WeTried Translations
Translator/Editor: Haruto
Discord: https://dsc.gg/wetried
◈ The Dark Fantasy Doctor Was Mistaken for a Saint ◈
Chapter 76: Good Healer (4)
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* * *
I had just met Ayla in the hallway.
Since it was her first day, I wanted to show her around the clinic.
But the situation did not allow it.
“Patient report, please.”
“Male in his forties, fell at a construction site. His consciousness is deteriorating, and his left pupil has begun to dilate.”
The healer reporting had spent the past few months at this clinic training exclusively in stroke cases.
Of course, by twenty-first-century standards, it was still lacking.
But by this era’s standards, it was a remarkably solid briefing.
“How dilated is it?”
“Eight millimeters.”
“Understood.”
I examined the patient’s head.
The surgical site had already been shaved and disinfected.
The assistant healers had handled it before I arrived.
We had been working together for several months now.
At this point, we understood each other without needing to say much.
“How long has it been since the cocaine was applied?”
“Five minutes.”
“Then I’ll begin the craniotomy.”
I picked up a scalpel from the instrument table.
It was my custom scalpel, made after repeatedly modifying a silverwork razor blade.
The tip of the scalpel touched the small bump in front of the patient’s ear canal.
Starting there, I made a wide curve around the ear and up to the crown of his head.
A question-mark-shaped incision.
The thin red line gradually thickened.
I immediately spoke to the assistant healer.
“Refresh.”
“Refresh.”
The assistant healer repeated my words and used divine magic on the incision.
Refresh was a spell even lower in rank than low-grade Heal.
It simply bathed the target in divine power, without a catalyst, symbol, or spell formula.
Because it was so simple, it could only stop bleeding from capillaries and provide a little relief from fatigue.
But that was enough to stop bleeding from the incision.
“Forceps.”
“Forceps.”
I clamped the incision and peeled the scalp back.
The white skull was exposed.
“Give me the hammer and chisel.”
“Yes.”
I positioned the nail against the skull.
Normally, there was a special head drill called a perforator.
It could not be made in this world.
So I used a nail and hammer instead.
Tap, tap!
First, I made grooves in the skull.
“Trephine.”
I received an instrument resembling a wine opener and drilled a hole.
You might worry about what would happen if I misjudged the force and went too deep.
It was also a question other healers often asked.
My answer was always the same.
“It would be unfortunate.”
This was how they opened skulls in the world where I had lived.
Surgical perforators stopped automatically if they touched the brain, but that was twenty-first-century technology.
In the twentieth century, when romance was alive and well, they performed brain surgery with nails, hammers, and wine openers.
And if they made a mistake?
Well, they had contributed to the advancement of medicine.
Anyway.
Five holes were completed along the edge of the skull.
“Gigli saw.”
I took the thin, sturdy wire saw.
It was an expensive wire saw plated with mithril, one of fantasy’s favorite materials.
I pushed the wire saw through the first hole and pulled it out through the second.
Holding it with both hands, I sawed back and forth.
After repeating that several times, a solid line formed in the skull.
“Elevator.”
I inserted the elevator along the edge of the bone flap I had cut free.
Applying force with the principle of the lever...
Pop.
Skull lid off. Success.
“Please place the bone in saline.”
The opened skull flap was placed in saline.
Now it was time to inspect the brain.
“The hematoma is severe.”
A dark red clot beneath the dura was pressing down on the brain.
As I examined the hematoma, I sensed someone behind me.
It was Ayla.
With her back against the wall, she stood at a distance where she could not touch anything, staring blankly at the operation.
Her face looked pale.
It was a common reaction among medical students entering an operating room or anatomy lab for the first time.
“Student Ayla.”
Ayla flinched at my call.
“Most seminary students collapse at this point. But you seem all right, Student Ayla.”
Other healers occasionally brought acquaintances or their children to the clinic.
Most of them were seminary students hoping to become healers.
The majority fainted on the spot when they saw scenes like this.
But Ayla had not collapsed.
“Do you feel like you absolutely can’t bear it?”
Ayla shook her head.
“That’s good. Let me know if it gets too difficult.”
I knew this was harsh for a girl who had only just awakened divine power.
But it was a reality she would have to face someday.
Even if it were not in my operating room, this was a rite of passage she would eventually go through.
According to the healers, novice healers were generally put through something like this.
They showed them horrific images, traces of injuries, or actual scenes to prepare them mentally.
If they did not steel themselves, they would break down at the most important moment.
“You disinfected your hands before coming in, so don’t touch anything. Just stand there. You’ll be participating in the surgery soon.”
“Yes...”
Leaving Ayla, who answered weakly, alone.
The next step.
“I’m incising the dura. Prepare suction.”
“Suction is ready.”
I placed the scalpel against the dura and made a cross-shaped incision.
Gush.
The moment the membrane split.
The trapped blood, a subdural hematoma, poured out.
The clot that had accumulated between the brain and dura burst out all at once.
“Suction.”
“Suction.”
Repeating my words, the assistant healer brought the manual suction device to the blood pooled around the brain.
With a hissing sound, they began pumping out the blood.
