I Became a Plague Doctor in a Romance Fantasy Novel

Severe Trauma Patient (1)

Severe Trauma Patient (1)

Under the sky, on the ground.

Every place where the wind blows and the sunlight touches is the territory of the Imperial Family, but such things couldn’t fix Princess Mint’s mood.

Princess Mint was troubled.

Even if I come to the academy, everyone is scared of me because I’m a princess. Except for the reduced time seeing a certain someone… I just wish we could go back to the palace together.

It seems that personal information has been leaked somewhere.

Spam emails are flying in even in this other world.

It might simply be that the Academy’s Healing Department is bringing all the letters addressed to me. Either way, spam emails are piling up. It’s hard to read them all.

The ones I do read are letters from people whose names I recognize. Like the Baron of Lapis.

– There is a public health issue on which I would like to ask Professor Asterix’s opinion. I would appreciate it if you could reply as soon as you see this letter. I will compensate you for your time.

– Baron of Lapis.

This was a letter I had to answer.

The Prince.

– How is Mint? No reply.

– You insolent brat, pretending you didn’t receive the letter. This is an official royal document. Fill two pages with your response.

I haven’t even seen his face. How did he know I wasn’t planning to reply? As expected, he’s not just any prince. His intuition is superhuman.

There are a few letters from people I know that I have to read. I don’t know why so many are coming. Ah. Could there be a fresh student’s graduate school application mixed in?

I searched through the pile of letters for a long time, but there was no graduate school application. Well, if a student was thinking of coming to graduate school, they would have come to see me first.

Sigh.

Then, what are all these?

Most of the letters were from healers outside the Academy. Half of them were rebuttals. Your opinion is wrong, can I try an experiment, this didn’t work, this seems to make sense.

It seems impossible to read them all.

I’ll have to ask Istina to do it later.

Anyway.

The academic situation is chaotic, but work must be done. I have to see patients and watch over the ward. If I don’t do it, Istina will have to.

Still, only a few of the patients who come to see me. Most of them come with uncomplicated illnesses, receive healing magic, and leave.

‘It’s a relief that there aren’t many inpatients.’

I muttered quietly.

As soon as I said that there weren’t many, bang bang bang. There was a knock on the lab door.

Bang bang bang.

A hurried knock could only mean one thing.

Istina urgently poked her head into the lab. I sighed inwardly.

“Professor. A new inpatient has arrived.”

“No way, even talking to myself sets off a flag?”

“Did you say something?”

“No. What kind of patient is it?”

Istina opened her notebook.

“There are several. First, one patient came in with a bruise on the left upper abdomen, feeling dizzy and unable to see, and another one said they heard a bang from their ankle-“

It was a chilling sound.

“Wait a minute. A bruise on the left upper abdomen and can’t see? How much time has passed?”

“I don’t know how long since the accident, but they just arrived at the hospital, professor-“

I ran towards the ward.

“Professor! The patient is just a bit sleepy, but they received a lot of healing magic on the way here, and they took pain-relieving herbs for the pain and felt better-“

“No, if they fall asleep like this, they’ll die!”

Of course, the patient might be sleepy. They might be tired. But if a patient with massive bleeding falls asleep, they can’t wake up.

“Didn’t you cover him with a blanket?”

“Blanket? It’s in the ward.”

This is bad.

You shouldn’t cover him with a blanket.

“Istina! Go fill a bucket with water.”

Bang! I ran to my ward.

Hmm, the trauma patient Istina mentioned, he still seems to be awake. That’s a relief.

Another young male patient. But he doesn’t seem to be of academy student age.

Judging by his clothes, he doesn’t seem to be a commoner.

His complexion is pale, his eyelids and gaze are drooping as if he’s sleepy. The most suspicious thing is the decreased consciousness due to bleeding.

The cause of the bleeding is trauma. I don’t know which organ is damaged, but it’s likely the spleen.

I immediately snatched the blanket the patient was covered with and threw it on the floor, then shook the patient awake.

“Sir! If you sleep now, you’ll die!”

“What?”

“Wake up right now!”

“Ugh, I’m tired…”

Oh no, don’t close your eyes.

“Please tell me your name!”

“Kailas Copperfield. Uh, I was training at the academy training ground. That, uh, ah.”

His consciousness is fluctuating.

This patient is dying.

In fact, it doesn’t matter who this patient is. What matters is that the patient came in with upper abdominal trauma and is losing consciousness.

I heard the name.

