Chapter 46: Intravenous Fluid [2]
Chapter 46: Intravenous Fluid [2]
In conclusion, getting angry and muddling through things was probably not something I could use often.
The two of them grumbled so much.
If I had not been the one who inspired Joseph to dream of becoming a doctor, and if I had not been something like Alfred’s savior, it would not have been strange if they had poured the boiling water on me instead, given the intensity of their doubts.
Still…
I stayed by the patient’s side.
Meanwhile, the others had boiled the water and brought it back.
While it cooled—in other words, while we waited—I secured the vessel.
“Uh… but is it really okay to go for such a large blood vessel?”
I could not just tie something like a tourniquet around the arm and find it the way people drew blood.
To begin with, this was an era without new materials like rubber or plastic, so there was no such concept as a line.
No, before that, there was no concept of securing a line in the first place.
Anyway, this was an age without anything.
If anything…
Honestly, a central venous catheter looked safer.
“The needle is too big…”
“Ah…”
The needle really was huge.
In alternate-history novels, people always said that if you simply placed the order, smiths from the Joseon era could make anything delicate and precise, so I honestly did not know why the people of nineteenth-century London were like this.
To begin with, it was not made for injections, but for drawing blood—in other words, it was so thick it almost seemed designed for killing.
Sliiick.
Anyway, I found the patient’s jugular vein as his consciousness flickered in and out and inserted the needle there.
“Ugh, ughhh…”
Pain?
Of course there was going to be pain.
The patient groaned incessantly even in his half-conscious state.
“Hey, can’t you anesthetize him?”
Unable to bear watching any longer, Alfred spoke up.
His gaze lingered between the patient and his fingers.
Since he had once personally gone through unbearable pain, I suppose he could not help but empathize.
I can’t exactly say it might lower his blood pressure or suppress his breathing… can I?
At present, the only anesthetic I had confirmed was nitrous oxide.
And I did not know that much about the gas.
At first it seemed almost to stimulate the patient a bit, then it anesthetized them, and beyond that, it could lead to respiratory suppression and death—that much, at least.
This patient was in no condition anyone could call healthy, even if they were being generous, and I was supposed to use it here?
Would surgical departments in the twenty-first century have bothered checking whether a patient could safely undergo anesthesia if it were not important?
Even when anesthetics had improved tremendously, they still did so, so what would happen if I used it recklessly now?
“It’s only one puncture.”
“That’s practically a knife…? If you stab someone with something like a knife, can you really call that ‘just once’?”
“Well… in any case, it worked, didn’t it?”
So I could not use the anesthetic.
The excuse was a little inhumane, but…
Anyway, I succeeded in inserting it.
Someone unskilled might even hit the carotid artery instead of the jugular vein in a situation like this, but I was a genius surgeon, wasn’t I?
In an instant, even though he had lost so much blood that the vessel walls were practically stuck together, I managed to slide such a thick needle right into the gap in the vein.
“Has the water cooled?”
“Huh? No. It’s still hot.”
“Hey! Don’t stick your hand in it!”
“Why?”
“Because it’s… hot.”
This lunatic had actually tried to stick his finger in it after going through the trouble of boiling it.
Or maybe he already had.
Now that I thought about it, I had not seen how he carried it here.
Still, I could hardly tell them to boil it again.
All I can do is hope the patient is absurdly tough…
To begin with, could this even be called a sterile procedure?
At best, I had wiped the skin with chloride of lime and inserted a needle that had been dipped in boiling water.
And other parts of the patient’s body were still covered in dirt.
And the problem isn’t just now…
Come to think of it, that bastard Jémel really was a bastard.
It was not just that he had drawn blood.
When he pierced the patient to let the blood out—whether it was with a needle or a goose feather—did he really disinfect any of it?
Of course not.
If infection was going to happen, then it had already happened.
Even so, I could not bring myself to think of mixing in unboiled water.
The Thames… that filthy sewage water…
No matter how I thought about it, London at this time clearly did not have proper water and sewage infrastructure.
If it did, then would the water smell like this?
It was already bad enough after boiling—if I used it unboiled…?
That really would have been an excellent way to murder someone.
Next time… maybe I should make some distilled water in advance so I’ll have it ready in emergencies.
As I kept having those random thoughts—or rather thoughts that could just as well be called laments—I gradually felt that the water had cooled.
That did not mean I had touched it.
I could tell from the temperature transmitted through the metal vessel.
“Oh, oh! The patient’s having a seizure!”
Just then, the patient’s whole body went into convulsions.
It was not something you saw every day, but neither was it especially rare.
At least if you had ever seen trauma patients, it was the sort of situation you were bound to be familiar with.
If blood flow to the brain dropped because the blood loss was too severe, this could happen from time to time.
So what should be done?
Either stop the source of bleeding or give blood.
Right now, both were impossible, so at the very least we had to give water.
Even if it was just diluted blood, whatever it was, we had to make something circulate through his body.
“You two hold him. Don’t let that come out no matter what.”
“O-okay!”
“Right!”
Anyway, Joseph and Alfred were not stupid—they were just ignorant.
Even while holding down the patient’s body as he convulsed all over, they were careful not to let the needle I had inserted earlier slip out.
Whatever else, they seemed to grasp by instinct that it had been difficult to insert and absolutely could not come out now.
“Haa…”
That did not mean the situation had improved much.
It had not.
