To Hell with Being a Saint, I’m a Doctor

Chapter 168: The Lesian Empire (3)



He looked down at the robustly built old man.

“Looks like muscle rigidity… I’ll have to undress him to be sure.”

Ray murmured nonchalantly, as if it were nothing, and began to undress the Emperor.

Then, on the Emperor’s abdomen and arm, there appeared bruises or marks similar to bruises, but they were blue in color.

Ray instantly understood the Emperor’s condition upon seeing this.

“It doesn’t seem like bruises from blunt trauma. Wow, someone really did a number on the Emperor.”

As he carefully lifted the Emperor’s stiff body, his expression turned grim.

The body, stiffened from muscle rigidity, had to be handled with care.

Due to the nature of rigidity with cramps, muscles could easily tear, leading to a risk of injury.

The injuries Ray saw on the Emperor weren’t just from abnormal muscle contractions.

Some madman had apparently tried to forcefully move the rigid muscles.

This must have led to muscle tears and internal bleeding, starting from the skeletal muscles.

Skeletal muscles have a rich blood supply.

Moreover, blood vessels and nerves pass through the perimysium that surrounds muscle fibers.

When these muscles tore, they lost their function.

Even if treated, the aftereffects couldn’t be mitigated.

The Emperor would likely complain of severe pain during muscle palpation.

But that wasn’t all.

He pressed down from the Emperor’s shoulder to the elbow.

It seemed that a tendon injury had also occurred in the bruised arm area.

The tightly packed, elastic collagenous fibers had reached their breaking point, and the collagen fibers had snapped.

Normally, when a tendon is under load, collagen fibers align straight in the direction of the load.

But here, the muscles were forcibly torn, leaving no chance for the tendons to withstand the strain.

This would eventually lead to chronic muscle injuries due to the absorption of collagen fibers.

The situation was quite serious.

Though it wasn’t life-threatening, the ongoing shock was not a good sign.

“I’ll have to perform a laparotomy to stop the bleeding. Correcting the shock caused by internal bleeding might bring back consciousness.”

As his speculation from last night turned into conviction, Ray immediately prepared the Emperor’s abdomen for surgery.

Somewhere in his abdomen, there was a site of bleeding.

He had no other option but to open it up and take a look.

He did not hesitate. Even if it risked damaging the precious body of the Emperor, he couldn’t let him die.

“Clean.”

He magically cleaned both the Emperor and himself as a precaution, then slightly loosened the suppression of his divine power.

As he diminished the surrounding mana to alleviate the pressure of divine power, the air purifiers created by god around Ray began to whirl furiously.

Being ‘Made in god,’ their efficiency was guaranteed.

The surroundings were purified, and the Emperor’s chamber quickly became a sterile environment suitable for surgery.

After inspecting the Emperor’s body once again, Ray cast a locking spell on the door.

“Lock.”

It would be problematic if someone entered during the laparotomy.

With his aura, Ray fashioned a small scalpel.

The method of incision in a laparotomy varies depending on the targeted organ or location.

The anatomical structures and characteristics of the abdominal wall must be considered to minimize unnecessary tissue damage.

For this purpose, a vertical incision along the midline was advantageous.

The mana-made scalpel cut through the Emperor’s peritoneum.

His organs came into view.

Ray examined each organ, lifting them one by one.

Finding no perforation in the duodenum, stomach, small intestine, or sigmoid colon, it appeared there was no peritonitis.

Continuing his search, he soon located the site of bleeding.

A small amount of blood had collected in the lower part of the peritoneum and the corner of the descending colon.

Ray felt a wave of relief at this discovery.

Fortunately, it was not a severe hemorrhage.

The Emperor appeared to have fallen into a state of shock due to sudden internal bleeding.

With skilled manipulation of his thumb, index, and little fingers, Ray used threads of mana to suture the wounded area.

He succeeded in stopping the internal bleeding, but during the laparotomy, he encountered a new problem.

His expression hardened slightly.

The intestines were unusually distended.

‘Early intestinal obstruction, it seems.’

Intestinal obstruction is a condition where the intestines are partially or completely blocked, which prevents food, digestive juices, or gas from passing.

In this instance, there were two types: mechanical obstruction and paralytic ileus. Ray suspected the latter for the Emperor.

Nonetheless, since it was in the initial stage, it didn’t seem to require immediate concern.

Typically, this condition resolves on its own, and with proper electrolyte intake, it should improve.

Maintaining good nutritional status is crucial until then, but it seemed difficult for the Emperor to consume anything in his current state.

Ray finished suturing the Emperor’s abdomen.

He had managed the internal bleeding and determined the patient had an early-stage intestinal obstruction.

