WeTried Translations
Translator/Editor: Haruto
Discord: https://dsc.gg/wetried
◈ The Dark Fantasy Doctor Was Mistaken for a Saint ◈
Chapter 107: Miracle (2)
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IO (intraosseous access)
It is a method of administering fluids or medication through bone instead of a vein.
The principle is simple.
Contrary to how they look, bones are hollow inside and directly connected to veins.
Therefore, if fluid is injected into the bone, the medication flows through it and into the veins.
Most drugs used intravenously can also be used through IO access. And unlike thin veins, bones are large, so the chance of failure is very low.
But after hearing that much, a natural question probably comes to mind.
“If it’s easier to access than a vein and has no medication side effects, why not always use the bone?”
It sounded like a procedure with no drawbacks at all, so why were people who had experienced it so rare?
The reason was simple.
“Ugh...! Aaaagh!”
“Gregor! Hold her tight!”
“Aaaagh!”
“Endure it! You must hold on!”
It hurt like hell.
From the moment the needle went in, all the while the fluid was being administered.
Enough to pull a mother hovering at death’s door from puerperal fever straight back into the land of the living.
A needle was going into her bone. Of course it hurt.
“Saint... are you sure this is all right?”
Gregor pressed down on the mother’s shin as he anxiously questioned me.
He was skillfully restraining the struggling patient so she would not injure herself.
“Yes. You’re doing well.”
As I spoke, I connected the needle in the bone to the fluid line.
Then I looked at Erpen.
“Erpen, could you keep pumping the fluid?”
“Wouldn’t it enter too quickly and burst her veins?”
“That would be true if it were going into a vein. But we’re putting it into the bone.”
The inside of a bone was hollow, but it was filled with bone marrow.
Unlike veins, bone marrow did not flow, and it had considerable pressure.
Simply raising the fluid bottle would not make the medication enter the bone.
That was why IO access had to be pumped by hand.
“How long must I keep doing this?”
“Prontosil needs to maintain a certain concentration in the blood for a certain period before we can expect an antibacterial effect. We must keep administering it until the patient is back on her feet.”
Then I remembered Erpen’s position and amended my words.
“You can have another junior healer do it.”
“No. It feels good, as though I’ve returned to my roots.”
The director smiled as they pumped the fluid.
A junior healer fidgeted anxiously beside us.
“It’s been so long since I felt the thrill of learning.”
Probably three hundred years.
I swallowed those words and refocused on the patient.
The mother thrashed as Gregor restrained her.
Erpen, who had been watching her worriedly, offered an opinion.
“Isn’t the injection too painful? Perhaps a little anesthetic would help...”
“It wouldn’t.”
I rejected the suggestion firmly.
The pain of an intraosseous injection came less from the needle and more from the fluid filling the bone.
Fluid was filling a space that should have remained empty, pressing steadily against the bone from within and tormenting the patient.
Local anesthetics were not particularly effective against this kind of pain.
General anesthesia could not be used either, because sepsis patients faced a risk of respiratory depression.
In the end, this patient’s suffering was hers alone to bear.
“This degree of pain won’t kill her.”
“Mmph...!”
“Gregor. Gag her.”
“Understood.”
“Mmph!”
It was not good for the Marquis’s wife’s dignity, but it could not be helped.
Dignity only mattered if one was alive to preserve it.
A few minutes passed as we struggled with the patient.
“The time is up. The antibiotic should have spread through her body by now.”
“Understood. I’ll cast Heal at once.”
Erpen, who had been pumping the fluid, formed a spell formula.
But then,
Crash!
“It fizzled. I must have miscalculated the concentration in the body fluids.”
Perhaps they were not used to sensing antibiotics and bacteria in the blood, because the spell failed once.
“I’ll cast it again. Putting it into the bone instead of a vein must require some adjustment.”
Erpen cast Heal once more.
This time, warm light successfully seeped into the mother.
‘Perhaps healers can calculate things like this on the spot because they’re mages.’
It was a skill I did not possess.
They calculated the ratio of harmful and beneficial energies flowing through a human body, then reflected it in their spell formula.
There was no way an ordinary person like me could do that.
‘I should leave the therapeutic concentration of antibiotics to the healers.’
My role ended here.
Once I developed the medicine and confirmed that it worked, the rest was the healers’ responsibility.
It was also the limitation of a healer who could not use divine magic, isolated from everyone else in this world.
As I thought that, the patient’s fever began dropping rapidly.
“Hah... huff...”
I placed my stethoscope against the rapidly breathing mother’s chest.
Wet crackles came from her lungs.
‘Pulmonary edema?’
It was a complication that could easily appear in puerperal fever worsened by sepsis.
Fortunately, someone capable of handling pulmonary edema was present.
“Erpen.”
“Speak.”
“One last bloodletting, please.”
“Did you not say bloodletting was pointless in sepsis?”
“It would be pointless if the bacteria were multiplying.”
As I spoke, I beckoned the elderly elf closer and held the stethoscope to their ears.
