Nineteenth Century Medical Guide

Chapter 501, Section 497: The Greed for a One-Time Solution
From the moment Luna saw Orni appear, she felt unwell, experiencing dizziness, tinnitus, and a fine sheen of sweat on her forehead.

As the argument escalated, she felt as if all her strength had been drained away, her legs swayed, and her body spun like a top until she collapsed to the ground.

At first, she was conscious; she felt unable to breathe, speak, or see. She felt as if she had been drenched in icy water, not just her inner lining, but the outside of her skirt and even the hem were soaked.

Then I fainted and knew nothing more.

"Doctor, why are her eyes open?"

"Yes, that's normal."

"Normal? She's Mr. Jose's precious daughter!"

"It doesn't matter whose daughter she is."

"."

"Don't worry, she'll wake up soon."

Just as this person said, Luna fainted quickly, but she also woke up quickly, regaining consciousness in less than a minute.

She didn't remember fainting, and she wasn't sure if her eyes were open or not. Anyway, as soon as she could hear sounds, she closed her eyes and didn't want to open them, afraid that seeing the ward would remind her of Orni's heartless words and cause her emotions to spiral out of control again.

"What should we do next?"

"Make a note of her medical record, let her stay here for one night and continue to observe her. If everything is fine, let her leave tomorrow."

"Write medical records? We're not doctors."

"Write down what you see. You don't necessarily need a medical record book; any piece of paper will do. When Antonio comes back, he can revise and fill in the missing parts himself."

Luna could tell that the nurses were in a panic, while the gentle male voice beside her sounded remarkably calm.

He spoke at a moderate pace, with clear thinking. His tone wasn't very pleasant, a bit condescending, but it wasn't unlikeable.

Like an indifferent bystander, it seemed that the heated argument and even his own fainting were just trivial matters, and everything was under his control.

"Write it down? We...we have some words."

"Oh, then let's wait for him to come back and tell him what we saw. Anyway, the surgery will be over soon."

"All right."

After the conversation ended, footsteps could be heard as they left.

"Awake?"

A man's voice suddenly appeared, closer than before, accompanied by a strange scent. It was faint and unfamiliar; it was definitely not perfume, nor any of the scents she was used to.

Then a warm hand gently touched her face, two times, three times, the rhythm was fast and light, forcing Luna to open her eyes.

She could have continued to pretend to be "dizzy," but subconsciously she was warning that if she did, something bad would definitely happen.

As for how bad it is, Luna has no idea.

She had the same feeling when she secretly went to Orni's house last time, and the consequences were very serious. Before coming here, on Ian's carriage, she also had a vague feeling that her heart was being tugged, and now it seems that those feelings were real.

Luna opened her eyes and saw a familiar-looking young man.

He wore a black uniform with bright blue buttons; the well-tailored cut avoided highlighting his slender figure, fully revealing his broad shoulders and chest. Underneath, a light smoky gray shirt could be vaguely seen, with a large white patch on the collar, as if it had been soaked in bleach.

He wore his ever-present police hat and held a rose in his hand. The pale yellow moonlight shone on his back as he leaned his entire body towards her.

Everything happened so suddenly!
"Mr. Orney!"

Luna was very excited. She sat up abruptly, grabbed the man's hand tightly, and looked closely before realizing that the person in front of her didn't seem to be Orni.

The two men looked similar, and their faces were her type, so she subconsciously mistook his thick, curly brown hair for a police cap. What he held in his hand wasn't a rose, but a small metal hammer with soft rubber covering both ends.

Kavi looked at her calmly: "I usually only hold a patient's hand when they are dying."

Luna quickly withdrew her hands, brought her feet together, pulled the blanket over herself, and curled up into a ball to hide her embarrassment: "Yes, I'm sorry, I mistook you for someone else."

"It's okay, this is normal when you first regain consciousness, don't worry about it."

Having practiced medicine for so many years, Kavi had seen all sorts of patients and had no reaction to the girl's reaction: "It was only a short time. It's good that you woke up. If you don't wake up, we'll have to find someone to call your father."

Luna's head was spinning and a little sore, and she didn't react for a moment, only managing to say thank you.

He immediately realized something was wrong after saying that. After thinking about it carefully, he suddenly remembered that he had been missing for quite some time. He quickly looked up at the window and asked, "What time is it?!"

It's almost six o'clock.

