Nineteenth Century Medical Guide

Chapter 378 374.Leave

[The floor drain was clogged last night. Although it seems like an excuse, I still have to say it]

Because of the location of throat cancer, there were few suitable solutions in the 19th century.

The first person to use laryngostomy was French doctor Desault, but he did not do it to treat laryngeal cancer, but to remove foreign bodies stuck in the larynx. Many times the foreign body is located very far back and is difficult to grasp with instruments, so a knife will be chosen in front of the neck.

Compared with the slow process of tumor resection, the speed of removing foreign bodies is definitely much faster, so tracheotomy is not necessary, the amount of bleeding is much less, and the success rate is naturally higher than that of laryngeal cancer.

The success rate of laryngeal dehiscence surgery that is actually applied to laryngeal cancer is very impressive. From the invention of the surgery in 1813 to the partial laryngectomy performed by Carvey today, there have been less than 40 cases in total, with a success rate of less than 30%. And even if the operation is successfully performed, the postoperative period is often not ideal. Infection and scarring will affect throat function and life.

The reason is nothing more than immaturity in anesthesia technology, disinfection technology, tracheotomy, antibiotics and postoperative recovery concepts.

These are Kawei’s modern surgical advantages, and they have become the cornerstone for the successful resection of laryngeal cancer.

But not many people can really see things beyond surgery. More doctors still marvel at Kawei's meticulous operation during the resection surgery and the Vienna Surgery's proficiency in tracheotomy. At this point, Cediyo also had to admit that Kawi’s technical skills were already at the top level in the world.

In fact, he felt that the other party did not use all his strength today.

After working with Kawei for so long, today was the most awkward and difficult time for Sediyo to integrate into the entire surgical process. However, the unfamiliarity caused by the lack of anatomical practice and surgical experience was quietly resolved with the help of Kawei.

Cediyo sighed softly, and could only drive away the feeling of loss surrounding his head, and immerse himself in the operation again.

After Kawei finished stating Bizet's vital signs and announced the success of the operation, the audience immediately burst into warm applause, even louder than before.

Originally, major newspapers including "Le Figaro", "Le Progress", and "Times of France" had been tracking the news about Kavi.

Cedieu is the chief of surgery and the face of the Paris Department of Surgery, so he naturally knows what this means.

Kawei doesn't like socializing, but he enjoys it. But it is not that easy to really leave the Surgical Association, and you have to pass the reporter at the gate.

Some will also ask very detailed questions, such as "How should Mr. Alphonse's broken penis be further treated?", "Will Mr. Bizet be unable to speak?", "Would you consider writing some teaching materials?" etc.

After Kawei introduced the post-operative care to Bizet's doctors in charge, the doctors surrounded Kawei and asked about the details and insights of the operation, hoping to squeeze more knowledge from it to supplement their lack of surgical skills. 【5】

At 5:40, the skin suturing was completed and the operation ended.

It wasn't until the nobles and royals from the second floor appeared that the doctors gradually dispersed. The world's first supraglottic partial laryngectomy with preservation of arytenoid cartilage came to an end amidst the greetings of everyone and the white snow flying in the sky of Paris.

4:43, check the resection margin to ensure it is smooth and tidy, with no tumor remaining. The mass was handed over to Berget for pathological biopsy, and Kawi and Cediyo were ready to suture it, repair the base of the tongue, and close the pharyngeal cavity. 【3】

At 4:35, it was basically clear that the location of the tumor did not involve the arytenoid cartilage. Carvey successfully cut off the tumor and preserved Bizet's arytenoid cartilage. 【2】

"Professor Sedieu, next we need to remove the tumor." In a daze, Kawei straightened the tissue forceps in his hand and reminded, "During the resection, it is necessary to expose enough visual field to clearly define the boundaries around the tumor. There should be no residue and no excessive damage to normal tissue.”

Today, due to the emergence of nobles and royal families, "La Vie Paris" and "Le Gaulois", which pay more attention to social celebrities, have no choice but to join in. Even the largest Catholic newspaper "Pilgrim", which has drawn a clear line with the mainstream media, also Followed all the way from St. Augustine’s Church.

