The Thoughts of Dr. Otto

Discretion of Treatment

When one looks at my various postings, it must look like a most dreadful career. Given forlorn wards in the many acclaimed 'death houses' that take in the most destitute and paid only by a commission of religious charity! But I've often found these places to be the most ideal spots to expel myself of any wanton urges that may spring up. It's always more opportune to have your victims come to you then if and find them yourself. People who won't be missed and loved ones unable to pursue legal retaliation in the event malpractice is assumed. In a more positive light, this does allow my more unorthodox practices in medicine to go uncontested, which leads to many sweet healings of wounds to those who come here. My practice of boiling away the blood's lingering miasma from the instruments before each operation, combined with my use of gloves in postoperative observations, sees less people riddle with infections by odors found in other wards. Such a strong stench permeates these halls that the mask that perturbs so many seems entirely justified in my attire; in fact its beak of aromatics and lavender have kept all the vapors of disease at bay since I came into Its possession.

The irony isn't lost on me that I dress the part of the plague doctors of yore, who gave aid to the poor sick and dying during the Great Black Death in service of the church and My wards filled with destitute patients of the present. 'The Modern Von Rom' Phillippe would say after I had returned from quarantine while tending to those struck with the newest plague of that day. Still today, when these diseases appear I am called on by villages in the most dire straits for treatment of the sick when all else fails. The label of 'quackery' means nothing to the desperate, though I do still find insult in the accusations. They claim me ignorant of medical practices, I think Them ignorant of God's desire for suffering. The irony wasn't lost on me when Father Joshua,of the hospital where I am currently posted, greeted me with 'Memento mori'.

Though I most often wear the garment, I am not always bound to outbreaks of plague and find myself tending to the injured, sick and insane when they arrive without subscription to a place of reputation. Most of those who end up here being caught in machinery, victims of violent crime or prostitutes and their clients. Once a very strange case even happened to involve all three in a comedic tragedy! These cases I get to handle with discretion and let me show much bravado by the expanse of fields in which I practice. Be it amputating the arm of a child who had it caught in the gears of some large steam powered machine, or administering medication to balance the humors affecting the mind of a patient suffering from madness. I see no reason to restrict myself in any way, be it in spirit or practice. Indeed it is a benefit that I am able to pull apart both the body and the mind for this gives me the opportunity to personally test the various hypotheses that spring into my mind.

One thesis being that malfunctions in the brain could be corrected with therapies that redirect the humors of the brain. With this premise I will undergo the creation and direct application of solutions to change the body's distribution of humors from the brain and cure mental illness. With this I hope to strike down and bury the therapeutic nihilists of psychology!

This though is something that is being worked on and I will publish the papers with great haste once the work is complete on the redirection of all four humors. Surely this work will garner more praise from the community than the orphan amputee choir that had been formed after my suggestion to Father Joshua. For if it had not been so absolutely shocking when the audience began to boo at the disjointed singing of the child on their first recital, I would have been too appalled at the situation to laugh.

It had been my decision to amputate most of the limbs missing on the stage that night, with only one third missing entirely from infection. They, like every other whose wounds discharge the most foul pus or suffers from a compound fracture, had to undergo an amputation to stave off the gangrene before it could fully develop. While I have found great success in the remedy of vinegar to combat the vapors that cause the infection, It does not always stop the need to fulfill God's need for suffering before he enacts it on them, but I've always strived to save the body by taking the limb. Something that I've grown quite accustomed to in my time. Like most I've taken to timing myself with the operation; Even with the introduction of ether to surgery, I keep myself sharp for the most dire moments.

One dire situation did not involve the saving of the life, but the willing malpractice which led to one death to cause another. It had been a cold day in November evening when my dinner was interrupted by a woman holding a bleeding wound in her lower abdomen while in a hysterical fit over her husband and a baby brought in by two nurses. Not too long after he too arrived at the hospital before I had the opportunity to begin surgery on the dying woman. To my surprise it was a man who had frequented my care in recent months for onset syphilis and to be given several mercury enemas through the urethra to combat it. From gossip with other patients I knew he had also been frequenting a cathouse where he most likely caught the disease. At Least two girls came to me for treatment of it from that place! Besides that the man also had a habit of being unable to last very long and would not seek treatment for this issue. Growing irritable from this, He often took out his rage on the women he spent the night with, going as far as to send one to hospital with a fractured tibia. Clearly this man was a bastard of some degree, and I had an interesting opportunity in front of me.

His wife lay bleeding before me on the stone slab I had acquired long ago to serve as my operating table, clearly the result of being stabbed by a kitchen knife of some sort and a chance to live that depended on a coin flip. If I began now and set to work with all the normal proceedings of surgery, she would at least have that. Possibly she would live through such a traumatic event, give trial for an attempt at murder and they would go their separate ways after. I too would give testimony on how the knife had been used to stab her and what it had done. Then I heard the shadow on the wall blurt out an idea in a voice so dissimilar to my own for it to be a conscious thought heard aloud. I then begin prod away at the intestines shredded by the knife's jerking back and forth in the initial attack. It serves no other purpose than to cause more damage that I know will never heal. Still I attempt to make my movements look deliberate to the onlookers. I submit myself to the enjoyment of removing muscle and tissue in an operation I knew would soon be dragging on too long. When I should have been stitching her up, I am dropping two fistfuls of shredded entrails into a bucket on the floor filled with sawdust. I sew her shut, the ether having started to wear off and a look of anguish on her face. Most of her colon is gone, I'm sure even behind my mask that I see a slice of ovary amongst the refuse in the bucket. Poor dear.

She dies two days later and by the same day the following week I was before the judge to testify on the situation. It is only before my time on the stand, whilst in the pews that I get the full story of that night. A neighbor had heard the disturbance in the night between them over the wife's desire to start a family. He accused her of impotence and She had retorted in kind; this enraged him to grab a knife from the counter and stab her in the gut multiple times. The constables, after checking in at the hospital after she had been seen rushing to the hospital holding her bleeding wound, had returned to their flat and found the bloody knife in the skin and the valve handle broken off. It was a clear cut case even before I gave my testimony. Still I stood before them all and with all power of will to hold back any grin that may emerge, lie in saying all was done in haste to save the woman's life. I follow up by giving a description of the weapon and how it was most likely used in the attack. I did even need to hear the gavel to know the verdict.

I stood out on the snow covered ground on the second day of December to watch the man drop with flowers in hand. He's the third in line that day, one of the few who will swing for his crime. With the cold air of the winter months I could forgo my mask and my joy is plain for all to see that day, for I was to be granted the body after the hanging for dissection! Although when asked I told them of a sweetheart I planned to see that day. In truth, I was happy just to see his neck snap. I had been given the opportunity to save two lives that day, or to condemn one alongside another. I could have accepted her survival, but it unfortunately would guarantee His life with it and that left a bitter taste in my mouth and in my mind.

I do go and place all but one of the flowers on the lady's grave as to give respect to her sacrifice. The remaining flower I bring to a lady smoking a cigar out back of 'The Red Velvet' in a mockery of courtship as she sits with one leg cocked from underneath the table in a splint. We take the time to revel in conversation and I deliver to her the medication for her rash chosen by my discretion.