The Transfusion (1)
Squelch.
Praying with every fiber of my being, I made the incision into the uterus. The infant came into view. Thank God… it was alive. For now, at least. What might happen once it drew its first breath out in the cold air was anyone’s guess, but right this second, a pulse remained.
“Take the child!” I barked.
“Yes, Doctor!”
The moment the baby was pulled free, the midwives sprang into motion. Dr. Blundell, who had been waiting anxiously on standby, followed suit with equal haste. Whether the man actually possessed a clue about what he was doing in this frantic rush was entirely debatable, but surely he was better suited for it than I was. I had never held an infant in my life. Forget raising children—I hadn’t even married. Hell, I had barely managed to go on a proper date.
God damn it… will things be any different in this life? Could they be? I had no idea. But before a wave of gloom could wash over me, duty called.
“Uh…”
“What is it?” I snapped.
“No, well… it’s just…”
I was about to tell them to let me close up as fast as humanly possible, but Alfred’s hesitant stammer stopped me. I glanced toward the head of the table. The patient’s condition had turned grave. Her face was as pale as chalk. If we had a way to measure blood pressure, the mercury would have plunged straight to zero, if we could find a reading at all. The reason? The reason was painfully obvious.
“Fuck. Fuck!”
Where the infant had just been extracted—in the hollow, empty cavern of the uterus—blood was pooling. It was filling up at a terrifying speed.
“Suture! Suture, now!”
“Y-Yes! Right away!”
Contamination? Sepsis? Who gave a damn about that right now? If this bleeding continued, she would die right here on this bed, her belly wide open. An on-table death. That was what we were looking at. For the operating surgeon, it was an absolute nightmare, but for the patient’s family, it was an unfathomable tragedy.
How did I know? Because I had lived through it once before. Not as the lead surgeon, but as a resident assisting in the theater. Back then… my attending professor had broken down completely, and the family had shattered into pieces right outside the door.
“Scissors!”
“Uh…”
“Don’t ‘uh’ me! Cut it! Cut it now!”
“Y-Yes, sir!”
We didn't have a single second to dither, yet they were standing there blinking. Whatever nonsense I had spouted about them being surgical masters—I took it all back. At best, they were barely scraping by, following the crude manual I had drilled into their heads. Expecting anything beyond that, expecting them to respond to a catastrophe like this, was asking for the impossible. Yes, it was my fault for expecting too much.
“Another ligature!”
“Yes!”
“Stop just answering me! Does saying ‘yes’ tie off a fucking artery?”
“N-No, sir!”
Joseph, Colin, and even Blundell—who had somehow been dragged back to the field to assist—were flustered, trembling under my furious glare. I wasn’t throwing a tantrum for sport. The woman on the table was slipping away.
“I-It will be alright. She will pull through.”
Amid my razor-sharp focus, a faint voice drifted in from the edge of the room. It was Liston. Only then did my spatial awareness snap back enough to realize what was happening behind me: the patient’s husband had already collapsed in a dead faint, and Sir Jamie’s countenance was drained of all color. I was reminded that this wasn't an operating theater, but an aristocratic bedchamber. Not that it changed a single thing about what my hands had to do. The patient was still bleeding to death.
“Suture!”
“Here, Doctor.”
The only saving grace in this nightmare was that my surgical instincts hadn't rusted. Even if performing a Cesarean section or a hysterectomy under these primitive conditions was clumsy, identifying bleeding vessels and throwing swift, precise ligatures was a universal test of a surgeon's fundamental competence. In what felt like a flash to me—and what must have appeared as nothing short of sorcery to everyone else—the vessels were secured.
The crimson torrent gushing into the pelvis finally slowed to a halt. Good. That was a relief. But…
Hmm.
Just how much blood had she lost? Could saline and sheer willpower sustain her through this?
If she were an ordinary woman… she would already be dead.
Had she belonged to London’s nineteenth-century working class, this level of blood loss would have been an instant death sentence. The poor possessed zero physiological reserves to begin with. Some might argue that surviving the brutal London slums meant having a body forged of iron, but the reality was simpler: if a laborer managed to survive to adulthood here, it was solely because their constitution was absurdly tough. Yet even such rugged bodies walked a razor's edge; introduce a single critical variable, and they were swept straight into the hereafter. Fortunately, as Sir Jamie’s granddaughter-in-law, this noblewoman had enjoyed exceptional lifelong nutrition. Her body was holding on by a thread—though that thread wouldn't hold for long.
