"Damn it..."
"Are you feeling a little better now...?"
"Yes, Doctor."
In the end, I even taught her how to swear.
It wasn't entirely my idea.
Liston suggested it.
He said that strangely, cursing made the pain a little more bearable.
If I was going to squeeze her wound without anesthesia, I might as well give her something to hold onto.
'Well... I felt pretty guilty too.'
Squeezing pus out of someone without anesthesia...
You know those dermatological procedures?
Imagine that, but a hundred times worse—and with no prep.
It's agony, even when you're doing it with good intentions.
So, out of sheer desperation, I taught her to curse—and surprisingly, it worked.
"Alright. Today's the last time..."
I muttered while examining the wound, now empty no matter how hard I pressed.
Right.
It's been a week already.
After squeezing her raw every day, not a single drop was left.
"You really went all out, didn't you?"
Liston had been hiding to the side, unable to watch directly.
Only after the screaming and cursing ended did he reappear.
"Yeah. It seems like it was effective, no?"
"Certainly. She said she slept well from the very first day. The pain subsided immediately. So miasma causes pain like that too... There's so much to study."
"Study?"
"Yeah. When I get back, I'll check if there are any patients with pus buildup."
And then he'd cut them open.
In the past, I would've been worried...
But not anymore.
They've grasped the basic concept now.
Other than still calling pathogens "miasma," well...
They've modernized a bit, haven't they?
The chances of them doing something outrageous have dropped significantly.
"Sounds good. Anyway—"
"Today's the day?"
"Today."
"Gonna be a hell of a busy day, eh? Surgery and an anatomy lecture..."
Anatomy lecture.
Calling it a "lecture" is generous—it's going to be more of a spectacle.
Me...
Even if I'm not a specialist in anatomy, compared to people of this era, I'm practically an expert, right?
The Parisians might not see it that way, but today, I was planning to wipe the floor with them.
Honestly, I should've done this days ago, but my companions stopped me.
"You want to dissect a cholera corpse?! Do you have any idea how much miasma is in there?!"
"What the—what the hell are you talking about?"
"You primitive fools! Do you still think miasma is just 'bad air'?! It's real microorganisms! Invisible ones! And corpses of cholera victims are filled with them!"
"No, that's—"
"You wanna die, bastard?"
It wasn't exactly a peaceful discussion.
More like borderline coercion.
Honestly? Watching Liston get his mind blown was kinda satisfying.
These guys have been pissing me off for ages.
Anyway, finding a corpse that wasn't a cholera victim took some time.
How we found it and what kind of corpse we "procured" remains a secret.
I wasn't particularly curious.
Well, I was, but I kept my mouth shut because I had a feeling I'd become an accomplice if I knew.
"Right. It's going to be a packed day, isn't it?"
"Well... I suppose. But no surgery should take more than 30 minutes, right?"
Heh.
One mountain after another, huh?
Liston himself said it.
With anesthesia available, surgeons would have so much more time to spend on patients.
Thirty minutes is a massive leap for him—the man who used to amputate limbs in thirty seconds.
Quick math... how many times is that?
'Dr. Liston... In less than 200 years, there'll be surgeries that take over 30 hours.'
I wasn't in the room for those.
But I've assisted in some.
Otolaryngology cases...
Head and neck cancer resections with reconstructions—that's when I realized just how grueling surgery could be.
"Not sure how long it'll take. But probably longer than that."
"Really? Just cut it out, remove it, stitch it up—done, no?"
Liston glanced at the patient, now lying still with fresh gauze over her wound.
When I first saw her, she looked so haggard I couldn't believe she was only in her fifties. But after draining the abscess and letting her rest, she looked much better.
"That's why it'll take longer. We can't just rush it."
"Really? The prostate surgery didn't take that long, did it?"
"That's true."
I wanted to ask if he really thought prostate surgery and mastectomy were the same.
Or benign hyperplasia and cancer.
But I held back.
Why?
Because with our current anesthesia techniques, the limit is about an hour.
Even pushing it, we shouldn't exceed two.
We can't even precisely control the dosage.
We don't really know how much is going into the patient's system.
Our assistants just eyeball it based on the patient's reactions.
'Wow...'
We're doing anesthesia by feel.
This is another thing we need to research properly.
We have to determine dosages and durations based on gender, age, and weight.
Easy?
It'll take clinical trials...
'First, let's deal with the patient in front of me.'
My head was spinning.
This wasn't good.
I shook my head and refocused.
Luckily, it didn't take long.
Living in the 19th century, where problems pile up like mountains, teaches you to simplify your thoughts.
"Still... I'm not sure. But with you here, it'll go much smoother."
"Right, of course."
"Professor Blundell."
"Huh?"
"Since it's a gynecological issue, you'll assist, right?"