Erpen focused on the mother’s breathing.
“This sound is...”
“Her lungs have filled with fluid.”
The bacteria had disrupted the osmotic pressure in her body, causing fluid from the blood to fill her lungs.
Now, a question.
If the lungs had filled with fluid, what was the fastest way to remove it?
“It’s time for bloodletting.”
“Correct.”
Strictly speaking, what she needed was not bloodletting but emergency dialysis.
To explain in more detail, pulmonary edema accompanying sepsis was first treated with diuretics.
They removed the fluid through urine.
If the diuretics did not work well enough, emergency dialysis was performed.
But we had no diuretics here, so we would leave it to our high-performance bloodletting machine, Erpen.
“Then if this kind of breathing difficulty is observed in a sepsis patient, should bloodletting be performed?”
“Hmm... I’ll explain the details later.”
“Very well!”
Erpen eagerly began preparing to bleed the mother.
Watching them skillfully cut into the inside of her thigh, I was impressed.
‘Oh, using the femoral vein? They really are an authority on bloodletting.’
There was an order to the veins used for bloodletting, or rather, dialysis.
First was the jugular vein.
Second was the femoral vein.
This patient’s veins were difficult to see, so Erpen was approaching through the femoral vein, which had a relatively low chance of failure.
Erpen then inserted a tube into the vein, cast Heal, and replaced the blood with fresh blood.
The elf healer’s eyes shone as they watched the blood fill a bucket.
“I have found a new method of bloodletting. Thank you, Saint.”
“...”
Why were they so obsessed with bloodletting?
I wanted to ask, but held back.
I did not want to hear a long, sprawling epic of bloodletting stretching back three hundred years.
As I left the patient in Erpen’s care, a healer approached and whispered to me.
Whisper, whisper.
The moment I heard the news, I turned my back on the sickroom.
Gregor followed me out.
“Saint, where are you going in such a hurry?”
“To the Lafabri Sect’s healing center.”
“What business do you have there...?”
“I’ve just heard news regarding what will be done with the Lafabri Sect.”
“What will be done with them?”
“Yes.”
A few days earlier.
Right after the Lafabri Sect announced that it did not support the germ theory, I had considered how they should be dealt with.
No matter how much they valued their own lives, denying the germ theory was little different from shirking responsibility.
As I considered their punishment,
“Seeing what happened today has convinced me. At the very least, those people did their best in their own positions.”
The moment they concluded that they could not save the patient, they sent her to us.
That convinced me that they deserved a chance.
“I’ve spoken with the Inspectorate. The Lafabri Sect will not be held responsible for any of its mistakes thus far.”
“The... Inspectorate?”
Gregor looked at me in surprise.
A pardon from the Inspectorate was no different from an imperial pardon.
Ignoring it and punishing someone anyway would be practically the same as disregarding the Imperial Family’s authority.
Naturally, Gregor was shocked that such an organization would pardon the Lafabri Sect.
“May I ask why they were able to receive a pardon?”
“Ah, well...”
A dry laugh escaped from beneath my crow mask.
“This will take a while to explain. I’ll explain it in the car on the way.”
* * *
A few days after Prontosil began to see full-scale use at Adamberta Healing Center, the Lafabri Sect abruptly reversed its position on the germ theory.
[Our sect also actively supports the germ theory, and from this moment onward, we declare that all midwives will be employed as honorary healers of the Lafabri Sect.]
The greatest reason for their sudden change in attitude was the Inspectorate’s pardon.
[From this moment onward, the Inspectorate shall ensure that imperial law cannot hold the Lafabri Sect accountable for any “mistakes” it has committed thus far, nor shall it permit any disadvantage to befall them.]
The Inspectorate’s sudden support for the Lafabri Sect.
Three major factors lay behind that support.
And in a visiting room at Eschenwald Academy, Gregor, the Black Saint’s holy knight, was discussing the matter with the woman seated across from him.
“What are those three factors, Brother?”
“One is Viagra.”
Viagra.
The final bastion for men of this era who had lost their virility for countless reasons, including spinal injuries, drug addiction, heavy-metal poisoning, side effects from magical experiments, and the passage of time.
Since the appearance of this miraculous medicine, it was no exaggeration to say that the Empire’s reproductive age limit had risen dramatically.
“I hear even the head of Count Horn’s house, who took a concubine late in life, recently had a child.”
“Wasn’t he in his fifties?”
“I could scarcely believe it when I heard.”
Gregor’s beard twitched as he let out an incredulous laugh.
“And it isn’t only the count’s house. Similar news is frequently heard from other nonhuman couples. More children are being born with every passing day.”
“The Lafabri Sect must be busy.”
“Indeed.”
It had been roughly three years since Viagra was introduced.
During that time, the number of births had risen by nearly twenty percent.
“And second, we must pay attention to vaccines.”
Vaccines.
The means of preventing the epidemics that had claimed the lives of more children than anything else in this world.
“Since vaccines were introduced, child mortality has fallen exponentially.”
