We should tackle hemorrhoid surgery too…
But I tabled it for now.
Yeah, I know.
Hemorrhoids—fucking painful.
Agonizing.
But.
"Fine… if there's no choice, so be it. But are you sure about this?"
"Positive. I've dissected over twenty cadavers from Zemel alone."
"That's a lot of corpses."
"When someone says their stomach hurts, what can we do?"
"What do you mean, 'nothing'? We bleed them, dose them with mercury… Hell, some hospitals just pump them full of morphine."
"And then they die, right?"
"Well… some survive, but…"
"Most in severe pain don't."
"Yeah. Almost none."
Look at this conversation.
Still not getting it?
Then listen closer.
"Alright, so… Hmm. Open them up. If the appendix is swollen, cut it out. If not, leave it… They'd die anyway?"
"Exactly."
"Then patient selection is critical."
At this point, I thought, 'The director's still the director.'
Patient selection—in other words, applying strict indications.
Right. That's how it should be.
"Only patients whose deaths won't cause trouble."
But then, with the face of a true villain, he added:
I glanced at Reston, wondering if this was insanity—only to see him nodding.
"Naturally. It's still experimental."
"Once we've honed it, we'll expand to regular patients. But the abdomen… It unsettles me."
"With anesthesia, we can take our time. Though more practice wouldn't hurt…"
"Fine. Approved. But only the patients I designate. Plenty of 'problematic' cases other hospitals won't touch anyway."
"Understood."
Watching this, you'd think they were gangsters planning a hit, not doctors.
Hard to believe?
Welcome to 19th-century London.
Here, there were people whose deaths wouldn't raise an eyebrow.
In a city bloated by rapid industrialization, where progress trampled humanity… how many could claim to live as people?
'The hospital's 'problematic' cases…'
Street vagrants were never healthy.
But they hadn't started that way.
Companies that discarded injured workers like trash were the real issue.
Cast onto the streets, these people spiraled into oblivion.
Dying in some hospital's ward… or sold to corpse suppliers.
'But that doesn't mean we can let them die.'
Moments like this remind me I'm still a 21st-century man.
The concept of inalienable human rights—something we took for granted—doesn't exist here.
No, it technically does under "natural law," but only for a specific tier of humans.
The rest? Not even considered people.
"Mm?"
Anyway, I stopped Reston as he strode out—clearly off to kill someone.
"What?"
"About the abdomen earlier."
"Don't tell me you're about to spout conservative drivel too. Medicine—though you might not know—can leap forward now with anesthesia. Soon, surgeons might treat most diseases, not those quack physicians."
Ugh…
Now he's in visionary mode.
Can't he pick one—barbarian or enlightened?
Why so confusing—
'Wait, no.'
His words should resonate with me, a fellow surgeon.
But good intentions aren't enough.
Proving his theory right would require…
'A mountain of corpses.'
Ah, right—we'd need sterilization for abdominal surgery.
How long until they grasp even that basic idea?
How many will die for nothing?
And these idiots will just blame "miasma" or some nonsense.
"No, I agree we should operate."
"Oh? Knew you would. You're the most progressive man I know! Let's go—having you with me is even better."
"But shouldn't we… be more cautious?"
"Cautious?"
Where to even begin?
This was the real challenge.
Teaching someone who thinks they know everything—when they know nothing—isn't easy.
Luckily, I had experience.
By now, little fazed me.
"Yes. You said some patients had swollen appendices, but others didn't."
"That's the mystery. Hence, cutting them open."
'Do you normally crack open living people to satisfy curiosity?'
I barely held back the question.
Because the answer would've been yes.
And then I'd have no rebuttal.
"Can't we predict it somehow first?"
"How?"
"Symptoms… or something?"
"They all say 'stomach pain.' No difference. You think I didn't check? Hah."
Hah.
You're laughing?
Who lumps all abdominal pain into one category— Oh. Right. You.
Sigh.
This era's hopeless.
Appendicitis—a treatable condition—left to these morons?
It's Russian roulette.
"Could the location of the pain matter? Where it starts?"
"Huh? Like Zemel's nonsense? That quack says 'upper stomach pain means vomiting,' so he induces vomiting first… You believe that?"
Oh God.
They're doing what now?
Upper abdominal pain could suggest gastric issues, but—
Inducing vomiting? Whose deranged idea was that?
Anyway, I tapped into my most honed skill here: bullshitting.
"The vomiting part's iffy… but upper pain could correlate with nausea."
"Why?"
"What's in the upper abdomen?"
"The… upper abdomen?"
I nearly abandoned diplomacy for violence.
Or maybe just death.
If dying sent me further back in time…
Pre-19th century might be better.
"No, inside it."
"Inside? Oh… Inside. Dissections show… Right. The stomach. So 'stomach pain'? Hoh."
But there's no guarantee things would improve.
Hell, I don't even know why I was reborn here.
Maybe it's to fix the needless deaths during medical evolution.
So I tried again.
Luckily, Reston was a genius.
"Right. So appendicitis pain might localize here, no?"
"Hm. Logical. Let's go."
"Where?"
"The medical ward. Stomach pain cases are all there. We'll open up the right ones."
"Wait—"
Just like that?
Well…
With me there, at least they wouldn't butcher it.
Skill-wise, I could cover most mistakes.
I was a professor, after all.
Still am—just not in the 21st century, where this recklessness would get me sued.
"Now?"
"Who knows how many Zemel's killed already? His ward's the top corpse supplier."
"…True."
All this talk of "corpse suppliers"—
But the real suppliers are Zemel and Blundell.
Ugh.
Infuriating.
But fine. This has to be done.
"Let's go."
"That's my brother! Hah!"
And so, laughing like madmen, we headed to the medical ward—
A different circle of hell.
"Ughhh…"
"Help me…"
"Haa…"
Through a doorway, I saw—
Holy shit.
They're draining blood.
How is anyone alive after that?
Maybe 19th-century humans can donate a liter, not just 400mL.
"Here."
Reston led me to the stomach pain patients.
Another hellscape.
Wow.
Every "treatment" imaginable was underway.
"Hm? What brings you here?"
Zemel, the ringleader of these butchers, spotted us first.
(Or maybe others did but were too scared of Reston to speak.)
"Here for stomach pain cases."
"Finally taking an interest in real medicine? Wise—"
"No. We're operating."
"What? Open the abdomen, and they die."
Zemel said this with gravitas.
Not wrong—yet.
But only because I hadn't been here.
"They die without it too. Or have you cured them all?"
"Must you slander me in front of patients?"
"Got any 'hopeless' cases? Ones the director greenlit for… discontinuation?"
"Well… those can't pay…"
Ah, there's the 19th-century ethos.
No money, no family name? Not even human.
Zemel, sharing this mindset, quietly stepped aside—his earlier "ethical" objections forgotten.
And so we faced four patients:
Doomed.
Abandoned.
'Is this… luck?'
A blessing?
Too poor for bloodletting or drugs.
Just left to suffer.
In this era, that might've been the best prognosis.
At least no one made it worse.
"Let's examine them."
"Right."
With that thought, Reston and I began.