"Ah... Yeah, sure. But I'm a bit..."
This let me focus entirely on the patient.
While talking, I moved her onto the operating table I'd prepared earlier.
Back in London, we used lecture hall desks, but here, since it's a house, I had an excuse to set up properly.
Not everyone was thrilled.
"There's already a bed... Why go to such lengths?"
"Such lengths," huh...
It might seem like a fuss, but the surgeon's comfort matters.
Soon, that'll be common sense.
And I was confident.
Why bother with an operating table?
Once they experience it, they'll never go back.
"Because it's cancer?"
"Yeah. Cancer's incurable... I've never seen messing with it end well."
I positioned the patient on the cross-shaped table, securing her knees and arms.
Meanwhile, I thought about Blundell's grim expression.
'Cancer...'
Humanity's greatest enemy, no exaggeration.
Of course, in the 19th century, cancer was a minor player among diseases.
A small mercy.
Because we have so few ways to treat it now.
Even I have limited options—for others, it's practically hopeless.
Reading the medical texts of this era is depressing.
"That's because they did it wrong. Do it properly, and it'll work."
"Is that how they do it in Joseon...?"
"Mhm. Yes."
I've lost track.
You guys just nod along anyway, don't you?
"Joseon really is..."
"A land of miracles..."
"I'll have to ask Father to take me there someday."
The students muttered among themselves, but the two professors just watched silently.
"Alright... Bring the distilled alcohol."
I exposed the patient's affected area on the table, then poured whiskey-based distilled alcohol over it.
Normally, you wouldn't do this on an open wound, but...
'Well, we've done it a few times already. Patients screamed, but...'
Alcohol burns.
It literally destroys tissue.
But since this patient's breast wasn't an open wound yet, it was fine.
"This is terrifying..."
"Pyeong really is..."
"I'm never going to Joseon."
My students flinched back, unnerved.
I didn't care.
This is the right way.
Sterilization has to be thorough.
And she's restrained so she won't move under anesthesia.
"Colin, anesthesia."
"Ah, right."
By now, my students followed orders without hesitation. The patient's head soon lolled to the side.
"Start ventilating. Tell me if anything's wrong. We're cutting now."
"Got it."
Colin began gently pumping air into her lungs using a modified bellows—a crude ambu bag.
Since spontaneous breathing wasn't fully suppressed, he had to work carefully.
A delicate task—and Colin was good at it.
For short procedures, even clumsy hands like Joseph or Alfred could manage, but...
This surgery would take at least an hour.
Colin would have to tough it out.
"Scalpel."
"Here."
What was Alfred doing?
Assisting.
And the rest?
Crowded around the patient, watching intently.
Unlike before, they wore caps and masks.
Were they sterile?
I couldn't say for sure, but...
Still, massive progress.
Sssk.
I made the first incision.
"Huh? Why not cut the center?"
I answered Liston without looking up.
"To avoid disturbing the tumor."
"Isn't that the whole point of the surgery?"
"We're exposing it completely."
"Ah... So removing the entire breast...?"
"Yes."
"That's why it's called a resection... Now the diagram makes sense. But... is that really necessary?"
We were still talking past each other.
How could I explain that even a single remaining cancer cell could cause recurrence?
And the concept of not disturbing the tumor was still new.
Iatrogenic Metastasis.
Artificially spreading cancer cells via surgical tools.
"Check the records. When has directly handling cancer ever ended well?"
"It gets worse. That's why we avoid it. I thought you had some clever trick."
"The trick is not touching it—just removing it all."
"What kind of...? Fine. I'll shut up and watch."
"Thanks."
Thankfully, Liston had moved past just acknowledging my "genius" to accepting that I might know something he doesn't.
Was that really a good thing?
I could be accused of witchcraft...
Well...
At this point, I doubt they'd burn me.
Sssk.
I made incisions above and below the breast, avoiding the nipple—though its position made preservation impossible.
The only saving grace?
Plenty of fatty tissue.
That gave me room to work.
Even if I removed a lot near the tumor, there'd still be enough left.
Tap. Tap.
Cutting with the scalpel, blotting with gauze—I resected the tumor in one piece.
Thud.
When I set it on the instrument tray, everyone stared.
"Hmm."
Despite the surgery taking far longer than usual, no one's focus wavered.
Surgeries are one thing, but they've stayed up all night dissecting before.
Their reactions, though, were... odd.
"He really didn't touch the tumor..."
"You removed this much...?"
"Hmm..."
Without understanding cancer, their confusion was inevitable.
It's fine.
From what I recall, proper mastectomy survival rates weren't documented until the 1890s.
We're decades ahead, but Liston will catch on quickly.
Radical surgeons are already attempting breast resections elsewhere.
They're all failures—but studying those will help him see why I'm right.