episode_0178

Episode 178. Anatomy of the Gastrointestinal Tract (1)

****

It seems like I’ve been doing dissections a lot lately.

Well, I have a lot to teach others. This time, it was even more so because there were scholars from abroad. I checked the gown.

“Is everyone here?”

“Yes.”

Amy and Linea came to the dissection room today. The goal of today’s dissection was to directly examine the structure and function of the digestive organs.

“Amy, you’ve never dissected an abdomen, right?”

“Yes.”

“Well… … . You can try it. The abdomen is filled with the small and large intestines. Today, we will dissect and study the digestive organs.”

Linea nodded.

“In my hometown, human dissection is illegal, right? This is my first time cutting open a human body.”

Dissection is prohibited by law?

Well, maybe it’s not that strange.

I don’t know if it’s completely legal in the Empire, but there were some exceptions for large educational institutions like the Academies.

“Then. Let’s take a look. Dr. Amy. Do you remember any recent surgeries?”

“Come to think of it. Didn’t you have appendicitis and had your stomach cut out and something cut out?”

“That’s right. I cut out the appendix.”

Linea frowned.

“What did you cut out?”

“Additional request.”

“Can I do without that?”

I nodded, and Linea looked at me as if asking what I was talking about. It’s not that the appendix is not functional, but you won’t die without it.

Anyway, let’s continue.

“Check gown and mask.”

“Confirmed.”

“Confirm.”

Let’s begin the dissection.

****

Experience matters. Linea may be smarter and have been studying longer, but it was Amy who studied with me for the past few months.

Amy was much more adept at packing up her gear and preparing her gown. I thought that was something I needed to learn.

“Since we’re going to look at the digestive system, let’s start from the top and go all the way down. If we start with the mouth, we’ll start by swallowing and chewing food, right?”

“Yes.”

“Keep watching.”

I cut open the corpse’s throat with a knife. The corpse’s esophagus was immediately revealed.

“Look. There are two sphincters in the esophagus, namely, ring-shaped sphincters. The upper esophageal sphincter is obviously on the top.”

Linea nodded.

“Can you see the muscles in the esophagus?”

“Yes.”

“In this way, the esophageal muscles move involuntarily, pushing the food back.”

It was already dead for a long time, so I don’t know if you could tell by touching it, but I could feel the muscle fibers. Amy felt the esophagus.

“The lower esophageal sphincter is more clinically important. It prevents acid from flowing back up into the esophagus from the stomach. Amy, can you remember what the disease was?”

“Oh, it’s reflux esophagitis.”

Amy proudly declared. Linea stared blankly at me from the side. Well, Linea probably never learned what that was.

I took the knife, cut the esophagus in the middle, then went down a little further and held the stomach in my hand.

There were blood clots on the autopsied corpse, but not enough to interfere with finding the stomach.

I opened the esophagus with scissors and found the lower esophageal sphincter. Can you see it? The elf and the graduate student stuck their heads in my direction.

I opened the upper part of my esophagus.

“Look at this. There is stomach acid above, and if the stomach acid refluxes and goes up into the esophagus, the stomach acid can cause injury to the esophagus.”

I was lucky.

Although it is a common disease, as soon as we brought it up, we succeeded in finding traces of reflux esophagitis.

There were several vertical wounds on the lower part of the esophagus, which should have been smooth. Linea felt my open esophagus with her hand.

“What is this?”

“If you have gastroesophageal reflux disease, scars like this will remain in the lower part of your esophagus.”

“Aha.”

“Amy. So, can you give me some reasons why reflux esophagitis is clinically important?”

“Oh, it seems to have something to do with where the reflux esophagitis occurs… … .”

Since I started working at the Academy, I’ve seen three patients with GERD. Or maybe four? Amy might remember.

I opened my mouth.

“Gastroesophageal reflux disease can cause chest pain because it occurs near the heart. It can be mistaken for heart disease.”

Amy nodded. I completely removed the corpse’s stomach while I was talking.

“Symptoms of reflux esophagitis include indigestion, chest pain, and heartburn. It’s a common disease, and the treatment is, do you remember what it is?”

“Lie on your left side with the antacid tablets.”