“Phew…”
First, I excised the damaged uterus.
“A-Ah!”
As Blundell instinctively received the removed organ, a startled gasp ripped from his throat. He had already been murmuring about how crimson and bloody the infant looked, so holding an organ soaked in dark blood completely unhinged him. In his shock, he fumbled, and the trapped fluid inside spilled outward in an ugly surge. The luxurious bedlinens and the plush carpet underneath were instantly painted in gore. Naturally, not a soul in the room cared about ruined carpets right now—least of all Sir Jamie, the master of the house.
I want to tell them she’ll be fine, but…
If my surgical muscle memory had blinded me to the room's tension earlier, I was keenly aware of it now. Yet I couldn't bring myself to speak. My brain was calculating furiously.
That mess isn’t entirely blood.
Inside the pelvic cavity, it had been too dark to distinguish, but seeing it out in the light made things clearer. Looking at the pale, watery dilution of the fluids pooling on the floor, it was evident that the blood had mixed heavily with amniotic fluid. That meant the two to three liters of liquid soaking the bed wasn't pure arterial blood.
Amniotic fluid… normal volume is roughly six hundred to a thousand milliliters. Which means…
God damn it all.
Even accounting for the amniotic fluid, she had hemorrhaged well over a liter of whole blood. That was a volume deficit exceeding twenty percent. And when an acute hemorrhage strips away more than a fifth of a human being's total blood volume…
That’s the clinical threshold for a blood transfusion. What the hell do I do?
She needed blood. Without it, she would die. Look at her chest—her breathing was already ragged and shallow. While I had managed to clamp and tie the major vessels, it was impossible to guarantee complete hemostasis. Microscopic oozing would persist.
If her blood loss passes thirty percent, even a transfusion might not reverse the hemorrhagic shock. She’ll cross the point of no return.
The question wasn't whether to transfuse or not. If I didn't perform it immediately, even attempting it later would be futile.
Snip.
While my mind spiraled through catastrophic scenarios, my hands seamlessly closed the abdominal fascia and skin. Thank heavens for my hands. Truly.
“Call the family in,” I said aloud.
Now came the crucial part: how to pull off the greatest bluff of my life. It was time for Joseon’s premier con artist to take the stage. Strangely enough, under sheer survival pressure, my brain began firing on all cylinders. Thoughts connected at lightning speed.
“O-Of course!”
While the twenty-first century was an era of isolated nuclear families, the nineteenth century belonged to sprawling dynasties. For a grand aristocrat of Sir Jamie’s stature, it was no exaggeration to say three generations lived under one roof. In an age where children dropped like flies, people bred prolifically; consequently, the moment the call went out for family, the bedchamber was swarmed by a small army of relatives.
“Direct lineage only! Only this lady's direct blood relatives!” I bellowed.
“Ah, right!”
At my roar, the crowd drained back out like the tide. Apparently, the notion that married women belonged to their husband's house wasn't exclusive to old Joseon. Out of several dozen relatives, only four remained who shared her direct bloodline. Counting Sir Jamie, his son, and the swooning husband, seven men and women stood before me.
“Doctor, what is the situation?”
“First… the child is well,” I began, choosing to lead with good news.
The question of whether the infant was truly robust remained open, but it had cried upon delivery and was currently wriggling under the blankets. Had it required a modern neonatal incubator, it would have expired already. Factoring in the bloody mess, its color looked reasonably fair.
“Thank God… thank you, Doctor!”
“The problem,” I continued gravely, “lies with the mother. She has lost far too much blood.”
“Ah… is she to die, then?”
Here came the bad news. In some ways, treating people in the nineteenth century was vastly easier than in modern times. Mention significant blood loss, and people instantly accepted that death was knocking at the door. In an era where death was a common houseguest, such fatalism was only natural. But I had to shake my head.
“N-No. Not yet.”
“Then there is still time to pray,” Sir Jamie said, his voice heavy. “I shall send for the vicar at once.”
“No, that is not what I mean!”
“Then what is it?”
“A way forward still exists.”
“What?”
At my words, a middle-aged couple—presumably the patient’s parents—stepped forward, their eyes wild with desperate hope.
“She can live?”
“After bleeding like that…?”
