Chapter 120: Anatomy Lecture [2]
When did humanity first become aware of hormones? I did not know the exact details, but it must have been sometime in the late nineteenth or early twentieth century. In other words, right now, no one had a clue. And in that context, saying things like, “This is the thyroid gland, and here is where thyroid hormone comes out. It is essential to survival, so don’t damage it,” was that really okay?
“See… The cross…”
In the twenty-first century, the word “cross” immediately brought the church to mind. It was practically a cultural template. You took a thing, stood it upright, and it became a cross. But back here, that idea was tangled in superstition and half-truths. “You said you nailed it? And that’s the end of the story?” No. The savages would start crying. Bring fire. Bring light.
“Now, look here. This pink bit. I don’t know exactly what it is… but when our Lord designed the human body, do you really think He made anything useless?”
“Amen.”
“Yes, I guess not.”
Thankfully, we were living in an era that had already gone through the Renaissance and humanism. You could call it a time of merging science and religion. I did not know the full details. I was not a historian. But invoking faith still earned more support than I expected.
“Then let us pray three times to the Lord for a clean incision, careful not to harm what He has created.”
“Amen.”
“Lord…”
Of course, among the so-called doctors, those who proudly called themselves scientists, there were quite a few closeted atheists.
You could tell just by looking at their mouths.
As for the upper class, nobles and royals, they were just sitting up there repeating “Amen,” even though they were not the ones doing the cutting. But really, what else could you expect? Darwin had not published On the Origin of Species yet. Creationism was still taken as absolute truth. And the human body was so intricately made that when I studied anatomy, I sometimes found myself wondering if a designer was behind it all, even if I did not believe in a literal god. So for first-timers witnessing this dissection, it was bound to feel divine.
“All right… No. I told you to be careful, and you went and sliced it right in half.”
Anyway, I drifted back into the operating space. What I found easy was still difficult for everyone else. The thing was, surgery did not work unless you followed principles. And those principles were born from endless trial and error. These guys might be called surgeons, but let’s be honest, they had not done enough surgeries to have trial and error. This was still a time when you had to finish before the patient died from the pain alone.
“You saw me do it earlier, right? Use the tweezers like this. Make a small incision. You’ll see a gap inside. Stick something in to lift it gently, then cut.”
“Ah…”
What was the key to not damaging internal structures? Just don’t let the blade touch them. It was simple. But in an era when this kind of thinking was brand new, what could you do? You had to know what was inside before you could avoid it. You needed a mental map, and even though knowledge was growing rapidly thanks to cadaver theft, large parts of the body remained uncharted.
“All right… well, something got sliced. Let’s skip that for now. The point is, don’t do this when operating on living people.”
I went around to a few more tables, offering explanations. The more I spoke, the more favorable the reactions from the upper-level observers became. And of course they would be impressed. I made it look easy, but everyone else here? They were hopeless. And these were not no-names. These were London’s finest.
“Wow… Your skills are truly impressive.”
“And what you say actually makes sense.”
“Above all, at least he’s not a pagan.”
“Well… he might technically be a pagan, but I think he’s more devout than any of us.”
Maybe it was what I said earlier, but suddenly, everyone was staring at me, especially the women. Not all of them, of course. There were still some who looked annoyed by my yellow skin. They might pretend otherwise, but bodies did not lie. Just wait until they felt pain. Then they would come to me.
“All right, now let’s lift the thyroid gland. No, don’t use the knife! How many times do I have to say it? You need to avoid damaging this part. Use a device like this. Go to the blacksmith down the street. They can make it. Watch carefully.”
Ignoring the stares, I continued the surgical demonstration. It was not a difficult procedure, so I did not need to rush. Then came the highlight.
“All right, what do you see here?”
“Uh… is it a bone?”
“No, no. Look closely. It’s too soft to be bone, right?”
What we had in front of us now was the trachea, the airway. Air traveled from the nose or mouth down into the lungs. The trachea had a distinctive structure, which made sense if you understood how breathing worked.
God, I want to show off so badly.
