There were none.
“Then let us begin. The patient is in the surgical room next door.”
Yozef followed the abbey staff next door to a moaning woman lying with arms and legs strapped to an operating platform. Two female medicants held her hands and wiped sweat and tears from her face. Pain and fear chased each other across her face. The husband waited outside, as was the custom on Caedellium.
Brother Dyllis was to be the lead surgeon, and he and his assistants moved quickly. Everything had been planned, and they didn’t delay. Two sections of raised steps had been put together and placed on both sides of the table to allow staff to see the details of the operation. Yozef cringed at the lack of masks and the larger-than-necessary room but didn’t see it as the time to bring up aseptic conditions.
He stood on a top step, looking over people’s heads and down at the woman. Though the room seemed chill to him, his shirt armpits were soaked, and a cold sweat ran down his neck and back. While all of the tests checked out, this was for real. The assurances from Diera that this was the woman’s and the child’s best option had not assuaged the voice nagging him that he had facilitated something based on so little experience, and something that could kill one or both of the patients. His breathing was deep and harsh, just short of gasps, as his lungs hyperventilated.
Dyllis removed the cloths covering the woman’s swollen abdomen. Another sister swabbed the abdomen with what appeared to be concentrated soapy water. Yozef later learned the cloths and the instruments had been boiled in acidified water. While the woman was being prepped, Dyllis, another brother, and a sister washed their hands and forearms with soap and a basin of evidently water hot enough to give off steam but tolerable to the three medicants.
Sister Varnia held a leather sack serving to deliver the ether, while Brother Bolwyn unstoppered the brown bottle. He shook ether drops into the bag, Varnia closed the opening, rotated the bag several times, then opened it again and placed the opening over the mouth and the nose of the suffering woman. Her eyes widened, as the bag covered much of her face. She took several shallow breaths, gasped as the ether hit her, then closed her eyes. Varnia bent to put one ear to the woman’s chest and the other ear to hear the woman’s breathing, keeping the bag over the patient’s mouth and nose. Dyllis kept a hand on the woman’s chest to follow her breathing and motioned for Varnia to remove the bag. Everyone in the room held their collective breaths while they watched the woman. Her chest rose and fell in normal rhythm.
Dyllis continued checking her pulse and breathing. “Everything seems normal at this point. Now we’ll check for responses.” The classic knee-jerk response was positive, as were iris responses to a light held close. “Now for pain.” He took a large needle and did a minor stab to her forearm. No response. Dyllis looked up at the observers and nodded, then repeated the test at several other parts of her anatomy with increasing force.
“No response to the pricks and breathing still normal. We’re ready to proceed.” He looked at Diera, who nodded assent to continue. Varnia swabbed the woman’s abdomen again. Dyllis picked up a scalpel-like instrument and made a quick, shallow, vertical cut in the abdomen. He pulled back to observe whether there was any response. “No response,” said Dyllis with more than a little wonder in his voice. “I’ll proceed with removing the baby.”
Dyllis stepped forward and with a quick and steady hand cut through the abdominal muscles and then the uterus, exposing the placenta. More careful strokes and the baby was exposed, then pulled out from the mother. The umbilical cord was cut and the baby given to another medicant, who carried out the classic swat on the butt while holding the baby by its feet. The collective exhalation of breaths was matched in intensity by the wail of the single small source. While the baby was further stimulated and cleaned, Dyllis applied a gentle pull on the umbilical cord until the placenta came out through the incision, and the mother was sewn closed.
Dyllis again checked the mother’s vitals, then announced, “Procedure is complete, mother and baby survived to this point.”
Applause and exultations broke out from the audience, followed by multiple conversations and congratulations all around. Yozef was exhausted. He had never imagined how standing and watching something could be so draining.
The following minutes were still tense, as they waited for the mother to awaken, as well as to see whether either she or her new daughter showed any ill effects. The woman awoke less than twenty minutes after the operation. It took her ten minutes to go from first responsiveness to being awake enough to answer questions. She was in pain, though not exceptional, all things considering.
By the next day, she was eating, was talking freely, and had started nursing. Abbot Sistian held a special ceremony that evening in the cathedral. He had insisted Yozef attend and gave effusive thanks, first to God, of course, then to Yozef.
During the next two sixdays, two more surgeries were successful using ether anesthetic. One patient was a tree cutter whose forearm had to be amputated, and a second involved a badly infected wisdom tooth. Yozef didn’t see either patient but was called on for a third case. He was with his three full-time workers in a new ether shop, housed in a small building outside the Abersford, and was inspecting the latest changes in the procedure. They were about to start a reaction run with a new vessel setup when Brother Alber arrived.
“Yozef, Sister Diera asks you come to the abbey. She has a patient she wants to ask you about.”
“A patient? Why does the Abbess want me?”
“I’m just the messenger,” groused Alber. “I was doing an inventory of the hospital supply room when she came in and asked me to find you.”
“Okay, I’ll be right with you.” Yozef turned to Filtin Fuller, the youngest of his workers and the most innovative. Yozef and Carnigan’s sometime drinking companion at the Snarling Graeko was on long-term loan from the glass-blowing shop. “Go ahead with your tests, and I’ll be back as soon as I find out what the abbess wants.”
A small two-seat cart was outside the shop, its stocky brown work pony untied and waiting patiently. Alber hustled Yozef onto the narrow bench, and they were off as soon as Yozef’s rear hit the wood. The cart wasn’t intended for the quick pace Alber pressed, and Yozef and his rear were relieved the trip to the hospital was short. Within a treatment room, Abbess Beynom attended a teenage boy of about seventeen years. She looked up as Yozef came in.
“Yozef, thank you for coming so soon. Come look at this.” She indicated the patient lying on the table and covered with a cloth. Yozef approached as she pulled down the cloth to expose the lower abdomen. The boy sweated profusely, obviously in pain. The lower right of the abdomen appeared distended and flushed. Diera put her hand lightly on the area, and the boy flinched and groaned even at her light touch. “The skin is hot. Experience indicates the origin of the problem is the . . . ,” and Diera used a new Caedelli word.
It must be appendicitis and a new word for my dictionary.
“Are you talking about the small extension of the intestines where it bends here?” He pointed to the boy’s lower right abdomen.
“Yes,” said a surprised Diera. “You know of this structure?” They exchanged words, and Yozef did his usual categorization and word substitution.
“Yes, it’s the appendix and caused by some obstruction that leads to the death of the tissue,” he confirmed.
Diera listened to Yozef’s casual comment, raised a questioning eyebrow, nodded, and said, “Our only treatment is to make the patient as comfortable as possible and hope for his recovery. If the pain gets severe enough, we would normally give him small amounts of opiates to help, but since we have none left and since your ether is more a short-term solution to pain, there’s nothing more we can do. I asked you to come when it occurred to me your people might have a treatment we don’t have.”