Chapter 71: Absence (2).

"It's not as easy as I thought…"

The problem was the absence.

The fact that the patient was male was also an issue.

Of course, to call it a problem might be a stretch, since the prevalence of urinary stones is inherently much higher in men…

"I've brought all the old surgical methods."

Anyway, since I wasn't getting any easy answers, I asked Joseph and Alfred to bring me some books.

In the meantime, I sketched a rough anatomical diagram of the nearby area on a blank sheet of paper.

Of course, my memory isn't photographic, so I used a cadaver as a reference.

I didn't draw the entire lower abdomen—just from the urethra to the bladder, focusing only on the area where urinary stones typically form.

'The prostate… that's the issue, isn't it?'

How old was the patient again?

Maybe it's because this hospital is a mess, but I didn't even receive basic information like that during registration.

Isn't gender and age supposed to be the most basic information?

I guess I'll have to go ask directly…

"Ugh, aaaaah!"

The patient in the next room was screaming as if he were about to die at any moment.

I knew it was a painful condition, but I didn't expect it to be this bad.

It didn't seem like he was exaggerating.

If you were here, you'd understand—this era isn't one where people tolerate pain easily.

It's like the place is filled with people who'd be great at independence movements…

'It's not like they're not treating him at all, not giving him any medication or anything…'

What the hell…

A urinary stone patient from South Korea comes here, and they just leave him like this?

I guess we should be grateful this isn't a country where guns are easily accessible.

'He's probably over 30.'

Judging by his appearance, he could even be over 40, but this is an era where people tend to look older than they are.

Dr. Liston looked like he was well over 50, not even close to 40.

Anyway, if that's the case, then the prostate shouldn't be the issue.

"I brought it."

"Here. Ugh, it smells… it really smells."

Getting past the prostate hurdle was a good thing.

Of course, that wasn't the end of it, so I was still pondering when Joseph and Alfred approached.

They were carrying books.

When they said it smelled, I realized the books were slightly rotting.

They were poorly made to begin with, and the storage was just as bad, so it was no surprise.

Still, the content inside wasn't completely lost, so I was able to look up surgical methods soon enough.

"Ugh…"

"They really… do this?"

"No… even heathens wouldn't go this far."

The surgical method was… how should I put it?

Well, it gave off a grotesque vibe.

Not just to me, but even to these two, who are aspiring doctors in this era—or rather, aspiring torturers—the contents were horrifying enough to make them recoil.

"So they insert this into the urethra and spread it to remove the stone, right?"

The idea of inserting something like an iron skewer into the urethra was terrifying enough, but the thought of using not one, but two of them to pry out a stone made me wonder what kind of lunatic came up with this.

If they were at least skilled with chopsticks, it might have been slightly better, but what kind of confidence did these people have to even attempt such a thing?

The results, as expected, were disastrous.

There were accounts of people trembling violently, their limbs turning pale, and then dying—likely from the pain.

Pain-induced shock.

"Is this… really going to work? Are you really going to do this, Pyeong?"

Joseph looked at me with a face that clearly said he hoped I wouldn't.

Honestly, it annoyed me a bit.

Do I really look like the kind of person who would do something like this?

"No, are you crazy?"

"Right? Right?"

"Look here. There are people who bled to death… and others who suddenly couldn't urinate at all."

The former was obvious just from the look of the skewer-like tool… but the latter was likely due to the wound healing improperly, causing a stricture that blocked the urethra.

Urine was being produced, but it couldn't exit the body, leading to death…

'Damn…'

They were essentially causing renal failure and killing the patient.

I brushed off the goosebumps rising not just on my arms but all over my body and moved on to the next chapter.

There, another eye-popping illustration greeted me.

"What… what is this?"

"I don't know. What the hell is this?"

Joseph and Alfred were also rubbing their eyes in disbelief.

Of course they were.

If you could look at this and remain unfazed, you weren't human.

At least, you shouldn't be a doctor…

'Ah… so they insert a hand into the rectum… to feel for the stone in front… I see.'

But upon closer inspection, there was a reason for it.

A somewhat logical reason, at that.

Damn.

'So they push the stone forward… and then cut it out?'

It made sense to approach the stone from the closest possible distance to palpate it.

The only thing that didn't make sense was whether the stone could even be that large.

"Aaaaah! Aaaaaaah!"

At that moment, a scream echoed from the next room.

Listening to that scream, this surgical method started to seem more reasonable.

'No, wait. If you think about it… they wouldn't come here unless they were in extreme pain, right? Plus, they know about drinking water and urinating… so they must have come here because they couldn't pass it no matter what… Hmm.'

It seemed likely that the stones here were much larger than what we'd typically see in the 21st century.

Sure enough, the descriptions mentioned stones as large as eggs.

What the hell.

At that size, endoscopy would be impossible…

'Wait, what should I do?'

In cases like this, even cystoscopy would be out of the question.

We couldn't even make such equipment in the first place.

And it's not like we have X-rays here either.

We were in a completely hopeless situation.

'Should I really… leave it to them?'

I couldn't help but think of the group I'd seen earlier.

