.
He didn't memorize many auction skills, and his mind was filled with scenes of Kawei talking to the two queens. He tossed and turned all night, and fell asleep in a daze at seven in the morning.
Compared to others who are theoretically advanced, Gustav is an absolute activist. Otherwise, he would have followed the development path given by his father, studied hard, followed in the footsteps of his two older brothers, and entered the University of Zurich to study economics, philosophy, or law.
After graduation, you can become a part of the management department of your family's private bank, or you can choose to start your own company and try your luck.
But he is obviously unwilling to succumb to other people's plans. He has his own artistic ideals...
Although he was judged to have no relevant talents by a certain painter a, a certain musician b and a certain sculptor c who were invited to his home when he was 7, 10 and 12 years old respectively, and his ideals were shattered one by one, Gustav still hoped that he would Future work can be closer to artworks.
This was not his first time abroad. Before coming to Paris, he had already been to New York and London due to his poor high school academic performance.
In the eyes of ordinary people, this has no internal logical relationship, but in the eyes of my father, it is a completely different idea. He felt that if he didn't go out for a walk now, Gustav would probably live in Winterthur, a small town in the canton of Zurich, for the rest of his life, with no chance to go abroad to broaden his horizons.
Who knew that these two recreational trips allowed Gustav to find his life goal.
He is by no means qualified to manage a bank, and the business scope of his own small private bank is not large enough for him to use his skills. If you want to do it, you have to do something that can change the world. Since you can't lead the trend of world art, you can become a middleman like Bernard who controls the price of world-class art.
That's what he thought, and that's what he did.
After two years of studying (luan) at the University of Zurich's seminary, he successfully dropped out of school, and after much hard work, his father had to write a letter to his old friend [1]. Send yourself to Drouot for "experience"...
At ten o'clock in the morning, Gustav woke up after only sleeping for three hours.
The brain did not become calm due to sleep, but the appearance of that person became clearer. Unable to suppress his thoughts, he got up, put on his clothes, washed briefly, stuffed half a piece of bread into his mouth and rushed to the hotel where Kawei was.
Bernard asked Gustave to get to know Kavi, but the "knowledge" he understood was by no means simply knowing that this person existed, or having a deeper understanding of this person's character and habits. Or just to open up information channels, simply insert him into your personal network, and then pull him out to chat at a special time in the future to squeeze out information resources.
Gustav's "acquaintance" is to become friends with the other party, at least the relationship between his father and Bernard.
In short, he has deeply realized the importance of making friends with Qavi.
It's a pity that Gustav has his own ideas and drive to do things, but he lacks prudentness and carefulness. After the auction, he relied on the far-fetched reason of returning the receipt to ask for Kawei's residence address, but he never thought that the other party was a busy man with very little free time.
"I'm sorry, Dr. Kawei is not in the hotel right now."
"Where did he go?"
The waiter shook his head helplessly: "I don't know. Dr. Kawei's itinerary is personal privacy, and we have no right to interfere."
"Then..." Gustav took out a note pad, wrote a paragraph neatly with the pen at the front desk [2], and then handed it to the waiter, "If he comes back, please be sure to give this note Give him the note."
Leaving messages is very common in hotels. The waiter habitually raised his hand to take the note, but stopped mid-air. His eyes were a little panicked, and he hesitated not knowing what to say.
Gustav just felt strange and didn't pay attention, thinking that he didn't hear clearly. Just when he was about to say it again, a man in black suddenly appeared next to him: "Who are you? Why are you looking for Doctor Carvey?"
"What does who I am have to do with you?"
Almost as soon as he answered, Gustave subconsciously sensed something was wrong. The other person's clothes and behavior were strange, he didn't speak French very fluently, and his eyes made him very uncomfortable as he inquired back and forth.
But before he could change his words, the other party patted the waiter on the shoulder and left.
what's the situation?
Gustav was a little confused by the accident. Seeing the strange expression on the waiter's face, he asked, "Who is that person? Is he from the hotel?"
"I am not sure as well."
"How strange..." Gustav's eyes flickered back and forth between the man in black and the waiter, without delving further, "By the way, when will Dr. Carvey be back? If it's the afternoon. , I can wait here."
