Chapter 209: Residence Behind

Recognizing the patient's identity by his distinctive sideways posture, Kraft immediately identified him. Just two punctures ago, this man had been sitting in the examination room, asking if there was any chance of a cure.

He mumbled, trying to squeeze out a few words between short, rapid gasps. Despite enduring the pain and exerting his maximum strength, his breath was as faint as a spider's thread, making even correct articulation difficult.

Kraft quickly leaned close to listen to what he was saying, but what entered his ears was not a description of symptoms, but words like "Church" and "cemetery."

"I need you to tell me what happened and how you feel!" the baffled doctor shouted into his ear, trying to pull the man back from his nonsensical mental state.

"Not the public cemetery..."

Now finally understanding what he was saying, Kraft, half-amused and half-frustrated, asked the young man who had brought him to help move the patient onto the bedboard in a semi-reclined position, to let this fellow who was prematurely asking about posthumous housing calm down.

"Who are you?" The other party's enthusiastic demeanor suggested he wasn't merely helping out of kindness; they should at least know each other.

"This is my father. He suddenly collapsed like this on the road just now." The young man looked anxiously at the doctor, momentarily at a loss for words. Pressing his hand against his own chest to mimic what he had witnessed, it seemed the patient had suddenly suffered chest pain while walking and was brought back before going very far.

【Damn, I'm not an emergency room doctor.】

He urgently recalled the patient's posture since their meeting again; instinctively leaning to the right to protect that side, it was consistent from start to finish. It seemed like an exacerbation of an existing condition.

"Massive hemoptysis?" Dai Wei asked from the side, flipping open the patient's lips but finding no blood overflowing the mouth.

It didn't look like it. Even in this short time, if a specific blood vessel had ruptured, it shouldn't be like this. Kraft decisively pulled a small knife from his box, cut open and tore off the patient's shirt, casually ripped off the troublesome pendant, and examined the entire upper body.

The two sides of the chest cavity were obviously asymmetrical; the right side, which should have been restricted in breathing, was now more distended. The trachea was not in the midline but slightly curved and shifted to the left, and the jugular veins on both sides were engorged and bulging under the skin.

Under the stethoscope, breath sounds had completely disappeared from most of the right lung field, just as after a pneumothorax puncture, except the range was much larger, so large that the lung had no room to expand.

"Pneumothorax."

"But didn't we perform an artificial pneumothorax on him?"

"Then guess why it's called 'artificial' pneumothorax."

The thoracic cavity is a closed space; besides piercing the chest wall from the outside to let gas in, there is naturally another possibility—gas leaking from the inside.

"His lung has ruptured." Lungs ravaged by tuberculosis form various lesions and structural damage, even involving the pleura in this case, like an old, worn-out skin bag.

When the patient engages in strenuous activity, such as suddenly walking a long distance, with deep breathing, the weak spot can no longer withstand the rising air pressure, suddenly rupturing. The air inhaled into the lung rushes into the thoracic cavity through the tear, compressing the lung in return.

In the case before him, the speed of progression and severity were clearly not typical of ordinary pneumothorax; a large amount of gas had accumulated in the thoracic cavity in a short time, reaching a nearly fatal level.

【Tension Pneumothorax】

When the tear allows air in but not completely out, it can form a very special valve-like structure.

Air can enter the thoracic cavity during inhalation but cannot be squeezed back out through the tear during exhalation, operating like a one-way valve, resulting in air entering but not leaving.

This process of inflating the thoracic cavity is uncontrollable. As everyone knows, a person dies if they stop breathing, yet every breath also fuels the illness, making breathing even more difficult as thoracic pressure gradually rises.

The rising pressure compresses not only the lungs but everything else in the thoracic cavity, including the heart. Blood unable to return fills the blood vessels, causing the visible bulging veins.

"Needle, rubber tube." Kraft took out the remaining half bottle of alcohol, poured it generously over the patient's right chest, and filled the empty bottle with clean water.

