Chapter 186: More Advanced Surgery [3]
Obsessed with hygiene.
If I had to sum up the current atmosphere in a single phrase, that would be it. Hygiene obsession.
Since when had these lunatics become so obsessed with sanitation?
“Oh my God… Slit your hand!”
“Ugh! I have to do this to kill the miasma!”
Seriously…
If Liston were not around, I might have slapped someone.
Although… I’m in no position to talk.
Who was to blame, really? I was the one who dunked my students’ hands in lime chloride. Meanwhile, I had only rinsed mine with diluted water or soap.
And this was the result.
As soon as I return, I should clarify that even washing with soap greatly reduces miasma. Disinfecting gloves is more important than disinfecting hands… No, wait… that’s not quite right either…
Could I really justify it?
Even in the twenty-first century, soap was just soap. Washing your hands might be enough when dealing with patients, but for surgery? No way. In modern medicine, you would use povidone-iodine—and not with bare hands, but with gloved ones.
Is that really necessary…? Wait, what am I thinking?
Had my brain been completely marinated in nineteenth-century thinking? Did I really think that much cleaning was overkill?
No. Of course not.
“Eww!”
“Right… Gloves. You should wear gloves.”
“With bare hands?!”
“Pyeong! That’s gross!”
I was irrationally annoyed by their dramatics, but still…
It was good.
A nineteenth-century doctor worrying about hygiene?
Incredible.
“Come now, patient. There may be miasma here—”
“No! Wait a minute!”
But spraying lime chloride directly on the patient’s skin? That was crossing the line. Skin was the body’s natural barrier. If you damaged it, you actually increased the risk of infection.
“Why?”
“We have to eliminate the miasma!”
“Right! We have to wipe it out!”
“No, no. Wait. Look, not on the patient. It’ll hurt too much.”
How was I supposed to explain this?
I tried muttering something about the skin being a protective layer. Liston chuckled.
“Haha! What’s a little pain? Pyeong, we are on the verge of a medical revolution! The cholera outbreak inspired me. Everything just clicked into place! We only need to return to London and present our findings! Ha ha ha!”
Genius was as genius did, I suppose.
He really did have a spark of insight.
But modern medicine was not born from a single genius. It was built by dozens, even hundreds, through trial and error.
No one could do it alone.
“Professor… Oh! That reminds me—Senior Alfred!”
“Eh? Me? Why me? I wasn’t doing anything. I’ve been quiet!”
Desperation made you see solutions.
Maybe not for them, but for me, Alfred was the key.
The poor guy looked panicked. Understandably so. He was still scarred from the whole catheter incident. But since I was not doing anything like that today, I could at least be confident.
“Senior Alfred.”
“Eh? Me? Why me? I wasn’t doing anything. I’ve been quiet!”
It had been a minor cut from a dissection accident. The wound itself had not been huge, but because it scraped against the road, it became infected. Still, he survived, so I could not complain.
You’re glaring at me…
Alfred was shooting daggers at me, probably remembering the pain.
But what could I do?
“How did I survive? Well, anyway, listen. When you get injured, the wound festers, right?”
“Yeah, obviously. If I’m lucky, I live. If not, I lose the limb—or die.”
“Why do you think it festers?”
“Huh? Because… miasma?”
His answer carried a hint of uncertainty.
Liston’s attention had already shifted from Alfred’s hand to the patient’s back, where pus was visibly pooling.
“Right. That’s what happens. But think about it. What is a wound?”
“A tear in the skin. Bleeding.”
Exactly.
Yes.
Smart people loved being taught things.
I glanced at Blundell, who still looked solemn, and at my three students whispering among themselves before turning back to Liston.
“Yes. When the skin is torn, miasma gets in through the gap. That’s why wounds fester.”
“Ooh… So as long as it stays outside, it’s fine?”
“Right. That’s why the patient is in greater danger if her skin is already damaged.”
“Wait. Then our hands—what should we do? Am I getting cholera? Is it festering already?! The fate of London rests in my hands!”
Liston looked as though he were about to convulse.
Sure, minor wounds did not usually cause serious infections in healthy people, but how was I supposed to explain that without antibiotics?
The Joseon miracle excuse won’t work this time.
So I changed tactics.
“We’re not wearing gloves.”
“Oh. I see.”
The logic was full of holes, but their understanding was already like a sieve. So somehow, everything worked out.
“The key is cleanliness. That’s what matters. Instead of using lime chloride on the patient, let’s use something gentler.”
“Like what?”
“Alcohol. When I distilled it and used it to clean wounds, the miasma decreased.”
“Alcohol? So the older methods had some scientific basis?”
