Chapter 137: Finally, Surgery [3]
After performing Digital Rectal Exams on three groups, around thirty patients in total, I was able to select eight who, in my judgment, would not suffer an accident even if I operated. Among the remaining people, there were at least ten who did not show any clear symptoms at all. That was when I felt like I truly understood what “public welfare” meant in nineteenth-century London. Of course, that was just my opinion…
“Hey! Why not me?!”
A kid far too young to be having prostate issues was yelling, glaring straight at me. If I had been alone, I probably would have been nervous. But now?
“Are you dissatisfied?”
“No… it’s just…”
Liston had that kind of presence. He could make you admit a mistake even when you had not made one. This time was no different. A few of the louder complainers were immediately kicked out. Some tried to blend in and keep quiet so they would not be noticed and dragged off, but Lord Damien’s private soldiers were merciless.
“So, these eight are suitable for surgery?”
There were eight patients left in the room. All looked elderly and haggard. A faint earthy smell wafted from their clothes. The wealthy could afford perfume to cover up body odor. For these men, perfume might as well be a myth. They were too busy trying to stay alive. Nostalgia was a luxury.
“Yes. We’ll be operating on these eight.”
“What… That’s more than I expected. And they do seem to have more serious symptoms.”
A reporter asked me directly, but they were also chatting among themselves. Since I was not hiding anything, I could hear everything.
“I was wondering what was going on…”
“There are records that say prostate size can be evaluated this way. The knowledge itself isn’t new.”
“But can you really decide whether to operate based on size alone?”
“Eh, I think it’s more about discomfort. Ultimately, it’s the surgeon’s call.”
It was not exactly a productive conversation, but it did highlight one of this era’s limitations.
Right… there’s no such thing as clear surgical indication here.
“It’s up to the surgeon.” That might sound like trust, but in this time period, it was terrifying. It basically meant: do whatever you want. There was no standardized treatment. If a surgeon wanted to try something new, he simply did it. Sure, that might occasionally lead to innovation, but far more often, it just led to accidents.
One step at a time. Let’s fix what we can.
Today, I found one thing to improve. Granted, there were too many things that needed fixing… but I pushed that aside and called in the first patient.
“You fasted, right?”
“Ah… yes. But why? I’m starving…”
Like the others, this man was very old. Even accounting for the fact that nineteenth-century people looked older, he seemed over eighty. Honestly, he looked like he had just crawled out of a coffin.
“You really didn’t eat?”
“Oh… well, not exactly…”
“Okay, I believe you.”
It was not right to scold someone like that. Nor was it right to be too strict with him.
If this were a different kind of surgery, abdominal surgery, for instance, he would be admitted and made to fast. But this… this was prostate surgery.
Unless something went wrong, I would not even need to touch anything else. And I was being extremely conservative with patient selection. I was not aiming for glory with these operations.
Fortunately, vomiting was not a known side effect of this Anesthetic Gas.
That said, we had not used it enough to be sure. Statistically, our sample size was still too small. I remembered reading an article years ago about Anesthesia use in Korea. It did not sound too dangerous. In any case, the man probably had not eaten much to begin with.
Life must be hard. His teeth were in terrible shape.
I doubted he would survive long like this. There was a saying: exercise was half the battle, and diet was the other. In the elderly, eating well was everything.
Still, for now, we were good to proceed.
While I prepared mentally, my assistants, Joseph, Alfred, and Colin, brought in the sterilized surgical instruments. The operating table was already inside the room, so we did not have to move anything large. Still, setting up all over again for each surgery was annoying. But what could I do? For people of this era, the idea of disinfection and sterilization was completely foreign.
If the professor criticizes me, I’ll criticize him right back. That’s the power of being one myself.
Even in the twenty-first century, the power dynamic between professors and students was steep. In the nineteenth century? It was even worse. But right now, the medical license was half in my hands, so I had to keep playing that game.
Clack.
The surgical instruments clinked into place beside the table. A few reporters approached, wide-eyed with fascination. I could not blame them. They had never seen tools like these before. But…
“Whoa…”
“This is…”
“Don’t touch anything.”