Even Dr. Liston was practically a butcher, but those guys were outright slaughterers.

To treat a human body like that…

They'd split the genitals in half to look for the stone.

Humans shouldn't do that to other humans.

"Wait… wait a second."

"Huh? I'm waiting."

"What are you talking about?"

I shook my head and pulled myself together.

In this damn era, if I don't step up, there's a 95% chance the patient will end up worse off.

I had to do something, that's what it came down to.

"I think I like this method."

"Huh…?"

"This one…? You're sticking your hand up their ass, Pyeong."

My two friends looked at me with worried expressions.

And they had every right to.

Even I thought this was a bit barbaric.

There weren't any detailed mentions, but it was obvious that many had died from rectal ruptures.

Even if they survived, their anal sphincters would be ruined, leaving them to suffer from fecal incontinence for the rest of their lives.

And most importantly, these surgeries were performed without anesthesia.

'Which means it must be excruciating, right?'

Who would lie still while someone did this to them unless they were in unbearable pain?

"First, I'll have to open the abdomen."

Anyway, I gave up on the idea of doing something through the urethra.

If I had a cystoscope, maybe, but I couldn't just make one on the spot.

I should probably prepare one for situations like this, but it wasn't going to help the patient who had been screaming in agony for over an hour in the next room.

"Open the… abdomen?"

"But that's forbidden, isn't it?"

"So you're just going to leave the patient like that?"

"No, who said anything about leaving him? Just hand him over."

"I mean… it's such a gruesome surgery…"

I didn't plan on making it gruesome.

Opening the abdomen might sound horrifying in this era, but if you disinfect properly, it shouldn't be too difficult, right?

It's not like I'd be doing it bare-handed—I'd be wearing gloves, so it'd be much better.

Lime chloride and all that nonsense wouldn't melt rubber, would it?

So the disinfection issue was naturally resolved.

'I have enough anatomical knowledge. The only problem is if the stone isn't in the bladder but somewhere else… but it's probably in a narrow area.'

As I continued to think, the other two kept chattering away.

"You know what?"

"What?"

It was mostly Alfred leading the conversation.

I might be the most skilled doctor in this world, whether I'm a rookie or not, but Joseph couldn't possibly match that.

He's learning a lot thanks to me, but his background knowledge of this era is inevitably lacking.

"There's even a song about lithotomy."

"Huh…? A song?"

"Yeah. A French composer wrote it after undergoing the surgery. I heard it once, and it's not bad."

"Really?"

I usually ignore his nonsense, but this was hard to overlook.

There's a song about it?

Wait, more importantly, he survived the surgery?

Was he a composer or a wrestler?

"Yeah, that's what I heard. That's how bad… this surgery is."

"Then why is Pyeong so determined?"

"He's stubborn. He was raised in a noble family in Joseon, so that's just how he is."

"Ah… well… I guess."

Joseph, who knew my secret, just nodded and looked at me.

He was telling me to drop it and move on.

Unfortunately for him, I had just come up with a plausible method around that time.

'Alright. It's probably stuck in the prostate. Or maybe it's in the bladder. Good. Good! I can do this!'

I stood up with renewed determination.

*Creak.*

Just then, Dr. Liston walked in.

"Huh? Is the patient dead?"

He said something that sounded a bit too grim for a doctor.

"What?"

"It's quiet."

"Oh. Huh?"

Now that he mentioned it, the patient had gone quiet.

Had he passed out?

Otherwise, how could he be so quiet?

I rushed over to check, but the room was empty.

"He's not dead, they took him. What were you doing that you didn't even notice?"

"They took him?"

"They handle lithotomies over there. They're quite proud of it."

"Oh no, that's not good."

"It might already be over."

I wasn't sure if he meant the surgery was over or the patient's life was over.

The problem was that the two didn't sound all that different.

If the surgery was over, there was a high chance that…

"Hey, let's go!"

"Wait, us too?"

"Aren't you his friends?"

"Yeah, yeah."

I started running.

I didn't know where I was going, but I ran.

What gave me the confidence?

"Ah, no! Save me!"

I was sure I'd hear screams.

Sure enough, screams were coming from a corner of the hospital.

From the sound of it, it didn't seem like he'd been anesthetized yet.

*Thud.*

I entered the room and saw the patient thrashing on the operating table, trying to escape.

"What's this?"

And finally, I met the surgeon.

Dr. Cain.

He looked like someone straight out of a movie.

Not the hero, but the kind of villain who'd poison people from behind the scenes… the sneaky, underhanded type.

"Ah, I'm—"

"That's our patient."

I tried to back away in fear, but my back hit a solid wall.

It was Dr. Liston.

He stepped forward with a reassuring expression, speaking on my behalf.

"What are you talking about? It's a lithotomy."

"What you're doing… can't even be called surgery, no matter how nicely you put it."

"What nonsense!"

"It's torture."

"Then call it murder? Either way, Pyeong here would do a better job. He's a genius."

He was being a bit too forward, which was a problem.

'Hey… what am I supposed to do if I run into you without you around…?'