Even after closing the Liston-style skull lid, the surgery didn't end immediately.
Why?
It was only natural.
No, isn't it natural?
'Is this the right way to close it...?'
I was genuinely pondering for the first time in a while.
Actually, after brain surgery, unless it's something quite minor...
That is, unless it's something like a biopsy, we usually insert a drain or something to monitor.
Well, for brain tumors like pituitary tumors that aren't exactly inside the brain, we do just close it up.
Nowadays, we go through the nose anyway, so there's no need to open the head.
'But should we open it...? The head...?'
Let's say we insert a drain into the head to reduce intracranial pressure and to remove it if blood accumulates again.
The intention is too good...
We actually inserted drains all the time after abdominal surgery, remember?
Because it looked like a grenade, we always called it 'grenade' instead of its proper name, and now I feel the karma of that.
I can't even remember what the proper name was.
Anyway, if we somehow make that... I mean, what if we attach that suction container?
- Wow... So this is how people die.
Lines like that from Liston pop into my head instantly.
Because it's obvious an infection will develop in the head, right?
Then...
"Wait a moment."
"Huh?"
Liston, who was preparing to suture, turned to look at me.
In the old days, this would have been unimaginable.
Me entrusting the suturing to someone else.
But now it's possible.
No, after having him do it, I found out Liston is really good at it.
Actually, for this current surgery, I only provided the concept, but it's no exaggeration to say Liston performed almost all of the actual procedure, right?
I only made the incision...
Opening the skull, removing the hematoma - Liston did all of that.
If Liston hadn't been here in the first place, we couldn't have done it either.
"Let's... close it without this."
"Without this...? No, but isn't that wrong?"
Liston asked with a face that showed he didn't understand, saying 'Without this?' loudly at first, then whispering the rest.
Even so, since all the relevant personnel are already inside the operating room, it probably won't make much difference...
Anyway, I whispered back to him.
"Wasn't the headache caused by this dead blood pressing down?"
"That's right. But didn't we remove it all? So shouldn't we restore it to its original state?"
Liston's point is correct, of course.
Naturally, reconstruction means restoring it to its original state.
Compared to that, what I'm about to say is somewhat nonsensical.
There is a reason, but thinking with the common sense of this era, it's really just 'woof woof' (nonsense).
"Now, think about it. You should know well, Brother."
"Usually, I do know well."
There was a time when Liston used to be humble.
It was natural because I knew everything and this guy knew nothing...
But as his talent turned out to be insanely great, he's been taking on quite significant roles like in today's surgery, roles for which there is no substitute, causing his ego to inflate again.
Well...
I don't think I'm in a position to say anything.
Because now I really can't do without Liston.
"What happens when you hit a person?"
"It depends on what my intention was when hitting them."
"Ah, right. Let's say you hit them roughly. A sincere punch would kill anyone."
"Ah... It would break."
"What if you hit them with enough force... not to break?"
"That's not hitting. That's just tapping them. Anyway? You're reminiscing."
"Yes, then the person's face, or anyway, the area that was hit swells up a lot, right?"
"That's right... Aha. The head swells too?"
"Yes."
Look at him now.
He understands this dogshit explanation perfectly.
Considering this guy is a 19th-century person, not a 21st-century one, it's really amazing.
Much of this guy's common sense is actually filled with fiction and falsehoods.
But the fact that he has such intact thought processes is really...
"Aren't we essentially hitting him again now? What do you think will happen if we just close it? It will swell because of us."
"Aha. Oho... Hmm. Certainly... But this... Is it okay without this...?"
Liston was looking down at the skull lid.
Because he chiseled it out so amazingly, it was perfectly round.
It wasn't even that big.
If I had done it, I would have probably broken it a few times and wouldn't have gotten it to come off so cleanly.
'It's okay without it...'
Anyway, looking at that piece of skull, I reminisced about the distant past.
When you work in a trauma center, the most frequently contacted department is neurosurgery, right?
As a surgeon, I'm not ignoring the importance of abdominal organs... but looking at single organs alone, there's no place like the head.
Anyway, back then, we used to remove skull pieces much larger than this, and it was okay without them.
It just looks a bit... but...
For a patient like this, it probably won't even be noticeable.
"Let's try it, and if it seems like it won't work, we can put it back in."
"Can we do that? He's a human, not a dog."
"Isn't it an unavoidable situation? We can't prevent the brain from swelling."
"Well... that is common sense, but..."
Liston made a flabbergasted expression at my statement.
Then, soon understanding, he continued.
"Right, what can we do? It's his fault for getting his head injured. It's not our fault, is it?"
He was using miraculous logic...
It's not like I can say anything because I was thinking exactly the same thing.
Well... Did I hit him?
No, I didn't.
"Right. Did we make him drink? Why does he overdrink?"
"Right. Okay. Let's do that."
United by miraculous logic, we placed the lid on the operating table.
Of course, if we just leave it like this, the bone will get damaged and we won't be able to use it if a situation arises where we really need to put it back in, so I turned to look at Joseph.
