A Method of No Method

Kraft adjusted his state of mind. No matter the situation, the patient could panic, and the family could panic, but he absolutely could not. There were no senior physicians here to bail him out.

"The current situation is that we may need some special treatment options," he replied to Gris in as calm a tone as possible. "But I need a little time before I can give you a specific answer."

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

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

"Alright, do not feed her anything now. If she is thirsty, you may let her moisten her mouth with a little water, but she cannot drink." After giving these instructions, Kraft turned and walked toward the door. "I need some time."

Kraft pulled the door open. The students were still outside, and Lucius was standing by the entrance clutching a blanket.

"Thank you, Lucius. Give the blanket to Gris, then come to the room next door... well, everyone come over. Also, can someone go fetch the other lecturers?"

In a sense, the priest was at least entirely correct about one thing: "From here on, it is all in God's hands."

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

Either they just watched, and as time dragged on, the incarcerated segment of the intestine would not spontaneously reduce itself. The blood vessels would be unable to supply blood to this blocked section, and the condition would gradually deteriorate.

The ischemic intestine would become completely necrotic in a day or two, and eventually, the patient would die in agony. This era had no autopsies or other means to confirm the cause of death; no one would ever know that such a simple anatomical structure had led to such a horrific death.

Then, this terrible secret would remain buried until, countless years later, supported by modern science, surgery would truly rise, and this current terminal illness would become a "minor issue."

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

He would have to put this hastily conceived plan into practice, performing a surgery that was essentially unheard of in his own time, restore that section of the intestine to its proper place, and then pray that there would be no postoperative infections or the like.

If a postoperative infection were to break out, given Lis's physical condition and the level of internal medicine here, Kraft didn't even dare to think about it.

Back when he was an intern in pediatric surgery, if anyone had proposed something that could make the director's heart rate monitor go haywire, the director would have surely taken them down with him before he left.

One outcome was certain death, the other was probable death; it didn't seem like much of a choice. If a choice had to be made, it would be up to Lis and Gris. Kraft could only find the best possible plan to offer them.

Setting up a blackboard in the classroom next door, once everyone had arrived, Kraft drew a sketch of the current situation to see if the others could provide any help that fit the current constraints.

"I believe everyone listened quite carefully in my Human Anatomy class, so I don't need to waste time explaining exactly where this is.

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

Sounds simple? To be frank, in the Medical School, we don't need to be too squeamish. Many of you have likely seen dissections, or even performed them yourselves, though not on the living.

But this time is different, gentlemen. This time, it is completely different."

Kraft tapped the blackboard. The gesture was clearly redundant, as everyone's attention was already fixed there, including the few lecturers who had just entered from the back row.

"Are there any special requirements?" one of the lecturers spoke up. He occasionally frequented Kraft's classes, listening quietly and leaving quietly; Kraft had some impression of his curly hair.

"I need things to be as clean as possible. Linen, silk thread, iron needles, knives, and people to assist." It was difficult for Kraft to explain his concept of asepsis to them, so he could only phrase it this way. "It would probably be better to boil everything in water first."

This was the only method he could think of for now. Formaldehyde and high-pressure steam did not exist here, and high-concentration alcohol depended on distillation.

The person sitting next to the curly-haired lecturer offered his own perspective: "We have plenty of lime. I have never seen anything spoil after being dusted with this stuff. At the very least, you could use limewater to wash your hands."

He pointed to the small block of lime Kraft had been using to write on the board. It was a case of being unable to see what was right under one's nose; he used it to write every day but hadn't thought of it. Kraft had been wondering if there was any distilled spirits for disinfection, but now, there was no such thing.

Sterility was impossible, so he would just have to make it as clean as possible. Kraft broke into a cold sweat for the patient's recovery and moved on to the next topic.

"Forgive my shallow knowledge in this area, but I would like to ask if there exists a method to make a patient temporarily lose sensation, such that cutting through skin and flesh has no effect."

"Can't you just tie the patient down and finish as quickly as possible?" Lucius asked. This was the standard way of handling all amputations—if that could even be called surgery.

"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 was often not that simple. The actual state of the abdominal cavity was vastly different from the clear, colorful diagrams in anatomy books. The boundaries of various structures were not as distinct as one might imagine; the membranes, ligaments, and adhesions caused by various factors wrapping around the organs made the field of view under the light a complete mess.

