I Became a Plague Doctor in a Romance Fantasy Novel

Episode 9. Reporting to the Ward (4)

Episode 9. Reporting to the Ward (4)

This is the operating room.

We were just performing surgery to align the patient’s arm bone. Fortunately, the joint wasn’t injured, as that’s beyond my ability to fix.

Now, I have to decide whether to reopen the wound from behind and set the bone again, or just go a bit deeper.

“……”

Looking at the patient’s expression, I understand. It seems so. It will hurt a bit, but it’s better to dig in and fix it firmly to the ulna. Reopening the incision would be too much of a burden.

“Ugh! uuugh!”

Istina pressed the patient’s arm even tighter. Moving now could cause serious injury.

“What is your criterion for surgery?”

“Good question. If it’s just a crack in the bone, a splint might suffice, but if the bone is shattered in multiple places like this… If we don’t operate, you’ll never be able to use your arm again.”

“Ugh! uuugh!”

The patient screamed again with the gag in his mouth.

No, I just administered a fentanyl patch and a sedative dose of propofol. Why is he still conscious? Is he resistant to the medication?

Anyway, the surgery is almost over.

“You’ve done very well, patient.”

All the nails are in the metal plate. I put down the surgical tools I had been using.

Oh. Performing bone-setting surgery on a conscious patient. This is a first for me.

*

The bones are all set now. I hope I didn’t touch any blood vessels or nerves in there. Even if I did, wouldn’t healing magic take care of it?

Honestly, even if there is a problem, I’m not sure I can perform vascular surgery here. That might be too difficult.

I placed the torn muscles and tendons back in place and closed the incision. There doesn’t seem to be any muscle damage. The swelling should go down too.

Now it’s time to stitch up the wound.

“Istina, what do you use to stitch wounds?”

“Us? Well, what was it made of…”

“If it’s not silk thread, you’ll get an allergic reaction. Because of the immune response. Only silk thread is used for stitching up people.”

Silk thread, that’s it. The thread drawn from silkworm cocoons.

Most materials cause severe antigen reactions, so they can’t be used for stitching up people. Nylon is possible, but it’s hard to come by in this world.

On the other hand, silk thread was often used even in the royal palace.

In my previous life, silk thread was also used quite often. It’s hard to explain exactly, but it seems the molecular structure of silk causes less immune response.

The specific mechanism is a bit complicated to explain here.

“Istina. Do you know how to stitch up wounds?”

“I’ve done a lot of sewing, but I’ve never stitched up a person. I don’t do surgeries often, so it might be difficult.”

I nodded.

“Then watch carefully how it’s done.”

“Yes.”

“Later, practice on a pig carcass or something. Next time, you’ll stitch up the wound.”

“Oh, understood.”

The needle moved slowly.

“Since it’s an arm, I’ll put the knots at 4-millimeter intervals. The stitches can probably be removed in a week, but that depends on how it heals,”

If we use healing magic, it might heal faster. It’s hard to say for sure. Stitching up the arm took quite a while.

It’s done.

Still, it’s a relief. If it had been a tendon or blood vessel issue, I wouldn’t have been able to handle it at all.

“Istina. Dressing.”

“Do you need a splint, patient?”

No splint is needed. Whether it’s a splint or a cast, nothing can be more effective than the metal plate attached to the bone.

“In this patient’s case, since the bone was directly fixed, a splint is unnecessary. It would only cause inconvenience in daily life.”

“Ah.”

I looked at the patient’s face.

“Patient, once the swelling goes down, you should be able to move your arm starting tomorrow. It might take a few weeks to fully recover, but it will likely be shorter.”

Finally, the medication seems to be working. The patient only gave a slight nod.

“Estina, watch the patient fall asleep and record their condition every three hours.”

“Yes, understood.”

“When bones are crushed like this, the fat inside the marrow can be released, causing fat embolism. Muscle damage from compartment syndrome can also lead to kidney failure.”

Estina looked at me with blank eyes.

“Uh…”

“Just record it. I’ll be nearby.”

“Yes, thank you.”

Even the undergraduates I saw in my previous life weren’t this clueless. Of course, it’s not Estina’s fault. It’s just the times we live in.

