Chapter 86: I Guess We Need to Operate? (3).

"Scalpel."

"Ah... you mean this knife?"

"Yeah. Isn't it about time you knew what a scalpel is?"

"Ah, right. Sorry."

"Pull the abdomen."

"Okay. But why do we need to pull it?"

I can't tell if this is surgery or a teaching session...

If Joseph wasn't my friend, I would've smacked him by now...

'Professor... was this how you felt?'

How did you even endure this, seriously?

Thinking back, I was such a clueless student back then...

I tried hard to remember my own days as a clueless intern, and somehow, it started to make sense.

Well, maybe "making sense" isn't the right word. More like rationalizing?

Whatever you call it, anyway...

"You need to pull the abdomen to make a clean incision. You've seen this during dissections, right?"

"Ah... right."

"Watch carefully."

Besides, I was so used to surgeries that minor distractions didn't even bother me.

I was a surgery professor, after all.

Sure, I died shortly after being officially appointed, but still.

The training period to become a professor was brutal.

*Sigh*

Anyway, I soon made a diagonal incision at Alfred's McBurney's point with the scalpel.

Joseph looked a bit surprised.

Even though I told him to pull the area, he still seemed shocked.

Well, it was understandable.

During dissections, we'd make a bold incision from the sternum down to the pubic area.

Compared to that, this must seem like nothing, right?

Especially since it's a horizontal cut.

"Hmm... is this enough?"

"If you open it more, the patient will die."

"Really? I thought visibility was important."

"Of course, visibility is important. But... you can't just aim for perfect visibility. The patient is in pain here. Why would you cut more than necessary?"

"I see..."

"Pull this. No, not upwards. Yes, to the sides. A bit higher. Yes, like that."

I handed Joseph a crudely made Richardson Retractor.

Honestly, it looked more like an Army Retractor than a Richardson.

But it worked.

As long as it could pull, it was fine.

"Light, over here. No, damn it. My face is burning. Adjust it. Yes, there."

It was pulled, but the inside wasn't very visible.

Well, it was to be expected.

There's no ceiling light here.

In the operating room, there are shadowless lamps, and we even wear headlamps, so lighting isn't an issue... but here, everything that was taken for granted in the 21st century is not just a luxury—it's something unimaginable.

*Sigh*

I glared at the servant who had brought the lamp too close to my face and then looked back into the abdomen.

'This is harder than I thought.'

The light.

It was more critical than I expected.

Part of it was because I was used to operating in such a well-equipped environment.

There's a saying that in the operating room, the one holding the scalpel is the boss, regardless of rank.

Thanks to that, I was able to perform surgeries in a proper environment even before becoming a professor.

But here, there was nothing.

'Take it slow... stay calm. This is just an appendix. It's not a difficult surgery...'

I took a deep breath and inserted my index finger into the abdomen.

It's not even a difficult surgery—it's a basic one.

Each department has its own introductory surgery, and for surgery, it's usually the appendectomy.

That means it's a surgery I've done countless times since my third year of residency.

After that, the frequency decreased, but by then, I had already performed much more complex surgeries.

The anatomical structure of the abdomen was so clear in my mind that I could visualize it with my eyes closed.

"Good."

I first located the area where the ileum connects to the ascending colon and then felt around the cecum.

The appendix is a tail-like structure that extends from the cecum.

'It's swollen... really swollen.'

Since it's a terminal structure connected to the cecum, sometimes fecal matter or hard food particles can block it, causing inflammation.

When that inflammation doesn't resolve on its own and swells up, it becomes what we commonly know as appendicitis.

"Here we go."

I pulled out the appendix, which should have been slender but was now swollen and inflamed.

*Thud*

Just then, the door opened.

I didn't bother to look up.

It was a critical moment, and by now, I figured no one would dare interrupt.

"Master, I've brought him!"

"Shh. Quiet."

"Huh?"

"Dr. Piyoung seems to be doing well, so let's just wait."

As expected.

When any action reaches a certain level of mastery, even a layperson can tell that something special is happening.

In that sense, my appendectomy was a kind of art.

From the moment I picked up the scalpel, I had been working seamlessly, without a single hiccup.

And what I just pulled out...

Doesn't it look wrong?

Doesn't it seem like the cause?

The organ, which should have been a healthy pink, was now a dark red, swollen to the point of bursting. Even someone who knew nothing would think it needed to be removed.

"Then why did you bring me here?"

An elderly voice spoke, and I couldn't help but turn my head.

It was someone I hadn't seen before.

If he were a surgeon, I would have thought he was Liston, but he didn't seem to be.

"Just in case. I apologize for the inconvenience."

"Apologize? You think that's enough? Look at that! Cutting open the abdomen! This is... this is outrageous!"

"But look at that."

Of course, I didn't keep staring.

I had to hurry.

The patient wasn't in immediate danger, but the lack of antibiotics was a huge problem.

Leaving the abdomen open for too long would only increase the risk of infection.

*Sigh*

I tied off the appendix at its base with thread.

Normally, I would have used Vicryl or sterile silk, but...

All I had now was regular thread.

