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Chapter 264 The First Cu

The female bovine moaned as the doctors approached. Vishnu took the liberty of translating common speak to cow tongue for her. The mother of the unborn calf calmed down a little and Hua Tuo instructed Zero to start sterilising the tools while he started to help the cow get into a surgery ’dress’ made out of faded cloth.

The fat cow licked her tail twice and allowed Hua Tuo to feel around her rump. Hua Tuo was marking out the places where he would be making the incision when Zero returned with conjured water in a bucket and sterilised tools.

"Start the anaesthesia procedure, remember to insert the needles deeper just past the skin and into the blood vessels. Watch for ruptures."

Zero nodded and let out a huge sigh to calm his nerves. He steadied his hand and felt around the cow’s thick hide and fur to find a pulse. According to Hua Tuo, the cow’s skin was about four to five centimetres thick, unlike human’s skin which ranged anywhere from half a millimetre to four millimetres. Zero also had to manoeuvre away from the tricky areas that had organs. It was surprisingly compact inside of such a big animal. Zero was told that cows had multiple stomachs unlike humans and wondered if anyone else in the village had multiple stomachs.

The acupuncture needles were thin and looked fragile so Zero worried for a moment that they would break under the thick hide before they reached any blood vessel but Hua Tuo reassured him otherwise.

"If it were any normal needle, they would have broken by now. The needles you are using belong to me and they have been reinforced with magic."

Zero nodded and swallowed a little nervously as he inserted the first needle. Other than a harsh tail-flick once from the cow, Zero received no other bad reaction. The needle pierced through the thick hide easily like a knife through tofu and Zero wondered if this was also because of the special properties of Hua Tuo’s needle.

Although both Hua Tuo and Zero’s faces were covered with masks, their hair under bandanas, and their hands covered with gloves, nobody could mistake that observant look in the Sage God’s eyes. Zero moved in a slightly unsure manner the first time but Hua Tuo chose to say nothing and continued to observe what course of action his student would take next.

At the three centimetre mark, Zero realised that something was wrong. He’d penetrated the skin with the wrong angle earlier due to his lack of knowledge about the muscle structure underneath the skin. Quickly, he removed the needles and apologised to the mother before correcting his penetration angle and attempting it again.

This time, Zero successfully administered the first needle and flicked it like what Hua Tuo taught him. Here lies his second dilemma. The needle didn’t rock as much as he thought it would. Unsure if it would be sufficient, Zero turned to give his teacher a pleading look.

Hua Tuo nodded. "You can flick it if rocking isn’t enough. You just need the needle to sit in deeper into the point to stop any interference of flow to the area we are operating on afterwards."

The teen nodded and did as instructed before moving on to the second point more confidently this time. Hua Tuo watched his disciple like a hawk, not daring to take his eyes off Zero at all. While his student was bright, Hua Tuo wouldn’t put it past the teen to try strange things from time to time.

Thankfully, Zero seemed mature enough and quickly inserted the needle with good accuracy before moving to the next point. It didn’t take too long for the brunet to completely numb the area and Hua Tuo tested the cow’s reflexes.

"Good work, she’s numb to the area. Ready some sterile water. Once the calf is out, I need you to clean the mother up while I cut the umbilical cord. Remember to clean her thoroughly before the suturing otherwise there will be a high chance she gets infected."

Zero beamed at the praise from beneath his mask and nodded. The boy quickly got to work and Hua Tuo used a short razor blade to get rid of the hair covering the patch of skin where he was going to make the incision.

Zero watched carefully and Hua Tuo explained that they were going to perform the simplest form of surgery.

"As the calf has been developed in the posterior position upside down in the cow’s womb, we cannot deliver it with the normal birthing methods safely. The easiest way to approach this without adding further complications is to operate from the left side of the body. We will make an incision about ten centimetres wide, just enough to get through to the womb and bring the calf out safely. The cow is healthy and has no issues standing throughout the surgery while the calf is normal sized which makes this method of surgery possible."

Hua Tuo made the first cut and Zero held his breath with his eyes trained on the gloved hands holding that sharp scalpel. Hua Tuo rambled on explaining about the types of other surgery methods and the circumstances that required them. Zero didn’t think that there would be so many different methods of delivering a baby in a cow but as Hua Tuo explained the pros and cons of each type of surgery, Zero came to understand one thing.

"Is there no fixed method of delivery?" he asked.

Hua Tuo widened the cut and dragged his blade down. Blood gushed but the mother cow didn’t seem to be in any pain. Zero noticed how little blood there was. The acupuncture must be doing a good job of restraining blood flow into the area and Zero could tell that the blood was stale.

"There are many ways to do the same thing. The method of surgery depends on the surgeon’s confidence, skills and assessment. Sometimes, surgical methods have to be changed during the operation due to complications. As a surgeon, you must be well-prepared for unforeseen circumstances and react quickly to it. I’ve had at least two assistants in the room with me whenever I performed an operation. Back then, healing magic wasn’t a thing and every surgery was a risk. Doctors often avoided surgery and used it as a last resort when the patient was guaranteed to die either way."

Zero cringed. That sounded awful.

"However, I didn’t think that surgery should be the last resort. Many doctors waited until it was too late before they attempted surgery. It was absurd. No patient would survive anything if they have already lost all their energy to fight and their will to live. I always believed that as long as the body was still energetic enough to recover and the mind strong enough to live, surgery should be the option after medicine. It’s fast, effective and the risks can be controlled during the early stages. Zero, hold this cut open for me."

The apprentice obeyed and was holding the huge gash open while Hua Tuo stuck his hands into the cow. The physician fumbled around without hesitation that made Zero feel a little queasy thinking about having someone playing around with his organs while he was awake. The physician then made a hum of approval after finding what he wanted.

