Episode 63: Brain Experts [1]
“Also…”
Dr. Liston looked at the patient. I couldn’t tell whether the sound he made was a sigh or something else.
“No…”
“So, you said it didn’t hurt because you were scared?”
Joseph and Alfred looked visibly shaken, and rightfully so. Doctors in this era had a strange kind of confidence. Who else but them would think of amputating someone’s arm four times without anesthesia? Even the devil might have said, “Professor, this is going a bit far…” Maybe it was reckless, but the fact that they were able to go that far showed they truly believed this was for the patient’s benefit.
“Whew…”
Me? I wasn’t that shocked. I already knew this theory was nonsense. What surprised me more was how pitiful this patient, who had looked like a strong sailor just a moment ago, had suddenly become. I gently patted him on the shoulder.
“Ugh.”
Still, I didn’t expect him to cry like that. Then again… maybe it was only natural. Every doctor he had seen so far had probably considered cutting off his arm first. It must have felt like being tested earlier in that room.
Doctors in this era… no, people in general had little sense of human rights.
Especially in a society built on rigid class structures. Just like in the past, where blue blood defined nobility, people often didn’t even treat others as fully human. Their methods and attitudes toward the weak were hard to comprehend with my modern sensibilities.
“It’s okay, it’s okay. I won’t cut your arm.”
“You’ve done something valuable. Didn’t other people almost end up like this too?”
I continued to comfort him, and Dr. Liston didn’t just stand idly by either. Should I say he had a kind of clumsy empathy? He gave my shoulder a reassuring pat, as if to say I had done well. Meanwhile, the patient kept muttering, “Hee-ik,” or “Please, just let me live…” To Liston, those reactions were so routine that he didn’t even flinch.
“Now then… how do we treat someone whose arm hurts even though the arm’s no longer there?”
Liston’s mind was full of patients. Strong men who had survived brutal surgery and anesthesia with nothing but grit and good immunity, but now suffered from pain in limbs they no longer had. And their numbers were growing. Would that number decrease in the future? I doubted it. We were still in a time without proper statistics, but as more people lost limbs, wouldn’t it be natural for phantom pain cases to increase?
“What do we do about this…”
It was natural for Liston to sigh.
“Sigh… seriously, what should I do?”
I sighed with him. Not because I didn’t know the answer. After all, I was a professor of medicine in twenty-first-century Korea. Of course I knew about phantom pain. The problem was…
This is brain science.
And brain science… even in the twenty-first century, wasn’t easy to explain. So here, in the nineteenth? Nearly impossible.
“If we cut deeper… No. I didn’t mean we should cut him more.”
Look at Liston. He was the only doctor in the room actually thinking. But the patient had already fainted. Cutting deeper into someone already terrified… was that what you wanted?
“I’ll take the patient with me first.”
“Oh, yes. This isn’t something we’ll solve here anyway. Besides…”
“Please, say it, Brother.”
I stood up to get the patient out of there. He was too heavy to move alone, so Joseph and Alfred helped. Just as I was about to leave, Liston hesitated, as if remembering something. That made me uneasy, so I asked again. Thankfully, we were on good terms, and Liston didn’t take offense.
“No, I mean… we have the patient’s testimony, but… isn’t there any actual evidence that the nerves aren’t bunched up?”
“Ah.”
You idiot. I almost swore out loud. My survival instinct kicked in, and I barely kept my mouth shut.
“Well, if someone with this pain dies, couldn’t we just do an autopsy?”
“Oh.”
Liston’s eyes lit up. At the same time, I glanced nervously at our poor patient, who looked like he might faint again.
Are you thinking of killing him just to dissect him?!
“Uh… Brother. I think you might seriously misunderstand this patient.”
“Ah. Yes. Okay. I’ll look for someone else.”
Even the thought of looking for someone like that was terrifying. But at least he gave up on killing this poor guy. Damn this nineteenth century…
“Patient, please run away.”
“Oh… y-yes. Thank you.”
Without swearing, I walked out and quietly told the patient to run. Thankfully, he took it naturally. For a moment, I considered stopping him. For the sake of studying phantom pain, we needed a patient. But…
That’s going too far…
Even in the twenty-first century, phantom pain cases were rare. Not because amputations had disappeared, but because situations requiring them had become much less common. First, physical trauma was rarer. Sure, difficult cases still existed, but compared to this era… this was basically a battlefield.