Amy got it all right. Linea looked at her notebook, but didn’t take notes because her gloves were already stained with blood and bodily fluids.

The elf healer squinted as if trying to remember what she had just heard. This time, I pulled up on the top and completely separated it.

“Don’t worry. I’ll show you the relevant content later in the lab… … .”

There will be a record in the lab.

If only no one had erased it on purpose.

****

I carefully lifted the stomach with both hands and resumed my explanation. Linea was fiddling with the esophagus that had been cut off from the side.

“There are two sphincters attached to the stomach. One connects the stomach to the esophagus, and the other connects the stomach to the small intestine.”

“Yes.”

I picked up the scissors again and opened the top.

“Look at this. The stomach is folded like this and is surrounded by a thick mucous membrane, so it is not damaged by stomach acid.”

“Aha.”

“Structure and function. The esophagus does not have a thick mucous membrane, so it is injured when it comes into contact with stomach acid.”

Linea put down her esophagus, adjusted the chair in front of the dissecting table with her feet, and sat down.

“Then. There is a mucosal layer in this wrinkle-like structure above, and because of this, it is not damaged by stomach acid? But the esophagus is damaged?”

“Yes.”

Linea ran her gloved hand over the folds of his stomach. He also had an ulcer, that guy.

“I don’t know why… …. Why is the human body so stupidly designed?”

That was not a question I could answer. Why is there no mucous membrane in the esophagus? Is it because food needs to be sent to the stomach quickly?

“I don’t know, me either. I thought it might be because there’s a risk of food getting stuck in the esophagus, where there’s no stomach acid.”

“That makes sense too.”

I cut it open and looked at the spread.

“There are several stomach ulcers. Here, when the mucosal layer is damaged, stomach acid and digestive enzymes in the stomach begin to attack the stomach tissue.”

“How do you treat this?”

I don’t know if there is a separate way to treat gastric ulcers. You can treat Helicobacter pylori infection or take antacids…

“As expected, it’s a sanjeongje.”

You keep saying the same thing over and over again. The treatment options available are very limited.

****

The next order above is the small intestine.

“Mr. Linea. Think about it. If the digestive system is 1m long, the stomach and esophagus are 1m long, and the large intestine is roughly 1m long, how long does the small intestine look?”

It’s very long.

“This looks at least 5m long. I didn’t think it would be this long. I guess it’s because I’ve never opened it up myself… … .”

“Then, Dr. Linea, do you still understand that the purpose of the digestive system is to absorb nutrients from food?”

“I guess so.”

“Considering the structure and function, where do you think food spends time in the body and where do nutrients get absorbed?”

Linea tilted her head.

“Well, the food you eat will spend the longest time in the small intestine. It would be right to assume that nutrients are absorbed in the small intestine.”

That was the correct explanation.

“Nutrients are mostly absorbed in the small intestine.”

“That’s something I didn’t know.”

Regarding the digestive system, there were some things that were not published because there was no clinical benefit that could be applied immediately. I was also busy up until now.

“How did you know all this, Professor?”

I couldn’t explain it like this: I saw it from the future… I had no choice but to follow logic.

“You have to look at the structure and function. The stomach has folds because it has to secrete gastric acid and mucus, and the small intestine has to absorb nutrients, so it is the longest digestive organ.”

It didn’t seem like she believed me. Linea looked at me as if she found it strange.

“If I go back to my home country- Oh, but come to think of it. I can’t do dissection in Linea’s hometown, even if I learn it.”

When I think about it, it was a shame.

****

Amy was a diligent and polite student. She also had a lot of experience working with me. But Linea was a little different from Amy.

Linea was rude and tactless.

I tend to do things roughly.

Amy seemed smart though. I think she’d be a much better person to work with.

Linea has a personality that is more suited to research than clinical work. If we have to compare, then yes. Anyway, we can’t even find graduate students.

what…….

If you’re just smart enough, that doesn’t really matter. If you just show your skills, your personality and manners can be considered the antics of a genius. I think it’s okay to let it go.

I looked at the two researchers who were placing the stomach on a metal tray. Couldn’t we make Linea a graduate student?