"This..." The waiter was stunned, and quickly replied with a smile: "I don't know exactly when he will come back, but I will hand over the note when he comes back."
"Okay, trouble."
...
On the other side, Kawei had already left the University of Paris, got into a taxi, and rushed to the Diocesan Hospital.
The mother's sudden labor also caught him off guard. After listening to Wan Wang's description, he couldn't help but ask: "Why did you go into labor just one night later?"
"We don't know. She is in good health and her fetal heart rate and movements are normal." Shanwang reviewed her medical records and said, "Even the fetal position is a normal head position. It was still there during the examination last night." It’s not in the basin yet.”
Kawei had asked before and naturally knew the position of the fetus, otherwise he wouldn't be so surprised: "Forget it, these are not important. What is important is how long it has been since you discovered it."
"I found out it was 9:30 and now it's 10:13. It's been almost an hour."
"After all, this is the third child. We are still some distance away from the hospital. It seems that it is too late." Kawei changed his mood and basically gave up the fantasy of surgery. "The next thing to do is how to keep the baby during normal delivery. At the same time, hemorrhage was contained.”
Clinical practice is not about memorizing medical books. It is difficult and important to temporarily change your judgment and put it into practice immediately.
This requires great courage and self-confidence, but at this moment Kawei made this judgment not because of self-confidence, but simply because the cesarean section itself had lost its meaning.
From a time point of view, the birth of the child is certain, and it will become very easy once labor enters the birth canal. As long as the child enters the birth canal of a multiparous woman, it is equivalent to getting on the highway. Natural delivery is much faster than cesarean section.
Next, it will be divided into three situations according to bleeding.
The first is that the amount of bleeding is not large, which is almost impossible, but it is indeed a possibility. If you encounter this situation, it does not mean that the mother is safe. It also depends on the separation of the placenta. Only when the placenta is completely separated and the vital signs are intact can you rest assured.
The second type is a huge amount of bleeding. The child bleeds more than 1000ml just after birth. The situation is extremely critical, but there is no need to think too much. Open the abdomen directly and stop the bleeding if it can. If it cannot stop the bleeding, cut off the uterus directly to cut off the source of bleeding.
The third type is also the most troublesome for Kawei. On the surface, the amount of bleeding seems to be stuck in the middle between the two, more or less, and the key vital signs have not fluctuated much.
Laparotomy is inherently risky and should not be done blindly just because the previous surgeries were all successful. But if the abdomen is not opened, the amount of bleeding is very ambiguous, and the heart rate and blood pressure may double at some point. It is simply a fantasy to rely on the simple medicines in hand to save the patient.
At this time, you need to judge the situation carefully. If you make one wrong step, you may make the same mistake every step after...
Kawei leaned on the back of his chair and looked out the window. There were not many cars on the road at noon, and the distance between the two places was not long. He used the little time he had to quickly go through the possible situations and preparations, and finally at 10 o'clock We arrived at the preparation room of the surgical theater half a day ago.
It has now been 1 hour since the mother went into labor.
"How is it?" This was the first sentence Kawei said when he opened the door and entered the room. After hearing the mother's cry, the second sentence came immediately after, "How is the bleeding volume?"
"About more than 400 ml, there are blood clots, I just vomited once, it was what I ate last night." The person who reported the report was Kallen. Others gathered around the mother to stop the bleeding and deliver the baby. "The vital signs are pretty good, the blood pressure is 124 /76, heart rate 93.”
Kawei breathed a sigh of relief, at least now it seemed that the amount of bleeding was not too much, and his team had opened two intravenous channels, one for infusion of normal saline + oxytocin, and one for infusion of anticoagulated autologous blood.
But these are not enough. There is a crucial thing in the entire labor process. As long as this thing does not come out, the so-called treatment has not even stepped on the starting line: "I remember that she had central placenta previa, and the placenta should come out faster than the baby. Earlier, it’s been an hour now, has the placenta come out?”
Kallen shook her head, her expression extremely ugly: "No..."
As expected, without Kawei's medical treatment, the 400ml bleeding volume was just an illusion. As long as the placenta did not come out, the bleeding would not stop and the baby would not come out.
】
"In fact, children also..."
