When I took it out, the size of the stone was even more absurd than I had imagined.
What the hell.
How could something like this have been inside the bladder?
I glanced at the patient, who had passed out, with a sense of awe.
'How did they endure this?'
People in this era were known for their high tolerance for pain. After all, enduring pain often had a higher survival rate than seeking medical help, so it made sense.
But still…
"This is…"
I was so stunned that I picked up the stone to examine it.
It was solid.
How many years had it taken for something like this to form?
I almost burst out laughing at the absurdity of it all. Of course, laughing while holding a scalpel and looking at a patient would make me seem like a complete psychopath, so I held it in.
"This is… incredible."
"So this is what a bladder stone looks like."
The others in the room were equally amazed, though it seemed they had some misconceptions about what a bladder stone should look like. Normally, stones were supposed to be the size of a fingernail, but explaining that now would be pointless. Besides, this wasn't the time for that.
I couldn't afford to stand around in awe for too long. The open bladder and peritoneum were starting to worry me.
'From this point on, this isn't just medicine… it's entering the realm of the divine.'
Normally, the inner bladder would be stitched with absorbable sutures, and the outer muscle and skin would be stitched with non-absorbable nylon sutures. But now, that wasn't an option.
'Nylon sutures are supposed to significantly reduce the risk of infection, right?'
In surgery, skill was important, but infection control was always the top priority. Of course, in modern medicine, operating room infections were almost 100% controlled, but that didn't happen by itself. The sterilization protocols in place were so thorough that an outsider might think we were being overly meticulous.
'Using silk sutures here… that's a risk in itself.'
Being in this environment made me sigh deeply. The problem was that I was the only one who understood the gravity of the situation. Everyone else thought the current treatment was excessive.
"Why did you even bother boiling this?"
"Exactly. The sutures are all coming apart… this is going to cost a fortune."
Especially Alfred, who, true to his merchant background, was grumbling about the cost. Even though this was a place where doctors charged whatever they wanted, he still complained. If it cost more, they could just charge more, right?
'Well… this guy doesn't look like he has much money.'
Of course, providing good treatment at a low cost was ideal. But cutting corners could lead to death, and that was the last thing anyone wanted.
"Quiet. Watch closely and learn how to suture."
"Uh… okay."
"But did the needle really have to be round? That must have cost… never mind, I'll shut up."
After glaring at Alfred, who clearly didn't understand the importance of my custom-made needle, I threaded the suture through it.
'I really need to train an apprentice before I get too old.'
Normally, needles came pre-threaded. Reusing needles… wasn't that a bit unsanitary? But here, making a single round needle was no small feat. So, I had to thread the suture manually every time. It was manageable now that I was young, but it would be a problem as I got older.
*Thud.*
With that, I began suturing the bladder. Normally, I would have sutured each layer separately—muscle to muscle, connective tissue to connective tissue, and skin to skin. But using silk sutures would have significantly increased the risk of infection. At least, that was my judgment, so I decided to suture all the layers at once.
"Hmm… the round needle actually seems to work better than the pointed one."
Liston, who was watching from the side, marveled at my suturing skills. And he should have. Even though ignoring the layers was technically wrong, skill was skill. Plus, the professor I had trained under had emphasized meticulous suturing, so I was better at it than most surgeons with similar experience.
'Just changing the needle won't make you as good as me, Doctor.'
I finished suturing the bladder quickly and moved on to closing the abdomen. There was a bit of internal conflict here. The abdomen… was under a lot of tension. In other words, if I sutured it carelessly, it could split open.
'I've read records of people dying because their abdomens burst open…'
There was a reason people said not to mess with the abdomen. It wasn't just about infection. If the abdomen split open, it would be a disaster. Even in modern medicine, there were cases where the abdomen couldn't be closed immediately after surgery, especially if the organs were swollen. In those cases, the abdomen was left open, covered with sterile plastic, until the swelling went down.
*Thud.*
After some deliberation, I decided to suture it all at once.
'I'll just use multiple sutures… and the silk thread is thick enough.'
The thread was unusually thick, and since it was twisted, it had considerable tensile strength. Of course, that also meant there were more gaps for bacteria to get trapped, increasing the risk of infection… but when you have an advantage, you should use it.
