Chapter 106: An Object Called a Bicycle [3]
“Your voice won’t come out right now.”
The next day, some time later, the patient finally opened his eyes. Meanwhile, his face was still swollen. Naturally, given how severe the injury was, it was a miracle the front facial bones were not shattered. His nasal bone, though… probably dislocated. I had never reset one before.
I did that for no reason… There’s a high chance the bones at the base of the skull are fractured. If I touch the wrong spot and trigger something…
Better to live with a crooked, low bridge than to die, right? It was not as if the guy made a living off his looks. In the twenty-first century, we would have called ENT in five seconds flat, but here? I was the best they had, and everyone else was basically a quack. The patient would just have to settle.
Hiss.
As I looked at him with as much compassion as I could muster, the patient tried his best to speak. All that came out was a hiss of air, not a voice.
Because I drilled a hole.
Air was bypassing the vocal cords entirely.
“I know you can’t speak. It’s okay. It’s just temporary…”
Shish. Sisik!
Was that him swearing at me with his eyes?
“Haha. It really doesn’t come out, does it?”
Liston chuckled beside me. Don’t laugh… You’re clearly enjoying this too much.
Shh.
Still, the patient seemed stable. Would he be angry at Liston? Unlikely. Anyone who could still glare after a Tracheotomy was already pretty incredible.
“He fell while riding a bicycle. If you remember falling, blink once. Twice if you don’t.”
“Blink. That counts as speaking here.”
Communication was hard enough in this era without surgery in the mix. Most couples did not talk to each other, so what hope was there for doctors and patients? Normally, this would have been a nightmare, but with Liston helping, it was not so bad.
“You don’t remember? Does your tongue hurt?”
“It must. Isn’t that what he’s saying?”
“I think the second blink was tears.”
“It’s frustrating… When can I talk?”
“We have to let that settle first—”
“Why don’t you take it out then?”
“No. Those are pores. Just look at his tongue. It’s too swollen. Right now, it’s not possible.”
“Will the swelling go down over time?”
Thankfully, I could still manage this conversation. Even if he could not talk, at least he was breathing. If I had not made that incision yesterday, he would have died.
Shhh.
He kept making noises, clearly frustrated. I could not sense any gratitude in his expression. Still, I checked his condition.
First of all… Lord, thank you for keeping him alive overnight.
Did he know I was thanking God?
Wait… Am I leaking cerebrospinal fluid? …Damn it.
So much for gratitude. What was that? That shiny stuff at the back of his nasal cavity?
Maybe if we wait, it’ll get better… right?
I put on the best poker face I had learned over decades of medical practice.
“First… the patient will need to continue lying down like this.”
“Is that necessary? You lie down when you sleep anyway.”
I argued my case until the patient was tilted about thirty degrees. This was not the twenty-first century, where we had adjustable hospital beds. Here, the best I could do was wedge a pillow behind him. Luckily, his injuries made it hard for him to move, so he stayed put. Not that he was happy about it.
“If you look under the lamp, doesn’t something seem to be leaking behind his nose?”
“It’s just a runny nose.”
No, the bigger obstacle was Liston, and all the other doctors of this time. They thought the only things that came out of the nose were snot or blood. Morons. They did not even know the brain floated in cerebrospinal fluid, much less that it could leak if the skull base fractured. They did not realize it could heal on its own either, if you just reduced pressure.
“There’s blood too.”
“Compared to yesterday, it’s almost stopped. Besides, his tongue was swollen, and he couldn’t breathe. He’ll improve.”
I had to keep up this exhausting conversation.
“Right, right.”
“So, can you remember what happened now?”
The conversation was not frustrating because I was quick-witted. It was because everything had to be dumbed down.
“His tongue’s swollen. Elevation helps reduce swelling.”
“Huh… That sounds convincing.”
It was convincing because it was true. Sure, that was not the reason we did it, but the body obeyed gravity. Raise the injury, and the swelling went down. Common sense.
“It sounds plausible, but shouldn’t we remove that thing soon? He can’t talk.”
“Well, yes. It’s uncomfortable. But it might save people who would otherwise die from airway obstruction.”
“Still… maybe we should teach other surgeons. Is there any other way?”
“That too. Living mute is better than dying.”
Liston rubbed his chin. When I first met him, he always brushed his bangs when he was deep in thought.
“Why are you looking at me?”
“No, no. Nothing.”
Was it because we had been doing more surgeries lately thanks to anesthesia? He looked unusually serious.
“Don’t stare like that.”
