I Became a Plague Doctor in a Romance Fantasy Novel

Graduate Student Istina

10. Graduate Student Istina

The surgery went well. Now that I’ve seen the patient, I need to record what treatment was done.

In the homeless clinic I saw in my past life, where there was no computerized system, medical records were written like this. Each patient had their own brown envelope, and all related records were put in it.

Couldn’t we do something similar?

Istina tilted her head while looking at me.

“Professor, how do you keep patient records?”

“Well… Is there any other way? Prepare an envelope, write the date on it, and note down everything that happened to the patient that day.”

It will be tough, but I plan to do the same here. I started writing the medical record. First, I wrote the date at the top.

– Surgery to fix the upper arm bone with a titanium plate was performed. The surgery was completed successfully.

– Due to the impossibility of general anesthesia, sedatives, painkillers, and local anesthetics were administered together. Liver and kidney toxicity needs to be monitored, but it is expected to be fine.

In fact, if a problem arises in that area, there’s no solution. The inability to perform blood tests is a real big problem. If we have to treat kidney failure just by looking at the patient’s appearance…

It’s horrifying.

– No allergic reactions or side effects were observed for the anesthetics used: propofol (intravenous), fentanyl (patch), and lidocaine (subcutaneous injection).

– The patient’s condition is stable.

Does Istina have anything to add?

“How is the patient? Report the condition.”

“Understood.”

The apprentice healer nodded.

“How should I report it?”

“Report in the order of patient identity, reason for admission, treatment performed, and current condition. Then we discuss what needs to be done next and any concerns regarding patient management.”

Istina nodded and took out her notebook.

I’ve done patient reports in my past life too, and the most important issue with patient reports is this:

If I don’t know the patient’s condition well, I obviously can’t report the patient’s condition to others.

So, I need to be fully aware of the relevant details to make a report, but that’s easier said than done. If there’s even one mistake, it can lead to a lot of trouble.

“Patient Benjamin. His status is an academy student, and he was hospitalized after falling from a horse, resulting in a broken arm and compartment syndrome. After a fasciotomy and bone assembly, his current condition is stable.”

That’s correct. I picked up my pen and continued to write down the details in the medical record. Istina looked over my shoulder at the medical record.

– Suspected compartment syndrome. Confirmed and resolved after fasciotomy, under observation.

– Suspected comminuted fracture. Confirmed through exploratory surgery, then treated by fixing it with a titanium arm. Currently, all fingers can move normally.

“Okay. What’s the next step?”

“Discharge, perhaps?”

How nice it would be if a patient could be discharged a day after surgery. Unfortunately, that’s not the case.

“It’s a bit too soon for discharge. Once the bone starts to heal, we’ll need to proceed with rehabilitation therapy. Since there are damaged bones and tendons, it will take time and effort to return to normal.”

This patient is also not in a condition to be discharged immediately.

We need to check if the surgical wounds are healing, if the bones are joining, and if he can move his arm.

Wouldn’t it take about a week?

It depends on how powerful the healing magic is. The wounds might heal in a few days, but I’m not sure how long it will take for functional recovery.

“Let’s see for a week. He’s our first patient, after all.”

“Understood.”

Istina nodded but didn’t leave. She seemed to have more to say. Judging by her hesitation, she had more questions.

“If you have more questions, sit down and ask.”

Istina sat right in front of my desk.

As if she had been waiting.

“Professor, I was curious about something else too. Bones are like hard stone-like substances, right? Then how can bones attach and grow?”

“Trees have growth rings, don’t they? It’s similar.”

“But bones don’t have growth rings, do they?”

Wow… She’s smart.

The exact principle of how bones grow and attach is like this. First of all, most of the bone is made up of fibers and calcium phosphate crystals produced by cells.

There are various types of cells in bones. Osteoclasts break down bones, and osteoblasts make bones. This process happens simultaneously, achieving a kind of dynamic equilibrium.

When a bone cracks or breaks, osteoblasts work harder, and when there’s a protruding part of the bone, osteoclasts work more.

