Chapter 143: Let’s Reduce Amputation [1]
That bastard… was he a drug addict?
Morphine isn’t necessarily a bad thing. It depends on the person using it… I guess Pyeong’s a bit like that?
You’re always bullying the professor.
Apparently, my smile gave the wrong impression. I could tell from the way the three of them were whispering about drugs. What could I say? Medicine and science were pretty strange during this period. Nitrous Oxide was already known as Laughing Gas, ether existed, and yet anesthesia was still just done with alcohol. Morphine, despite its incredible pain-relieving properties, was likely being ignored.
It’s fine… I can handle a few misunderstandings.
It was worth enduring if it meant saving lives. Reputation was secondary. And since the social climate here was fairly tolerant of opium and morphine, I doubted I would face any real restrictions using it.
“Anyway… I’m glad the surgery went well.”
Lord Damien smiled weakly, patting his now-empty bladder.
“Honestly, I’m fine with just feeling cool down there. It’s a bit uncomfortable otherwise, but… I can live like this for the rest of my life.”
“Forever” might be a stretch. Given the average life expectancy in this era, Lord Damien likely did not have many years left. Not that I was cursing him. It was just a statistical reality. Still, saying it aloud would have made me sound like a heartless lunatic.
“Good, okay. Just hearing that makes me feel better. You did well. I’ll make sure to repay you.”
“I didn’t do it for that, but… thank you.”
“Yes, yes. Don’t be picky. When nobles give gifts, it’s polite to accept them.”
“Right. I’ll keep that in mind.”
I left Lord Damien’s bedside and made my rounds to check on the others who underwent surgery yesterday. Most of them looked stable. They were clearly older and, unlike Lord Damien, suffered from poor hygiene and malnutrition, but there were no immediate signs of infection. There was always a risk of UTI later, but luckily, with the humidity this time of year, even moldy bread might come in handy if needed in an emergency.
“This is all thanks to you, brother.”
I thanked Liston sincerely. I was not just buttering him up. Without his help, especially his prostate check via rectal exam, some of the patients might have ruptured from internal abscesses. That could have been fatal.
“But next time… let one of your students handle it.”
“Think they’ll be any good? Sensitivity is a talent too, you know.”
“Right…”
“I can only trust you, brother.”
“…Understood.”
Liston sighed. It was nice being trusted, but I did not want to be the one always stuck with it. Still, I needed him for future surgeries, so I had to play along.
“Professor! There you are!”
One of Liston’s students came running over. I recognized his face. It looked like he was a regular assistant.
“Huh? What is it?”
“We’ve got another Amputation round today.”
The student mimed chopping his arm off with a bright grin. Somehow, that cheered Liston up. He straightened up and smiled.
“Right, right. How many today?”
“Ten.”
“That won’t take long.”
Only someone like Liston could say that ten Amputations would not take long. In any sane world, performing ten limb Amputations in a day would be horrifying. But this was nineteenth-century surgery, and Liston was a legend. Fast, precise, and terrifying.
“You haven’t been here in a while. It’s progressing little by little.”
“Yeah… something like that.”
It would probably take an hour or two at most. If helping with this was the price for getting his assistance with yesterday’s operation, I would gladly pay it. So I followed them to the operating theater. It was already packed, not just with patients and their guardians, but with curious onlookers. Yes, watching surgeries was apparently entertainment.
“Huh? Don’t bring in spectators? Haha! Do you know how much their money helps run the hospital? Sometimes nobles pay extra! Say that again, and you’ll be dragged away before you even know it!”
That was what the director told me when I once suggested banning spectators for hygiene reasons. Well, considering he also blamed “the energy of the earth” for Puerperal Fever, I guessed I should not have expected much. Insane.
Ah. Why is he here again?
Among the crowd was the director himself. From what I knew, he was a fairly prominent physician. Lately, he had been hanging around the hospital aimlessly. He could not even sit still. He just stood and hovered.
“It’s Liston!”
“It’s Sword Master Liston!”
“Over here!”
