Chapter 318 314. Auction begins

[The opinions in this chapter belong to the protagonist and have nothing to do with the author]

In the previous surgical model, the surgeon was the absolute core, followed by the first assistant and instrument nurse who could help the surgeon speed up.

Except for these three, the other personnel's work is more like physical work, which does not require high experience and technology, but more proficiency. And proficiency is the least valuable in extremely involutional surgeries.

Even ordinary people who have not gone to medical school can become competent after a period of practice.

But this statement has a premise, that is, the surgical environment must be stable and there should be little gap between the parties.

Looking at the entire development path of surgical medicine, the mid-19th century does meet this description. Anesthesia has been on the rise for more than ten years, but the surgical model is still limited to infection and hemostasis techniques, and it will not be able to achieve true significance in the next ten years.

innovation on.

If you want to break this environment, you must have a new understanding of hemostasis, blood transfusion and anti-infection, and put it into practice.

In this kind of environment where surgical techniques are superior to the chief surgeon, it is necessary to have assistants who are familiar with this type of model. The importance of the team is self-evident. When the new surgical techniques are understood by others, everyone begins to

After use, the entire environment will return to a situation where the surgeon's personal skills are more dominant.

Therefore, whether surgery depends on the surgeon or the innovation in surgical procedures is actually determined by the development of science, technology and medicine itself.

When Kawei plunged into the chaotic 1860s, he brought not only brand-new surgical concepts, but also surgical techniques that had been updated and iterated by countless surgical sages. This model and the situation of two excellent surgeons,

A sufficiently skilled assistant is required to achieve maximum effect.

"I know this is a bit difficult for you, but it is an inevitable part of climbing the peak of medical skills, and it is not a kind of dedication."

"No bacteria were found in the sediment, but there were a small number of white blood cells and red blood cells."

"It is impossible for us to recruit new nurses specifically for him. Even if Teacher Ignatz agrees, the dean may not agree."

Domestic surgery has just started, and all we can learn are some materials brought back by our predecessors after going abroad. Some of them are already outdated. And it doesn't matter what you asked for at the beginning. Even the syringe and leather strips are not disposable and need to be cleaned before reuse.

The three of them looked at each other, and even though they were embarrassed, they told the truth: "Mr. Edem said that nurses are not his type."

Damirgaon also had some enlightenment: "Indeed, the first thing a doctor must have is medical skills. Whether you are willing to dedicate it is a matter of life and has nothing to do with the profession itself."

Kawei's learning environment was also not good back then.

"What's the main problem now?"

"Since it is a professional character, it naturally serves the profession." Kawei asked again, "So what are doctors used for?"

"We talked to Mr. Edem and arranged to urinate once every three hours. The effect was pretty good," Herman replied, "but it was difficult for him to get up on time in the middle of the night, so he couldn't control it very well."

"But he was talking about professional character." Berget seemed to understand what Kawei meant. "Those priests and nuns also have dedication, but this is the 19th century and they can't save people."

"To put it bluntly, devoting oneself cannot eliminate difficulties. At most, the people who are suffering can see that we are also suffering, so that we will feel better. This approach is not medicine, it is..."

"How else can we solve this problem? We have also looked for several nurses in the internal medicine department, but to no avail."

"So that's it."

Kawei made a sign of the cross in front of him, and then brought the topic back to Edem: "Doctors are far from being as noble as Herman said, because if the threshold is really set so high, how can we cultivate so many responsible people?"

Doctors who treat illnesses and save lives.

Herman's father is at most a bought new noble, and he is quite open-minded about such things. But Berget is different. The Celestine family is a noble viscount, how could they do such a dirty thing?

trade.

Kawei explained: "You think dedication is the most important, so does Mr. Ignatz have dedication? What about the dean of the School of Surgery, his father, Professor Waterman? And Vice President Bill Rotter, Orr

Ji, Massimov. There are so many high-ranking chief physicians, do they all have the spirit of dedication?"

"Herman, you just talked about dedication. Have you ever thought about making a contribution to Mr. Edem's recovery of boki?"

Kawei looked at Damirgang and Berget again, sighed and said: "Do you think I am meeting Mr. Edem's request? No, no, I am doing this entirely to verify whether there was an error in the operation.

.If we don’t get feedback in time after the operation, and after a long time, he still doesn’t boki, is it caused after the operation or during the operation?”

"Boki, we also asked him to try it, but unfortunately it didn't work."

In fact, judging from the content written in the medical records alone, the three of them have done a very good job, and are more detailed than all medical records in the same period.

"The body temperature has been maintained below 38 degrees since the third day." Herman handed over Edem's postoperative medical records and treatment sheets. "The incision is growing well. There was obvious redness and swelling in the first three days. On the fifth day,

Just retreated."

"Monitor vital signs and anastomotic leakage."

The concepts of modern surgery are based on major basic medical disciplines, and their knowledge is very poor. Kawei can only force the concepts into their minds over and over again, changing their original habits little by little.