Still, with healing magic, we should be able to keep the patient alive until I return… I need to publish my research soon.

The higher the level, the easier my work becomes, and the more patients I can save.

[Heal.]

Estina picked up the staff again, and warm light filled the ward.

The surgery, at least, ended successfully. I returned to the lab with Istina.

I don’t know how the system works here, but we should leave records of surgeries or ward logs. Paper charts would be good too.

Paper medical records. I haven’t seen them since volunteering at the homeless shelter. Usually, we use computerized medical records.

I guess I need to organize the medical records too.

“Um, Professor. I’m sorry.”

Istina was hesitating. What does she want this time?

“What is it?”

“You’ll accept me as a graduate student, right?”

I had forgotten. I said I would decide in a few days whether to accept her as a graduate student, didn’t I?

“Yes, I will.”

“Thank you. I’ll work hard.”

Istina bowed her head.

“Professor, I know you’re busy, but I have a few questions about the patient we saw today.”

“Go ahead.”

Rustling.

Istina pulled out paper and pen from somewhere.

“First, I didn’t fully understand what compartment syndrome is. I couldn’t ask properly earlier because the situation was urgent.”

Compartment syndrome.

It’s a disease you can see more often than you think.

“You know there’s a membrane around the muscles, right?”

“Yes.”

“It’s a condition where there’s bleeding or swelling inside the fascia, causing the internal pressure of the fascia to rise. The treatment is to cut the fascia to relieve the pressure.”

Istina scratched her head.

“Um, just one more thing. Why is it a problem if the internal pressure of the fascia rises?”

“Well, if the internal pressure of the fascia becomes higher than the blood pressure in the capillaries, blood circulation stops. Do you not know what capillaries are?”

This is the problem with explaining from the basics. She doesn’t even know what capillaries are, and she only vaguely understands the concept of pressure, so she can’t understand what I’m saying at all.

Well, it can’t be helped.

Let’s prove the existence of capillaries next time. Once the microscope is completed, we might be able to see them.

“Anyway, you can think of it as the inside of the fascia being so full that blood can’t get in.”

“I understand. What happens if the fascia isn’t cut in time?”

Death.

Even if the person doesn’t die, the muscles will.

“If it progresses to the end, the muscle tissue will necrotize. The necrotized tissue will travel through the blood vessels and cause systemic problems. I don’t know what will happen if you add healing magic to that.”

Istina nodded.

“Understood. Thank you for telling me.”

“Get some rest and go back to the ward.”

Istina left for the ward, and I thought for a bit. I remember that capillaries were discovered in the 17th century.

It’s not unreasonable that these people don’t know.

I definitely need to recruit more graduate students. That way, we can compile the research even a day sooner, and communicate with the people of this world even a day sooner.

Meanwhile, in Professor Asterix’s ward.

The patient, Benjamin Brisbane, slowly opened his eyes. The last thing he remembered was the healers administering medication for surgery.

The surgery itself seemed incredibly painful, but he couldn’t clearly recall the process. Only the aftertaste of the handkerchief he had been biting on remained.

Benjamin was the heir of the Brisbane family and a student at the academy. He had taken a serious fall while riding a horse at full speed…

It might be a miracle that only his arm was injured.

“Where… am I?”

“You’re in the hospital.”

The terrible pain he had felt in his arm had mostly disappeared. Still, since it was surgery, it was inevitable that the places where the knife had touched were a bit sore.

A healer with a plain appearance stood next to the bed. Wearing a black robe and a plague doctor’s mask, he had a somewhat grim reaper-like impression.

“We operated on your arm. You might be able to move it a little starting tomorrow, but it will take a few weeks to fully recover.”

“Did you fix it, doctor?”

Istina shook her head.

“The new professor who just arrived saw you. He used to be the royal physician.”

“When can I see him?”

Benjamin looked worried, and Istina hesitated a bit. How should she explain this?

“Maybe he’ll come back to the ward today, I’m not sure. But if there’s any problem, we’ll call him right away.”

“I’ll be able to use my arm, right?”

Istina nodded. The professor had said he would be able to use his arm in a few days, so it should be fine.