Chapter 119: Anatomy Lecture [1]
After using Dr. Liston’s name like a weapon, the students who had been sulking or swinging their knives around carelessly finally calmed down. To be fair, Professor Blundell helped too. That gentleman… Blundell, the so-called devil of obstetrics and gynecology. How did someone with a fatality rate approaching fifty percent still manage to be one of London’s most respected physicians? No matter how many times I thought about it, it was baffling. But what else could I do?
“Dr. Pyeong is incredibly intelligent. I’m sure he’ll be helpful. Have you had many patients who struggle to breathe? We’ve actually saved several patients with this surgery at our hospital.”
“Really?”
“Of course! When have I ever lied?”
“Oh, no, Professor.”
Apparently, Blundell’s reputation was enough to make statements like that go unquestioned. And honestly, even from a twenty-first-century perspective, most of what Blundell said was not complete nonsense. Whatever the reason, it was working in my favor now.
“Let’s see… All right. Okay. Everyone, those are U-shaped incisions. Some of you went too deep, so stay where you are for now until I give further instructions.”
“I understand.”
Somehow, everyone managed to make a U-shaped incision. It was not complicated. Start from just below the right ear, trace downward to the collarbone, curve above the clavicle, and then cut up to the left earlobe. It might sound dramatic, but if you sketched it out, you would get the idea. In regular surgery, you would never draw a line this extensive. But for special cases, say, a total laryngectomy for cancer, you would.
Am I really going to do that kind of surgery in this life too?
I did not know. I really did not.
“Now, if you’ve made the incision as deep as I described, grab a wide instrument. No, not a broad knife! I’m going in with gloves and my fingers. Yes, fingers. Use the handle of the scalpel. No, not the blade, the handle. What are you trying to do, kill someone? Look at this knife. Oh, it’s Dr. Liston’s. Professor, you’re wearing gloves. That’s good. Use your fingers… wow, those hands are huge. Anyway, that’s it.”
I did not know whether these skills would still be relevant in the future, but for now, this was a valuable, high-quality lesson. And I was confident in this. It was not my first time teaching. Honestly, teaching was even easier now, without Formalin getting in the way.
“Now, watch as I lift the slightly cut flap here… See the structures separating, almost like tearing paper? Slide your finger between them. It happens in an instant.”
“Wow…”
“Oh…”
“This…”
This sort of peeling would be completely impossible if the cadaver had been preserved with Formalin. It was the kind of thing you could only teach in an actual operating room. For those seeing it for the first time, it probably looked like some kind of magic trick. It was clearly a human body, but the layers came apart so cleanly, split with fingers instead of a knife. To modern students, it might seem logical. But to these people, no matter their status, it was probably surreal.
“And…”
“I find this fascinating.”
“Hmm… It’s like sorcery.”
Of course. These were the elites, after all. Sitting in their specially shaped chairs, murmuring with awe.
Hehehe.
If even people wrapped up in tradition and formality reacted like that, how much more amazed would the common folk be? I had kept my mouth shut out of caution, but with even my superiors looking stunned, it felt like the reins had come off.
“This is insane.”
“Wow…”
“What even is that?”
In this electric atmosphere, I peeled off the skin of the neck with a single finger. It was not something I did every day, but once you learned it, it was a skill worth mastering.
Thanks, otorhinolaryngology…
Maybe it was because it was a famous department, but even though I had only learned it once, it stuck with me. Of course, it helped that my baseline skills were solid. Thanks to that, I was able to smoothly perform a standard neck dissection procedure: the platysma muscle flap.
“Why… why can’t I do this…?”
“Ah, this is hard.”
“Ugh. I made a hole in the skin.”
If someone only watched what I was doing, they might think it looked easy. But if that were true, why not try it on a dog or a cow? I had already taught Dr. Liston and Blundell separately. Dr. Liston, in particular, never made mistakes. He had talent on par with mine. But the others? Not so much.
“No, I said to use something blunt.”
“It’s not working.”
“Why… Wait, look here. See this part? It’s just above the muscle. That’s where you’re supposed to go. Why are you holding the knife like that?”
“Ah… Is that wrong?”
“Look carefully. That’s the pink muscle between the tendons. Hmm… Well, now it’s messed up. I’ll just lift here.”
“No, it’s not working. Wait… this…?”
