episode_0106

Episode 106. Mortality rate cut in half (2)

****

We started pulling on the patient’s shin, and the patient screamed for the ward to leave. It was still a long way from being the same length as the other leg. This was a big problem.

We pulled for a while. The patient’s gag seemed to have loosened a bit.

“Eww! Eww! I just, I just want to die!”

“No, you can’t. If you’re going to die, walk away and die. You won’t be able to walk anyway.”

Who gets to die at will?

“Please re-tie the gag. Hold the patient properly so that his/her posture is not distorted!”

“No, wait! Put it away!”

I wonder if the nurse can really tie the gag properly. She seemed to be having a hard time.

Still, we’ve managed to pull the leg back to its original length. Now we just need to tie the leg that we’ve pulled back with the fixation strap to the splint. We’ve tied the patient’s shin to the steel frame of the splint and fixed it in place.

I double-checked that the patient’s leg was properly fixed. But the other leg was fine, so I just had to adjust it to the other leg.

Now the next step.

“Professor. Are you done?”

“Yes, almost done.”

Actually, it’s not over. Now it’s time to set the bones. I feel like I’m going to faint at this rate…

I sighed and held onto the patient’s upper leg. This was going to really hurt.

“Now we just need to fit the bones.”

“Yes?”

The femur was still likely out of alignment. I moved the patient’s leg a bit. I felt something hitting it and-

What was more certain than the sensation of bones colliding was the scream heard every time bones touched each other.

“Ouch! Aaaah!”

“Oh my.”

The problem is that the area where the two bones touch must be maximized… …. It also means that it must be as painful as possible. Life is a continuation of pain.

I’m so sick.

“Fuck you little shit! I said it was over!”

“Oh my, I’m sorry.”

I said it was almost over, I didn’t say it was all over. There’s no other way.

This is different from when you had surgery on a broken arm. You can open the upper arm, but opening the thigh to operate is a whole other level of work.

It cannot be attempted without general anesthesia.

They say that you can just push out the upper arm muscles with your fingers, but the leg muscles are so strong that it is impossible to operate on them in that way.

There was a lot of trial and error though.

The bones seemed to have finally come together.

“Now, are you going to put on a plaster cast?”

“No.”

If you apply a cast now, the swelling could cause compartment syndrome again.

It seemed like the only option was to keep it in a Thomas cast until the swelling from the fracture went down. Would a cast on the femur even be possible?

I don’t think it will work.

I have never seen this even in a modern hospital.

“It’s really over now.”

The patient’s gag was dripping with drool, as if it had been dipped in water. The patient’s eyes were bloodshot, perhaps from screaming so much.

“Are you feeling okay?”

The patient retched a few times and wiped his mouth with his hand. Normally, one can feel dizzy after experiencing extreme pain.

It looked much better than I expected.

“Does this look okay?”

I guess it’s okay since you still have the presence of mind to joke around. I nodded.

“How did you get hurt?”

“Construction site accident.”

still.

It was fortunate that the patient did not pass out from shock. I breathed a sigh of relief.

“Well, don’t worry. In a few months, it won’t be noticeable. In a few weeks, you’ll be able to return to normal life to some extent.”

“Really?”

“Yes.”

“You lied earlier and said it wouldn’t hurt.”

“This is real.”

“What… … .”

“I didn’t say it to make you laugh, I thought you’d understand it as a polite remark. If you say it’s going to hurt, it’ll hurt more.”

The patient frowned.

In fact, the patient’s expression was already crumpled from pain, so there was no difference. I received the medical records from Istina.

“What is the patient’s name?”

“This is Schneider.”

“Yes, Mr. Schneider. The patient has a broken leg and will need to be kept in a stable position for the time being. Is there anything else that hurts?”

“I don’t know, my legs hurt so much.”

“Are you out of breath?”

“Not really.”

“Is your heart pounding?”

The patient shook his head.

“Take a rest. If you have any problems, call me.”

“Oh my, I was planning to go to Kubona, but I’ll have to listen to the doctor and rest.”

Is this a joke? I scratched my head and left the hospital bed with Istina.

