I Became a Plague Doctor in a Romance Fantasy Novel

Episode 64. Summer Getaway Plan (1)

Episode 64. Summer Getaway Plan (1)

The event concluded with great success. The dean of the Academy’s Department of Healing Studies, Predolin Fischer. The white-haired old professor sat arrogantly in front of his desk.

“It went as I said, didn’t it?”

“Yes.”

One of Professor Fischer’s graduate students, Alain, nodded. Things had truly unfolded according to Professor Fischer’s plan.

The gist of what Fischer had said was this:

During this monster hunting festival, if possible, send all patients to Professor Asterix.

It was a lesson learned from the swordsmanship tournament.

It was all thanks to that professor. This time too, there were quite a few serious accidents, but the event ended without anyone dying or being seriously injured.

Honestly, among the professors of the Department of Healing Studies, it’s rare to find someone who isn’t weird. Rather, Professor Asterix is closer to being normal…

To say that is frankly a lie. Anyway.

“What did that professor say?”

“He didn’t say anything in particular.”

“Good.”

Professor Fischer nodded.

Among the patients Professor Asterix had seen during the event, there were some with rather serious ailments.

Patients who had collapsed unconscious for some reason, or patients whose hearts were damaged by monster attacks. That was the rumor going around the ward.

The rumor that he opened a heart on a living patient was the most shocking. Professor Fischer thought it was all nonsense.

“What happened to the patient with the heart injury? Rumor has it, Professor Asterix operated on his heart. Seems a bit exaggerated, don’t you think?”

Alain hesitated a moment before answering.

“I asked a nurse about it. She said they made an incision below the fourth rib, then reached the heart through the rib cage.”

It wasn’t an easy claim to believe. It was also unclear what benefit could come from opening the heart.

Professor Fisher’s eyes narrowed with disbelief.

“Are you serious?”

“Yes, I am.”

“That’s more like magic than magic itself. You’re telling me they actually opened the place where the heart is? Is the patient even alive?”

“I saw him alive.”

“That’s bizarre. Bloodletting is a long-abandoned theory. Why would Professor Asterix, who loves new things, resort to such a method?”

“Well… maybe because it was necessary?”

“Hey. Do you think he would’ve done it if it wasn’t necessary?”

“Oh, no, you’re right.”

Professor Fisher stared at his graduate student with a dumbfounded look. Of course he’d do it if he thought it was necessary. It was like saying you eat when you’re hungry.

It wasn’t wrong, though.

“Alain. Go ask Professor Asterix. What exactly did he do with that patient whose heart he opened? It was surgery, right?”

“Yes.”

“Heart surgery is usually impossible. Why did he open the heart, and how did he succeed?”

Alain nodded.

He was just as curious. Why on earth would they cut between the ribs to draw blood? Was there any reason that would help?

Logically. If you open up a heart and draw blood, shouldn’t a person normally die? But that professor drew blood and still saved the person.

The king of internal medicine ailments, the diagnosis of sepsis.

Actually, this is a topic even modern doctors disagree on. Body temperature aside. A heart rate of 90 and a respiratory rate of 20 can occur due to strenuous exercise, among other reasons.

Body temperature, heart rate, respiration, white blood cell count. If two or more out of these four criteria are abnormal, it’s considered Systemic Inflammatory Response Syndrome, and the protocol for that is followed according to the textbook.

There was a somewhat ambiguous aspect to it. Some doctors even argued that the concept of ‘Systemic Inflammatory Response Syndrome’ itself should be abolished.

Many patients have heart rates over 90 and respiratory rates over 20, and it wasn’t reasonable to suspect and treat all of them for sepsis.

After a long debate, the concept of Systemic Inflammatory Response Syndrome was completely abandoned by the academic community. Though it didn’t disappear in clinical practice.

They introduced something called the Sequential Organ Failure Assessment score, for the diagnosis and assessment of sepsis, or maybe it was something else, I can’t quite remember. Anyway, the SOFA score.

However. No matter what anyone says, Systemic Inflammatory Response Syndrome was a useful concept.

Heart rate, respiratory rate, body temperature. The fact that you could suspect and respond to sepsis based on those indicators alone, practically visible to the eye, was a huge advantage. Just look at the situation right now.

I hope I explained that well?

It ended up being a bit long-winded in the explanation.

I was explaining to Istina what sepsis was, and how to respond to the illness. It might be a bit complex.

“In summary, that’s it.”