“Why not? Is it cursed?”
“No. It’s sterilized.”
If they touched it, I would have to boil it again. And even then, boiling was not completely effective.
Stay calm. Breathe.
I had lost my composure for a second, but I regained it quickly. I had to. The fates of dozens of Londoners’ testicles, and my own reputation, rested in my hands. I was still wondering whether Princess Victoria might become my official sponsor. I could not afford a screw-up now.
Even if this was a time when you could kill one or two people without anyone caring… that was not how I worked.
“Patient, lie down, please.”
“Uh… yes.”
The patient looked at me, then at Lord Damien. Only when Lord Damien gave a silent nod did the man lie on the table. He must have wondered what kind of doctor he was getting. I pushed the thought aside.
“Shall we put you under?”
“Ah, yes.”
Colin moved quickly, placing the mask over the man’s nose and mouth. I do not think I mentioned this before, but the mask had been upgraded. I had already worked with rubber when making urinals. I asked the Chemist to try making something similar, and he delivered something crude but functional. Primitive, yes, but it kept the person next to the patient from getting anesthetized too.
“Ugh…”
Soon, the patient lost consciousness. Compared to younger patients, older people seemed to respond differently to the gas.
Better not take too long.
If I repeated this too many times, I would end up with a corpse that had its prostate gouged out. That was not exactly the goal.
“Let’s position him.”
“Yes.”
With practiced efficiency, Joseph and Alfred helped remove the patient’s trousers and spread his legs apart. It was not a sight I wanted to see, not now, not ever. But medically, this was the right view. In surgery, visibility was everything.
“Let’s disinfect the area. Bring the alcohol.”
“Right.”
Originally, I had planned to use Lime Chloride, but Alfred convinced me that it might cause a stir if it touched a sensitive spot. Honestly, my hands were sore too.
Will alcohol be enough?
I was not sure. But I cleaned the area with a cotton pad soaked in alcohol. It had to be better than nothing. Then I shaved the hair.
“What is this?”
“Why are you doing that?”
Apparently, my already-ugly face was looking even worse. The reporters started whispering again.
Idiots.
I did not usually act like a chosen one, but I would make an exception this time. This was for hygiene. Hair, no matter how clean it looked, trapped bacteria. And this man clearly did not wash his clothes regularly. Who knew what microbes were thriving here?
“Urine line.”
“Got it.”
After finishing disinfection, I pulled the penis taut and carefully inserted the Urinary Catheter, crafted with a blend of the Chemist’s sweat and Alfred’s blood and tears.
“Couldn’t you have done that before Anesthesia?”
“Quiet.”
There was a brief complaint from Alfred, but I ignored it and focused.
“Mmph!”
At one point, I felt a lot of resistance.
Ah… the prostate. Definitely enlarged. Classic BPH.
Good thing I used the sturdiest of the three catheter materials. Anything softer would have failed here. I braced myself.
Pop!
With a final push, the tube passed through, and urine gushed out onto the floor.
Ah, crap…
The original urinal had a bag attached. This prototype did not. The wooden floor soaked it right up, and the smell settled into the room.
And who was watching?
Liston.
“…Shit.”
He was giving me that look, the one that could kill. I quickly turned back to the patient to escape his glare. After the urine flow slowed, I removed the catheter and inserted my secret weapon: the Prostatectomy Tool.
“Wow…”
“Look at that!”
The reporters were buzzing. The device slid into place smoothly.
Good… We’re in business.
I took a breath and calmed myself.
Footnotes
Translator’s Notes
Digital Rectal Exam — A physical examination in which a doctor inserts a gloved finger into the rectum to assess the prostate. Before modern imaging, it was one of the few available ways to estimate prostate enlargement.
Anesthetic Gas — Gas used to induce Anesthesia during surgery.
Lime Chloride — A harsh disinfectant used experimentally for hygiene in the hospital wards. Pyeong avoids using it on a sensitive area and uses alcohol instead.