Then, as you get older, osteoclasts become dominant, leading to osteoporosis.

That’s the content. How do I explain all this?

I pondered my word choice for a moment. How should I explain it so that Istina can easily understand?

“Istina, how much do you know about the microstructure of human tissue? Have you ever heard of the term ‘cell’?”

“I’m not sure.”

The cell structure is common knowledge to modern people. But in the original history, before Hooke observed the cell structure with a microscope, most people didn’t believe in cell theory.

When viewed microscopically, human tissue is not made up of brick-like components but is considered a kind of continuum. Actually, the former is correct.

Let’s try explaining without using the term ‘cell.’

“Bones dissolve. The components that make up bones dissolve and reassemble the bones continuously. That’s how bones can grow and reattach.”

“So that’s why there are no growth rings.”

I nodded. Since bones dissolve and regenerate, there’s no reason for growth rings to form like in trees. Except for young children, the size of bones doesn’t change much.

Istina wrote down my words in her notebook.

“So, you’re saying that bones are also part of a living organism? Not something like a stone.”

“Bones are alive too. You just saw the blood vessels running through the bones. Haven’t you ever done a dissection?”

Istina nodded.

“We didn’t do it during our undergraduate studies. Graduate students usually do it, but as you know…”

She was expelled from graduate school.

Istina became a bit gloomy.

“Don’t worry.”

“About what?”

“Learn under me, conduct research with me, and crush those who judge others with such ridiculous standards with your skills.”

“Thank you.”

Besides, I should look into anatomy classes later. It’s unacceptable for a doctor who hasn’t even done a proper dissection to be seeing patients under me.

The research I think should be prioritized for publication is as follows. Four papers from the history of reality.

First.

Robert Hooke’s ＜Micrographia＞, a basic book on microscopy. By the way, Hooke didn’t discover bacteria because he didn’t know how to stain them to be visible under a microscope.

This laid the foundation for observing bacteria.

Of course, it’s difficult to see bacteria with a regular optical microscope. You need to stain the bacteria or form colonies.

Second.

Pasteur’s ＜Records of Microorganisms Present in the Atmosphere＞ sent to the French Academy of Sciences.

With the famous goose-neck flask experiment, it was an experiment that disproved the hypothesis that factors causing decay and disease arise spontaneously.

This proves that bacteria are the cause of decay and disease, and that bacteria can be killed by methods such as heating.

Third.

Hans Christian Gram’s discovery of Gram staining in ＜On the Dry or Incision Treatment of Dividing Fungi＞.

Honestly, I don’t remember the exact name of the report Gram wrote, but it is true that Gram staining of bacteria started from that report.

With Gram staining and a microscope, bacteria can be directly observed. From here, it is also possible to classify them according to their characteristics. If we go a little further, we might be able to use antibiotics suitable for the type.

Fourth.

And. Joseph Lister’s ＜Antiseptic Principle of the Practice of Surgery＞. Lister came up with a method to disinfect the wound area and the operating room to prevent infection after surgery.

Yes, the same person as in Listerine. With this, we can inform how to act in the actual hospital setting to prevent infection.

The structure of the plan prepared to persuade the academic world is like this. The direction I am thinking of now is also like this.

I will re-experiment and submit the four papers mentioned above to the academic world in this world.

Then this world will realize the existence of bacteria and develop aseptic surgery hundreds of years ahead. This much seems possible.

If only I write the papers properly.

Istina, who had been quietly listening to me, scratched her head after some thought.

“So, you have to write four papers?”

“That’s the plan.”

“Isn’t that too much?”

“We’re overdoing it together, Mr. Lee. Are we strangers?”

Where are you trying to slack off? We all suffer together.

It’s like a puzzle.

We need to publish the research as soon as possible, so that treatment and the next research can proceed a little more easily.

Let’s work hard for just a few years, Istina.

We might be able to change the history of imperial medicine.

Istina already had a tired expression.