Chapter 196: Hygiene Obsession [5]
“What do I clean it with?”
Normally, wasn’t that something you should figure out before laying the patient down?
I looked down at Liston, who was muttering while staring at the unconscious patient, and swallowed the words rising in my throat. What if I got punched for saying it out loud? More importantly, this was not about criticizing Liston right now. It was about what we would actually use to disinfect.
We had two candidates: phenol, also known as carbolic acid, and iodine.
Of course, I wanted to use iodine. That had been my choice from the beginning of the experiment.
I think iodine was improved somehow… Betadine? Isn’t that like an upgraded version of iodine?
At first, I was convinced it had to be iodine. But the moment I heard the others say the word out loud, doubt crept in. It probably was not just iodine in modern usage. If that was true…
Then phenol can’t be the complete answer either… Is that what this means?
That left only one option: human testing.
So what were we supposed to do now?
For once, I had no clear answer.
“Pyeong, do you have any thoughts?”
“Yes? Ah, yes, brother… I don’t know.”
“Don’t they even do this kind of thing in Joseon?”
“Well…”
Did they? Surgery had been virtually absent from Joseon’s medical development. Disinfection before surgery? Unlikely.
“No.”
“That’s what I thought. So what now?”
As I remained silent for once, time passed awkwardly. But not everyone stayed quiet.
“I think—” Alfred began.
“You stay out of it,” Liston interrupted.
“Still…”
“Well, do you want to take a phenol bath? If you volunteer, I’ll think highly of you.”
“Ah…”
It was no use. In fact, it could have been dangerous. Alfred was practically our designated test subject. Even I had considered using him for this.
“Hmm…”
While I was silently thinking, the patient suddenly woke up. I could not believe he came to so quickly after being jabbed in the back by Liston. He must have been a tough man. Still, even the toughest would cower in front of Liston, and the pain in his abdomen had already worn him down.
“Damn it. These… these bastards!”
He tried to shout, but could barely muster his voice. It seemed he had no intention of swinging at Liston again, which was fortunate.
“Hey, brother, you’re seriously going to pour that on his face?”
Liston picked up the bottles of phenol and iodine and held them out in front of the patient. I thought he might really do it.
“Do I seem like some kind of brute? I am a rational man of science, thank you. I’m disappointed.”
“Ah… no, I didn’t mean it that way.”
“Good. Because I was going to ask.”
“…You’re asking?”
As I stood there confused, Liston, one bottle in each hand, looked down at the patient and asked him plainly:
“Which one do you prefer?”
“Uh…”
The patient blinked, clearly not understanding the question. So Liston leaned in, holding the bottles even closer to his face.
“What do you think is better?”
Phenol reeked. Iodine was not much better, though the smell was milder. The yellowish color, however, looked dangerous even to me. Naturally, the patient still looked baffled. Of course he did. How could he possibly know the difference? In a world where even doctors did not understand disinfection, how could a patient?
Still, something in Liston’s tone must have tipped him off. If he did not choose, something worse might happen. So he opened his mouth.
“Uh, just give me a second!”
“There we go. See?” Liston beamed. “Rational. Democratic. Scientific. What a civilized process!”
“Uh…”
Letting the patient choose the medicine. Had that ever happened, even in the twenty-first century? I found myself sincerely impressed.
Wait. No. The doctor’s job is to recommend the best treatment. This isn’t about preference.
I snapped out of it, but Liston, ever impatient, had already taken my moment of admiration as approval and looked pleased.
“From now on, we’ll just do it this way. There are only two options. It’s easy. And if something goes wrong later, it’s easier to shift the blame, isn’t it?”
He said this confidently, right in front of the patient. The man’s expression darkened, but Blundell, instead of stopping him, chuckled.
“Quite right. Reasonable. Scientific. Democratic. The very best of the United Kingdom.”
“Ha ha ha ha ha!”
“You’re amazing, professor!”
“You look great!”
“I respect you!”
The others joined in the flattery. What about me? I honestly thought it was reasonable for a moment. I did not know if nineteenth-century peer pressure had just evolved, or if this was truly progress.
