Chapter 138: Finally, Surgery [4]
I wasn’t the only one who had made up my mind.
“After this.”
Robert Liston had too. But he looked… tense. Not nervous. No, it was not nervousness.
“Shit.”
It was anger. He was shaking with rage. I was so anxious myself that even that anger felt unfamiliar.
“Brother?”
“Ah… he’s going.”
But what could I do? Everything that was about to happen was something Liston had brought upon himself.
Still… doesn’t this prove he’s a genius?
I was honestly shocked when Liston said that. For a man who had spent his entire life performing surgeries, especially in the nineteenth century… well, surgery back then was not the kind we thought of today. You could not rely on vision or touch in the same way. And yet Liston had come up with a method to monitor the surgical site by touch.
“Ha…”
Let me explain. “Monitoring the surgical site by touch” sounded fancy, but the method was not. Liston checked his gloved hand several times, came over to me, and inserted his finger into the patient’s rectum. Then he fumbled a bit with his index finger, frowned furiously, and nodded.
“I can feel it.”
“Yes.”
He had located the prostate by touch. In this case, it was large enough to feel easily, so there was nothing special there. But the idea itself was brilliant.
If this guy had been born in the twenty-first century, he could have done anything.
It hit me just how much of the ridicule I felt toward people here was unfair. The problem was not them. It was the limitations of their time. If this method could be refined, even patients with smaller prostates could be treated safely.
“Let me know if it starts to feel smaller.”
“Okay. Want to get started? By the way, did you wipe it earlier? I cleaned, but… why does it still smell?”
Well, because you just stuck your finger in someone’s rectum. They did not even have the concept of Enemas here. That was why we needed to be extra careful.
“Anyway, just let me know. The most important thing is avoiding complications.”
“Got it!”
“Good.”
Liston was still snapping angrily, but I was the one holding the scalpel now. In the operating room, the surgeon was king. And as king, you had to stay calm. Luckily, I had mastered that long ago.
Exhale.
If I was not careful, this patient could die. Septicemia from Fecal Contamination during prostate surgery? That kind of thing should keep anyone up at night. But I felt my heartbeat slow. Not because I was insane, but because surgeons got used to walking a tightrope like this.
Click.
Once I was fully focused, I started moving the instrument. Nothing flashy, just a careful back-and-forth motion of the blade inside the tool. Crude, really. Like pushing and pulling a syringe. But each motion sliced off a fingernail-sized piece of the prostate. I would need to do this at least a hundred times.
Ah… this is exhausting…
Back and forth. Over and over. It was slow, repetitive, and the tool felt ridiculously small. I wondered:
Can’t we just cut it in chunks?
But of course, Liston had already answered that.
“If you cut too deep and hit the rectum, the patient will die.”
“Why?”
Simple.
“When the rectum tears, feces leak.”
Right. They don’t even understand germs yet.
I needed to reframe it for them, maybe call it “bad energy” from feces or something. It was pathetic to fall back on pseudoscience after being trained in modern medicine, but I did not have a microscope, and physics gave me a headache.
“Leaking feces is dangerous,” I said. “To repair it, you’d have to open the abdomen.”
“Oh, we don’t open abdomens.”
Apparently, opening the belly was still viewed as taboo, almost superstitiously. That was another wall to tear down someday, but for now, I was grateful it meant we could keep using this slow but safer method.
Click.
Even so, the actual process was dull and grueling. I manually rotated the instrument 360 degrees, shaving away the prostate. No Endoscope, no live imaging. It was like carving in the dark. Thankfully, I was confident in my Anatomy knowledge. This was my first real surgery here, but I had studied and practiced enough to picture everything in 3D. If I had not, I might have fallen asleep from boredom.
“What kind of surgery is this? So dull.”
“What is he even doing?”
“Where’s the knife? Is this even Liston?”
“I’ve never seen such a timid operation!”
That was the reporters talking. Of course they did not get it. This was not exciting to watch. But I wanted to yell:
You idiots. That sword you admire is a relic. This is real medicine.
“Pyeong.”
“Yeah?”
“It feels smaller. Definitely less pressure.”
Liston’s index finger, still in the rectum, pressed forward. I could feel the change through the instrument. I double-checked with a few more back-and-forth motions.
“There’s definitely less resistance.”
“Good. I’m pulling out.”
With that, Liston removed his hand and threw the gloves, which landed right in the puddle of urine on the floor.
“…Holy shit.”
He picked them up with the kind of face that screamed “fuck,” if he had known the word. He glared at the gloves, then bolted off to wash up.
“Goddamn it… How many more patients are there?”
“Seven.”
“Damn…”
He kept cursing as he scrubbed. I had told him to wash up before, and he had ignored me. Now, a little feces changed everything. I considered using that as a teaching moment, but gave up. Some nineteenth-century doctors probably would not mind wiping their faces with feces if it helped them look tough.
Click.
I removed the device and inserted a catheter. It was not easy. Earlier, it had been too narrow. Now, it was too wide. If I angled it wrong, I would end up turning it inside the bladder. Thankfully, it went in smoothly this time.
“Make sure this doesn’t come out.”
“Got it.”
“I’ll tie it down.”
The “tie” looked more like something you would use on a prisoner than a patient. But if we secured it with that…
It’s not just restraint. It’s full-on immobilization.
This operation was short, so we probably would not see any Post-Op Delirium. Still, the willow bark solution I had used as an Analgesic was not that strong. Side effects were possible. Add to that the chaos inside the hospital: doctors, nurses, students, patients, everyone fighting over something. People here did not take instructions seriously. If you said “don’t move,” they would move just to spite you.
“Okay, we’re done.”
Finally. The operation was over. It may have seemed minor, but I had been tense the whole time. Sweat clung to my forehead as I wiped it away.
“It’s done?”
“Where’s the blood?”
“No screams?”
“What kind of boring surgery is this?!”
The reporters were shocked. What, did they come expecting an execution? Maybe they had. That would not have been odd here. London was still the kind of place where you could watch a beheading on the street and eat blood-soaked bread while doing it.
“Lord Damien, what did you think?”
“Very good. It didn’t look dangerous at all.”
“Yes, just as you saw. But I’ll monitor him just in case.”
“Of course. I appreciate it.”
At least Lord Damien, the patient, seemed genuinely pleased. Back then, even with Anesthesia, surgery was still viewed as extreme, sometimes even entertainment. Liston’s operations were the stuff of legend. Terrifying to outsiders. But not to me anymore.
“Hey… brother?”
“Ha…”
“Brother?”
“Ugh…”
“Brother?”
“Hehe…”
Liston and I continued operating on the remaining seven patients. With each one, I improved. The changes were minor, like inserting a mesh basket before the catheter, but things were getting cleaner and more efficient.
Only one thing was not improving: Liston’s mood.
“I’m sick of this plugging…”
He muttered, staring down at his ungloved hands. When Lord Damien stood again, he called out:
“Reporters, you may leave. It’s my turn now.”
Liston sighed deeply but did not leave the room. As always, for all his bravado, he was strangely weak when it came to authority.
Footnotes
Translator’s Notes
Septicemia — A severe bloodstream infection that can occur when bacteria spread through the body. Here, Pyeong fears it could result from fecal contamination during prostate surgery.
Fecal Contamination — Contamination by feces, especially dangerous during surgery because it can cause severe infection.
Post-Op Delirium — Confusion or agitation after surgery, especially in older or weakened patients.