Chapter 33

Kraft adjusted his state—no matter what, patients could panic, families could panic, but he absolutely could not. There were no senior doctors here to cover for him.

“The current situation is that we may need a specialized treatment plan,” he replied to Gris with as calm a tone as he could manage, “but I need some time to provide a concrete solution.”

“Before that, I need to ask: has she eaten or drunk anything since last night?”

Gris thought back and answered, “No, she hasn’t eaten anything since last night, only sipped a little water.”

“Understood. Do not give her anything to eat under any circumstances. If she’s thirsty, let her moisten her lips with water, but do not let her drink.” Kraft gave his instructions, then turned toward the door. “I need some time.”

Kraft opened the door. The students were still outside, and Lu Xiusi stood at the threshold holding a blanket.

“Thank you, Lu Xiusi. Hand the blanket to Gris, then come into the next room… yes, everyone come. Also, could someone go fetch the other lecturers?”

To some extent, the priest was at least entirely correct: “Now we can only leave it to divine will.”

Kraft knew clearly that under these conditions, there were only two possibilities.

One: simply watch as time passed—the obstructed segment of intestine would not spontaneously recover, blood vessels could not supply blood to the bunched-up section, and the condition would gradually worsen.

The blood-starved intestine would die completely within one or two days, and the patient would eventually perish in agony. In this era, there were no autopsies or other means to confirm the cause of death; no one knew such a simple structural failure could lead to such a horrific end.

Then this terrible secret would remain hidden until, many years later, supported by modern science, surgery finally rose to prominence, turning this current incurable disease into a “minor issue.”

Or Kraft had to devise a solution now—in this godforsaken era where even amputations were performed without anesthesia—within a limited timeframe, he had to come up with a viable surgical plan.

He had to carry out this procedure, one that had already vanished from medical schools in his time, to reposition the intestinal segment and then pray there would be no postoperative infection or other complications.

If a postoperative infection did break out, given Lis’s condition and the level of internal medicine here, Kraft dared not imagine the outcome.

Back in his pediatric surgery internship, anyone who proposed such a thing—something that would make the chief’s ECG go wild—would have been cut down by the chief before he even left the room.

One outcome was certain death, the other was probable death—it didn’t seem like much of a choice. The decision ultimately belonged to Lis and Gris. All Kraft could do now was find the best possible solution to offer them.

In the adjacent classroom, he set up a slate board. Once everyone had gathered, Kraft sketched the current condition, hoping others might offer assistance fitting the current constraints.

“I trust everyone paid close attention in my Human Anatomy class—I won’t waste time explaining exactly where this is.”

“What we need to do is make a small incision in the abdomen, return the intussuscepted segment to its proper position, then suture the incision shut.”

Sounds simple? Frankly, in medical school, we don’t need to be overly cautious—many of you have likely seen dissections, even performed them yourselves, though never on living subjects.

But this is different, gentlemen. This is entirely different.”

Kraft tapped the slate board. The gesture was clearly unnecessary—everyone’s attention was fixed here, including the several lecturers who had just entered from the back row.

“What special requirements do you have?” one lecturer spoke up. He occasionally attended Kraft’s lectures, listening quietly before leaving just as quietly; Kraft remembered his curly hair.

“I need as much cleanliness as possible: linen, silk thread, iron needles, knives, and the people involved.” Kraft found it hard to explain his concept of sterility, so he phrased it this way: “Perhaps running everything through boiling water would help.”

This was the only method he could currently conceive—formaldehyde and autoclave steam were unavailable, and high-concentration alcohol still depended on distillation.

The lecturer sitting beside the curly-haired man offered his view: “We have plenty of lime. I’ve never seen anything spoil after being dusted with it—you could at least wash your hands in lime water.”

He pointed to the small lump of lime Kraft had been using to write on the board. It was a case of blind spots under the lamp—he’d been using it daily for notes but never thought of it. Kraft had been wondering if distilled spirits could disinfect, but such things didn’t exist here.

Sterility was impossible. At best, we aim for cleanliness. Kraft clenched his fists in silent dread for the patient’s postoperative fate and moved on.

“Forgive my limited knowledge in this area—I’d like to ask: is there any method that could temporarily render the patient insensate, so that cutting into flesh and skin causes no reaction?”

“Why not just bind the patient tightly and finish quickly?” Lu Xiusi asked. This was the standard approach for all amputations—though if that could even be called surgery.

