Chapter 134: Improvement [5]
“Suddenly screaming like that… what kind of rudeness is this?”
Were there any nobles who enjoyed loud noise? Among the older gentlemen, Sir Jamie and Lord Damien clearly did not.
As people age, their hearing declines… but paradoxically, loud noises become even more unpleasant. That’s because the range of sound they can tolerate shrinks as their hearing threshold narrows.
Why did I, a surgeon, know this? It was not something every doctor learned. I only knew because one of my closest friends was an otolaryngologist.
“Ah… sorry.”
“And Dr. Liston. I know you’re a famous doctor, but I did not summon you. What exactly are you doing barging in like this?”
“My apologies. It’s just… this matter was urgent. As a doctor, I could not ignore it.”
Sir Jamie, who had managed to make the famously irritable Robert Liston apologize, looked like he knew he had just accomplished something extraordinary. It must have felt surreal, seeing someone as massive as Liston lower his head like that. His neck and arms were thick, his chest broader than a barrel. Words like “stocky” or “big” did not do him justice.
“So, you came into my room carrying a weapon?”
“A weapon?”
“That thing strapped to your waist.”
“Ah… this? It’s my surgical tool.”
Sir Jamie, reclining against his pillows, had a clear view from where he lay. And from that angle, the tool genuinely did look like a weapon. To be fair, he was not wrong. Though we called it a surgical instrument, it was mostly used to amputate limbs. In essence, it really was a sword.
There was even a rumor that Jack the Ripper used the same type of knife.
“Oh, is that the famous Liston knife? I heard it has saved many lives.”
“It’s somewhat overrated. But if I may… may I explain why I’m here?”
Liston, standing before nobility, was surprisingly composed. Calm. Polite. He sounded nothing like his usual impatient self. I had to admire the way he carried himself.
Sir Jamie seemed impressed too. Normally, Liston looked like a brute, a gorilla that had learned to walk upright. Now, it was as if a ghost had possessed him.
Even Harry the Butcher kept quiet. He stared at Liston as though he had seen the grim reaper. And to be fair, Liston had been the one who locked him up, and now here he was again, appearing the moment Harry was released.
“Very well,” Sir Jamie finally said. “You’ve come this far. I’ll allow you to speak.”
Liston cleared his throat.
“Sir Jamie, since the surgery… has the discomfort during urination improved?”
“Surgery? What surgery?”
“This one spilled the beans.”
“Hah. This fellow is unreliable. Still, you already know, so I might as well say it. Yes, it improved. In fact… I haven’t felt this relieved in years.”
Lord Damien’s expression brightened noticeably at those words. No wonder. He had been shifting uncomfortably for a while now, probably trying not to wet himself. But he also knew from experience that nothing happened whenever he tried to relieve himself.
“So that’s why you recommended it to Lord Damien?”
“Yes, that’s right. Though again… I probably should not have said anything.”
Harry, having just been released, had gone around telling people that the famous Lord Damien was planning to undergo the surgery too. He flinched under Sir Jamie’s sharp glare, but honestly, it was not that shocking. The concept of patient confidentiality did not exist yet. If you walked into any hospital now, you would hear staff openly gossiping about patients from the previous day.
“Anyway, my conclusion is this: don’t get the surgery. That man’s a butcher.”
“Hm… that’s a rather terrifying warning. But the results speak for themselves. I feel perfectly fine.”
It was baffling. I had seen Harry’s so-called clinic. It was a dump. The sort of place where you questioned whether it should even be called a clinic at all. His tools were filthy, probably never sharpened, and he lacked both skill and reputation. The man likely did not even understand proper technique.
And the surgery… well, I was certain something had been left inside.
Ugh.
The memory alone made my stomach churn. If this had not been a nobleman’s room, I might have vomited on the spot.
“Ugh… why me?”
While I was trying to hold myself together, Hugh, who had been trembling beside me, suddenly got dragged forward. He had a solid build, but Liston yanked him by the collar as though he weighed nothing.
“Hurk—!”
In one fluid motion, Liston drew and sheathed his knife. I only caught an afterimage.
Slap.
And Hugh’s trousers dropped.
The next few moments were grotesque, but 19th-century sensibilities could not always distinguish between horrifying and fascinating. The nobles merely watched with mild curiosity.
“What exactly is happening over there?”