Both stared at the blood-drenched floor. Anyone losing that much crimson fluid usually wound up in a pine box. They had witnessed it many times before. In an age where children played pretend funerals in the streets, death was an intimate companion. In the modern world, one rarely attended a relative’s funeral until high school or their thirties, but people here wore mourning clothes from childhood—not for distant uncles, but for their own brothers and sisters.
“There is a procedure known as a blood transfusion,” I announced. “She has lost vital blood. Would it not stand to reason that providing fresh blood might restore her?”
Beside me, Dr. Blundell’s eyes lit up with fanatic fervor.
“I shall volunteer my own blood!” he declared gallantly.
A noble sentiment, truly. How many doctors in my past life would willingly slit their own veins to save a stranger? Yet I had to ruthlessly shoot him down.
“Wait… does that procedure not kill people?” Sir Jamie asked, his brow furrowing.
“Indeed,” another relative murmured. “The Papal See banned it generations ago, though the decree has fallen into disuse.”
Listening to facts I already knew all too well, I let out a measured, theatrical sigh. It was time to weave the grand tapestry of deception.
“Allow me to speak of my homeland, Joseon.”
Joseon. What kind of country had it truly been back then? Hell if I knew. I had never lived in the Joseon Dynasty either.
Well, in the Republic of Korea, this is standard medical practice, isn't it? If I speak from ignorance of the dynastic era, it’s not technically a lie!
Having thoroughly rationalized the fabrication in my head, the words began rolling off my tongue like silk.
“It is a small kingdom, far to the east. For centuries uncounted, it weathered endless invasions from foreign empires—much like Britain did when the Vikings raided your shores, or when the Roman legions marched across your soil.”
“Good heavens…”
“We had no idea.”
“Constant warfare bred constant trauma, and through countless wounded warriors, our surgical arts were forced to evolve.”
How the hell would I know? But South Korea was certainly a global powerhouse in modern surgery, wasn’t it?
“Yet, even when flesh was mended and wounds were closed, men continued to perish. They died because their vessels ran dry. In their desperation, our ancient healers attempted to infuse blood from others—only for the wounded to die even swifter deaths. For blood is the very essence of life, as the Holy Scriptures themselves proclaim.”
“Indeed,” Sir Jamie nodded slowly. “That is true.”
“Realizing that any random blood would bring ruin, our physicians turned to a sacred principle: they used only the blood of kin. While some still perished, a miraculous truth emerged—far more men survived when sustained by the blood of their own lineage.”
“C-Could it be?”
“Is such a thing possible?”
Honestly, I didn’t know the exact historical odds either. But genetically, inherited antigens meant that parents and children shared compatible blood groups far more often than strangers. If both parents were Type A, the odds were heavily tilted in their favor.
“Furthermore,” I pressed on, puffing out my chest, “when I arrived in London and synthesized our ancient eastern heritage with western scientific methodology…”
“Ah, of course!”
“London is indeed the pinnacle of modern science!”
“And is my esteemed master not the great Dr. Robert Liston himself? Under his peerless guidance, I have refined these principles to perfection.”
“Haha! Hear, hear!”
“Well said!”
When selling an outrageous theory, one must implicate as many distinguished accomplices as possible. Especially when the inner voice in your head is screaming that you're spewing utter nonsense.
“Moreover, our esteemed Dr. Blundell here is a renowned pioneer in this very field. Has he not already performed transfusions on five separate occasions?”
“Oh! Truly?”
“No wonder he is regarded as London’s finest accoucheur!”
I deliberately omitted the minor detail that all five of Blundell's previous patients had died. Nor did I mention that they had died significantly faster than they would have without his help. What purpose would that serve right now? Instead, I adopted a fierce, commanding scowl. When a man runs out of logical arguments, anger is the ultimate weapon. In everyday debate, shouting weakens your stance, but when a physician barks orders over a dying patient, righteous fury commands absolute authority.
“If the blood does not match, it curdles into solid sludge within the veins!” I bellowed.
“What?”
“Curdles?”
“We have no time for questions! I shall explain the mechanics later! Bare your arms, all of you!”
“Wait, why our arms?”
“What are you going to do?”
“A human life is slipping away right before your eyes!” I roared, pointing a bloodstained finger at the bed. “Bare your arms this instant!”
“Y-Yes, of course!”
“Here! Take my arm, Doctor!”