Chapter 57: The Sinus Surgery... How Was It Done Again?(4).

Wow...

I stopped my hands and moved up toward the patient's head.

Looking at the place Alfred was pointing at, I could see that, sure enough, part of the brain had crumbled away as if it had been eroded.

I had never seen anything like this before.

"They say not to take ENT surgeries lightly... and they were right."

We perform surgeries by opening up the abdomen, while those guys just poke around in the nose. I wanted to ignore their warnings, but there was a brain.

...

They had dug into the brain.

They mistook it for pus and scraped it away.

"If visibility is poor, mistakes are bound to happen...

After all, vision is everything in surgery.

You have to see what you're cutting or doing."

I had acted without thinking, convinced there was no other option, but this was clearly my mistake.

"I can't be greedy, after all."

"Hmm?"

"No, I mean, I should just make a hole. I can't go digging inside and risk scraping the brain."

I thought about the two patients who had survived my selection process—no, the two who had been chosen for surgery.

Those two were suffering from unbearable headaches, no matter what they tried.

More importantly, an attempt at irrigation had caused otitis media.

That had to be dealt with, too...

Opening up the nasal passages might at least bring some relief.

"But the ear canal is even narrower. How am I supposed to operate on that?"

Two patients who came in with headaches and ended up with ear pain as well.

I had some ideas in my head about how to proceed.

Otitis media causes ear pain because the inflammation inside presses against the eardrum, right?

The best solution would be to reduce or remove the inflammation, but in an era without antibiotics or anti-inflammatory drugs, the most effective approach would be to perforate the eardrum.

That way, the pus inside could drain out.

Of course, that would leave a hole in the eardrum... but I had heard it heals well.

The problem was that I had no confidence in my ability to create that perforation through such a narrow ear canal.

"Not to mention, I don't even have the right tools."

Even if I just knew what kind of tool was used, it would be easier.

ENT was such a minor field that the course was only worth 0.5 credits, so I only saw a bit during clinical rotations and relied on study guides.

Damn, past me...

Why didn't you study more broadly?

If you had, you wouldn't be suffering now, stranded in the 19th century...

"Alright... I'll try on the next cadaver."

I pushed aside my useless thoughts and moved on to the next body.

Lifting the paper covering the face, I saw yet another young face staring back at me.

Damn it... Why do so many young people die every day in this wretched city of London, only to end up being sold to dissection rooms?

"When does this problem get solved?"

It was too horrific to ignore, but there was no point in worrying about something I didn't know the answer to.

Being a scientist to the bone and trained as such, I shook my head and turned to Joseph.

"Uh... yeah."

Joseph was still staring into the patient's head, nose, and mouth with a confused expression.

That was understandable.

His anatomical knowledge was still lacking.

I could visualize the structure of the head in 3D even with my eyes closed, piecing together each bone in my mind, but expecting that from someone in this era was unrealistic.

He probably had no idea how everything was connected to cause this condition.

Screech.

Still, Joseph followed my previous actions, pulling the upper lip upward to expose the gums.

I made an incision with my roughly improvised scalpel.

Then, using a chisel-like tool, I scraped away the soft tissue between the gums and bone.

A few clicks and cracks sounded as more of the inner bone surface came into view.

But I couldn't just break through the bone right away.

"Last time, I ended up exposing the roots of the upper teeth..."

For God's sake...

That time, I accidentally extracted three teeth.

Unintentionally.

Dr. Liston, Alfred, Joseph, and the other 19th-century brutes dismissed it, saying, "What's the big deal? Sometimes jaws get broken during surgery."

I must not get swept up in their mentality.

I nearly convinced myself, "Maybe it's fine," and that scared me.

No.

Absolutely not.

I'm different from them.

"I need the chisel."

Born in the 21st century, trained in one of the most advanced medical education systems in the world, not only a specialist but also a fellow, a clinical instructor, and even an assistant professor—I cannot be like them.

So I carefully elevated the soft tissue upward before using a chisel to create an opening in the bone.

Clang! Crack!

I was getting better at this.

How should I put it?

I was starting to feel the bone as I placed the chisel against it.

When I sensed a hollow space underneath, I applied more force, and the bone broke away, revealing the sinus cavity inside.

"Hmm."

As expected, the interior wasn't normal.

"Is it supposed to look like that?"

Joseph tilted his head, puzzled.

It was understandable.

Every single cadaver we had opened so far had inflamed maxillary sinuses, so he assumed that was normal.

"No, it shouldn't be like this."

"Really? Then why are they all like this?"

"The air in London must be the problem..."

I almost said it out loud but held my tongue.

Scientists of this era—though I hated to call them that—had no real concept of air pollution.

It wasn't that they didn't understand gases; they knew about oxygen, after all.

But they had no awareness of air pollution.

"Something in the air must be irritating the nose."

I left it vague, though I had no intention of letting this slide in the long run.

As expected, the 19th-century folks didn't react much.

"Anyway, clear out all the pus. The more I watch, the more I feel like I could do it myself."

Dr. Liston, a surgery fanatic, was already twitching his fingers.

His mind had likely already dissected several noses.

And it wasn't just him.

Alfred and Joseph were the same.

Future surgeons through and through, they couldn't wait to get their hands dirty.

"Things always look easier when you're just watching..."

The procedure I was performing...

It wasn't exactly the same, but it had a formal name.

The Caldwell-Luc operation.

Nowadays, it's rarely done due to endoscopic techniques, but in the past, this was the go-to surgery for sinus issues.

By "the past," I meant the late 20th century—after countless failed attempts.

In other words, without an endoscope, this was the best sinus surgery available.

And it was standardized, meaning it could be systematically taught.

"But if they try it themselv

es... it'll be incredibly difficult."

I might make it look easy...

"Alright... Done."

But it wasn't.

I was giving it my all.