Episode 87: Mercury. Mercury Chloride [1]
And… it wasn’t as if I had only done appendectomies for a day or two. Even for me, surgery in the nineteenth century was incredibly stressful. I really couldn’t sleep at all.
“Pyeong. Shouldn’t you be sleeping?”
I was so nervous that I stayed close beside my senior and watched over him while his guardian slept. No, could this really be called nursing? As I had said repeatedly, I was a pretty good doctor. This wasn’t empty talk. Objectively and subjectively, I was an excellent doctor. To me, the opinions of the patient and his guardian were not meaningless.
“It’s okay. He’s older than you… He’s holding up pretty well.”
“I think he looks a lot better than yesterday. Thank you again. I’ll make sure you never have to worry about money for the rest of your life.”
“That… thank you.”
“Well, I suppose I can make money with condoms. Anyway… I’ll make sure you don’t feel bad.”
“Thank you.”
Hearing those words was a small comfort. I felt like everything had stayed in order all night. I almost felt as if I had accomplished something great and ascended to heaven.
Uh… he has a fever. Surely it’s not atelectasis?
First of all, my senior had quite a fever. In fact, it was inevitable. There was no way to reduce it. Plus, the anesthesia had been a mess. I had been able to perform the surgery without him really feeling pain, and that alone was something to be grateful for.
“Senior. Senior. Breathe. Take a deep breath.”
“Haa… Ugh…”
Atelectasis. Simply put, it was when the lungs shrank because air wasn’t reaching them properly. This could happen even with modern anesthesia. When using a respirator or ventilator, air sometimes failed to reach parts of the lungs. That was where the fever came from… Since this primitive anesthetic gas also suppressed consciousness, breathing became incomplete, and atelectasis was inevitable.
Dr. Liston’s method… it might still be right.
Although amputations took longer than before, they were still quick operations, measured minute by minute. Because of that, atelectasis didn’t happen. But with sinusitis surgery, it was different. Surely… he had developed a fever too? Thinking it might be the same cause, or to be more precise, hoping it was the same cause, I told my senior to take deep breaths.
“Whoa… Haa…”
He kept taking deep breaths, seemingly without knowing what was happening. That was natural. He was very sick with appendicitis… his abdomen had been opened… would it be normal if he didn’t have a fever while conscious?
“Right. Good.”
If I had a stethoscope, it would have been easier to listen to different parts of his lungs. Since I didn’t have one, I had to listen with my own ears.
“Oh my. Sorry.”
“Uh. It’s okay.”
“No, no. Sorry for disturbing you.”
“I said it’s okay, damn it!”
Because my senior was a young adult man, his skin was thick, especially around his chest. I had to press my ear really close and move around to listen. A maid came in at that moment and saw me. It would have been better if she had just said, “Hmm…” but instead, she hurriedly left, which made me feel strange.
“Haa, whoa.”
Meanwhile, my senior was out of breath… I kept my ear close…
“Ugh, ugh.”
The maid was calming her shocked heart…
Damn…
Even thinking about it now made me feel feverish. Of course, that didn’t mean I regretted what I had done. Thanks to those efforts, my senior was still alive.
“Saa… Ssam…”
Sleep well… The fever had gone down now. Last night, he had woken up gasping for air, so it seemed his atelectasis had completely resolved. Not only had his symptoms improved, but I could also hear steady breathing when I put my ear to his chest.
“Hey, what about school?”
Joseph Lister, who had been sleeping beside me like a young boy, rubbed his sleepy eyes and asked. This bastard didn’t understand the severity of the situation at all. He had just been sleeping and was only waking up now. If you thought about it, it was a crazy situation where the professor stayed up all night while interns and trainees barely slept… Since Joseph didn’t know anything, there was nothing I could do. How could he know? How could he understand how dangerous abdominal surgery was? Especially now, when disinfection was poor, anesthesia was improperly administered, and there were no antibiotics…
Ha, fuck.
In that situation, I had saved my senior, for now. It felt like I had tied his life to this world. If I had a professor, he would have praised me a lot. If there were others who understood, they would have admired me.
There are only people who know nothing, so there’s no one to admire it…
Ah, damn it. I tried to let go of the anger rising inside me and looked back at Joseph.
“Okay, let’s go.”
Whatever happened, it was resolved for now. Above all, there were too many patients in the hospital. Two patients had undergone sinusitis surgery, there were patients with phantom pain, and there were patients in the amputation ward who needed medication and observation. Yes, it was just pain control, but in this era, pain control was so important that it was often more important than treatment itself.
“Is Senior Alfred okay?”
“You’re quick to ask. He’s okay for now. However… you have to watch him closely. Think of it as similar to what happened with your hand before.”
“Ah… then you’ll have a lot of trouble. Do we have to open his stomach and disinfect it every day?”
“Huh? That’s terrible… no, that shouldn’t happen.”
Having to open the abdomen again… didn’t that mean the inside would be completely full of pus? Even with antibiotics, that would be difficult. But in this situation?
It might be better to leave the body intact than to reopen it.
Anyway, we arrived at the hospital by carriage.
“Hey, you’re here? The patients with phantom pain have really improved.”
Shortly after entering, Dr. Liston approached me. His face always looked scary yet cheerful, and it was the same today.
I keep seeing this face… I feel like I can notice slight changes now…?
Surprisingly, I noticed some differences.
