NOVEL ONLINE FREE Chapter 64
Chapter 64: Summer Vacation Plans (1)
****
The event concluded in grand fashion. Dean of the Academy’s Department of Healing, Professor Fredolin Fisher, sat smugly at his desk, his silver hair gleaming under the light.
“Did everything go as I said?”
“Yes.”
One of Professor Fisher’s graduate students, Alaine, nodded. Indeed, things had unfolded exactly according to Fisher’s plan.
Fisher’s masterstroke was this:
During the Monster Hunting Festival, all patients should be sent to Professor Asterix whenever possible.
This strategy stemmed from lessons learned during the Swordsmanship Tournament.
Thanks to that professor, despite numerous serious accidents, no one died or suffered life-threatening injuries, and the event wrapped up successfully.
In truth, among the faculty of the Department of Healing, there were fewer professors with normal personalities than abnormal ones. Compared to others, Professor Asterix could almost be considered… well, relatively normal.
To say that would, frankly, be a lie. Anyway…
“What did that professor say?”
“He didn’t say much.”
“Good job.”
Fisher nodded approvingly.
Among the patients treated by Professor Asterix during the event, there were some with severe conditions.
Patients who collapsed unconscious for unknown reasons, or those whose hearts were damaged in monster attacks—these were the rumors circulating in the hospital wards.
The most shocking rumor was about a patient whose heart was surgically opened while they were still alive. Fisher thought it was probably exaggerated.
“What happened with the patient who had heart damage? There’s a rumor that Professor Asterix operated on their heart. Isn’t that a bit too far-fetched?”
Alaine hesitated before answering.
“I asked one of the nurses. Apparently, the professor made an incision below the fourth rib and accessed the heart through the gap between the ribs.”
It wasn’t easy to believe. What benefit could come from opening the heart?
Fisher squinted suspiciously.
“Are you serious?”
“Yes, I am.”
“Feels more magical than actual magic. Did he really open the heart? Is the patient still alive?”
“I saw them myself—they’re alive.”
“Strange. The theory of bloodletting has been discredited for ages now. Why would Professor Asterix, who favors modern techniques, use such an outdated method?”
“Maybe… because it was necessary?”
“Nah. If it wasn’t needed, he wouldn’t have done it, right?”
“Ah, yes, you’re right.”
Fisher looked at his graduate student with an expression of exasperation. Of course it was necessary—that’s like saying if you’re hungry, you eat food. Obvious stuff.
Not entirely wrong, though.
“Alaine, go ask Professor Asterix what exactly he did to that heart patient. Was it really surgery?”
“Yes, sir.”
“Heart surgery is supposed to be impossible. Why did he open the heart, and how did he succeed?”
Alaine nodded, equally curious. Why cut through the ribs and draw blood? What purpose could it possibly serve?
Common sense says that if you open someone’s heart and drain blood, they’d die. Yet somehow, the professor managed to save the patient.
****
The diagnosis of sepsis, often called the “king of internal diseases.”
In reality, even modern doctors debate over its criteria. While body temperature can indicate infection, other factors like a heart rate of 90 beats per minute and respiratory rate of 20 breaths per minute might also result from strenuous exercise.
Body temperature, heart rate, breathing rate, white blood cell count—if two out of these four metrics are abnormal, it qualifies as systemic inflammatory response syndrome (SIRS). Following textbook protocols, medical professionals treat accordingly.
Some argue that the concept of SIRS itself should be retired. After all, many patients exhibit heart rates and breathing rates above 90 and 20 respectively, but treating them all for sepsis isn’t practical.
After extensive discussions, the academic community officially retired the term “systemic inflammatory response syndrome,” though it remains relevant clinically.
To introduce sepsis diagnosis, they developed something called SOFA scores—but details escape me. Regardless, SIRS remains a useful concept.
Monitoring heart rate, breathing rate, and body temperature provides quick indicators of potential sepsis—a significant advantage. Clearly evident in today’s situation.