“Maybe. Possibly.”
“If you say so, then it must be true. Alright. Pour the drink.”
“Yes, right away.”
It worked.
Everything worked.
A white lie?
Maybe.
But it was helping correct their ideas about hygiene and infection, so I had no regrets.
I poured strong alcohol onto the patient’s back. It would not have worked with ordinary wine, but thankfully whiskey was easy enough to obtain in Paris.
Shiver.
After cleaning the wound thoroughly and allowing the alcohol to evaporate, I picked up the scalpel.
I was about to cut when—
“Wait. No anesthesia? You’re more brutal than I thought.”
“No, that’s not it…”
I had simply become momentarily confused.
Normally, when a patient was positioned like that, anesthesia had already been administered. But my explanation fell flat among people whose image of me had already become distorted.
Everyone simply stared at me with fearful expressions.
“It’s fine. I explained earlier. This is…”
“A test of endurance! I thought I was going to die!”
…Alfred again.
A bit dramatic, considering he had nearly died because of the wound, not because of me.
I saved him, didn’t I?
Still, while I was fumbling for a response, Liston suddenly spoke.
His voice was unusually gentle.
“Madame. This will hurt a little. But it will be brief. You can endure it.”
“Yes. I’ll try.”
…Was that a flirtatious tone?
I glanced at him.
He gave me a look, then shrugged.
“If you want to be popular, learn from me.”
“That—”
“You can’t. You’re cold-hearted.”
“No, I’m not…”
It felt unfair, but what could I say?
It was Liston.
One look at his face, and my frustration melted away.
“Alright, patient. It’ll sting a bit.”
“It’ll sting a lot. He’s a bit—ha ha.”
I ignored him and made the incision.
“Ugh…”
As the scalpel sliced through the tissue, a foul-smelling stream of pus poured out.
“Gauze.”
“Gauze? Oh, here.”
Even releasing the pressure made a significant difference. But to drain it completely, I needed to squeeze.
Fortunately, we had made gauze-like materials earlier during the cholera outbreak. In reality, they were just clean cloths, but they were better than nothing.
“Ahhh!”
“Pyeong! What are you doing?!”
I pressed on the wound with both hands and squeezed out the remaining pus.
The patient screamed.
Everyone looked horrified.
Especially Liston.
For all his cheerfulness, he was the most sensitive to patient pain. That was why he wielded the knife so quickly. In his mind, pain should last no more than thirty seconds.
“This is how I save lives.”
“This is how? That’s horrifying! If I’d known you were going to do that, I would have anesthetized her myself!”
“Huh?”
“You said you were going to anesthetize her… Then you didn’t. Good grief.”
And this was coming from the man who amputated limbs as though he were chopping vegetables.
Seeing him sigh while watching me work was a strange feeling.
But I really was trying to save her.
“It’s alright.”
Sophie Germain remained remarkably composed.
True to her reputation as a mathematician, she endured the procedure with extraordinary self-control.
“I need to squeeze a few more times. Will that be alright?”
Sorry, but there was still more inside.
In this era, without antibiotics, even this amount of infection could kill.
I had no choice but to clear it all.
“Ah.”
Sophie looked stunned.
Liston leaned toward me and whispered:
“If you ever need someone tortured, let me know.”
I had no comeback.
This really did look like torture.
After several more squeezes, I finally got everything out.
Now came the real dilemma.
Should I suture it?
If I had antibiotics, sure.
But without them, stitching it closed could trap infection inside and make things worse.
Plus, she still had to undergo a mastectomy.
If the infection spread because her immune system was weakened…
She would die.
“Let’s leave it open for now.”
“Open? You’re leaving it open?”
Luckily, I had logic on my side.
Thanks to our walking trauma encyclopedia.
“Senior has something to say.”
“Alfred?”
Liston looked at him expectantly.
Alfred blinked, then nodded and began explaining.
“Oh… right. Back then… not everything came out at once. You squeezed again, and again…”
His face turned pale, as if reliving a nightmare.
“So?”
“So the pain lasted for days. If you suture it now, you’ll just have to reopen it later and squeeze it again.”
“Oh dear. That won’t do.”
“Yeah. Back then, after about a week… Honestly, I wanted to kill Pyeong.”
Understandable.
Even with treatment, if it became infected again…
“She fainted.”
“Madame Germain?”
“Yes. Just now. I think the squeezing pushed her over the edge.”
Liston looked at me, his expression equal parts concern and blame.
“Was it because of the pain?”
“She was fine until a moment ago. I think the squeezing did it.”
Somehow, even though I had done everything right…
I still felt like the villain.