The only issue remaining was muscle rigidity.

‘It’s strange. Most causes of muscle stiffness are similar. If it’s a rigidity that doesn’t respond to divine power, could it be an immune system issue?’

As he pursued this line of thought, Ray felt he was getting closer to an answer.

An immune system problem? That was a plausible explanation.

Gluten sensitivity, which couldn’t be fully healed by divine power, was also an immune system issue.

If the empire’s divine magic had failed to cure the Emperor’s condition, it was possible, though uncertain, that the stiffness might also be related to the immune system.

Ray paused to consider.

Stiffness from an immune system problem?

It was a rare condition but not unheard of.

He regarded the Emperor with a thoughtful gaze.

“Could it be… Stiff-person syndrome?”

Also known as stiff human syndrome, this autoimmune disease can coexist with various autoimmune disorders like thyroiditis, vitiligo, pernicious anemia, and type 1 diabetes.

Although he wasn’t yet certain, if he had to suspect something, it would be this.

‘If it’s Stiff-person syndrome, that’s a bit tricky…’

This condition is caused by a malfunction in the immune system, leading to abnormally increased muscle tone.

As a result, it requires treatment with medication, but the problem was that he couldn’t produce the necessary drugs.

He knew what drugs were needed, but since he wasn’t a pharmaceutical specialist, he didn’t know how to make them.

Muscle relaxants and immunosuppressants were needed.

For early-stage Stiff-person syndrome, benzodiazepines were primarily required.

This includes chlordiazepoxide, a synthetic compound. But in his current situation, unlike in modern times, he couldn’t request a medical department or ask a pharmacist to produce it, which was problematic.

This drug, also found in sleeping pills, activates receptors related to GABA (gamma-aminobutyric acid), an amino acid found only in the brains of mammals, which is directly linked to the treatment of Stiff-person syndrome.

If he couldn’t produce the medication, he would have to resort to physical therapy and dietary treatment.

However, it didn’t seem likely to succeed.

While some improvement might be possible, a complete cure seemed difficult.

He sat down in a chair and sighed.

Once again, his treatment efforts had hit a wall.


Luciella, looking at herself in the mirror, ground her teeth in frustration.

She couldn’t forgive the Saint for ignoring her and moving away, feeling a deep scratch on her pride.

She felt that revenge was the only way to soothe her anger.

“To ignore an imperial princess of the empire? Hmph. That’s as far as his arrogance goes.”

She was the assistant to the first prince, the prime candidate for the imperial succession.

If she asked the first prince, surely the Saint would have to apologize to her formally.

However, she was mistaken.

Whether it was the first or second prince, they couldn’t casually meddle with a Saint.

Simply put, as children of the Emperor, their status was a notch lower than that of a Saint.

Moreover, the current Saint was not an ordinary one.

Young as she was, she likely didn’t understand the Saint’s status, but he was currently in a position no one could touch.

If the first prince followed Luciella’s suggestion and demanded an apology from Ray, instead of succeeding to the throne, he might end up dead, unnoticed by anyone.

Who could escape when faced with someone who could mold the heart of a dragon like clay?

However, this fact was not publicly known in the empire.

Neither the first nor second princes, let alone Luciella, would be privy to this information.

Only the first prince knew, having heard it directly from the Emperor.

Luciella stood up from her seat.

“Ah! This is so irritating!”

She left the room, slamming the door behind her.

Outside the window, figures were watching her.

Heukyeong, with a cold gaze, sent a signal.

-Hongyeong, that person will definitely cause trouble for the Saint. Shouldn’t we deal with her in advance?

The Seven Shadows.

Without a direct command, they had followed Ray from the Holy Kingdom to the empire.

Soyeong received her signal.

-Shouldn’t we wait until that immature princess actually does something? The Saint himself said not to interfere.

“……”

It was almost like an order.

After a moment of contemplation with closed eyes, Hongyeong shook his head.

-Let her be for now. There are instructions from him… We’ll just observe as much as possible.

There was no objection, as expected.

Hongyeong oversaw the Shadows, and her command was the second most important after the Saint’s.

They slightly bowed their heads in agreement.

-If Hongyeong says so…

-We follow Hongyeong’s command.

- But if they start plotting something serious and try to harm the Saint…

Hongyeong’s eyes flashed with a bloody glint.

- Then take immediate action.

Hongyeong did not permit indiscriminate killing.

Permission was granted when there was perceived harm to the one they served, when the Dain family was involved, or when personal judgment deemed killing necessary.

Although the princess was of the empire and the Saint’s command existed, this was permission to kill if necessary.

Thus, Luciella had the dubious honor of being under the intense surveillance of two of the Shadows.


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