“Yes, yes.”
Liston scratched his chin again and then spoke.
“What was that term you said earlier?”
It did not sound very meaningful. But I was getting worried. If I kept talking too much, I might get punched.
“Tracheotomy.”
“Ah, right. That. Yes… Good. That’s a meaningful procedure. Not too difficult.”
Not difficult? Only because I was the one doing it. In reality, it was not exactly easy. Sure, in the twenty-first century, we had tools that did it with a twist of a dial, and some internists could handle it. But this was not the twenty-first century.
“Yes, but if anything goes wrong, the patient will die. And not peacefully.”
“True.”
Liston closed his eyes. He was probably remembering yesterday’s surgery. The sight of that mangled face must have stuck with him. If the patient had died, it would have been horrifying.
“So we need to teach it properly.”
“Yeah… We can’t just do it in the classroom.”
“Then where?”
“The dissection room.”
There was nothing more I could do for the patient today except monitor him. If anyone else tried anything, they would probably kill him.
Emily… she’s okay too.
Thankfully, Emily was doing fine. Whether it was divine intervention or sheer luck, there were no signs of infection. No rabies symptoms either, thanks to the brain matter. This might be the second time I discharged someone and moved them to outpatient care. Actually, she only showed up again because I sent her money without warning.
“Are you okay? Just write. Don’t worry about money.”
God bless condoms. God bless France. Even after sponsoring Emily Brontë, I still had funds left.
“Now that we’ve talked about it… shall we head out?”
“Oh yeah. Let’s go. I’ve got time next week. I haven’t done a dissection in a while… I don’t even know what our turnover rate is anymore.”
Turnover rate? For cadavers? I gave Liston a puzzled look, but the man with the ridiculous sideburns went on like nothing was wrong.
“Oh, and I’m thinking we should make cyclists wear helmets.”
“Ah, that. Just implementing that would cut down on deaths from falls.”
“Right? Seems like common sense.”
It was a sensible idea. Helmets were not unheard of in the nineteenth century. People had experience with horseback riding. Horses were expensive and mostly owned by the upper class, but still.
“I relayed it to the police chief. They probably won’t adopt all of it, but it’s better than nothing.”
“Yes, yes.”
If I could, I would ban bicycles altogether. But you could not take away the poor man’s most efficient form of transportation just because of injury risk. Besides, I was an Asian doctor, not the queen. Even the queen probably could not pull that off. Maybe if she had a mustache and was born in Austria in the future…
Sorry. That was uncalled for.
As we chatted, we arrived at the dissection room. I had been in and out of here more frequently than Liston.
Why?
“Oh, you’re here!”
“The review came in!”
“Help us out!”
Because I had students like Joseph, Alfred, and Colin. We called each other friends, but after you taught someone for a thousand days straight, the teacher-student dynamic became real.
“Oh, wait a minute.”
“Professor!”
“Hey!”
“Please save me!”
I entered first, followed by Liston. The students, who had been rushing to the door, scattered like cockroaches caught in the kitchen light.
“What’s this?”
“They’ve been working hard.”
“Hmm… So only these three are quick?”
“I’m a little biased.”
“Is it okay for a future professor to say that publicly?”
“I won’t play favorites once I’m a professor. Until then…”
“Fair enough.”
Maybe I praised the fast learners too much early on. No one called me a yellow monkey out loud anymore, but some still whispered behind my back. Factions had formed. Joseph, Alfred, and Colin were on my side. The rest? Meh.
“If you want to die, don’t listen.”
“Isn’t that what the professor said… about killing?”
“I won’t kill you if you listen. So just do it. No difference between us.”
“That… seems like a big difference.”
While the students bickered, Liston walked around the room, frowning.
“There are too few bodies. Where should I get more?”
That was terrifying, even coming from an ally.
“And about the helmets…”
“You mean for the cyclist?”
“Yes.”
Footnotes
Translator’s Notes
ENT — Ear, Nose, and Throat medicine, also called otolaryngology. It deals with conditions involving the ear, nose, throat, head, and neck.
Cerebrospinal Fluid — Clear fluid surrounding the brain and spinal cord. It can leak through the nose if the skull base is fractured.
Skull Base Fracture — A fracture at the bottom of the skull. It can cause cerebrospinal fluid leakage, bleeding, and serious complications.
Tracheotomy — A surgical opening made in the neck into the windpipe to secure breathing.
Helmet — Protective headgear used to reduce head injury risk during riding, cycling, work, or combat.