Chapter 33: The Only Possible Solution

Kraft adjusted his state; no matter when, the patient may panic, the family may panic, but he absolutely cannot panic. There is no senior doctor here to back him up.

"The current situation is that we may need some special treatment plans." He answered Lu Xiusi in as calm a tone as possible, "but I need a little time before I can give a specific answer."

"Before that, I need to ask: has she eaten anything or drunk anything from last night until now?"

Lu Xiusi recalled for a moment and replied, "No, she hasn't eaten anything since last night, only drank a tiny bit of water."

"Alright, absolutely do not feed her anything now. If she is thirsty, she may sip a little water in her mouth, but she must not drink." After giving his instructions, Kraft turned and walked toward the door. "I need a little time."

Kraft opened the door; the students were still outside and had not left. Lu Xiusi stood at the doorway holding a blanket.

"Thank you, Lu Xiusi. Hand the blanket to Lu Xiusi, then come to the next room... hmm, everyone come over. Also, can someone go fetch the other lecturers?"

In a sense, the priest was at least completely correct in one statement: "From now on, we can only wait for God's will."

Kraft was clear in his mind that under these conditions, there were essentially only two scenarios.

Either they just watch as time drags on; the incarcerated intestinal segment will not recover on its own, blood vessels cannot supply blood to this clumped section of intestines, and the situation gradually worsens.

The intestines lacking blood supply will completely necrose after one or two days, and finally the patient will die in agony. This era had no autopsy or any other means to confirm the cause of death; no one knew that such a simple structure led to such a terrible death.

Then this terrible secret would be preserved until, many years later, supported by modern science, surgery truly rose, and this current terminal illness would become a "small problem."

Or Kraft must come up with a plan right now, in this damn era where even amputation has no anesthesia, to devise a feasible surgical procedure within a limited time.

He would have to put this hastily conceived plan into practice, perform a surgery that had become basically unseen since his school days, restore that section of intestine to its original position, and pray against postoperative infections and the like.

If a postoperative infection truly broke out, given Lis's physical condition combined with the internal medicine level here, Kraft dared not think further.

If this had been during his pediatric surgery internship, whoever proposed something that would make the department chief so angry his ECG would surf, the chief would definitely take him down with a single slash before leaving.

One is certain death, the other is highly probable death; there seems to be nothing good to choose between them. The choice belongs to Lis and Lu Xiusi themselves. Kraft can only go find the best plan to offer them.

In the adjacent classroom, he set up a blackboard. After everyone arrived, Kraft drew a rough sketch of the current situation to see if others could offer help fitting the present conditions.

"I believe everyone listened quite carefully in my 'Human Anatomy' class; I need not waste time explaining exactly where this is."

Now we need to make a small incision in the abdomen, return this intussuscepted section of intestine to its original position, and finally suture the opening.

Sounds simple? To be honest, in medical school, we need not be too reserved; quite a few people have probably seen dissections, even performed them personally, just not on the living.

But this time is different, gentlemen; this time is completely different."

Kraft tapped the blackboard; this action was obviously superfluous. Everyone's attention was focused here, including the several lecturers who had just entered from the back row.

"Is there any special requirement?" one of the lecturers spoke up. He sometimes attended Kraft's class, listened quietly, and then left quietly; Kraft had some impression of his curly hair.

"I need everything as clean as possible: linen, silk thread, iron needles, knives, and the people involved." Kraft found it hard to explain his concept of sterility to them, so he phrased it this way, "Probably boiling everything would be better."

This was the only method he could think of at present; formaldehyde and high-pressure steam were unavailable here, and high-concentration alcohol depended on distillation.

The person sitting next to the curly-haired lecturer offered his opinion: "We have plenty of lime. I have never seen anything spoil after being sprinkled with this stuff; at least you can wash your hands with lime water."

He pointed to the small piece of lime Kraft held for writing on the board. This was indeed being blind in the light of the lamp; he used it daily to write yet never thought of it. Kraft had been wondering if there was distilled strong wine for disinfection, but such a thing did not exist now.

Sterility is impossible; make it as clean as possible. Kraft felt a knot of anxiety for the patient's postoperative recovery and moved on to the next topic.

"Forgive my shallow knowledge in this area; I wish to inquire whether there exists a method that can temporarily make the patient lose sensation, one where cutting through skin and flesh has no effect."

"Can we not simply tie up the patient and finish as quickly as possible?" Lu Xiusi asked. This was the handling method for all current amputation surgeries—if those could truly be called surgeries.

"No, it is impossible to solve the problem with a single cut like an amputation." Kraft rejected his proposal. "At least I cannot do it."