****

Istina was sitting at the desk on one side of the ward with a tired look in her eyes. As if she had finished all her work for the day. I turned my head toward Istina.

“Istina!”

“Oh, yes.”

“Possible complications of femoral fracture. Recite them.”

“Oh, bleeding and walking difficulties?”

“Isn’t it more correct to see it as a direct symptom of a fracture rather than a complication? … . It’s not exactly wrong, though.”

That wasn’t the answer I was looking for.

“The most dangerous complication right now is fat embolism. Fat droplets in the bone marrow can circulate and block blood vessels.”

“Aha. What’s the cure?”

In fact, it is a disease with no cure. Once it occurs, there is no solution other than responding to the symptoms.

Anticoagulants and such could be used, but the side effects seemed greater than the benefits. We still don’t know where else besides the legs were injured.

“Because fat embolism usually occurs in the blood vessels of the lungs. I’m checking to see if the patient is breathing properly.”

“Yes.”

I checked the splint on the patient’s leg again. It seemed to be fine. The length of both legs were the same, and the bones were aligned.

“It seems to be fixed at this level. Check if the patient is injured anywhere else, and see when the swelling in the leg goes down. Let me know when it goes down.”

Istina nodded.

“Thanks to the splint that pulled it, the fire was put out, but the next step is the problem. Because of the location, surgery is difficult, and plaster casts or other splints are also difficult… … . It looks like we have no choice but to leave it alone. What do you think?”

Istina opened her notebook, thought about it for a moment, frowned, and shook her head.

“I don’t know… … ? Since the thighs are such big bones and muscles, I don’t think you should use a knife on them.”

I agree.

I don’t have the confidence to dig into the thigh muscles and fuse the femur. If you tell this patient to have surgery, I think he’ll crawl away.

“Let’s just leave the Thomas splint as is. I think we’ll just replace the fixation strap tied to the leg next week and keep it fixed.”

“It might be a little uncomfortable.”

“Okay.”

That thought… should have occurred to me before I broke the strongest bone in the human body in two. I thought this part was inevitable.

****

I left the patient in the ward and returned to the lab. This was probably going to be my last task before going to the banquet.

Thomas Splint.

I’ve been preparing this for a few weeks now, but thanks to a patient with a broken leg, I had the chance to demonstrate the Thomas splint.

It was a simple invention that could dramatically reduce the deaths and aftereffects of leg fracture patients. It was also relatively easy to use.

It is even said that soldiers in World War I practiced doing this task with their eyes closed in preparation for situations such as smoke or at night.

Now all we have to do is spread the word.

Of course, it may be less topical than other studies. I thought about how to persuade the academic world. Let’s see.

The Thomas splint became known to the medical community and was widely used during World War I. If it was such a simple method, why wasn’t it widely used until the early 20th century?

When I actually tried it, I thought I knew why. Pulling a broken leg is not something a sensible person would do.

If you don’t have confidence in the structure and function of the human body, it’s something no rational person would do. It just happened to be effective.

I’ve been thinking about it for a while. If I just publish my research, it might get buried, so I need to think of a way to present it to the academic community.

What would be good?

“Oh, the professor is back.”

Amy was sitting on one side of the lab.

“Was Amy there?”

“Yes.”

“A patient with a broken leg came in today? I’ll see you later. This time it’s an important case.”

“Okay. What kind of patient is this?”

I gave Amy the medical records I had been looking at earlier. Amy took the stack of papers, flipped through them for a bit, and then started reading.

“Ah. Since the patient has a broken leg, you have to pull the leg to straighten it? But how do you know how much to pull it?”

“You have two legs.”

“Ah.”

If you think about it, it’s obvious.

“Well, I’ve seen a few people who broke their legs and then recovered, but their legs got shorter, or they died and couldn’t use them. There was a way like this… … .”

****

Meanwhile, in Mint’s dorm room.

Mint was still a student, but she wasn’t without things to do. Who was coming to the banquet, what their interests were, and what to talk about.

I told the teacher as if it was nothing. The social circle was also one of the means of ruling the empire. If I went there without thinking, I knew I would get bitten like a school of sharks.

Choosing a suit or dress can be fun.