“Look over there. That patient got better too.”
“Uh…?”
“Do you want to know?”
“Yes, of course. Isn’t this the person Goodwill brought in back then?”
“Right. Haha, I suppose it’s because of the rumors these days. I hear a lot of people are coming. That friend also came and received help.”
“Good for him! Really.”
When I looked, I saw a man who had suffered trauma from having his arm cut off multiple times. His face had improved a lot. Mirror therapy helped. Anyway, wasn’t that much better than cutting off his arm?
“Ah, but why can’t I see Alfred?”
“Ah… he was sick yesterday.”
“Is he hurt? Are his limbs okay?”
Oh, now I remembered that Alfred had almost had his arm cut off. I roughly summarized and explained the whole story. I even said I had to open his abdomen because of appendicitis, but I thought Liston was someone I could tell.
“Oh… as expected, you’re amazing.”
“Thank you. We still have to wait and see.”
Indeed, that was true. Especially since Liston was in a particularly good mood. Something good must have happened today. That was how it felt.
“Oh, and the patients in the amputation ward are also getting better.”
“For one thing, the screams aren’t as loud… it does seem that way.”
“Yes, that’s right. Are you sure? No matter how suspicious that water sounded, I was a bit skeptical. But when I actually tried it, I liked it.”
“Thank goodness. What about nausea?”
“There’s some of that. But it’s much better than pain in the arms and legs. Isn’t that natural?”
Liston chuckled and handed me a cookie. It didn’t look delicious. It just looked like flour.
“They say it gets better if we eat this together. I’ll have to keep an eye on it.”
“Ah… I think that would be really good.”
“Anyway, take a look.”
“Yes.”
I passed the mirror therapy room and entered the amputation ward. It was definitely quieter than before. Of course, it was quiet by nineteenth-century standards, not actually silent. If you wanted to study here, you wouldn’t need noise-canceling earphones.
“Are you okay?”
“Yes, yes.”
“Are you okay?”
“Yes.”
“Great.”
“Yes.”
Liston’s rounds were almost like the director’s rounds. When he asked if someone was okay with that face, who could say no? Unless someone looked like they were about to die immediately, I nodded unconditionally. If he asked me if I was okay, I would probably nod without really knowing what was going on.
“Uh…”
Anyway, as I followed him, I came across an empty bed. It had originally been occupied, but now it was empty. Who was it? I didn’t remember much, but my heart went cold. Because in hospitals of this period, an empty bed often meant someone had died.
“This… isn’t this Killian’s bed?”
“Huh? Ah, that bastard. Uh? Did he run away?”
But it was Killian’s bed. Now that I thought about it, dirty bandages were still tied to the iron bedposts here and there, probably used to bind patients.
“Is he dead?”
“Dead? Even if it’s syphilis… he didn’t look like he was about to die.”
“You never know.”
It seemed possible that he died not from syphilis but from the mercury used in treatment. As we were talking, a nearby patient approached me. This was a patient whose pain had subsided after taking medicine other than what I gave him.
“People were dragging him away earlier.”
What I heard was quite absurd. No, shocking.
“Yes? They dragged him away?”
“What are you talking about?”
This was true not only for me but also for Dr. Liston. What did it mean to drag someone from a hospital? Were they police?
“I think it was hospital people… that… you said it was Dr. Jémel?”
It would have been better if it were the police. No matter how harsh those people were, Killian would just suffer cramps and not die. But being taken by hospital staff didn’t mean he had gone somewhere for treatment, right? Strangely, in this period, the more serious doctors were about treatment, the more people died…
“Where… where did they take him?”
Killian was a bad man. He had spread a disease with no cure. But that didn’t mean he should be dragged off and left to die like a dog. People shouldn’t die like that.
“I don’t know. He must have gone to treat syphilis.”
Of course, it was syphilis again. How did they intend to cure a disease with no proper medicine? I grew impatient and headed outside.
“Where are you going? I heard he went for treatment. He’ll get better.”
Liston said this behind my back, so I needed to step up too.
“Aaaaaa.”
Listening closely, I heard screams coming from the other side of the amputation ward. I didn’t know if it was Killian’s voice, but it was clear that someone was holding someone down.
Footnote 1 — Translator’s Notes
Appendectomy — Surgical removal of the appendix.
Atelectasis — Collapse or poor expansion of part of the lung, which can occur after anesthesia or shallow breathing.
Anesthesia — Medical method or substance used to block pain or consciousness during surgery.
Respirator / ventilator — Machine that helps a patient breathe. The narrator compares modern breathing support to this era’s crude anesthesia.
Stethoscope — Medical instrument used to listen to internal body sounds, especially the heart and lungs.
Abdominal surgery — Surgery involving an incision into the abdomen.
Antibiotics — Medicines used to treat bacterial infections. Their absence makes post-surgical infection much more dangerous.
Sinusitis surgery — Surgical treatment related to sinus infection or inflammation.
Phantom pain — Pain felt in a missing limb after amputation.
Pain control — Medical management of pain, treated here as extremely important because nineteenth-century surgery often lacked reliable relief.
Mirror therapy — Treatment method using a mirror reflection to help reduce phantom limb pain.
Mercury treatment — Historical syphilis treatment involving mercury compounds, which could poison the patient.
Syphilis — Sexually transmitted bacterial infection that was difficult to treat before modern antibiotics.