Dai Wei handed over the rubber tube connected to the needle, watching him insert the other end of the tube into the water-filled bottle. "Do you need anesthesia?"

"Hold him down!" Congratulating this patient for becoming the second person to challenge a thoracic puncture without anesthesia, hoping he possessed the willpower of the old duke; there was no time now to slowly inhale ether from a bottle for anesthesia.

Of course, considering the patient's family's emotions, Kraft still explained a couple of sentences with his hands constantly moving. "Your father's lung has taken in air, which is now pressing on his heart and lungs. I need to use a needle to release it; this will hurt a bit."

The young man, who hadn't yet realized what Kraft was about to say, was already stunned by the sudden illness and nodded in agreement.

The next second, Kraft's hand was already pressing on the desired spot, fixing the skin, and the needle pierced in. "Don't be nervous; it will be over soon."

Obviously, not everyone in this world can calmly endure pain, especially the pain of a thick needle piercing through the chest wall. The patient reflexively struggled, but fortunately, Kup lived up to expectations and held him down, preventing the needle from shifting.

This puncture could be done much more boldly; the lung had already been compressed very small, the area under the chest wall was full of air, and with skilled technique, he pierced through quickly, accurately, and ruthlessly.

Bubbles erupted in the inserted tube like boiling water; the high pressure in the thoracic cavity found an outlet, and gas rushed out through the tube.

As rapidly as the onset, within a few minutes, the patient's condition showed visible improvement.

Breathing gradually shifted from suppressed and rapid to steady, and consciousness returned from the dim state of hypoxia as he felt around his neck.

Kraft found the pendant by the pillow, an old-fashioned double-winged ring, and stuffed it into his hand. The patient, clutching the amulet, spoke his first complete sentence after regaining consciousness.

"I don't want to be buried in that place."

"No, you are very lucky; you have survived." Kraft wrapped the puncture site with a wet cloth to seal it and handed it to Dai Wei to secure.

Indeed, quite lucky. If a blood vessel had ruptured as well, evolving into a hemopneumothorax, there would be nowhere to cry. Opening the thoracic cavity to find the bleeding point and stop the bleeding was beyond anyone's capability now. Even if Kraft could cheat to find the bleeding point, he would be powerless.

"Then... when can this be pulled out?" Watching his father return from the gates of heaven with an iron needle stuck in his chest was somewhat frightening.

"It will be a long time. Until he stops leaking air, this thing must stay in place. If removed, it will be just like before. I recommend hospitalization... um, stay here for a few days for observation." Now the artificial pneumothorax that should have been performed was done, and the one that shouldn't have been happened to him on his own.

To be honest, Kraft didn't think this patient's prognosis would be good. Pleurisy or empyema might appear within a few days; trauma plus infection, no one could do anything about it. He could only keep him under his direct supervision, saving a day at a time.

"Dai Wei, give this person black elderberry juice, three times a day. Dilute it and let the family feed him slowly; don't let him choke."

During this period, forced by circumstances, he had gained some understanding of "primitive internal medicine," able to skillfully prescribe a medieval version of Isatis root, perhaps with a bit of Vitamin C.

The situation had mostly calmed down. Before leaving, Kraft felt a bit curious about the patient's obsession with the cemetery issue. "He was saying 'Church' and 'cemetery' just now; what exactly did that mean?"

The young man explained, "My father was devout all his life and wanted to be closer to the Lord, but it seems now... it might be quite difficult."

"What does that have to do with it?"

"It's like this, Professor. You might not be clear, but it is difficult for us tuberculosis patients to be buried in church cemeteries or ordinary public cemeteries." Dai Wei stepped closer to explain.

"Why?"

Dai Wei avoided the crowd and lowered his voice: "It's the Church's view, inherited from the time of the Great Plague. They consider highly infectious diseases, like tuberculosis and syphilis, to be unclean. Generally, they can only be arranged in specific cemeteries; the conditions are indeed worse compared to the church."

"All infectious patients?"

"Most of them, though exceptions can be made if the status is special."

"I see... is that so?"