episode_0032

Episode 32. But whose body is this (1)

****

The ward was peaceful again today. A space dominated only by screams, chaos, destruction, and death.

Still, the situation was stabilizing. Those with colds would be sent home as soon as the sun rose. Those who were injured in the swordsmanship competition would probably still have to stay for a day or two.

No. The person with the injured leg can go home as soon as the cast is made, but the person who had his spleen removed will probably have to stay for a few more days.

“How is the patient’s condition?”

“Just stable. We are checking to see if there is any inflammation at the surgical site.”

“It doesn’t look like that?”

Istina nodded, though her expression seemed a little curious.

“But, Professor. How did you guess what the trauma patients were suffering from and how to treat them?”

How did you get it right? You have to know what kind of disease you have and live with it. Is there any other way? Istina tilted her head, and I opened my mouth after thinking about it for a while.

“When I was in college.”

“Yes.”

“The professor taught me that. You can tell the type of snake by the shape of its teeth.”

“Aha. There’s something like that too.”

“So, one of the students who was listening to the class said, “No, do you have to know how to identify snakes to be a doctor? Something like that.” ”

“Right.”

“I don’t know either. I can’t tell the type of snake by its teeth or head shape, and I can’t tell the type of mushroom just by its appearance. How can a person memorize and live with that?”

But that’s not the point.

“But. In your life, have you ever seen a patient bitten by an unknown snake? You never know, right?”

It might be, it might not be.

“What I’m trying to say is this.”

“You have to know everything?”

The professor who taught me said that.

– You don’t have to know.

– But if you don’t know, someone could die.

“It’s not your fault that the patient is dying, and you can’t memorize all those little things. But, if you know one more thing, if you can save one more person while you live… … .”

I’m not trying to be sentimental, but that’s the reality. You have to know. If you don’t know, you have to find out. There’s no other choice.

“Aha.”

“You should memorize as many diseases as possible that you see frequently or are likely to see. If blood pressure drops after trauma, it means internal bleeding, and the cause of internal bleeding is usually a rupture of the liver or spleen. The spleen is located under the left rib cage. The spleen is an organ that can be removed.”

My thought process was like this.

“It’s difficult.”

“It’s not difficult.”

There’s nothing I can do. I’ll do what I can.

“Even I didn’t think of making a blood pressure monitor in advance, so I had a hard time finding a way to find out my blood pressure.”

To be exact, I never thought it would be possible to make a blood pressure monitor here. But it was inconvenient because there was no way to measure blood pressure.

“What is your blood pressure?”

“What?”

Istina seemed to have no idea what he was talking about. I knew he didn’t have a blood pressure monitor, but I didn’t know he didn’t know what blood pressure was.

No, wait a minute. So what is the theory being argued here? What was the theory that was believed before the principle of blood circulation was properly discovered?

I thought so, but I don’t know.

Did you think it was made in the heart?

“No, what is blood pressure? It’s the pressure at which blood passes through the blood vessels.”

This is also something I missed.

Internal bleeding, decreased blood pressure, decreased consciousness due to decreased blood pressure. All of these things are meaningful only when you understand the concept of blood ‘circulating’.

Istina, who did not know this fact, would not have understood the internal bleeding, decreased blood pressure, and decreased consciousness of the previous patient, and the thought process here.

I bet you heard nothing but nonsense throughout the surgery.

After thinking for a while, I opened my mouth.

“Istina. Do you think blood comes from where and where it goes?”

“Well, well. Isn’t blood made in the liver and distributed throughout the body?”

Oh, I remembered.

Before the discovery of blood circulation, the scientific community believed that blood was distributed and consumed, following the ideas of Galen, a Roman physician and philosopher.

It may seem counterintuitive to our common sense, but in fact, people at that time had no way of observing capillaries, so the tissues would have appeared to absorb blood like a sponge.

It is not logical to assume that absorbed blood is consumed.

Just, if you look at it with better equipment, you can find out that it is not. There are many reasons for this. You can calculate blood flow, or look at capillaries under a microscope, or… … .

This is a big deal. The academic world is probably still reeling from the germ hypothesis. Even if we hold an academic conference or invite professors, they’ll just keep talking about germs. Well, there’s no other way.