Preserving x-ray function and the ability to urinate autonomously are the two major advantages of this operation. If any one of them is missing, the operation will be considered a failure. So when he heard that Boki was unsuccessful, Kawei still couldn't help but feel a little bit in his heart: "Come on, tell me, yes

what's the situation?"

But Kawei's demands have always been like this, so they rarely let them intervene in the previous medical records. Now when Kawei suddenly leaves, the shortcomings in the overall strength of the team are exposed.

The three of them were silent again.

Of course, Heman and the others are still the taller among the dwarfs, and they are in the right place at the right time. If they want to really fit in with Kawei, they still need to learn a lot.

"I beg to differ." Herman shook his head and said contrary to his usual behavior, "Without dedication, how can one save lives and heal the wounded? This profession itself will subtly change a person's character."

The second is the recovery situation of Justina and Edem.

But the degree was still controllable. For a sixty-year-old man, it was already remarkable that he could survive the surgery.

Kawei went in a big circle, and the last thing he wanted to say was Edem: "What did you do when you saw that Edem, who strongly requested to restore X function after surgery, was unable to do boki?"

In addition to the surgical team, this train also brought something else.

"There was a cough, and we did the same thing after that." Begert coughed twice and replied, "We just didn't write it down in the medical record."

"Since they are treating illnesses and saving lives, what is the most important thing for a doctor?"

"We're worried about whether it's going to become chronic inflammation," Herman said. "And there's also poor control of nocturia."

"Cure the sick and save the lives."

My position as a doctor is to demonstrate medical skills to the extreme within the legal framework. First of all, I must ensure that I can cure diseases and save lives at all times, only then can I be considered a doctor. As for whether I am dedicated or not, that is more important.

High-level requirements are not necessary for this profession.”

"It's written down how to move the limbs in bed, and the urine output is also recorded. How do you arrange timed urination?" Kawei said, "And what about the timed boki? These are not recorded. If something goes wrong, how can I find the cause?"

"

If they could all be called dedicated, the world would be in chaos.

"It is true that the medicine has been used, but what about the drainage?" Kawei pointed at the medical record they wrote and asked, "Why is the drainage not written down? There is no description and no calculation of the amount of drainage. Also, since there was infection at the beginning,

What about urinary tract irrigation?”

"Medical skills!" Berget said.

"No, you still don't understand what I mean."

It has been half a year and more than two months since Justina's two surgeries respectively, and her recovery is satisfactory. From her confident smile when she followed Elizabeth out of the car, it can be seen that she is very satisfied with Kawei's technology.

After hearing these answers, Kawei finally knew what the problem was: "So you didn't continue to look for a feasible solution after knowing that he had no boki?"

"Spend some money and let more professional people deal with this problem. They have better solutions than you on this matter." Kavi said, "When you get to the hotel, write a letter back to Vienna and ask Igna

Mr. Ci can do me a favor, he is very familiar with Hoyntz Street anyway."

"What is the first request I made before?" Kawei looked at the treatment sheet and asked.

"What about the cough? There is no mention of coughing and sputum in the medical records." Kawei sighed and shook his head, "I don't think the ward of the Municipal General Hospital can be so spotless."

Damirgang, who came from a lower background, finally realized the crux of the problem after being repeatedly prompted: "You mean to go to Hoints Street and find a solution?"

The first is the supplement of drugs and equipment, including sodium citrate, oxytocin, methylene blue, cystoscope, thermometer, sphygmomanometer, various types of finer and tougher sutures, curved needles and needle holders suitable for deep tissues.

These are especially important for Kawei's surgery.

"On the third day, the body temperature dropped below 38, and of course there was less drainage!" Kawei was a little disappointed with their performance. "The delay in railway delivery is not the reason why you forgot to record the drainage. I have repeatedly emphasized this and it must be done.

arrive!"

The three people immediately understood his intention, but it was useless and they had to come up with a solution. Kawei only asked them all with one question: "Nurse can't do it, have you ever thought about other women?"

In addition to rote memorization, admonitions that appear from time to time are also very necessary and will become a catalyst for deepening memory, just like what he is doing now: "How about the microscopic examination after lavage?"

"Well, what happens next?" Kawei seemed to be used to this kind of situation and asked calmly, "Then how do you solve it?"

"The main reason was that there was a delay in the railway delivery. By the time we got these requirements, it was already the third day." Damirgaon said, "At that time we observed that the drainage fluid was gone, so"

He also came through this step by step, knowing that there is no shortcut in this way of "learning".

"Other women can't do it, either."

This may become a point of contention and even quarrel among people in modern times, but in 19th century Europe, doctors were far from dedicated.

The three of them felt aggrieved.

From what Kawei meant, if they were girls, they might have to sell their looks to be considered dedicated. But in fact, what Kawei wanted was not this kind of dedication, but to think about the problem from a different angle.

"I think it is the spirit of dedication. When the plague hits the city, without dedication, who will save people?" Herman felt that it was not appropriate to just talk about medical skills. "If you are not willing to save people at this time, then what is the use of the medical skills you have learned?

?”
To be continued...