Sir Jamie must have had poor eyesight. Even from where I stood, I could see the cloudy whiteness of early-stage cataracts in his eyes.
People of rank live longer, which means they’re more likely to develop cataracts. Maybe I should start treating those. England’s cloudy, but if I were in sunny France, there’d be even more patients. Treat them properly, and before long I’d have enough fame and money to open my own clinic…
“His name is Hugh. He’s a sailor. He suffered a severe injury to the groin while working, and now both testicles are gone. Can you see?”
“Ah… oh. Yes. It’s… not pleasant.”
Now that I looked closely, it truly was a disaster. A sailor’s life was hard enough already, but this? His “family jewels” had been completely destroyed.
Back in my days as a military doctor, the Navy guys swore more than anyone else. And those ships were modern. I did not even want to imagine how brutal life at sea was in the 19th century.
There was that one guy too… The one who asked me to amputate his arm again just to stop the phantom pain.
“What do you think? Can you still perform…?”
Liston slapped Hugh lightly, prompting him to answer. The poor man looked dazed, clearly unable to process what was happening.
“I… I can’t stand.”
“You used to be able to, right?”
“Yeah. I used to be… pretty strong.”
“Does it hurt?”
“Yes. Yes, it does.”
“Now look at your legs. What’s happening there? You’ve lost muscle. You’re wasting away.”
Liston patted Hugh on the shoulder and pointed toward the inside of his thighs.
As the conversation continued, Sir Jamie, Lord Damien, and even the young men who seemed to be Sir Jamie’s sons all leaned forward, listening intently. I could not blame them. Whenever the topic shifted to a man’s lower half, everyone paid attention. I was no different.
“All of this… because we don’t yet have the right tools.”
“No… No…”
Sir Jamie had already sunk into despair, muttering “no” like a man possessed. He sounded exactly like a Korean father hearing that surgery would cost ten million won.
“Sigh…”
In contrast, Lord Damien remained composed. After all, he still had both of his.
“But seriously,” he said. “How am I supposed to fix the urination problem? It always feels like my bladder’s full. I can’t relax during social gatherings.”
Ah. I had missed it earlier, distracted by Hugh’s shocking appearance, but now it was obvious. He had classic symptoms of benign prostatic hyperplasia.
As the prostate enlarged, it compressed the urethra, causing residual urine, constant pressure, dull bladder sensation, and uncontrollable urges. For someone with an active social life, it must have been maddening.
“Dr. Pyeong, my student and also a professor at our university, will explain.”
“Doctor Pyeong? That name sounds unfamiliar.”
“Not long ago, we performed autopsies on death-row inmates at the Royal Opera House.”
“Iced coffee! Right, right. There can’t be many Asian doctors in London. You must be that one.”
Sir Jamie mumbled while fumbling with his blanket, speaking almost to himself. I decided to ignore him and focus on Lord Damien instead.
“Yes, I’m Professor Pyeong. It’s an honor to meet you.”
Though honestly, this did not feel honorable at all. A nobleman whispering anxiously about his testicles, a butcher lurking behind me, Hugh’s trousers still pooled around his ankles…
“All right. Go on.”
Thankfully, Lord Damien did not seem bothered and gestured for me to continue.
“First, something useful. Ah, thank you. A ruler, please.”
I drew a simple anatomical diagram: kidneys, ureters, bladder, urethra, prostate.
“When the prostate enlarges, it presses against the urethra. That obstructs urine flow. Up until now, treatment involved cutting through this area to widen the passage, but that method is dangerous and not very effective.”
“And your method… is safer?”
“Yes. It avoids the worst complications. So here is the new approach I’m proposing…”
As I sketched the instruments and explained the procedure, time slipped by.
Behind me, I could hear Sir Jamie quietly sobbing, but it was not enough to distract me from the explanation.
Footnotes
Translator’s Notes
Jack the Ripper — Unidentified serial killer active in London’s Whitechapel district in 1888, infamous for murdering and mutilating women. The narration references the type of knife associated with Robert Liston’s surgical instruments.
Otolaryngologist — Medical specialist focused on diseases of the ear, nose, and throat (ENT).
Benign Prostatic Hyperplasia (BPH) — Noncancerous enlargement of the prostate gland that commonly affects older men and causes urinary obstruction.
Phantom Pain — Pain sensation perceived in a body part that has already been amputated or lost.