All I can do is tell as many people as possible during class time and make the presentation quickly.

Suddenly, I have a ton of work to do.

“Let’s go somewhere later.”

“Where are you?”

If only the patients in my ward could stabilize a bit, I think I’ll have the materials I need for the next class.

It’s finally time to bring ‘it’ out.

“Let’s finish up the ward work quickly and go.”

“Yes.”

The fencing competition isn’t important right now.

As soon as the two patients currently hospitalized stabilize, I need to quickly teach Istina what blood pressure is and make her a blood pressure monitor.

****

Medical research requires cadavers.

It can’t be helped. It’s impossible for someone who hasn’t even opened a corpse to open a living patient. Isn’t it also problematic to prescribe medicine to treat something you’ve never seen yourself?

It’s not just used for the purpose of learning by looking at the corpse. It’s often needed for experiments.

A famous case made the news when the US military used donated bodies to test the performance of bomb protection equipment.

by the way.

“Whose body is this…?”

“I don’t know either.”

“Where did you come from?”

This is the Academy’s underground dungeon.

A corpse was lying on a table in the underground dungeon. Istina and I, wearing plague doctor masks, looked down at the corpse.

“They were selling it at the execution grounds.”

“Can I just buy that?”

I nodded.

“Why are you so curious? I just bought it because it was on sale. I don’t know much either.”

“No, if you buy and sell corpses, wouldn’t you have a few questions?”

I brought it in case you need it. By the way, it’s been under a spell for the past few days.

“Isn’t that weird?”

Honestly, I don’t know if it’s legal. No matter how bad the imperial law is, isn’t it a bit strange that you can buy a corpse like you can buy a mattress?

Are you just selling it because you’re a doctor?

“Anyway, let’s see first.”

What I brought into the basement were several buckets of water and a glass bottle containing alcohol.

First, I took out the organs, preserved them in alcohol, and planned to use them as teaching materials.

What’s important is the structure and function of the organ.

“Let’s open it first.”

I heard the math. This, next time I teach, it’s going to be hard to have a corpse in the classroom. Should the students come down here?

That seems a bit strange too.

Let’s focus on teaching and persuading Istina for now. That’s what’s important.

I heard from the top.

“Istina. Do you know where the heart is?”

“In the middle of the chest.”

“Right. From here to here, it’s the ribs, so let’s cut open the ribs with a saw and take out the heart. You take the other side, and cut gently.”

Istina started sawing, starting from her collarbone, while feeling nauseous. In the past, hospitals used to cut it with something like metal scissors.

Crunch, crunch. The sound of ribs breaking.

“Ugh… … .”

In modern hospitals, it’s not easy to get a body, but here, if you pay money, you can get one relatively easily. That’s good.

As for the downside.

The cadavers seen in modern hospitals were perfectly preserved, but this one was not. Blood was pooled all over the inside of the body, and tissues such as nerves had already decayed or deteriorated, making it difficult to see delicate structures.

Anyway, the rib cage was opened. I finished the work with iron scissors, and completely opened the front of the rib cage to expose the lungs and heart.

“Here’s the heart. Take it out.”

Istina took the scalpel and cut the great vessels of the heart with it, then carefully removed the heart.

“Now rinse it in water.”

Because it was difficult to observe the structure when blood was pooled, Istina silently wiped her heart with water. The dark red clump of blood fell away.

“Structure and function. Remember?”

“Yes.”

“How many holes are there?”

“Oh, there are four big holes.”

That’s right. Each is a hole where the aorta, vena cava, pulmonary artery, and pulmonary vein are connected. The vena cava is divided into the superior vena cava and the inferior vena cava.

There are four large holes.

This is the point.

The heart is not simply where blood goes out. It is also where it comes in. Blood is not consumed, but circulates throughout the body.

“What can you tell by looking at the heart?”

“Uh, I don’t know yet.”

Istina slowly turned her heart.

“Then. How does it feel?”

“Oh, it’s very hard, right?”

Behind the plague doctor’s mask, Istina’s eyes were furrowed. She seemed not to understand what he was trying to say. Well, let’s take it slow for now.

“Give it to me.”

I received a heart from Istina. Let’s see, I should start with the aortic valve.