Was my explanation clear enough?
Sorry, I got carried away explaining.
****
I was explaining to Istina what sepsis is and how to respond to it. It might be complicated, but…
“To summarize, that’s basically it.”
“Ah… I see.”
“Not perfectly accurate, but since this patient is high-risk for sepsis, any characteristic symptoms would confirm the diagnosis.”
Istina adjusted her glasses, which she occasionally wore. That look meant she was deep in thought, trying to understand.
I reconsidered my wording. How could I explain it more simply? Istina frowned after pondering for a moment.
Of course! Now it’s Istina’s turn to say, “I don’t get it.”
“I don’t understand what you mean.”
Ah, so my explanation fell flat.
Since Istina didn’t grasp it, let’s revisit the basics. What causes sepsis?
Specifically, cytokines—proteins signaling inflammation—are released throughout the body, causing systemic inflammation.
This is the systemic inflammatory response we discussed earlier. If bacteria cause this reaction, it confirms septicemia.
“Do you know what inflammation is?”
“Yes.”
“Right. When your body reacts to inflammation, there’s swelling, fever, redness, etc., right?”
“Yeah.”
“If this reaction occurs systemically, rapid pulse, increased breathing, and high fever may occur. Monitor for these signs—it suggests possible infection at the surgical site.”
Istina jotted something down in her notebook.
“So, sepsis happens when bacterial inflammation spreads through the bloodstream, right? Since this patient’s pericardium was exposed to outside air, they’re prone to it?”
“Exactly.”
Precisely correct.
If hygiene management fails, post-surgery sepsis can occur. Given our current conditions, such incidents are likely.
“Oh, I think I get it! We’ll keep an eye on whether the patient’s body temperature rises or if they start breathing faster.”
For doctors, conclusions matter most.
“One last thing: how do we treat bacteremia or sepsis?”
“Ah, that?”
The most important part is monitoring the patient.
“Administer antibiotics and intravenous fluids, and monitor the patient closely to ensure they don’t suffocate.”
Still complicated.
When suspecting bacteremia, take blood samples for culture, administer antibiotics, connect IVs, and monitor the patient continuously.
Blood cultures aren’t feasible here, and antibiotics aren’t readily available unless specifically requested.
“What are antibiotics?”
“Medicine that kills bacteria.”
We could potentially create antibiotics. Ideally, penicillin would be great, but it’ll take time.
Question time is over. Istina folded her notebook and stretched her legs.
“By the way, Professor, the new graduate student… was her name Amy?”
“Yeah, that’s her.”
“Got it. I’ll arrange for her to shadow us when she arrives. Maybe we can grab lunch sometime…”
Istina’s face brightened as she gazed off into the distance. Plenty to do indeed.
New papers need drafting, old ones require revisiting, questions about past publications must be answered, and antibiotic production needs exploring.
Most importantly, training the new grad student awaits. Hopefully, more will join besides Amy.
“Istina.”
“Yes?”
“Go home early. I have some cleaning up to do.”
“Can I stay a bit longer?”
Sure, do as you please.
Istina sprawled out on the lab sofa.
****
The next morning, upon arriving at the lab, I found a familiar face already seated inside.
Imperial Princess Mint.
“Long time no see, teacher.”
Honestly, it wasn’t that long. We met just the other day. Nevertheless…
Mint gestured for me to sit beside her. Lately, she seems somewhat restless, perhaps due to the humid weather and frequent rain.
Her overall demeanor remained unchanged.
Neatly dressed in her royal uniform, her soft golden-brown hair framed her delicate features. Her large eyes were wide open, and her hands fidgeted nervously.
Though her expressions have grown more varied compared to before, her inherent aloof, doll-like aura persists.
“We met the other day.”
“True… seeing you too often loses its charm.”
“I’m glad to see you, Your Highness.”
“Could you hurry up and sit already?”
Well… can’t argue with that. I obliged and sat beside Mint. She smiled faintly, covering her mouth with her hand.
What brings her here today?