"Watch carefully," Hua Tuo held the cut open with his hands so that Zero could have a better view. "This is the stomach, you don’t want to cut this on accident so make the incision very carefully. This is the intestine and sometimes they will get in the way so move them out. Over here is what we are looking for."

Zero leaned in to get a better look and Hua Tuo explained.

"This is the uterus, you must be careful not to damage it or the mother and child will both be in danger. We don’t want to risk the mother’s health, so I will make a thin cut. The uterus’ lining isn’t very thick so make small and light cuts on the surface until the womb reveals itself then widen the cut from there."

Zero nodded and watched how Hua Tuo’s steady hands made swift but careful cuts to the same spot. Slowly but surely, they were able to see the womb. Zero thought that it looked a little like a water balloon with a baby cow in it. Now that they could see the baby, Hua Tuo explained a little more about the fetus’ development.

"As you can see, the placenta is attached to the wall of the mother’s womb. You might not be able to see everything clearly with so much blood and water so let’s remove it carefully. Hold steady now..."

Zero did his best to swallow down the sickness he felt watching Hua Tuo grab parts of the cow out. The womb slid out of the uterus through that cut slowly. The process was very slow and tedious with Hua Tuo carefully adjusting the calf’s position and also taking pins to widen the cut little by little so as not to tear open the organ.

Zero huffed lightly under his mask, feeling tired at the level of concentration required. He didn’t know how long they spent trying to deliver the baby cow but he knew that soon enough, he would be cleaning and suturing the mother. The apprentice mentally prepared himself for that and ran through Hua Tuo’s instructions over and over in his head.

The physician had also stopped talking for a while, struggling a little to get the heavy calf out safely.

Once the rear of the calf was out, the rest was easy. Zero couldn’t believe how fast the birth was. The womb came out smoothly and the calf fell onto the floor with the cord still attached to the mother. The water bag broke and Hua Tuo quickly instructed Zero to raise the calf’s head while he tore the umbilical cord from the mother and cut it from the calf.

"Tear the rest of the womb stuff off the baby and wait for it to breathe. Once it can breathe, get it to stand and lead it away from its mother. Once you’re done, clean the cuts and stitch the uterus back."

While Zero busied away, Hua Tuo had to calm the eager mother who wanted to groom her newborn. Sadly, they were still in the middle of surgery so the reunion had to wait.

The calf spluttered to life and whined. At that moment, Zero felt a huge ball of mixed feelings. Witnessing the process of something gain life touched him on many different levels. He might not be able to create life but he could help bring life to the world. The witnessing of birth via operation and the natural process was very different. For baby Seff, Zero didn’t feel as much accomplishment even though he was happy Karris delivered safely. Perhaps it was because he had a hand in delivering this calf that Zero felt it was special. The umbilical cutting was still painful to watch but Zero knew what must be done.

Once the calf was able to stand, Zero called out to Vishnu who was on standby in the vicinity. The minotaur took the baby away and Zero quickly conjured water to clean the wounds. Hua Tuo watched as Zero threaded the silver needle with practised ease by hand instead of magic. Although Zero’s stitchwork was still sloppy compared to Mitchnew’s, it was good enough to hold the cut flesh together.

When his student was done with suturing the uterus, Hua Tuo inspected it carefully before telling Zero to finish sewing the cow’s skin back. Zero did so without hesitation although he struggled a little with how thick the hide was.

Zero found it odd that the suturing process was a lot faster than the incision process. He took special care to not puncture anything when sewing the skin up but because it had been opened so widely before, the skin was loose enough to make the process simple.

"Remember that we need to open the cut again to remove the stitches on the uterus in a few weeks so don’t make it too difficult to cut the stitches away," Hua Tuo reminded his student who nodded.

Once the stitching was done, Hua Tuo inspected his student’s work again. Satisfied at the result, he told Zero to remove the acupuncture needles and feed the mother cow some grass with medical herbs for pain relief. The calf can be brought back to its mother for its first feeding.

"Well done. That wasn’t very scary, was it? You did a good job not fainting or throwing up. Most young surgeons would do either or on their first session."

The teenager looked at his bloodied gloves and swallowed thickly. He didn’t want to tell his teacher that he was nauseous initially. The feeling of prying open something living was different from being inside something living even if both were icky. Zero would rather be eaten by birds and shellfish than to move organs around in a still breathing creature. However, in order to be a good surgeon, Zero knew he had to get used to the feeling.

"Go wash up," his teacher instructed. "We will begin your anatomy classes tomorrow. You will be on kitchen duties for a week with me. Let’s get used to seeing body parts of living creatures before I let you dissect toads."

Zero felt queasy when he heard that and bowed, excusing himself quickly for a bath when in reality, he felt to the river and dry heaved.

The boy removed his dirtied clothes and burned the gloves instead of washing them. With that much blood, it was impossible to get it cleaned. He’d just apologise to his teacher to get a new pair tomorrow. For now, Zero wanted to sink in the river and let the water wash away all the blood.

It was merely a surgery so why did Zero feel as if he was committing torture or murder? As he held his breath underwater, Zero couldn’t help but compare the memories of Venn’s slaughter and Hua Tuo’s surgery. He couldn’t forget that heavy smell of rust when the blood gushed out of that first cut.

At least now he understood why Hua Tuo was hailed as a respected surgeon. Unlike the rest of his medical training, surgery tested a doctor’s finest resolve to stare at the possibility of death and walking that thin line between torture and murder to save someone. It was a cruel kind of kindness that Zero found so incredibly bittersweet. Sometimes, it was necessary to hurt someone in order to save them.