The Elder Brother's Surgery, Part IV
"I am dreadfully nervous."
The results? The results had turned out splendidly.
Well... claiming they were entirely flawless might be an exaggeration, as the contour still appeared somewhat unnatural. Even so, raising a framework of cartilage looked leagues better than merely draping a flap of bare flesh over the void—it actually resembled a proper nose now. Of course, nostril passages would need to be fashioned separately at a later stage, but that should prove simple enough to handle. Not that I intended to be careless, mind you; I simply meant it wouldn't pose any insurmountable difficulty.
"There is no need to fret. Rest your mind at ease."
At any rate, once we confirmed the structural integrity of the graft, we summoned Colin's elder brother. Naturally, he did not come alone. His father and mother arrived in tow.
This bastard... he comes from an even grander family than I thought.
I had assumed he belonged to the bottom rung of the aristocracy. Affixing "low-ranking" to nobility sounded a bit contradictory, but regardless. Yet one look at the garments they wore dispelled any such notion. These people were no ordinary minor nobles.
"We place him in your capable hands."
"We have heard that you are already looking after our boy with great care. You have our deepest gratitude."
The sheer fact that they addressed me with such poise, without a single twitch in their expressions, said everything. Even our esteemed dukes, though quite cordial these days, had initially frozen solid the moment they laid eyes on me. It was only natural. Had I been living in Joseon and encountered a white or black person for the first time, wouldn't I have been just as startled?
Well... they are involved in merchant shipping, so foreign faces are likely familiar to them, but even so...
Such exquisite manners, such immaculate attire. Born between parents of such refinement, why on earth was Colin so utterly desperate for the progress of surgery?
Understood, Director.
Amidst my bewilderment, I did not miss the Hospital Director's sly wink. I wasn't the only one realizing this household was far more prominent than anticipated. If even Liston could tell at a glance, the Director certainly knew. That wink clearly conveyed: Handle this with utmost care.
"Joseph."
"Yeah! Er, I mean, yes! Professor!"
Nothing would go awry. Our surgical team was comprised of genuine veterans now.
Swish, scrub.
Joseph sprang into motion, vigorously scouring the patient's chest first. Since the patient had not yet been anesthetized, it must have stung fiercely. Yet unlike Colin, his elder brother was built like an ox; he merely scowled, never letting out so much as a whimper. Come to think of it, the father possessed an identical build. Thoroughly macho. It must have been stifling for someone like Colin to endure living among them. Colin, no matter how one looked at him, was clearly cut from the same cloth as myself.
Watching Joseph scrub was like watching a consummate master at work. He cleaned with such terrifying precision that he even shorn clean the thick pelt of hair sprouting across the man's chest.
Is this what they call profound emotion...?
Shaving hair? Forget shaving—these savages hadn't even disinfected anything before. To see them now shaving and scrubbing promptly on their own initiative brought tears to my eyes. In truth, they had been operating like this for quite some time, yet the sentiment lingered. It was likely lingering trauma from the sheer horror of witnessing their initial butchery.
"Now, Alfred."
"Yes, sir!"
The quick-witted senior discarded his usual casual "Yeah" in favor of an impeccably submissive "Yes, sir," before opening the gas valve. Because Colin's brother was a hulking brute by contemporary standards, Alfred cranked the concentration to about one-and-a-half times the usual dose.
Perhaps that was why, the moment the mask sealed over his face, the man's consciousness drifted away in an instant. He let out a faint chuckle midway through—evidently, he had indulged in laughing gas recreationally on occasion.
Well... in this era, the very concept of illicit narcotics doesn't exist.
Seriously, if you stepped outside right now, you would catch the pungent whiff of cannabis lingering at some corner of an alley. Not only that, but acquiring opium or morphine was becoming easier by the day. It was truly bizarre.
"Let us ruin them with opium and wage war!"
As far as I knew, the higher-ups seemed to realize that opium was harmful, at least to some degree. Yet they enacted no crackdowns. Far from it—they were turning it into beverages. It might sound like needless anxiety, but I half-expected them to start bottling it as a tonic for children any day now. Though... surely they wouldn't go that far.
"Pyeong-shin?"
"Uh, right. Joseph."
"Yes!"
Having stood blankly lost in thought, Joseph had practically cursed at me. Not that he intended to insult me, but when someone says 'Pyeong-shin,' it sounds an awful lot like calling someone a cripple, which grates on the ears nonetheless. Regardless, it served its purpose. Snapping back to reality, I watched Joseph disinfect the face. Truly, this fellow's sanitization belonged strictly to the realm of genius. The deft, relentless rhythm of his scrubbing was borderline insane.
"Good. Scalpel."
"Scalpel."
"Commencing nasal reconstruction utilizing a frontalis myofascial flap."
"Commencing rib cartilage harvest."
I had already been contemplating establishing a standardized operative protocol, and with two distinguished aristocrats observing, the timing couldn't have been better. I recited the procedure name as I usually did. Liston, who always became strangely deferential before aristocrats, echoed my words verbatim. His recitation was slightly awkward, yet that alone appeared immensely impressive. A quick glance revealed the parents clasping hands, gazing at each other with palpable pride.
Ah, so it isn't just because of me.
Looking closely, their eyes were fixed on Colin. Indeed... Colin in the operating theater was an entirely different creature from Colin anywhere else. The boy possessed truly exceptional surgical hands. That alone was evident from the fact that Liston, notorious for his prickly temper and impossible standards, utilized him as a surgical assistant without a single grumble. Was Liston not a genius himself? A man who had cut open countless bodies. And for Colin to keep pace with Liston's lightning-fast technique while assisting him—calling Colin a prodigy was no exaggeration.