"I have to leave, I want to go home."

Luna had a headache, felt weak all over, and was covered in cold sweat. But she couldn't care less. With a twist of her waist, her feet touched the ground. Even though she felt dizzy, nauseous, and wanted to vomit, she had to get back as soon as possible, or her father would definitely make her suffer.

Kavi blocked her way: "I didn't agree to let you leave."

"I have to go home!" Luna then realized that the other person was the doctor who had been painting earlier. "I'm sorry, Dr. Kavi, I disturbed your work. I'm awake now, it's alright."

It was "It's alright" again, the same excuse as Anders.

Kavi was speechless. Were Spaniards really that afraid of hospitals?

“You’re awake, but whether you’re alright or not isn’t up to you.” Kavi pushed her back onto the bed, shaking the small hammer in his hand. “There are a lot of causes of fainting. I need to do some tests first. I’ll let you go back once I’m sure you’re really alright.”

Luna was eager to leave and was very stubborn, but it was Kavi's push that made her fall back onto the hospital bed, feeling a sense of comfort throughout her body.

The dizziness was gone, the nausea and vomiting were gone, and the headache was still there but not nearly as severe as before. If she could, she would gladly stay the night and see the sun rise the next day before leaving.

Kavi lifted her calf with one hand and tapped her knee with a hammer in the other: "Have you ever fainted before?"

“Once when I was little, I think it happened once.” Luna stared blankly at the ceiling, her emotions seemingly calming down. “That morning, I secretly went to feed a bull by myself. It was the first time my father took me to the bullring.”

“Your nerve reflexes are all normal. Your body didn’t shake when you were dizzy. Open your mouth and say something.” Kavi approached her mouth. “Your tongue isn’t injured (it’s not epilepsy).”

After doing all that, he took down the candle from the wall and gently pried open her eyes: "You can speak without any problems, your pupils are normal, you have a headache but it's not severe, so it doesn't seem to be a vascular issue." Luna had never undergone this kind of examination before.

She only remembered that the doctors she met when she was a child would only ask questions, never perform any procedures, and certainly wouldn't examine her in such detail. She stared blankly at Kavi, feeling like she was that dead bull, and tears streamed down her face uncontrollably.

Kavi performed a simple muscle strength test, then grasped her forearm: "Come on, push. Good, your muscle strength is fine."

Luna lay there stiffly: "Dr. Kavi, even if you can't become a doctor, you can still become a very famous chef."

Kavi didn't respond, but continued explaining, "I was there when it happened. Your eyes rolled upwards, which means it wasn't a mentally induced pseudosyncope. Your muscle strength is normal, so it wasn't a sudden collapse caused by muscle weakness, nor was it dizziness or unconsciousness."

"So what's wrong with me?"

“Simple fainting due to emotional distress.” Kavi then took out his stethoscope. “I need to listen to your heartbeat. I hope you don’t mind.”

"Um, whatever." Luna looked down at him slightly. "Dr. Kavi, am I particularly annoying?"

Kavi moved the stethoscope head back and forth, putting a finger to his lips: "Shh~"

After a while, he took off his stethoscope: "There's nothing seriously wrong with your heart, but your heart rate is a little slow. I don't know your usual heart rate, so you'll have to rest here for half an hour, and I'll come back to check it again once you've recovered."

"Dr. Kavi."

"As long as you recover, everything else is minor. I've seen all sorts of complicated situations in the ward, so there's no need for you to blame yourself." Kavi helped her pull up the curtain. "Don't think about anything, just rest. That's what you need most right now."

The interlude came to an end, albeit with an imperfect conclusion, but it did restore peace to the ward.

To Kavi's relief, Ugo remained calm; at least when he heard that surgery was needed, he didn't mention trying to escape with the drainage device. Just as Anders had said, he was a brave man.
"Mr. Ugo, what's wrong?"

"Me? Nothing happened to me."

Ugo's expression was quite different from before; some faint wrinkles had appeared on his face that he hadn't seen before. If you looked closely and for a while, you could occasionally see these wrinkles twitching slightly.

Kavi was preoccupied with urinating into his chest and wouldn't notice such a minor detail.

He came to the bedside, picked up the hand-drawn anatomical diagram, and continued to explain the surgical plan: "I will have you lie on your side, then I will cut open your skin, find the ruptures in the diaphragm and kidneys, and repair them with sutures."