When you make a small incision in the belly, trying to determine your location in a surgical field without clear landmark structures is clearly not as simple as a crude amputation.

The patient was only a three-year-old girl, not Guan Yu or Rambo. To cut open the abdominal cavity, rummage around, and perform a suture without anesthesia—it was impossible to imagine what would happen during that time.

"There are indeed some things that can cause a loss of consciousness, but..." A student flipped through a book, stopping halfway. He felt that the recorded drugs basically could not meet the requirements.

Some caused the patient to fall into a sleep from which they would never wake, while others only had a mild paralytic effect, which could not be applied to a surgery that required time.

This was the fundamental reason why complex surgeries did not exist in this era; even infection and blood loss were secondary concerns. Without anesthesia, the patient could not survive such a surgery.

"Lecturer Kraft, I must say, this is only a plan that holds up in Human Anatomy."

The speaker was the pharmacology lecturer, Romolo. Kraft remembered his name because they had shared a table during lunch one day. The two had chatted about some issues regarding medicine, but in the end, they hadn't seen eye to eye due to differing philosophies.

Kraft was quite resistant to Humorism, while Romolo was a loyal supporter of traditional Humorism, happy to use that framework to explain the relationship between the four elements and medicinal effects.

"Unless the Red Fluid or White Fluid dries up, there is no method that can absolutely make a living person have no reaction to pain." Romolo was the person most familiar with all drugs in the academy besides Professor Calman; he was the only one present qualified to draw a conclusion on this.

"But the massive loss of Red Fluid and White Fluid would quickly lead to death, so I think this is unrealistic—it is a plan that only considers structure. But there is no other way at the moment; we can only try tying the patient down."

He said "try," but there was no hint of hope in his tone. He shook his head and sat back in his chair, ending his statement.

"Since Lecturer Romolo has said so, it seems we can only hope for speed." Kraft set down the lime block and took one last look at his sketch. "Everyone, go to your classes. We have already delayed long enough today."

The students stood up 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's have a formal introduction. My name is Liston. Please allow me to express my admiration."

"Why do you say that?" Kraft did not take the box. Judging by its exquisite craftsmanship, whatever was inside would not be cheap.

Liston smiled and said, "Perhaps it is admiration for a pioneer. I have secretly attended a few of your classes. Your understanding of Human Anatomy left a deep impression on me, but applying what one has learned from the dead to the living is not easy."

"I don't believe no one has tried before."

"But their goals were not clear. Before cutting open the abdominal cavity, they had no idea what condition they were facing." He looked at Kraft with burning eyes, as if looking at some kind of treasure. "You are different. You knew exactly what you were going to do before you even saw it."

"So I feel it's necessary to join in on this historical first, and this knife shall serve as my introductory gift. I designed and commissioned this scalpel myself specifically for dissections; it hasn't even been used yet."

Liston held the box, waiting for Kraft's reply.

"Of course, I couldn't possibly complete this task alone." Kraft took the box, a polite smile appearing on his face; an assistant with a solid understanding of anatomy was exactly what he needed.

The smile vanished in a flash, as his anxiety regarding the upcoming surgery made it impossible for him to maintain the expression.

Liston sensed Kraft's mood and took his leave first, giving Kraft the space to think in peace. "Then I'll head to the Observation Classroom to scrub down the stone table; it's the only place suitable for this."

"Thank you, and remember to use lime. We'll come by once we've prepared the other supplies." Kraft held the box distractedly, not even noticing that Lucius in the front row hadn't left either.

Lucius had been sitting quietly, looking as if he were organizing his notes. Only after Liston walked out and the classroom was left with just Kraft and himself did he stand up, walk over to Kraft's side, and hand him the meeting minutes he had just recorded.

"Thank you so much, Lucius. I really don't know what to say."

Kraft took the notes and glanced at them; although he didn't actually need such things, Lucius's attentiveness still moved him. It really hadn't been a waste of time worrying about this kid for so many days.

It looked like he would have to trouble Lucius for another day, having him join himself and Liston to prepare for this surgery that looked increasingly grim.

Lucius didn't respond to Kraft's words. He remained uncharacteristically silent for a moment, glanced at the classroom door to confirm that only the two of them were there, and then blurted out a sentence that came out of nowhere.

"Actually, it's not like there's no way."