The atmosphere was closer to a concert hall than an operating room. These people were insane. Amputating limbs was a violent, gruesome procedure, not a party trick.
“Ha ha ha! Hello.”
Of course, Liston loved it. Fame, money, reputation. What more could a doctor want?
Sigh…
With brilliance came shadow.
The first patient trembled visibly. Thanks to anesthesia, he did not need to be physically restrained anymore. But fear? That was not going anywhere. Amputation was terrifying no matter the era. Losing an arm or a leg was no small thing.
What kind of wound did he have in the first place…?
Amputation had not vanished even in the twenty-first century. Diabetes-related gangrene and serious trauma from car accidents, especially motorcycle crashes or pedestrian injuries, were still common causes. In those cases, there were often no other options.
But here… people get amputated for something as small as a splinter.
Tetanus came to mind, but that could not be the only cause. Honestly, I did not know. I had only been here for less than a year and mostly stayed with Liston. I saw lots of Amputations, but not much actual wound care beforehand.
Well, at least the prostate crisis is behind us. Let’s take a look at hemorrhoids next.
That had somehow become my job too. But unlike prostate surgeries, hemorrhoid treatments did not require brutal operations like orchiectomies. No need to rush. Sure, my specialty was not colorectal surgery, but in Korea, hemorrhoid cases kept many surgeons financially afloat. I knew the ropes.
“Hoo…”
The patient let out a terrified breath. My assistant handed me the mask I designed, loaded with Anesthetic gas. That system still needed refining. In fact, we really needed to rely more on local anesthesia rather than general anesthesia. It was safer. Even though I did not fully understand the long-term effects of these Anesthetics, I doubted they were doing anything good for the brain.
“Hoo…”
“You’re up now, Professor!”
Liston responded to his assistant’s call with a grunt. He slipped on his signature black gloves and picked up his massive surgical knife. I tried lifting it once. It was not light. Certainly not something you would want to swing around.
Humming.
“And now… the wind rises!”
“He’s incredible!”
Even that huge blade—Liston handled it like it was part of his own body. His movements were swift and precise. The assistants quickly tied off the patient’s upper arm to reduce blood flow.
“All right… Here we go.”
“Yes, sir.”
Humming.
“And!”
With that shout, the blade came down. Before the crowd could even gasp, the saw was already in Liston’s hand.
I’m going insane…
His speed had improved again. But it made sense. Performing ten or twenty Amputations a day meant he was only getting faster.
Step by step, the bone was cut. Blood vessels were tied off. If they were not tied properly, bleeding would recur, but that was something you could teach. You just had to do it naturally. Teach by doing.
“Hm.”
At that moment, the director approached me. He clearly wanted to talk, so I turned to face him.
“Yes?”
“Let’s step outside.”
“Ah… sure.”
I thought he was just here to observe, but apparently not. We stepped into the hallway. The director glanced back into the operating room, then spoke.
“As you can see, the number of Amputations is going down.”
“Ah…”
Only ten today, come to think of it.
“Everyone who needed to be cut… has been cut.”
He was not asking me to go out and find more Amputation cases, was he?
“This trend will continue. But the problem is… people really hate Amputation. You know that, right?”
Of course I knew. Still, I nodded politely.
“Yes.”
“Good. I’m surprised you understand.”
Surprised? Was it not obvious that no one wanted their limbs cut off?
“So I thought, what if we could treat these cases without Amputation?”
“That would be amazing.”
“Of course, it won’t be easy. But you know, British medicine is the best in the world right now. It’s the culmination of scientific achievement, developed with the uniquely bold spirit of our empire.”
“…Ah. Yes.”
So many things were wrong with that sentence that I did not even know where to start. If he were not the director, I might have decked him on the spot.
“Still… you’ve clearly got a fresh perspective. That’s why I made you a professor, even at your age.”
“That’s high praise.”
“So take a look at our wound care system. Let me know if anything can be improved.”
“I’ll do my best.”
Even if he had not asked, I was planning on it anyway. But if the director was giving the green light, then I would not hesitate.