At 5:11, the pharyngeal cavity was completely closed, and Damirgang began to suture the anterior cervical fascia, muscles and skin at various locations. 【4】

Among them, "itinerary after leaving Paris", "whether to participate in next year's World Expo" and "future career plans" are the three most common questions, followed by "feelings about the level of surgery in Paris", "comparison of the hardware level of hospitals in the two countries" and "Is Paris still the surgical center of the world?" and other medical-related questions.

In their eyes, surgery, which is overflowing with blood, is not only a tool to cure diseases and save lives, but also a novel platform for social interaction. The ultimate goal is to enhance his reputation, and of course Kawei does have the ability to make them attend.

too strong.

Regardless of limbs, chest, abdominal cavity, brain, breast, obstetrics, gunshot wounds, burns, tumor removal, cesarean section or even plastic surgery, Sedieu can't find even the slightest advantage, and there is no hope of catching up.

The three emperors and queens chatted briefly with Kawei before saying goodbye in a hurry, as did most of the upper-class socialites.

It was 4:11 pm, less than 2 hours after the operation started, and Carvey had already observed Bizet's throat swelling [1]. Bizet's vital signs were stable, indicating that the depth of anesthesia given by Amor was very appropriate.

The questions are all purposeful, in order to capture the last bit of news value of Cavell's stay in Paris.

This means that in the preparation time of more than a week before, Kawei only relied on the two cadavers given by the Surgical Association. Not only did he prepare in detail what he should do, but he also took into account what Ichisuke had to do.

Of course, news is not limited to medicine, but also goes beyond medicine. With the participation of several newspapers, questions will inevitably deviate to interpersonal relationships.

Questions such as "What is your relationship with the Countess of Bortale", "Why did you meet Princess Alex that day", "Will you settle in Paris in the future", "Who is your favorite painter", "Have you continued to participate in German painting?" Rouault and Her Majesty’s Intention to Bid” would pop up from time to time.

Apart from these, there will definitely be some weird questions. After all, some are normal and some are abnormal, and some are just stupid.

When it comes to newspaper sales tomorrow, someone has to ask stupid questions, such as "Do you have a girl you like?" "Have you considered marrying a French girl?" "Are you a Catholic?" "Is Place Pigalle fun?" "Will my wife deliver the baby myself when she gives birth in the future?"

These questions were meaningless to Kawei. The more he didn't respond, the more people became more enthusiastic. Finally, with the help of Sedieu and several doctors, he finally got on the carriage.

The car door closed with a bang, cutting off the noisy sounds around him and truly reflecting the meaning of Mick's existence.

"These reporters are so annoying. They ask all kinds of questions."

"Yeah, Dr. Carvey, are you okay?"

"fine."

"Let's go to the Regis Hotel first."

The carriage started to move slowly, and after it separated from the crowd and hit the road, it slowly started to speed up.

The snow flakes outside the window gradually grew from fine fluff at the beginning to wide, and finally like butterflies, they kept fluttering towards the window glass, bumped on the glass, then flew back gracefully, flew to the ground, and finally wrapped up in the wheels and formed a pattern. A puddle of water on the streets of Paris.

".It's snowing~" "Yes, it's snowing."

Due to geographical factors, Paris is not a city that often snows. Both Hort and Prince Napoleon looked out the window and admired the street scene as a painting.

Cediyo was sitting next to Kawi, but all he could think about was the surgery just now.

They were both standing on both sides of Bizet's neck, seemingly experiencing the same operation from opposite perspectives. But in fact, Cediyo only felt that he was sleepwalking and had no real sense of surgery. He felt like a loom following mechanical instructions, or a bloated public carriage running on the rails, unconsciously and step by step doing the right movements.

There is no need to think deeply, and there is no time for him to think deeply. When his mind has thought of the meaning of the previous step and is ready to think about this step, the next step has already begun.

The most infuriating thing is that he never doubted whether the instruction was right or wrong.

This is not because he is too weak, nor does he have lost his self-esteem. Cediyo firmly believes that there will never be a surgeon in the country who is more outstanding than himself. Because before Kawei came, the rankings and opinions in the surgical community were like this. He was the strongest group, no doubt.

This situation just showed that he had completely lost control of his throat cancer surgery. Only those who are at a loss will give up thinking and firmly believe that the sound coming into their ears is completely correct.