It began with the smallpox vaccine, but other vaccines had gradually begun appearing recently.
There were still only three kinds.
Even so, the number of children who safely reached adulthood had nearly doubled.
The number grew even larger when children spared from disability were included.
“More children are being born, and unlike before, they are less likely to fall seriously ill. On top of that, the Saint has recently created...”
Gregor stopped and looked around.
After checking his surroundings, he lowered his voice until only the woman across from him could hear.
“Don’t speak of this elsewhere. The Saint recently created a medicine that kills bacteria. It will be revealed in a few months, so tell no one until then.”
“All right. But what does that have to do with the Lafabri Sect?”
“That medicine treats postpartum fever.”
“...What?”
The woman murmured blankly.
“Postpartum fever...?”
Postpartum fever.
The leading cause of death for women in this era.
And the most common reason many children lost their mothers.
Even the finest senior healers had been unable to do anything about that disease.
And now, a medicine to treat it had appeared?
“Then if it had only come a little sooner, our mother too...”
“...”
The two fell silent and lowered their heads.
The woman broke the silence with a joke, trying to lighten the mood.
“If a medicine that truly treats postpartum fever has appeared, the nonhuman peoples’ populations will increase dramatically.”
“I imagine so. The beastfolk population may double in particular.”
She nodded at Gregor’s words.
“I understand what you mean, Brother. But why does that relate to pardoning the Lafabri Sect?”
“Both the Church and the Empire believe the birth rate will rise by one and a half times, perhaps even double. And if the Lafabri Sect properly assists childbirth, the population will grow explosively.”
“That is why they are being pardoned.”
“Yes.”
Population was national strength.
Of course, population overcrowding was not desirable.
But for humanity, which could be destroyed by magical beasts at any moment, more people were better for now.
“That is also why they hired so many midwives.”
A healer was not especially needed to deliver a child.
The midwives would deliver babies, while healers treated any complications afterward.
“Then if even the Lafabri Sect has acknowledged the existence of bacteria...”
“Only the Mensia Sect remains.”
The woman nodded.
“That explains it. My friends in the Healing Studies Department have been saying that the Mensia Sect’s days are numbered. So this is why.”
“Yes.”
“Thank you, Brother.”
The woman rose from her seat.
“Thanks to you, I can decide which sect to join.”
“I’m glad I could help. But I have one question...”
“What is it?”
“Are you not still a first-year student in Healing Studies?”
“In a few months, I’ll be a second-year.”
“Even so, you still have two years before graduation. And you will train for another four years at the Academy healing center the Saint is establishing for healer training. Doesn’t that mean you have six years left?”
The woman looked at Gregor as though he were absurd.
“You must choose your sect early and build connections while you are still a student.”
“If you say so...”
Gregor accepted the answer with some reluctance.
Then he remembered something and spoke to the woman as though offering a warning.
“Right. Father also told me to remind you that the Academy healing center opens next year. You know that, correct?”
“I know well, Brother.”
“The Black Saint will be there too, so don’t issue the Black Saint a challenge as you did to the other healers before, understand?”
“All right.”
“And not to the Saintess of the Lantern either!”
“I said I understand.”
The black-haired woman barely listened to Gregor’s warning.
“Instead, I hope you won’t take your clothes off inside the healing center, Brother.”
“What do you mean by that?”
Still seated, Gregor struck a pose that emphasized his forearm.
“A healthy mind resides in a healthy body. Showing this healthy body to the sick and inspiring them to desire muscles, isn’t that the best treatment I can offer?”
“Haah... I distinctly heard Father say you had improved...”
The woman clutched her head.
Just before she left the visiting room, Gregor spoke to the woman, Jenny Lailic.
“Right, Jenny. Father has something to tell you.”
“What is it, Brother?”
“He says to keep your gambling under control.”
Jenny flinched.
“Just in case, you’re not working as an assistant at the healing center because you spent all your allowance gambling, are you?”
“I don’t gamble these days...”
“What about horse racing?”
“...”
Jenny closed her mouth.
Gregor’s gaze sharpened.
“You haven’t borrowed money from a friend or something...?”
“I borrowed a little from my roommate...”
“How much?”
Jenny held up three fingers.
“Three copper?”
She shook her head.
“Three silver?”
She shook her head again.
“Surely not... three gold?”
Nnn...od.
“...”
“...”
“Please explain it well to Father.”
“I’ll tell him exactly what happened.”
“No!”
Jenny grabbed Gregor’s clerical robe and clung to him.
Gregor shook off his younger sister and shouted.
“Let go! Visiting hours are over! I must return to the capital!”
“I won’t! At least don’t tell him that I borrowed money from Charlotte!”
“I understand!”
“And that I’m working as a divine-power shuttle at the healing center?”
“That I must tell him. You were sent there to study, but you’re only earning gambling money.”
“Aaaagh! It’s practical training! Something like practical training!”
“Enough! Don’t talk nonsense!”
Gregor finally left the visiting room an hour later.
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