“No, it’s impossible to resolve this like an amputation with a single cut,” Kraft rejected his proposal. “At least, I can’t.”

Abdominal surgery was rarely simple. The actual state of the abdominal cavity differed greatly from the clear, colorful diagrams in anatomy textbooks; boundaries between structures were far less distinct, membranes and ligaments surrounding organs, along with adhesions from various causes, turned the surgical field into a chaotic mess.

When you open a small incision in the abdomen, clearly identifying your position within an unmarked surgical field is nothing like the crude, blunt approach of amputation.

The patient is only a three-year-old girl—not Guan Yu, not Rambo. Performing an open abdominal exploration and suturing without anesthesia? The suffering during that time was unimaginable.

“There are indeed substances that can induce unconsciousness, but…” a student flipped through a book, then trailed off—he felt none of the recorded drugs met the requirements.

Some caused permanent unconsciousness; others offered only mild paralysis, insufficient for a prolonged procedure.

This was the fundamental reason complex surgeries didn’t exist in this era—even infection and hemorrhage were secondary concerns. Without anesthesia, patients couldn’t survive such procedures.

“Kraft lecturer, I must say, this is only a plan that holds up in Human Anatomy.”

The speaker was the pharmacology lecturer, Luo Moluo. Kraft remembered his name because they’d once shared a lunch table and discussed drugs—eventually falling out over differing views.

Kraft rejected the humoral theory; Luo Moluo was a devout adherent, eager to explain the relationship between the four elements and drug effects through that framework.

“Unless white or red humors are completely depleted, there is no absolute method to render a living person insensate to pain,” Luo Moluo said. He was the most knowledgeable person in the college about drugs, second only to Professor Karlman, and the only one here qualified to make such a declaration.

“But massive loss of white or red humors leads swiftly to death. So I consider this impractical—a plan that considers only structure. But since there’s no other option, we must bind the patient and try.”

He said “try,” but his tone held no hope whatsoever. He shook his head and sat back down, ending his remarks.

“Since Lecturer Luo Moluo says so, it seems we can only rely on speed,” Kraft set down the lump of lime and gave his sketch one final glance. “Everyone, return to class. We’ve already wasted enough time today.”

The students rose to leave. The curly-haired lecturer walked down from the back row, pulled a small box from beneath his black robe, and handed it to Kraft. “Let me properly introduce myself—I’m Li Siton. Allow me to express my admiration.”

“Why say that?” Kraft did not take the box. Given its craftsmanship, whatever was inside was certainly not cheap.

Li Siton smiled. “Perhaps admiration for a pioneer. I’ve secretly attended several of your lectures. Your understanding of human anatomy impressed me deeply—but applying knowledge gained from corpses to living patients is no easy thing.”

“I don’t believe no one ever tried before.”

“But their goals were unclear. Before cutting open the abdomen, they had no idea what disease they were facing,” he stared at Kraft with bright eyes, as if gazing upon a treasure. “You are different. You knew exactly what you needed to do before you even saw it.”

“So I feel it necessary to join the first in history. This knife is my gift to you. I designed and commissioned it myself for dissection—it’s never been used.”

Li Siton held out the box, waiting for Kraft’s response.

“Of course. I can’t accomplish this alone,” Kraft accepted the box, offering a polite smile. An assistant with substantial knowledge of anatomy was precisely what he needed.

The smile vanished instantly. His inner dread over the upcoming surgery made it impossible to maintain the expression.

Li Siton sensed Kraft’s mood and took his leave, granting him space to think in silence. “I’ll go to the observation room and clean the stone table first—only there is suitable.”

“Thank you. Remember to use lime. We’ll bring the rest of the supplies shortly.” Kraft absently held the box, not even noticing that Lu Xiusi in the front row had not left.

Lu Xiusi had sat quietly, appearing to organize his notes. Only after Li Siton exited and the room was left with only Kraft and himself did he rise, walk over, and hand Kraft his written record of the discussion.

“Thank you so much, Lu Xiusi. I don’t even know what to say.”

Kraft took the notes and glanced at them. Though he didn’t need them, Lu Xiusi’s thoughtfulness moved him deeply. All those days of worry over this boy had not been in vain.

He’d likely have to trouble Lu Xiusi again tomorrow—joining him and Li Siton to prepare for this perilous surgery.

Lu Xiusi did not respond to Kraft’s words. He remained unusually silent for a moment, glanced at the classroom door, confirmed they were alone, then suddenly spoke without preamble.

“Actually, there is a way.”