The fish are jumping,” Pantaleon said, “time to dig for worms.”
Carriscant cut into the flesh of the loin. It was pulpy and oedematous, which made him worried. The man on the operating table, a money-changer from Binondo, had been one of Cruz’s patients who had returned to the hospital after being discharged, complaining of pains in his abdomen and of a cloudiness in his urine. Carriscant cut through the integument and separated the muscles. He paused while the nurses swabbed and sponged.
“What did Cruz do with this fellow, Panta?” he asked.
Pantaleon checked his notes. “He thought it might be malaria, or else—you’ll like this—obstinate constipation.”
“Good God.”
“He applied a hot fomentation over iodide of potash. Look, you can see the remains of the blistering.”
Carriscant felt disgusted. “You know, sometimes I feel we might as well be living in caves fighting dinosaurs. This man’s dying of perinephritis and Cruz is smearing ointments on him to blister his skin.”
“Don’t forget the morphia given as a suppository.”
“You’re joking!”
“And a diet of beef tea.”
Carriscant laughed loudly, joined by his theatre nurses. You had to laugh, he supposed. If people knew what misplaced trust in their physicians subjected them to…
The incision was held apart by retractors and Carriscant looked at the exposed organ. What he could see of it was an unhealthy grey, there was a lot of fat and fibrous tissue obscuring much of the surface. He inserted his finger into the cavity, feeling between the kidney and the diaphragm. There was a spurt of pus that spattered on to his sleeve. He smelt its farinaceous sweetness, noting that it was a brackish green in colour. He had found the abscess, about the size of a tangerine, he guessed.
“How’s the new project going?” he asked Pantaleon as he stitched the wall of the abscess cavity to the lip of the wound.
“Very well. I must say the standard of local carpentry is astonishing. They’ll make anything.”
“I know.” Carriscant pulled away with his fingers loose sloughs of cellular tissue and shook them off into a bowl. “I remember having some marquetry replaced by a fellow who lived in Tondo. Just a little shack really. This stuff had been done in Japan. When he’d finished you couldn’t tell the difference.”
“You should see the propeller blades, exquisite. How much longer? Pulse is a bit thready.”
“Five minutes…Dressing forceps, Nurse.”
Carriscant pulled away more of the adipose tissue. “Depends if there’s a fistula, I suppose.” He felt with his finger. “Don’t think so.”
“I hope to have all the panels done by next week.”
“Really? Fast work…Lot of suppuration here.”
He washed out the abscess cavity with a solution of carbolic acid and inserted a drainage tube. He had found out where the Gerlinger school was, where the American woman worked. Bad idea to wait there while the children were studying. Later in the day perhaps. He closed up the wound with some sutures. One of the nurses laid a large wadding of soaked cotton wool over the wound.
“That should do it,” he said. “And I think a large and abundant enema might be called for.”
Pantaleon chuckled. “Cruz would certainly approve.”
“And some ergot of rye. Two doses for the next three days. Wheel him out.”
He walked over to the sink to wash his hands. Stink of pus clung to you. How Annaliese hated that. Carried the smell of your work home. Like being married to a fishmonger.
“What’s up next?” he called to his nurse.
“Volvulus of the small intestine.”
Busy day, he thought, busy day.