I had boiled it, but it was still far from ideal.

'But... our senior is strong.'

Honestly, if he were going to die, he would have died when he injured his finger before.

He survived the bacteria from the corpse back then. He's not going to die from something like an appendix.

Thinking that, I tightly tied it off and reached out my hand.

"Scissors."

"Huh? Oh."

Joseph's attitude had changed slightly from before.

It was only natural.

Even the old man seemed impressed, but Joseph, being a medical student, must have felt something more.

He probably had a lot of questions.

Why?

Because this isn't something you can explain just by calling me a genius.

A technique that's over a century ahead of its time is bound to be astonishing, even with crude tools.

'You... if you keep this up, you might start praying.'

Fortunately, or not, he had the look of someone who had witnessed something sacred.

What do they call it?

Ah, yes.

The face of someone who has received grace.

*Snip*

Anyway, I cut the appendix with the scissors he handed me and placed it on a metal tray.

In a normal operating room, that would have been the end of it.

The specimen would be sent to pathology.

But is there a pathology department here?

No, there are only skeptics.

The old man had been impressed for a while now, and with the guardian acting like that, there shouldn't be any issues, but...

'That doctor or whatever is kind of annoying...'

The elderly guy was getting on my nerves.

"Scalpel."

"Huh? You're cutting again?"

"Don't you want to see what it looks like?"

"Ah... I guess I do."

"It's going to smell, so be careful."

"Huh? Oh, okay."

Joseph handed me the scalpel, his demeanor different from before.

Of course, it was natural.

Even the old man seemed deeply impressed, but Joseph, being a medical student, must have felt something more.

He probably had a lot of questions.

Why?

Because this isn't something you can explain just by calling me a genius.

A technique that's over a century ahead of its time is bound to be astonishing, even with crude tools.

'You... if you keep this up, you might start praying.'

Fortunately, or not, he had the look of someone who had witnessed something sacred.

What do they call it?

Ah, yes.

The face of someone who has received grace.

*Snip*

Anyway, I cut the appendix with the scissors he handed me and placed it on a metal tray.

In a normal operating room, that would have been the end of it.

The specimen would be sent to pathology.

But is there a pathology department here?

No, there are only skeptics.

The old man had been impressed for a while now, and with the guardian acting like that, there shouldn't be any issues, but...

'That doctor or whatever is kind of annoying...'

The elderly guy was getting on my nerves.

"Scalpel."

"Huh? You're cutting again?"

"Don't you want to see what it looks like?"

"Ah... I guess I do."

"It's going to smell, so be careful."

"Huh? Oh, okay."

Joseph handed me the scalpel, and I glanced at the doctor before making a quick incision.

"Ugh."

"Ow."

"What the..."

As soon as the swollen appendix was cut open, a foul smell filled the room.

Honestly, the smell of blood had already made the room less than pleasant, but now the stench was overwhelming.

"That was inside the body. Good thing we removed it."

"Ugh, yeah."

"Do you still think cutting open the abdomen was wrong?"

"Well... *cough*."

The doctor couldn't respond to the old man's words.

He still looked displeased, but what could he do?

He probably didn't even know what I had just removed.

He might not even know which part of the body it came from.

The abdomen was a forbidden area, and even Liston, who was considered an anatomy expert in this era, only saw it as a subject of study, so his knowledge was limited.

"Alright. Let's close it now."

"Huh? Close it?"

"You want to leave the abdomen open?"

"Ah... right. We should close it. But how...?"

"Watch carefully."

The situation was different from when I only had basic needles.

Now, I had something I had specially ordered—something that, by the standards of this time, looked like a fishing hook.

With this, I could suture properly.

*Stitch*

Of course, due to the limitations of the thread, I couldn't layer the sutures perfectly...

But compared to before, I now had thinner thread, so I could suture the peritoneum and the abdominal muscles separately from the skin.

*Stitch*

"Wow..."

"How did you do that so neatly...?"

If I had pulled and sutured everything at once, it wouldn't have looked this good.

But by suturing the peritoneum separately, it looked almost magical to those who didn't know better.

Of course, the clean incision helped.

Anyway, Alfred's peritoneum was now neatly closed, except for the crossed sutures.

*Stitch*

I suppressed the urge to shrug at the surrounding cheers and continued closing the abdomen.

"Wow..."

"You need to cut this with scissors."

"Huh? Oh, okay."

"Don't cut it too close. Leave about 1cm so we can remove it later."

"cm?"

"Ah... about the width of a fingernail."

"Oh, okay."

As I closed the skin, the cheers grew louder.

When you make a large abdominal incision, you have to withstand a lot of tension, so the shape isn't a priority. But with this kind of incision, there's more leeway, so it's possible.

The skin also closed neatly, almost as if it hadn't been cut, except for the crossed sutures.

These people had never seen, let alone imagined, such suturing, so the cheers continued.

The lack of knowledge about keeping quiet in the operating room made it possible.

Every time they opened their mouths, the risk of infection increased, but it was too early to lecture them about that.

"Alright, it's done. Let's monitor him for now. The surgery went well."

I still had to carry the burden alone.