Istina came back quickly. Istina placed a bucket full of water next to me, and I poured the water over the patient.

“What, what the-!”

“Wake up, will you?”

The patient, and the area around the patient, were drenched. I grabbed a towel I had brought. Everyone was looking at me like I was crazy…

There was a good reason.

During World War II, or maybe it was World War I. Anyway, in a time when many people were getting shot, this happened.

Field surgeons found that soldiers who were left unattended and couldn’t even be covered with a blanket had a higher survival rate than those who were covered with a blanket after being shot.

Why?

There are many reasons, but the most important one is this. When the surroundings are warm, the parasympathetic nerves in the peripheral blood vessels of the body are activated.

When the surroundings are warm and the peripheral blood vessels dilate, the blood flow to the brain and heart decreases.

When this is combined with massive bleeding, the brain doesn’t get enough blood flow to function properly, and the person feels sleepy. If they just fall asleep at this point, they die.

This patient is suspected of having internal bleeding. Considering the location of the bruising, it’s probably the spleen.

“Is a patient who says they’re sleepy more urgent than a patient with a torn ankle tendon?”

“A torn ankle tendon won’t kill you.”

The Achilles tendon. No matter how bad it is, with crutches, they can still walk.

On the other hand, bleeding from internal injuries and the resulting decline in consciousness can be fatal within a few hours.

The patient with bruises looked at me with a puzzled expression, clutching his damp hospital gown. Trembling uncontrollably.

I felt sorry, but if he didn’t stop shaking, he could die. I pressed my fingers against the patient’s neck to check his pulse. 18 beats in 10 seconds.

Seems within the normal range.

Could be a bit fast.

“Are you feeling a bit more conscious?”

“I’m c-cold.”

“Try to stay with me.”

I realized I needed to make a blood pressure monitor.

I needed to know his blood pressure.

Suspecting internal bleeding, I tried to check the patient’s vital signs, but there was no blood pressure monitor. His blood pressure must have dropped since he was injured.

Is there a way to measure blood pressure without a monitor?

Let’s think.

Blood pressure. What can substitute for blood pressure? Pulse? No. If I press the wrist well, the difference in blood pressure… wouldn’t be felt.

Let’s reconsider what blood pressure is. Blood pressure is the pressure of blood flowing through the arteries. Usually, both systolic and diastolic values are considered.

Wait, why do I need to check blood pressure? The reason for checking blood pressure is to see if the patient has enough blood flow.

Ah, I realized there was a way to indirectly assess it. I tried to feel the patient’s wrist pulse, but it wasn’t there.

It varies from person to person, but the systolic blood pressure needs to be over 80 to feel the wrist pulse.

There’s another indirect method.

This isn’t arterial blood pressure, but a way to measure venous pressure. By pressing the jugular vein and checking the position where the jugular pulse is felt.

I pressed the patient’s neck with my index finger. The jugular pulse was felt 3 centimeters above the sternum. The estimated central venous pressure is 2mmHg.

Blood pressure is low.

Pallor, decreased consciousness, absence of wrist pulse, reduced central venous pressure. Considering various evidence, it seems that the blood pressure has dropped significantly due to bleeding.

There is only one thing to do.

“Patient! You need to make a choice.”

“What?”

I wish Mr. Kailas would stay alert and think carefully. Given the patient’s severely decreased consciousness, any choice made now might be one made in a daze.

It’s a life-or-death decision.

“I’ll be brief. It seems there is internal bleeding in your body. If left as is, I don’t think you’ll wake up tomorrow.”

“What?”

“We’ve already used healing magic. If you refuse surgery, we’ll try to keep you alive with healing magic and medication until you fall asleep.”

“Uh, it’s not that bad-“

Strange. If the spleen had ruptured, it would be extremely painful. Why is he fine? It might have hurt when it burst, but the pain could have subsided, or it might not hurt due to healing magic or medication.

That’s not the important part.

“I believe surgery is necessary. However, I can’t guarantee survival after surgery, I can’t be sure of the surgery’s success, and the surgery we’re about to perform will definitely have side effects.”

“If I don’t, I’ll die?”

I pondered my words. Sometimes doctors do that. We tell patients they have the right to decide on medical treatment, but…

Well, even if I had threatened him with a knife, the choice wouldn’t be more biased than this.

If you don’t have the surgery, you’ll die.

Will you have the surgery?

It’s just asking if he doesn’t want to die. The patient had no choice but to nod. Well… Let’s start the surgery as soon as possible.

A sin that can be forgiven if only one is saved.