“Ah… Okay.”

“It’s not perfectly like that, but, this patient is in the high-risk group for sepsis. If we see the characteristic symptoms, it’s practically a confirmed diagnosis.”

Istina wiped the lenses of her glasses, which she sometimes wears. That’s her expression when she’s racking her brain. The expression she makes when she doesn’t understand what’s going on.

I contemplated my choice of words. What’s the easiest way to explain it again… Istina frowned a little, after some deliberation.

Yeah, it’s obvious. Now it’s Istina’s turn to say, ‘I don’t know what you’re talking about.’

“I don’t know what you’re talking about.”

Guess I didn’t explain it right.

Since Istina didn’t understand, I need to rethink it from the basics. First, what causes sepsis?

Specifically speaking. It’s when cytokines, proteins that signal an inflammatory response, are released throughout the body, causing a systemic inflammatory response.

That’s the systemic inflammatory response I was talking about earlier. If the cause of this systemic inflammatory response is bacteria, then we can give a confirmed diagnosis of sepsis.

“Um. You know what inflammation is, right?”

“Yes.”

Nodding again.

“There are physical reactions to inflammation, right? Swelling, fever, redness, that kind of thing.”

“Right.”

“If an inflammatory response happens systemically, things like a rapid pulse, increased respiratory rate, and high fever can occur. That’s what we’re going to monitor for. It means the surgical site might be infected.”

Istina opened her notebook and wrote something down.

“So, sepsis is a disease caused when bacteria from inflammation travels through the bloodstream, right? And this patient’s pericardium is exposed to outside air, so it’s likely to occur?”

“Yeah, that’s right.”

Accurate.

If there’s poor infection control or hygiene, sepsis can occur after surgery. And under the circumstances here, it’s easy for that kind of accident to happen.

“Oh, I think I get it! So. I’ll carefully monitor whether this patient’s temperature is rising, or if they’re breathing too fast.”

The conclusion is the most important thing to a doctor anyway.

“One last thing. How do you treat bacteremia or sepsis if it occurs?”

“Ah, that?”

The most important thing is monitoring the patient.

“Antibiotics and fluid supply, and monitoring to make sure the patient isn’t suffocating.”

It’s complicated, as usual.

In the case of a patient suspected of bacteremia, blood needs to be drawn for blood culture, antibiotics administered, fluids connected, and the patient monitored.

Blood culture is realistically difficult here, so let’s skip that. And we don’t have any antibiotics, do we? Not unless I specially pull them out.

“What are antibiotics?”

“A drug that kills bacteria.”

I guess I could make antibiotics too. I wish I could make penicillin quickly. But it seems it’ll take some time still.

Question time is over. Istina closed her notebook and stretched her legs out as if yawning.

“Oh right, professor. The new grad student, her name is… Amy, was it?”

“Yeah. That one.”

“Got it. I’ll give her a tour when she arrives. We should grab a meal sometime…”

Istina, now with a bright expression, looked out into the distance. I’ve got quite a lot to do.

Prepare a new paper, answer the questions that sometimes come up about a previously published paper, if possible.

And I need to try making antibiotics.

There’s also the most important task left. Bring in new grad students and teach them. I wish we could bring in more than just Amy.

“Istina.”

“Yes.”

“Go home first. I have some things to wrap up.”

“Just stay a bit longer before you go…”

Fine, do as you please.

Istina sprawled out on the lab sofa.

The next day. When I came into the lab in the morning, a familiar face was sitting there.

Princess Mint.

“It’s been a while, teacher.”

Honestly, it hasn’t been that long. She was here just the day before yesterday. Anyway… Mint gestured beside her. It meant to come sit next to her.

These days Mint seems a little bored, which is worrying. Maybe it’s just the weather being humid and rainy, so she’s a bit lethargic.

Her overall impression was the same as always.

A tidy uniform, befitting a princess.

Soft light-brown, or blonde hair. Her eyes were wide open, and her hands were restlessly fidgeting.

Her expressions have become more varied compared to the past, but Mint’s characteristic slightly unapproachable, doll-like impression remains.

“I saw you the day before yesterday.”

“Yeah… I’m not exactly thrilled to see you so often.”

“I’m happy to see you, Your Highness.”

“Then you should have come faster?”

Well… I can’t help it. I sat down beside Mint, as she wished. Mint covered her mouth with her hand and smiled slightly.

What kind of whim has struck her today…?