I really did. I wanted to flex. All that knowledge I had stored up from the future was itching to come out. But I held myself back. After all, this was not common knowledge here. How did you explain negative pressure in a world where people thought lungs just inflated on their own? In truth, the diaphragm moved down, creating negative pressure, which drew air in. That was why the trachea needed to be structurally reinforced. Otherwise, it would collapse.
“I don’t know why, but…”
Pretending not to know everything was harder than it sounded. If I did not have a good excuse, I might have left.
“The Lord designed the trachea using alternating rings of cartilage and muscle.”
“Oh, this is cartilage?”
“A ring? But it looks straight.”
“Look closely. And hey, don’t twist the knife like that! What, are you angry because you’re bad with blades? If you want to swing a knife, challenge Dr. Liston to a duel instead!”
As I explained, someone stabbed a scalpel right into the side of the airway. That tore a blood vessel connected to the thyroid gland, and blood started gushing out.
Tch.
I held back a sigh. Princess Victoria was watching from above, after all. Still, I figured this was a good chance to step in.
“Hey.”
The guy looked terrified. And he should have. Dr. Liston was already approaching with his trademark death glare.
“This is someone’s neck. Can we just stab it like that?”
“No… definitely not.”
“Exactly. So do it right, okay?”
“Yes.”
With that, I elbowed him gently to the side and stepped in. He stumbled away, and I reached into the open wound with my gloved hand. Fortunately, the patient was already dead, so the blood was not actively spurting. When the heart stopped, blood pressure dropped. It did not harden immediately, but it also did not gush.
So even if an artery is cut, I can manage…
Anyone who had done neck surgery knew how dangerous it was. The anatomy was cramped and complex. But I had practice. Compared to the mess that was abdominal bleeding, this was manageable. I could even guess which vessel had been hit.
“There it is.”
I scooped out the pooled blood and clamped the vessel with forceps. Not quite as tight as a modern vessel clamp or mosquito hemostat, but it worked. Of course, I would not use these on a living patient, but the guy was dead, and the blood had begun to clot. It was good enough.
“Phew.”
“Oh… already?”
“Well, the neck anatomy is all in my head.”
It sounded cocky. In the twenty-first century, I would never say something so self-aggrandizing. But this was the nineteenth century, where the operating theater was literal, and fame was your marketing strategy.
Good job.
Thanks.
Liston patted my shoulder. A nod of approval from the great Robert Liston himself. I returned to my station, scalpel in hand. I had not even rinsed my gloves yet. They were still stained with blood.
He’s good at dissection and surgery…
He’s amazing…
People whispered around me. The compliments kept coming.
“All right… so, this white part is cartilage. The bits in between? Muscle. See for yourself.”
“Yes. Oh? Ugh—”
“What?”
Anyone seeing this for the first time would be startled. The trachea was hollow. Cutting into it felt like slicing air.
“That’s the airway. The patient isn’t breathing now, but when this opens up, expect things like phlegm to come out.”
If you were lucky, just phlegm. But blood was more likely. You would not know that unless you had seen it yourself. It was not written in textbooks. It was something you learned in the field.
“Anyway, now that it’s open… Do you remember what I told you to order when you applied for this internship?”
“Oh, yes.”
“Good.”
If you did not remember, you were hopeless. Dr. Liston and I had practically begged them to get it. Metal tools were expensive, but worth it.
“Insert it. From now on, the patient will breathe through this hole.”
“Whoa…”
It was a minor surgery, but the reaction said otherwise. Everyone looked stunned.
Well… it was a procedure that changed the entire concept of breathing.
At this rate, I was going to become famous far sooner than either I or Dr. Liston expected.
Footnotes
Translator’s Notes
Hormone — Chemical messenger produced by glands or tissues that affects body functions. The concept was not formally developed until later medical science.
Thyroid hormone — Hormone produced by the thyroid gland, essential for metabolism and survival.
On the Origin of Species — Charles Darwin’s 1859 book presenting the theory of evolution by natural selection.
Negative pressure breathing — Breathing mechanism in which expansion of the chest cavity lowers pressure, drawing air into the lungs.
Diaphragm — Main breathing muscle beneath the lungs; when it contracts downward, it helps pull air into the lungs.
Mosquito hemostat — Small clamp used to control bleeding from small vessels.