Chapter 4: Surgery With Nothing

Chapter 4: Surgery With Nothing

Wu Zhou followed proper surgical hand-scrubbing protocol, lathering from fingertips to elbows using water and soapnuts. Once through, he cupped both hands and poured strong liquor into them, carefully rubbing down every inch.

As he disinfected, he couldn’t help but sigh internally:

‘No tap water, no antibacterial handwash, no povidone-iodine, no chlorhexidine…’

Even the standard three-step surgical scrub had to be reduced to just two.

If this had been the ER, even the OR nurse would’ve chased him out with a scolding for that.

And this "strong liquor"—he wasn’t even sure it had enough alcohol content.

Judging by the smell, probably not!

Forget sterile gloves—no chance of those.

Whether the patient got infected or not now came down to sheer luck...

‘Oh right—no antibiotics either!’

‘No sulfonamides, no penicillin, no cephalosporins of any kind…’

Now he had to manually handle intestines with these bare hands.

Just imagining the infection risk post-closure gave Wu Zhou the chills.

But if the intestines were damaged, that was another nightmare entirely.

Once intestinal contents leaked into the abdominal cavity, the risk of peritonitis, sepsis, and countless complications—any one of them could kill.

In clinical settings, if you closed up without fixing bowel injuries and things went wrong, the GI surgery team would drown you in rotten eggs.

He had no choice but to choose the lesser evil.

Holding his breath, Wu Zhou started from the duodenum and slowly worked his way down the bowel, inch by inch.

Slick, blood-drenched loops of intestines slid through his fingers.

Then came the sound of violent retching:

“Uuurgh—!”

The broad-shouldered redhead dropped to all fours, curling into a ball with his face nearly buried in his own vomit.

The young priest went pale as a sheet, eyes pointed at the floor, lips pressed tight, cheeks puffing like he might burst.

A loud thud came from behind—it sounded like a water bucket falling, but it was the blond soldier who’d been carrying water also vomiting.

Let them puke. Puke enough times, and you get used to it, Wu Zhou thought to himself.

But when he looked back down at the patient, his soul nearly left his body.

“You’re awake?!—Hold him down! Hurry, hold him down!”

Goddamn it— intraoperative awakening?!

No—there was no anesthesia to begin with. This wasn’t an "awakening"… the patient had just woken up in the middle of surgery!

I’m handling your intestines here, dude!

PLEASE DON’T MOVE!

The soldiers, faces still dripping with vomit, lunged in with panic to pin the patient.

Despite at least 500ml of blood loss, the man thrashed with startling strength, and it took three of them to barely restrain him.

Wu Zhou had a loop of jejunum in his left hand, another segment of ileum in his right, sweat pouring down his face like rain.

“Don’t move! Stop—moving—!”

No anesthesia was terrifying.

If anyone had something heavy, maybe they could just knock the guy out—

—Kidding, obviously. If he caused an epidural hematoma, he wouldn’t have the faintest clue how to treat it.

Wu Zhou did his best to explain and calm the patient, who eventually quieted down.

Wu Zhou steadied his nerves and resumed the inspection, carefully examining every inch of the intestines.

Nothing, nothing…

The jejunum was intact—thank god!

Now for the ileum—this part had spilled out earlier, so it was the highest risk area...

There it was—a 5cm tear!

Thank heavens he caught it.

If that had been missed and the gut just shoved back in…

Wu Zhou’s mind immediately raced through a nightmare sequence:

Intestinal leakage → pus → peritonitis → sepsis → death.

In surgery, if you catch the tear and fix it, it’s no big deal.

Miss it? Even a tiny one? You’re screwed.

There was no way to suture it under these conditions.

But thankfully, he still had something else.

Very carefully, Wu Zhou flipped the vial of “mild injury healing potion” upside down and began dripping it onto the wound.

One drop… two drops…

Under his intense gaze, the long, narrow tear began to visibly close up—

Like watching time-lapse footage:

One centimeter… two centimeters…

And then—it stopped.

He quickly stuffed the cork back in, gave the bottle a shake, and yanked it open again.

Another desperate shake…

One last drop.

Heaven above, earth below, Amitābha, Jesus Christ, whatever gods exist in this world that make healing potions—please let this wound close—

No—please let this potion be enough!

Another centimeter healed.

One more drop…

Fully closed. Perfect.

Wu Zhou finally let out a breath of relief and continued his inspection.

Thankfully, the rest of the ileum, and the downstream cecum and colon, were all intact.

As for the rectum—that was low enough to be unlikely to have taken damage, no need to go fishing around.

Irrigation!

Close him up!

Right—there was no 37°C sterile saline here.

He’d have to mix it himself…

“Has the water boiled yet?”

“Not yet…”

See? Just look at this mess.

He should at least be grateful they had some rundown shack where they could boil water—and they even managed to find some salt?

Wu Zhou took a deep breath.

Then another.

Then a third.

Holding his hands level in front of his chest, he twisted his upper body into an awkward posture to avoid touching anything and waited for the pot to finally boil.

Once it started bubbling, he began dictating instructions to his teammates like a live cooking show:

“Pour the boiling water into the cold boiled water... Not too much! Taste it—no, not straight from the pot! Pour some out first. It should feel just like the inside of your mouth—not hot, not cold.

“Good. Now add salt. Not too much—like a pile the size of your thumb’s first joint. Crush it, toss it in, swirl it around. Now taste again. Salty, but not bitter? Perfect. One more taste just to be sure…”

“Why are we adding salt?”

The young priest finally recovered from his bout of vomiting.

His freckles looked duller now, but his eyes were still bright.

Hearing the question, Wu Zhou instinctively blurted out:

“Saline doesn’t sting when cleaning wounds.”

“Saline? …Why doesn’t it sting?”

Wu Zhou: “…”

Oh crap.

He said too much. These people didn’t even know what saline was!

And to explain why it didn’t sting…

What was he supposed to do—give a live physiology lecture? Start from osmotic pressure and go all the way to nerve signal transmission?

He cleared his throat.

“Saline is water that’s as salty as your blood… When your own blood flows into your wound, it doesn’t hurt much, right?”

“But… salt is expensive!”

Wait—what? Salt is expensive?!

Wu Zhou was drenched in sweat.

Back home, normal saline was one of the most commonly used consumables in medicine.

Used for debridement, for flushing tubes, for irrigating surgical cavities before closure.

Nobody thought twice about it—they’d just grab a bottle and pour freely.

One major surgery could burn through dozens of liters, and no one batted an eye.

And now they’re telling him salt is expensive?

Wu Zhou looked around at the crumbling stone walls, the thatched roof, the pitch-dark room.

—Okay. Yeah. Salt probably was expensive here.

“Even if it is, we still have to use it!”

“Without saline of the right concentration, wound healing will be awful!”

If they used plain water, the osmotic pressure would be too low—it’d kill a bunch of cells, maybe trigger ionic imbalances, or worse…

These people probably didn’t even know what cells or ions were.

The young priest seemed to be thinking seriously.

Just then, a voice called out with a cough from nearby:

“Ahem— Little Garrett, the saltwater’s ready!”