What he can't do, no one else can do either.

But Kawhi did it, and it looked particularly easy.

This is a surgery for throat cancer that almost no one touches, and there are only a handful of successful cases. There was also tracheostomy. From the anatomical location, surgical procedures to precautions, he explained everything clearly, and there was no doubt or need to discuss with anyone.

Thinking back to the previous skin grafting surgery, breast cancer resection, reconstruction, and cesarean section, he has been innovating almost all the time. Innovation is often accompanied by various failures, but his innovation makes it impossible to find shortcomings.

For the first time, Cediyo had doubts about Kawi's identity, and also took a keen interest in his daily anatomy training and surgical skills practice. He became more determined to go to Vienna, and vaguely had the selfish idea of ​​"why not just leave the main hospital alone and take his family with him to Vienna".

You must know that before Cavill appeared, he thought he was used to life in a big city and couldn't stand the daily routine of other places, so he hated leaving Paris.

When he was young, he once said that "Paris is the center of the world" and confessed that he would be bored to death once he left Paris, because in his opinion, the surgical technology in other cities was far inferior to Paris, and the tranquil nature and comfortable manors were not enough. to replace "vigorous surgical work."

From another perspective, Cediyo is still the same as before, but times have changed.

Paris is no longer the center of surgery in the world. Perhaps the scientific research atmosphere is still there, the historical heritage is still there, and the title on the head is still there. But now the fact is before our eyes, the center of surgery is quietly falling on the head of a certain genius, and the so-called center of Paris may no longer have the value to exist.

Perhaps Paris was no longer the center of surgery, and he naturally wanted to find the real center of the world.

Faced with such a pursuit of Cediyo, Kawi could not find a reason to reject him. In fact, he had welcomed Serdieu to Vienna, which could be regarded as another impact on Austrian surgery after Mosier.

However, this famous French surgeon is already over 50 years old. Years of late night practice and daily heavy work have caused his premature graying. His temples were like a street covered with wet snowflakes falling one after another, full of traces of the ruts of time.

Kawei had to remind: "There are a lot of talents there, and I can't guarantee your share of the stage."

"It's ok."

"Then you have to pack up quickly. Queen Elizabeth and I are taking the 9 o'clock train."

"I asked my wife to put it away a few days ago."

At 8:30 pm, darkness falls over Paris.

The snowflakes are stirring in the north wind and accompanied by dim lights, like a glass of corked red wine. It is rejected by adults, but children can add a teaspoon of honey to it with a smile, and then imitate adults to shake it around. The breath spilled on the ground of the Paris train station platform.

There was an important person going out tonight, so the place was cleaned very clean, and the idle people, including those selling groceries, were mostly driven away.

After a long time, the carriage of Queen Elizabeth and her entourage arrived at the train station.

In front of the station were Queen Eugenie and her entourage, while beside her stood her son and several ministers. The outer circle includes some of the top social circles, as well as some nobles who have various connections with Austria. Further outside, there were guards and some policemen lined up in two lines.

White snow covered the sky and covered the branches, sticking to these people's heads, shoulders and faces. They greeted each other and hurried through the waiting hall to the platform.

"The next time we see each other should be next summer."

"Yes."

"Bon Voyage."

"Take care of yourself too."

The queens of the two major European countries looked at each other, which seemed to symbolize that the relationship between the two countries had tended to ease. The band and the train whistle sounded successively, and Elizabeth, surrounded by her entourage, boarded the train back to Austria.

"Next is Dr. Carvey, the most commendable medical wizard of this century."

Eugenie waited for Kavi to step forward, lowered the brim of her hat to block the flying snow, then took out the note that Na San had written before and stuffed it into his pocket: "I talked about this with you before. It’s settled now.”

"Don't worry, Your Majesty the Queen, I will definitely come back next year. Please take care of yourself, Your Majesty the Emperor." Kawei took off his hat, hung his cane on his arm, bowed slightly and kissed his hand, "I wish in advance that the Paris World Expo can be successfully held."

"Thank you."

The train whistle sounded again, and Carvey and his surgical team boarded the carriage one after another: "See you next year, Paris."

(End of this chapter)