“Hmm…”
While we wasted time with nonsense, the patient stared back and forth between the phenol and the iodine. Eventually, he chose phenol, perhaps simply because Liston had subtly pushed it closer.
Maybe he just could not bear the smell anymore.
“It’s this one.”
“Good.”
“Hey!”
“Brother, brother, don’t hit me!”
“Oh, right. Use gas. Alfred, get ready.”
“Yes!”
Liston reflexively raised his hand as if to strike, but instead gestured with his chin for Alfred to move. Alfred promptly moved toward the patient’s head, holding the improved rubber anesthesia mask I had ordered.
Let’s see… the valve is open.
It reminded me of a previous mistake.
Is it turning blue?
Why?
No oxygen in the tank.
Ah!
I had tried it once before, but there had been no oxygen in the bottle, only nitrous oxide. The poor test subject nearly suffocated. Fortunately, it had only been a stray dog.
The dog had not died in the end, so I figured we could probably use it on a human. Anyway, Alfred administered the gas. The patient mumbled something, but soon passed out.
“Right, start scrubbing.”
Liston poured phenol over the area I had shaved. I braced for a screeching sound, but it did not come, at least not from the patient. One of the seats across the room, where hydrochloric acid had been spilled earlier, was melting with a hiss.
“Oh?”
“What is it?”
Blundell squinted. The patient’s skin tone had changed.
What the hell?
Phenol acted like bleach, so maybe the skin had been chemically lightened. But this was not that. I dabbed the area with a clean cotton swab, and a black smear came off.
Phenol was so caustic that it loosened the grime embedded in the skin. It was not just dirt. It was clumps of miasma.
“Ah.”
“Good God, how dirty can you be?”
“Ugh!”
Even people who normally would not flinch at filth were gagging now. We had learned that the black residue was not just filth, but disease incarnate. Maybe that was why.
“Hey, brother?”
“What is it?”
“Do you think this will peel off the skin too?”
“Well, maybe it should. That skin is disgusting.”
“No, but still—”
Liston, without missing a beat, resumed scrubbing. His technique was surprisingly gentle. I half-considered asking him to bathe me later, though only with soap, not bleach.
Anyway, the patient’s stomach was now squeaky clean.
Maybe phenol is the right choice… for now.
So many people never bathed. Could iodine even work on them?
“Alright, let’s open him up. Pyeong, help me.”
“Yes.”
“You too.”
“Huh? Ah. Got it.”
We began to make the incision, our phenol-scrubbed gloves in place.
Chiik.
The blade slid in cleanly. Now that the knife was smaller and sharper, surgery had become easier. And Liston really was a genius. I was no slouch myself, but he was a step above. His incision was remarkably precise.
“Brother, isn’t that a bit too small?”
“I think it’ll be enough. If it’s not, we’ll adjust. Won’t take long.”
“Ah, okay.”
This was probably the smallest incision possible without laparoscopy. I had not dared to do this before, when disinfection was uncertain. Now, at least, I could expose the abdominal cavity.
Chk.
Liston pulled out the nearby intestine and gently rolled it until he located the swollen appendix.
“Clamp.”
“Yes.”
He tied it off and removed it. Next would be replacing the organs and closing the wound. But more importantly—
Moldy bread won’t cut it.
I no longer had faith in penicillin. Maybe it had not even been the mold that healed Killian. Maybe it was mercury. In any case, we had to assume antibiotics did not exist. I was no chemist. I had failed here.
“Let’s pray.”
“Yeah.”
So we prayed, me and everyone else in our group. Whether it was to God or anyone else, we prayed this patient would avoid infection. He was important. He would become proof that antiseptic surgery could save lives.
Of course, since the room lacked sterilization, airflow control, or even the barest modern hygiene, disinfection alone was not enough. This had to be a group effort.
Afterward, we operated on several other poor patients suffering from lower right abdominal pain, people ignored until now because they had no money.
Six chose phenol. Four chose iodine. Two, unfortunately, did not even have appendicitis.
So much for diagnosis by palpation alone.
“Well, can’t be helped.”
That was Liston’s only reaction. And that, too, helped keep morale high. In many ways, he really was a great man.