Only then did Kawei realize that the mother's cry just now was not because of pain, but because the baby she was 37 weeks pregnant with was gone.
The placenta connects the child and the mother. If placenta previa bleeds heavily, not only the mother's blood but also the child's blood will be lost. As long as the treatment is slower, even if the treatment is done in time, stillbirth will occur due to ischemia and hypoxia.
Now that the fetal heartbeat has disappeared, the bleeding is severe, and the placenta is adherent and cannot be delivered, there is no need to wait.
Kawei walked to the bed, passed by the others, and touched the mother's belly with one hand. His face became more and more gloomy: "The uterus is not contracting well. Go and prepare. The surgery will be performed immediately according to the cesarean section."
"good."
"By the way, prepare the uterine hemostatic band. There will be a lot of bleeding later. And let those who prepare the blood come in quickly and start the blood transfusion now."
"good."
The death of the fetus prompted Cavite to try his best to save the mother. He was confident that surgery would solve the bleeding. If that doesn't work, there is no problem in removing the uterus, after all, the other party already has two children.
But unexpectedly, the mother suddenly grabbed his hand: "Doctor, doctor, is my baby gone?"
This is bad news that has been told to her a long time ago. There is no use in avoiding taboos. Both doctors and patients need to face it calmly: "Yes, the bleeding was too violent. We chose several positions but could not hear the fetal heartbeat... .Actually, you know better than us, only you can feel whether he is moving."
"Okay...Okay...I understand." The mother's voice was trembling, but she seemed to have made up her mind, "Doctor, I won't do surgery."
Everyone who was busy just now suddenly stopped, unable to believe their ears. Even Kawei had to carry a bunch of question marks over her head. She didn't know why she did this.
"Are you kidding me?"
"It's too dangerous without surgery. Dr. Kawei rushed back from college just to save you."
"This is more than dangerous. Placenta previa is stuck in the birth canal and keeps bleeding, and the uterus cannot contract. How can I survive?"
Three obstetricians, including Hugill, and three of Carvey's assistants all agreed that surgery was the only answer to the problem. They have experienced too many cases of death during vaginal delivery of placenta previa. Even if the delivery goes smoothly, postpartum hemorrhage is very easy, let alone now.
Kawei had the same attitude before. The indications for surgery were quite clear and there was no reason to object.
But after the others chirped, he seemed to understand something: "Your husband also agreed last night to have the uterus removed in a critical moment. You don't have to insist."
"That's because the child is still alive, and now he is dead. You said during the previous examination that there would be problems with the uterus after cesarean section, and it may be more difficult to get pregnant later. Once pregnant, there is a risk of uterine rupture." The mother said, "I Don’t want to do this.”
"Haven't you already given birth to two children..."
Kawei recalled the simple medical history record, which contained no record of whether the child was still alive. "I'm just talking about risks, not absolute. If possible, undergoing a safe cesarean section can reduce many risks." "
"No, Doctor Carvey, you will only stay in Paris for a month. Our family cannot afford the train ticket to Vienna, and it is impossible for you to leave all your work for me after a year or two and come to Paris at this time. .”
The mother turned her head and didn't want to explain any more: "I love my husband, we can't live without children, and I don't want to live alone in her old age like Mrs. Liz next door. Her legs and feet are inconvenient, her teeth have fallen out, and she can't even go out for a walk. I can’t even get a cup of coffee from the market. If that’s the case, I might as well die here!”
Kawei has modern surgical concepts in mind, and the surgical method is based on the premise that it is suitable for the patient and has the consent of the patient and his family.
Now that the mother does not agree to a cesarean section or even the removal of the uterus, Kawi’s first thought is to notify her family members and bypass the mother to obtain the consent of her husband.
But this is not enough. To believe in the love of men in the 19th century, especially the lower class men, for their wives is not as good as to believe in their own hands...
Today is not like the past few days. There are sufficient medicines, capable assistants, and all the equipment is well prepared. If a blood transfusion is required, there are more than a dozen reporters waiting outside the preparation room. They can contribute at least 200ml of blood at any time, and the operation does not need to take into account the child in the belly.
A normal birth...
Maybe there is no chance at all.
.