Abdominal surgery is often not that simple. The actual situation within the abdominal cavity differs greatly from the clear colored diagrams in anatomy textbooks; the boundaries of various structures are not as obvious as imagined; the membranes and ligaments wrapping the organs, along with adhesions caused by various reasons, make the microscopic field of view a mess.

When you open a small incision in the belly, clearly identifying your position in a surgical field without clear landmark structures is obviously not as simple as a crude amputation.

The patient is merely a three-year-old girl, not Guan Yu nor Rambo. To cut open the abdominal cavity, search and operate under no anesthesia, and then suture it up—what will happen during this period is unimaginable.

"There are indeed some things that can make people lose consciousness, but..." A student flipped through a book, stopped halfway through speaking, and felt that the recorded drugs basically failed to meet the requirements.

Some cause one to sleep and never wake up; others only have mild paralytic effects, unsuitable for a surgery requiring time.

This is also the fundamental reason why complex surgeries do not exist in this era; even infection and blood loss take a back seat. Without anesthesia, patients cannot endure such surgeries.

"Lecturer Kraft, I must say, this is merely a plan that holds true in 'Human Anatomy'."

The speaker was the academy's pharmacology lecturer, Luo Moluo. The reason Kraft remembered his name was that they had shared a table one day during lunch; the two discussed some matters regarding drugs but ultimately could not agree due to differing views.

Kraft was relatively opposed to the Four Humors theory, while Luo Moluo was a staunch adherent of the traditional Four Humors theory, eager to use this framework to explain the relationship between the four elements and drug efficacy.

"Unless the white humor or red humor dries up, there exists no method that can absolutely make a living person completely unresponsive to pain." Luo Moluo was the person most familiar with all drugs in the academy besides Professor Kalman; only he present was qualified to make such a conclusion.

"But massive loss of red humor and white humor will quickly lead to death, so I think this is unrealistic; it is a plan considering only structure. But currently there is no other way; we can only try tying up the patient."

He said "try," but his tone held not a shred of hope. He shook his head, sat back down on the chair, and ended his remarks.

"Since Lecturer Luo Moluo says so, it seems we can only rely on speed." Kraft set down the piece of lime, took one last look at his sketch, and said, "Everyone go to class; we have already delayed long enough today."

The students rose and left. The curly-haired lecturer walked down from the back row, pulled a small box from his black robe, and handed it to Kraft. "Let us formally introduce ourselves; my name is Li Si. Please allow me to express my admiration."

"Why do you say that?" Kraft did not take the box. Judging by the box's exquisite craftsmanship, it certainly did not contain anything cheap.

Li Si smiled and said, "Perhaps it is admiration for a pioneer. I secretly attended a few classes; my understanding of human anatomy left a deep impression on me, but applying knowledge learned from corpses to living people is not easy."

"I do not believe no one has tried before."

"But their objectives were not clear; before cutting open the abdominal cavity, they had no idea what illness they would face." He looked at Kraft with bright eyes, as if gazing upon some treasure. "You are different; you knew what you had to do before you even saw it."

"So I feel it necessary to join history's first attempt. This knife shall serve as my gift of introduction. It is a knife I designed and commissioned specifically for dissection; it has not even been used yet."

Li Si held the box, waiting for Kraft's reply.

"Of course, I cannot complete this work alone." Kraft accepted the box, a polite smile appearing on his face; an assistant with considerable knowledge of anatomy was exactly what he needed.

The smile flashed and vanished; worry about the upcoming surgery made it impossible for him to maintain this expression any longer.

Li Si sensed Kraft's mood, took his leave early, and left Kraft a quiet space to think. "Then I will go to the observation classroom to clean the stone table first; only that place is suitable."

"Thank you; remember to use lime. We will come once we have prepared the other items." Kraft held the box absentmindedly, not even noticing that Lu Xiusi in the front row had not left either.

Lu Xiusi had been sitting quietly, looking as if he were organizing his notes. Only after Li Si went out, leaving only Kraft and himself in the classroom, did he stand up, walk over to Kraft, and hand him the record of remarks he had just written.

"Thank you so much, Lu Xiusi. I truly do not know what to say."

Kraft took the notes and glanced at them. Although he did not need such things, Lu Xiusi's carefulness still moved him deeply. Truly, I have not worried about this boy in vain these many days.

Next, Lu Xiusi would probably have to be troubled for another day, accompanying himself and Li Si to prepare for this surgery where danger far outweighed hope.

Lu Xiusi did not respond to Kraft's words. He fell uncharacteristically silent for a moment, glanced at the classroom door, confirmed that only the two of them were present, and then blurted out a sentence without any preamble.

"Actually, there is a way."