More than half of amputees reportedly suffer from phantom pain…
But unlike here, modern medicine had treatment options. Back then, the Amputations themselves were brutal. If you were lucky, you had crutches. In many cases, people just shoved a blunt wooden stick into the stump and called it a day. I finally understood that those cartoon pirates with peg legs? They were real.
“But this… there’s nothing we can do about it, right?”
“How can we… No, maybe. If it’s an average case, we can do something.”
While I was lost in thought, Joseph and Alfred started chiming in. Then they turned and looked at me, hopeful. It wasn’t too much pressure. I did know the answer. The hard part was explaining it.
Maybe I should start with the cause?
I decided to postpone thinking about treatment. After all, it was strange to jump into treatment when you didn’t even know what the condition was. Though, to be fair, people often tried treatment first even when they didn’t understand the problem. I couldn’t. Or rather, I wouldn’t. Not until I could wow everyone later with just one word. For that, I needed to build things step by step.
“How would you know it’s me? But still…”
“Still?”
“Yes. You’re different. Do you know something?”
“I need to examine the patient first. You can’t solve something just by imagining it.”
“Isn’t science born from imagination?”
“Exactly.”
It wasn’t easy. These self-proclaimed scientists had far too many misconceptions about science. Yes, science did start from imagination. Many theories and hypotheses came from that. But imagination alone couldn’t carry it to the end.
This kind of thinking is what leads to cutting someone’s arm off…
Crazy bastards. I really wanted to curse, but I held back. Instead, I decided to steer the conversation with reason.
“Imagination isn’t enough… Do you even understand the symptoms?”
“I don’t have an arm, but it hurts.”
“No, not that.”
“Isn’t that everything?”
This wasn’t easy either. You needed basic knowledge to have a proper conversation. That was why medical school started with terminology. Otherwise, you got this mess.
“That’s it? Just ‘it hurts’? That’s too vague… It sounds like magic.”
“Magic? That’s not scientific.”
“You’re the one who brought up fantasy!”
“Why are you getting so angry? Be civil.”
It was said that a smart person could be mistaken for a fool.
“Anyway… let’s go. Maybe we’ll figure something out if we ask more patients.”
“But…”
“Just standing around here won’t help.”
“No, I suppose not.”
“Then follow me.”
“Uh… okay.”
The good news was that I was the most talkative person in this group. Without me, these guys would have kept amputating limbs without anesthesia, touching patients right after dissections, and worst of all, performing surgery without gloves, leading to infection and necrosis.
“Hmm…”
We arrived at the waiting room. It was supposed to be a “waiting” area, but it looked more like a bustling traditional market. Crowded. Chaotic. Still, that didn’t mean it was hard to find the kind of patients I was looking for.
“When’s my turn?”
“Me! Over here!”
It was noisy, but amputees stood out. Prosthetics weren’t developed yet. At best, some people had a hook like Captain Hook. Most just walked around with their sleeves flapping. People with amputated legs used crude crutches, homemade and uneven ones.
“Oops!”
They often fell. Their bodies were already weak, and another fall could mean death from unrelated causes.
If I get money later, I should develop some real prosthetics…
Until now, I hadn’t thought about it seriously. But seeing it firsthand, I realized this was a real problem. Truly the nineteenth century. The issues never ended. I almost felt proud for doing something useful here.
“Patient.”
Anyway, I called the patients over and gathered them together. Maybe because they were eager to be seen by a doctor, it wasn’t too hard. Besides, most of them were Professor Liston’s patients. To others, I was just some odd fellow, but to them, I was Liston’s right hand.
“Anyone here have pain in an amputated arm or leg?”
They looked surprised, as if wondering how I knew what they were experiencing. Slowly, they raised their good hands. I found five. All five had phantom pain.
Translator’s Notes:
Phantom Pain — Pain felt in a missing limb or body part after Amputation. It comes from the nervous system rather than from the missing limb itself.
Amputation — Surgical removal of a limb or body part. In this period, it was one of the most common major operations and was often performed under brutal conditions.
Anesthesia — Medical use of drugs or gases to block pain or awareness during surgery.
Autopsy — A medical examination of a dead body to determine disease, injury, or cause of death.
Necrosis — Death of body tissue, often due to infection, poor blood supply, or injury.
Prosthetics — Artificial body parts used to replace missing limbs or other structures.
Stump — The remaining end of a limb after Amputation.
Captain Hook — A fictional pirate character commonly depicted with a hook replacing one hand. The narrator uses him humorously while thinking about historical limb loss.