"Good. Fortunately, the patient possesses a broad forehead."
I wasn't flattering him; it was truly vast. It probably hadn't been this broad by nature, but had rapidly receded with age. Whom did he take after? There was no need to ask. It was the gentleman currently flinching across the room. Under normal circumstances, male pattern baldness was hardly a blessing, but...
Who knew going bald could actually be advantageous?
I had learned something new today. At any rate, thanks to his generous acreage, I was able to rotate a remarkably broad flap down toward the nasal bridge.
"Here."
"Thank you."
Meanwhile, Liston and Colin harvested the costal cartilage with ghostly precision and handed it over. They say surgical technique improves the more you cut, and the pair proved no exception. When they handed me that beautifully carved strut of cartilage, I almost thought I was consulting with a modern plastic surgery department.
"Puncture holes, please."
"Right."
And what Liston did next would have been nearly impossible even in the twenty-first century without an electric drill.
Thunk.
Thunk.
Yet Liston required nothing more than an awl. Who else on earth could puncture bone as effortlessly as jabbing chopsticks into soft tofu?
Is it truly... sword qi?
I had witnessed it several times already, yet every demonstration left me in awe. At this point, it felt like divine game-balancing. Some of the procedures that existed only in my head—operations conceivable only in the modern era—might actually be feasible if I made proper use of Liston's monstrous talents. Regardless, I anchored the cartilage, perforated at identical intervals, to the drilled bone.
I've already confirmed that thread disinfected to this degree holds up safely.
Treated with iodine, phenol, and alcohol under Joseph's fanatical supervision, the suture was somewhat compromised in tensile strength, but it mattered little. I wouldn't allow anyone to lay a finger on it for a long while anyway. Besides, in an era where people seldom washed their faces, when would he ever have cause to rub his nose?
"Done."
Having roughly shaped the nasal bridge, I draped the forehead flap neatly over it.
"Oh..."
"Heavens..."
Witnessing this, the parents gasped in awe. Naturally. In the blink of an eye, an entire nose had taken form before their very eyes. If this wasn't a miracle, what else could possibly be called one?
Of course, I could not afford to indulge in their amazement. I hurried through the remainder of the operation, closing the forehead defect. The sutures used here could not be sterilized as brutally as the buried ones. No matter how vast the forehead, excising a strip of flesh and drawing the margins together generated unavoidable tension.
Snip, pull.
So I placed somewhat sparse, widely spaced stitches, just as I normally would. Even so, "sparse" by modern standards was a remarkably meticulous closure by contemporary benchmarks, plenty to satisfy any observer.
"Incredible..."
"A truly astonishing procedure. Indeed... your renown these days is not without cause."
The mother's impressions remained brief, quite understandably, as she was sniffling into a handkerchief. But the father was different. He murmured something laden with intrigue.
Renown, is it...?
Between the dukes and the members of Parliament making such a fuss, something major was clearly brewing in society these days.
"Well, we are finished. He must keep it undisturbed, but... since frequent disinfection is essential, it would be best for him to remain admitted here if it is not too inconvenient."
Just as I tied off the final knot, Alfred timed it impeccably, gradually tapering off the gas so the patient stirred awake shortly thereafter. Thanks to his timing, I could address both the patient and his guardians together. Of course, the patient was far from lucid. Even modern general anesthetics leave patients disoriented upon emergence, so with primitive agents...
"We shall do so. We will follow your counsel. However, a general ward is rather..."
"Ah, we have a private room converted from a laboratory. You may use that one. Sir Jamie lodged there previously."
"Oh... then it will be more than adequate."
"Splendid."
In this era, conferring solely with the head of the household sufficed. Total authority rested in the hands of the father—the patriarch—the eldest gentleman.
"Colin."
Once the admission was arranged and clean-up was underway, the father called out to Colin. Colin rushed to his father, looking far more anxious than when I summoned him. Seeing him like this struck a chord of pity. Here was a fellow resolute enough to drink dirty toilet water without flinching, yet he trembled before his sire.
"From what I have seen, that fellow Pyeong is the genuine article. And seeing your skill today... you seem remarkably adept, and well recognized by your masters. Continue serving him with utmost diligence."
"Ah... thank you, Father."
"Indeed. It warms my heart to see you laboring with such fervor for once."
"Ah..."
I had feared he might scold the boy, but thankfully that wasn't the case.
A true master of social etiquette.
He had praised Colin openly, deliberately within earshot of me. It was a compliment to elevate his son while subtly asking me to look after him.
I wonder what face he would make if he discovered I made his son drink urine?
I was curious, but deemed it far safer never to find out. Disaster would surely follow. Naturally, my conscience remained clear. It wasn't my fault, after all.
"Ah, Doctor Pyeong."
"Ah. Yes, sir."
Perhaps my conscience wasn't quite as spotless as I claimed. Being addressed so abruptly gave me a mild start. Yet having worked for years in a university hospital, I possessed 'Composure' equipped as an innate passive skill. I approached him with an unruffled expression.
"My gratitude. It seems I am indebted to both of my sons."
"Not at all. Haha."
"I shall be certain to reward you handsomely for this matter."
"There is truly no need to trouble yourself."
"Haha. Nonsense. Of course I must. After all..."
Colin's father broke off mid-sentence, exchanging a meaningful glance with the Hospital Director before resuming.
"There will be good news in store for you."
He patted me firmly on the shoulder as he spoke.