The entire surgery was summarized in just three short sentences, leading Hugo to believe it was simple: "How long will it take? Half an hour? Or..."

"Two or three hours, but it depends on the extent of the damage."

Ugo gripped the edge of the bed with one hand and pressed down hard on his trembling knees with the other: "Will it take that long?"

"After all, it's a large incision, and I need to find the damaged area, which takes a lot of time."

Kavi put down the paper, propped up the pillow behind Ugo, and began to examine the swollen area. The swelling wasn't severe; some tiny bleeding points were visible on the skin, but the affected area seemed to have expanded slightly compared to before.

If the swelling doesn't change, he might schedule the surgery now and have Ugo's kidney repaired that very night.

The situation has changed. The upper edge of the swelling, which was originally level with the lower edge of the 5th rib, has now expanded upwards again.

Kavi hesitated again.

Modern assessments of injury rely on imaging examinations, but Carvy could only rely on visual observation. Patient descriptions and surface swelling and bruising were the primary, and almost sole, indicators for measuring the extent of injury in the 19th century.

Unless he cuts it open, he has no idea what's going on inside.

The swelling isn't severe right now because the injury happened relatively recently; only the surface capillaries are ruptured. In the next day or two, more blood will leak from the deeper blood vessels, and the bruising will become more visible.

Ugo is also doing well, with stable vital signs.

The pleural effusion seems strange, but the drainage is smooth and the bleeding is not heavy. It should be manageable to wait one night. At worst, I can stay in the hospital with Bergette.

Kavi hesitated whether to wait until the bruising had fully appeared and the extent of the deep injury was truly determined before performing surgery.

With a clear understanding of the surgical area, the location of the injury can be explored during surgery, and all problems can be addressed in one go. This avoids the need to make a new incision when other problems arise after surgery.

A second surgery performed in a short period of time will significantly increase the risk and slow down the postoperative healing process.

"Dr. Kavi, how confident are you about the surgery?" Ugo suddenly asked.

“About 70-80%,” Kavi replied. “It’s just repair work. Whether it succeeds or not depends on the extent of the damage you suffer, and it doesn’t really have much to do with me.”

"I see," Ugo secretly wiped the sweat from his palms onto the sheets. "What will happen if the surgery fails? Will I die?"

“Probably not. Even if it fails, it's just one kidney. You still have another one.” Kavi finally noticed the change in his expression. “Mr. Ugo, are you nervous?”

No, no.

Ugo shook his head, the wrinkles he had just made relaxed, and his body relaxed as well: "I'm just worried that I won't be able to fight bulls anymore."

"Relax, Mr. Anders' condition was even more serious than yours, but he's doing fine now, and his surgery is almost over."

Kavi appeared calm, comforting Luna and then Ugo. But a sliver of greed in his heart, a desire for a permanent solution, constantly tempted him, causing his thoughts to rise and fall.

To combat greed, like other doctors, he began cultivating caution in his heart from a young age, planting a seed for every mistake he made. As greed grew, so did his caution, constantly reminding him not to act impulsively.

Most rib fractures are well-displaced, but nothing is absolute, and fracture repair is a slow process.

If displacement occurs during the process, there may be other damage.

Or perhaps other damage has already occurred, but he's unaware of it yet. Performing surgery on the kidneys prematurely might exacerbate the damage.

Moreover, he is not a specialist surgeon in urology or orthopedics, and the diaphragm and kidneys are not his areas of expertise.

Over the years, he has done a lot of practice, dissecting whenever he has free time to solidify his anatomical knowledge. But it is really too difficult to broaden the level of 21st-century surgery with 19th-century research.

When faced with complex trauma, one can only rely on the emergency surgical experience accumulated over the years.

Just then, Bergett's voice came from outside the curtain: "Dr. Kavi, the surgery is over. We searched for a long time and only found that one incision."

"Is it clean?" Kavi asked again, not seeing Antonio. "How about the skin suturing? Isn't it finished yet?"

“I let Director Antonio take over. His suturing skills are quite good, but he lacks confidence.”

Bergert strode forward, glanced at the hand-drawn diagram beside the bed, and then squatted down to fiddle with the drainage bottle: "You haven't answered my question yet. Since it's kidney damage, the urine should flow into the abdominal cavity. How come it all went into the chest cavity?"