"Put this in saline solution."
"Huh? No, yes? That's..."
The reason he's so surprised is that saline solution is a really precious item at this point in time.
We have to distill the water, then add salt to the right concentration...
And we even have to store it so it doesn't spoil.
Since it's an era without refrigerators yet, it's really not an easy task...
'Actually, I don't know if it spoils or not.'
Because I don't know, under Joseph's responsibility, we make a small amount every week and discard it.
What do we use it for? As an IV fluid.
Only for really critical patients.
We didn't even use it for this patient, so you can guess how precious it is.
So, telling him to put a bone in that IV fluid is bound to be shocking.
"In case we need to put it back in, it needs to be in there until then."
"Why, why?"
It seems he's not just surprised but also curious.
It's understandable.
Seeing how everyone reacts that way, it's actually a reasonable curiosity.
Well... I can give a sufficiently reasonable, and also academic, answer.
However... this is the 19th century.
I looked up at the sky for a moment.
"Joseph."
Then I called Joseph in a holy voice.
I wasn't pretending to be possessed.
I just called him that way.
"Yes, yes?"
"What is saline solution?"
"Huh...?"
"I'm asking, what is saline solution that you cherish it so much?"
"Ah, ahh. It's similar to the body's fluids..."
"Right. Our sommelier did the鉴别 (identification/discernment), so it's certain, right?"
These guys think we adjust the concentration by taste.
But... actually, I just mixed it to the right concentration.
But how on earth did they figure that out? There's absolutely no way to explain it, right?
I realized that day that both the 'Joseon' excuse and the 'Lord' excuse have their limits.
So, we're pretending that we called a sommelier and adjusted it by taste... Anyway.
"Yes, yes."
"That bone is a part of our body, right?"
"Of course."
"It was originally surrounded by body fluid. So, shouldn't it survive if it's surrounded by saline solution, the liquid most similar to body fluid?"
"Ah... Ahh..."
"Wouldn't that be the Lord's providence?"
"Ah, Amen."
I watched Joseph as he went to get the saline solution, repeatedly saying 'Amen, Amen'.
The back of my neck felt hot, and when I turned around, Liston was also looking at me with a touched expression.
I am, after all, the one called a god.
I felt a slight worry that I might become a cult leader.
"Now, let's suture."
"Uh, right. Shall I...?"
"Yes, you've improved tremendously, Brother."
"Thank you. Hehe."
Well, that's that, but we need to finish the surgery, right?
It's not like becoming a cult leader would be so bad if it happens.
It's not like I'll do bad things; I'll just heal people.
In fact, it might even be better that way.
A cult intertwined with the political world...
Isn't this invincible?
'Should I think about it a bit?'
A religion whose doctrine is 'I alone received the medical revelation'.
Actually, the doctrine is hiding the fact that a doctor has regressed, but this is a secret that absolutely no one should know, so on the surface, it would be like that...
Ssskriiitch.
While I was lost in rather absurd thoughts, Liston was diligently and silently continuing the suturing.
Even seeing it again, he's good.
This guy definitely has skilled hands.
To think that such a person was once just arbitrarily cutting off limbs...
I felt anew how terrifying the limitations of an era can be.
"Alfred."
Anyway, while I was observing the situation, I saw signs that it was about to end, so I called Alfred.
Then Alfred, who, despite not directly participating in the surgery (and thus being in a position where he could be sleepy), was hyper-focused and immediately nodded.
He then began adjusting the gas valve shut-off with an amazing speed.
"Hmm."
As a result, the patient was able to wake up right after the suturing finished and Joseph wiped the area.
"Phew."
"Whew."
Starting with me, sighs of relief escaped from the mouths of all the medical staff without anyone taking the lead.
Listening carefully, the Director behind us was also sighing in relief together.
It was understandable, really.
Brain surgery...
Opening the head in the 19th century...
It's something I truly never dared to imagine when I first arrived.
"My head hurts..."
There was no time to be immersed in sentiment.
I immediately answered the patient's words.
The assistants had already moved the patient from the operating room to a private room.
It's called a private room, but... since it's a time with no proper way to monitor patients in real time, it was a room with a large window so that the inside could be roughly seen from anywhere in the hospital.
Privacy... screw that.
Being embarrassed or uncomfortable is better than dying.
"We opened your head, so it can't be helped. It's probably a different kind of pain, right?"
"Uh... That's true. It's a bit sharp now. But there's no heavy pain like before."
"That's because the surgery went well."
"Th, thank you."
"You should thank Brother Liston. I only provided the concept; Brother performed the entire surgery."
"I, I see. As expected... Sword Saint..."
"You flatter me."
I'm not sure if calling a doctor 'Sword Saint' is appropriate.
I'm not sure if being pleased to hear that is appropriate either.
Anyway, while watching that heartwarming scene, one thought came to my mind.
'Blood pressure... Right, I need to measure blood pressure.'