For one thing, there was no line.
The needle I had inserted was just a bare needle sitting there, and of course there was no tubing.
In all sorts of ways… once condoms get invented, there’s going to be a lot more to make besides just those, huh…?
For a brief moment, I thought of those long dark things scattered around what had been either a factory or a laboratory, and then I slowly poured the water into the funnel.
I was being careful, but even so, it seemed like the amount was fairly large.
To begin with, the blood vessel walls were practically stuck together.
“Wow…”
I could see the jugular vein swelling.
If air gets mixed in there… this could block instantly.
Air embolism.
That was what happened when an excessive amount of air entered the blood vessels, though people probably had not heard of it much.
Why?
Because it almost never happened.
Think about it.
Under normal circumstances, was there even any gap through which air could get in?
IV fluid bags and lines were all closed spaces.
And the person administering it was usually a practiced nurse, so how would an accident happen?
Damn it…
But this place was an exception.
Since I was literally pouring water into it out in open air, it was an environment practically begging for disaster.
If I poured too forcefully, bubbles would form and froth up, and if those went in, then wherever they blocked, he would die.
This patient’s body was not in any condition to solve even the smallest problem on its own.
“Uh… it’s stopping.”
Separate from that, the water I poured in steadily was restoring the patient’s shrunken plasma volume in real time.
Even if it was painfully diluted blood, it meant that blood could once again be transported throughout his body, including to his brain.
If this had been actual blood, nothing could have been better…
“Good.”
“Wow… how is this even…?”
“How can something like this even happen?”
Judging from their expressions, even this level of result was astonishing enough.
In this era, convulsions practically meant death, didn’t they?
In a time without transfusions and without any concept of volume, how could anyone possibly treat seizures caused by hypoperfusion?
There probably was not even any treatment that could provide a short-term effect.
So it was only natural that the two of them looked as though they had witnessed a miracle.
“From here on…”
These two were fine.
Neither of them would report me.
But I worried about what might happen if word of this got out.
Especially Jémel.
After all, I had openly saved the patient that bastard had killed.
And to make matters worse, Dr. Robert Liston was away in his hometown.
“Let’s pray.”
“Huh?”
“Pray?”
So I decided to demonstrate an astonishing degree of faith.
At this point, everything else is in God’s hands anyway…
When you thought about it, it was not actually all that remarkable.
There was nothing else I could do, so I might as well pray.
What was I supposed to do in this situation—give antibiotics, or blood?
All I could do was keep giving water, and I could not even estimate the exact amount of blood he had lost.
That was because blood testing was impossible.
Even if I don’t know for sure, his hemoglobin is probably below 5. Normal is 13 to 17…
There were elderly women who lived with a hemoglobin of 5 and hardly showed symptoms.
If it dropped gradually due to malnutrition or chronic illness, the body adapted.
But if a previously healthy adult man—someone whose only symptom had been a headache—suddenly dropped that low?
There was a reason they had mistaken him for dead and stuffed him into a coffin.
“R-right. Let’s pray.”
“As expected, Pyeong-i really does have deep faith.”
The other two, still looking confused, each took one of my hands and began to pray.
It was a sudden prayer, but both of them did it easily enough.
That was only natural, since they had grown up in the faith.
Creeeak.
Around then, the lecture hall door opened again.
Wouldn’t they be curious? It had been noisy for a while with talk of seizures and what to give him, and then it suddenly went quiet.
Of the three of us, I was the only one who was really just a nominal believer, so I cracked my eyes open slightly and looked at whoever was coming in.
Since my eyes were naturally small to begin with, it actually helped in moments like this.
It gave the impression that no one would ever imagine I could see anything with my eyes like that.
“Ah…”
“Are they praying for his soul?”
“Oh…”
“Good heavens. What kind of thing were you saying about such devout students, then?”
Blundell was among them.
Apparently Colin had tried to call Jémel and ended up calling Blundell instead.
That man would not have been offended even if someone called him Dr. Robert Liston’s subordinate, so how could I, who had basically become sworn brothers with that professor, be difficult for him?
And on top of that, he had just seen me praying, so he had no choice but to take my side.
“No.”
“What? Do you harbor irreverent thoughts even while looking at people praying?”
“N-no, sir. But that patient…”
“Do you have any proof he was dug up from a grave? Besides, he just moved his fingers, didn’t he? Are you saying he was buried alive? A medical student being taken in by urban legends like this—will that do?”
“But it’s true… it really is.”
“Ahem! Throwing your family’s weight around is something you’ve done often enough. That’s enough.”
Colin looked wronged.
Well, of course he did.
Just look at what had happened to him so far.
He nearly got beaten to death after inhaling laughing gas, then the very next day he had a perfectly healthy tooth pulled, and no one acknowledged any of it.
Then he was sure we had dug up a corpse, but everyone said otherwise.
And now we were even staging a scene that looked holy.
Mm… that’s not just the face of someone who feels wronged, is it…?
It felt a bit awkward saying this myself, but…
I was a genius, after all.
By nature, geniuses were the sort of existence that unintentionally wounded the people around them.
Especially when I was younger, my personality had not yet matured, so I used to make sure it showed.
In other words, I used to inflict narcissistic wounds on people all the time, and some of those people would make exactly that kind of face right before causing trouble.
Which meant that Colin, right now, had the exact expression of someone on the verge of doing something reckless.