Some of them had decent instincts. One even managed to peel along the subcutaneous fat layer above the muscle. Sure, I had told them how, but still, only about two centimeters in. Still impressive, especially using a scalpel that looked like it belonged to Liston. It almost felt like magic. If this were the old days, no one would have even recognized what I was doing.
“Whoa…”
“Look at that!”
“That’s amazing…”
Most of them tried to follow instructions, but could not. So when someone managed even a little progress, admiration naturally followed. The problem was that one of the noble students had literally put a hole in the skin.
“No… how am I supposed to do this?”
“You push like this.”
“Why is the handle bent like that?”
“I use that to poke stew.”
“What…”
Was that supposed to be a joke? Why… Why was the handle shaped like an awl?
“If you use that to remove a bullet, sure, it’ll come out.”
“Ah.”
A bullet might come out, but the patient would not survive. More like a corpse with fewer bullets. I really needed to study traumatology at some point.
No… No. I only have one body. One step at a time.
It was complete chaos.
“And…”
“That seems hard. I know the doctor who just got scolded.”
“Still… there’s something very organized about it…”
The good news was that a lot of people were watching and trying to learn, even among the elite. Maybe this would actually lead to something useful later.
All right… If I show them how skilled I am, maybe one day they’ll invite me for something important.
Of course, if they were racist, they might not. But that could not be helped. When it came to doctors, though, it was a different story. Even if I did not look the part, skill could speak louder than appearance.
“All right… once it’s open like this, you’ll see something. If you have a trident, use that. If not, grab something and lift it up.”
“Huh?”
“Oh…”
“Ohhh…”
“If you lift it properly, it’ll look like an apron being raised.”
That was why this incision was sometimes called the “apron.” Most of them did not get it quite right, but with my help, everyone got a decent view of the inside of the neck. For many, it was the first time they had ever seen a clean dissection. Hanged bodies usually came crushed. And as for stolen cadavers, those were often hacked apart by body snatchers trying to avoid detection.
“Here. This muscle runs from the bone below the ear to the middle of the neck. Try tilting your head down while someone resists, or pull back while someone tries to bend your head down. You’ll feel this one. Big, right?”
“It’s huge…”
“Is it the biggest muscle in the neck?”
“I guess so? Everything else seems tiny.”
It was everyone’s first time seeing this, and I could feel their focus intensify. Some students were following along, using their hands to feel their own necks, or others’. Hygiene? Protective gear? Not even in their vocabulary yet. In my past life, this kind of thing would have been romanticized as “rugged masculinity.” Maybe someday they would understand the importance of sanitation.
“We’ll go over that later. Look at the center. See the white line running between the muscles? If you don’t know what I’m talking about, come closer. But be careful. We’ve already had a few accidents, haven’t we?”
“I understand.”
“Dr. Liston, why are you holding a knife?”
“Are you planning to carve something?”
“I-I’m sorry.”
“You said you understood, but why the knife?”
“Sorry!”
One guy lost focus again, but Dr. Liston quickly re-educated him. Honestly, I was glad he came with me.
“Did you see that?”
“Yes.”
As I looked at the now-docile student, I pointed to the vertical white line through the center of the neck. It was the membrane that separated the muscles moving along the vertical axis.
Technically… the sternohyoid. That’s connective tissue between the sternohyoid muscles…
Not that I could say that out loud. Someone might know where Joseon was. Someone might know what kind of place it was. Even if they cursed me, there was a limit.
“Now, trace along this line. Not yet. Just watch. Like this.”
I traced the line with a scalpel. There were no blood vessels here. I made several shallow cuts to avoid hitting anything deeper, so there was no bleeding. Just a pop, and the two attached muscles parted.
“Now look inside. See that pink tissue? It’s dense and vascular. If you touch it the wrong way, it’ll bleed a lot, so be careful.”
I pointed to the thyroid gland now revealed.
Naturally, even Princess Victoria, known for her obsession with anatomy, would have trouble taking her eyes off either me or the thyroid.
Footnotes
Translator’s Notes
Otorhinolaryngology — Medical specialty dealing with the ear, nose, throat, and related head and neck structures; also called ENT.
Total laryngectomy — Surgical removal of the entire larynx, usually performed for advanced laryngeal cancer.
Platysma muscle flap — A flap involving the thin superficial neck muscle, used here as part of the neck dissection demonstration.
Sternohyoid — Strap muscle in the front of the neck running from the sternum to the hyoid bone.
Thyroid gland — Vascular endocrine gland in the front of the neck that produces hormones affecting metabolism.