I had no idea when nylon would be invented, but until then, this was the best I could do.
"Wow…"
"Incredible… it's seamless."
I pulled the incision closed and sutured it. The others were amazed, and for good reason. My incision technique was far superior to what people in this era were used to. Half of suturing was in the incision, and people in this time just cut without much thought.
'There's no muscle here, so it's even cleaner.'
In medical dramas, they just shout "Scalpel!" and cut, but there's a lot of anatomical consideration behind that. People in this era, who lacked that knowledge, might see it as almost magical.
"How did you do that?"
"Hmm… you really do have some impressive skills."
Even Cain, who had been skeptical, nodded in approval. It was only natural. They had never seen surgery like this before. Most surgeons in this era didn't have a deep understanding of anatomy.
"Alright, it's done. Phew."
Of course, before I could boast, I closed my eyes first.
"What are you doing?"
"I'm praying. For this patient's survival."
"Oh. How pious of you."
Liston chuckled and joined me in prayer. It wasn't entirely an act. The surgery had gone well, but that didn't guarantee the patient's survival. From this point on, it was in the hands of the heavens.
"Doctor Cain, what do you think?"
"Hmm. Opening the abdomen and removing it… this is…"
"Don't call it heresy. At the very least, it's far more humane than the surgeries you perform."
Cain looked visibly upset. He was used to amputating limbs, so hearing someone call his methods inhumane must have stung. But he couldn't really argue. Compared to his surgeries, this was indeed more humane.
'You don't have to amputate the genitals… right?'
Judging by the shocked look on his face, he was probably thinking something along those lines. What a lunatic. Why would you even amputate the genitals in the first place? That area was highly susceptible to infection, and the psychological trauma for the patient would be immense. Even in an era where psychological trauma was ignored, this was too much.
"I'll need to observe the results further."
"Do that. Whatever the outcome, it's bound to be better than what you do."
"Ugh…"
Cain looked thoroughly displeased but had no retort, so he left with his assistants.
Once the unwanted guests were gone, Liston's group approached. Colin was among them.
"That was… amazing."
He hesitated but still complimented me.
'Well… I'll take it.'
I smiled at Colin. Thinking about it, I had already scolded him, unintentionally scared him with a corpse, and even pulled out his tooth…
'If he doesn't forgive me, I'd be the real jerk, right?'
Our relationship had been rocky, but seeing him acknowledge my skills and show signs of improvement meant he wasn't a lost cause.
- Colin is a true noble. He's different from us.
Plus, Alfred had acknowledged him as a "golden spoon." Status still mattered in London, didn't it? Even if he was out of the line of succession, he still dreamed of becoming a doctor. He would be a great help when I eventually became the hospital director.
"It's nothing. You could do it too. You have good hands."
"R-really? That's a relief."
You little…
He's over the moon.
"Alright, let's move him to the ward."
"Yes. Um… can we put him in the ward I prepared?"
"Huh? Does it matter?"
Just as I was showing some leniency, Liston interjected. It was a reasonable request, but…
'The ward…'
The hospital ward was a hellhole masquerading as a medical facility.
Seriously…
Who the hell lets maggots grow in a hospital bed? And the doctors didn't even bat an eye. They just walked past like it was nothing. Patients were supposed to bring their own bedding, but if they didn't, they had to make do with whatever was left.
'Infection is already a concern, and this just makes it worse.'
I continued, "Opening the abdomen was a challenge for me. I want to do everything I can."
"Hmm… I can understand that, but don't you think there's too much of a difference between when you're holding a scalpel and when you're not? How can someone so cautious be so skilled with a blade?"
"Well…"
How does being cautious about hygiene equate to being overly cautious in general…?
"Anyway, go ahead."
Fortunately, Liston was favorable toward me, so I was able to move the patient to a relatively clean bed.
"You know this is all coming out of my pocket, right?"
Thanks to Alfred's help, of course.
"Oh, right. I'll pay you back when condoms come out."
"Ah, since we're on the topic, let's measure your size."
Damn it.
I shouldn't have brought that up.