Meanwhile, I turned back toward Ayla.
“Student Ayla.”
“Yes!”
“Do you know why Heal cannot treat a person with a head injury?”
“I’m not sure!”
Of course she wasn’t.
She was still a seminary student before she was a Healing Studies Department student.
To explain it to Ayla, and to review it with the other healers in the operating room, I raised my voice.
“Heal is magic that heals wounds. It is excellent for reconnecting torn blood vessels or broken bones.”
As the assistant continued pumping, the extracted clots were placed in a bucket.
“But Heal cannot remove blood that has already pooled. It cannot remove rotten toxins either.”
Heal was regeneration.
Not removal.
“This patient lost consciousness because blood pooled in his head is pressing against his brain. So even if you regenerate the torn blood vessels with Heal, the blood that has already escaped will still be pressing against the brain.”
I pointed to the hematoma being drawn out by the suction device.
“That’s why we open it directly and drain the blood like this.”
“Ah...”
“Before I explained this procedure, people mistook it for black magic. Right, Assistant?”
“Ha ha...”
The assistant healer gave a dry laugh.
When this person had first heard that I intended to open an unconscious person’s skull, they had demanded to know whether I was planning to use black magic.
Once I explained the principle, the misunderstanding was quickly cleared up.
“At the time, Director, you suddenly said we needed to open an unconscious person’s head and touch their brain without explaining the principle first...”
“Did I put it like that?”
I didn’t remember very well.
Anyway.
“You feel better now, right?”
I asked while checking Ayla’s complexion.
Ayla nodded.
Her face looked much better than before.
“The difficult part of entering an operating room for the first time only lasts a moment.”
As I examined the brain’s surface for the source of the bleeding, I continued.
“People cannot bear to watch cruel things because malice lies at the foundation of those acts. But even the same scene feels different once you know it is being done to save someone.”
I glanced at Ayla.
“What do you think? Now that you know why we open the head, does this surgery still feel as frightening as it did at first?”
Ayla shook her head.
“No... I think it feels much better than before.”
“Strange, isn’t it? Nobility is what makes people strong. Simply holding kindness and faith in our hearts can give us this kind of courage.”
Ayla nodded.
The assistant healers nodded silently as though they agreed with me.
A doctor’s tolerance for gore was proportional to their knowledge.
Why this surgery was necessary.
Why this person was dying.
What I could do for them.
The more clearly you understood those things, the stronger your stomach became.
Of course, there were classmates who could never enter an operating room even after understanding all that, but that was simply their nature.
“Good. Then come closer, Student.”
The pumping had ended while we were talking.
I had also identified the bleeding vessel.
The upper left parietal lobe.
A bridging vein had ruptured.
I immediately ligated the vein in several places with thread, then called Ayla closer.
“Student Ayla. You said you could use Refresh, correct?”
“Yes? Yes...”
“Now then, were you taught that Refresh can stop bleeding?”
Ayla shook her head.
“I heard that hemostasis requires at least low-grade Heal. Refresh should only be used to relieve fatigue and restore stamina.”
“Exactly. You studied well. Textbook-wise, that is the correct answer.”
I pointed to the bridging vein I had finished ligating.
The bleeding had stopped because it was tied with thread.
But the blood vessel itself had not regenerated.
If the thread came undone, it would bleed again.
“Now, use Refresh here.”
I pointed beside the severed blood vessel.
At the torn vessel.
“...Here?”
“Yes. Could you use Refresh once on the part I tied with thread?”
Ayla carefully reached out her hand.
A faint light bloomed at her trembling fingertips.
The moment Ayla’s divine power touched the ligated area, the torn vein twitched.
Soon, the hole in the blood vessel closed.
Ayla did not seem to have noticed the change yet.
So I untied the thread to show her.
“There. Refresh stopped the bleeding, didn’t it?”
“Huh? H-How?”
“Because the right conditions are in place.”
Divine magic was ultimately one branch of magic.
Only the resource was divine power. From catalysts and symbolic resonance to conditions, its principles were the same as any other magic.
“Student Ayla. If you were using magic to set wet wood and dry wood on fire, which would be easier to ignite?”
“The dry wood?”
“Right. You could ignite dry wood with low-grade flame magic, but wet wood would require more mana and a more complicated spell formula.”
A representative example was plague curses, which were now becoming increasingly rare.
Because of immunity built up through vaccination, the mana required to inflict a curse had increased exponentially.
That was why plague curse casters were so desperate to kill me.
This surgery was an extension of the same principle.
“Divine magic is the same. If you prepare the proper conditions, you can create the same miracle with less divine power and lower-level divine magic.”
With a can of oil, low-grade flame magic could produce the firepower of intermediate flame magic.
In the cold north, you could use less mana to cast more powerful ice magic.
And when a patient received proper first aid, a miracle could be created with less divine power.
Depending on the case, even low-grade Heal could save a patient with a brain hemorrhage.
“Healing magic has developed in that direction until now. Vein ligation is the same kind of technique.”
A blood vessel pouring blood could barely be stopped even with high-grade Heal.
But if the torn area was sutured with thread, even Refresh could close it.
Of course, that was only possible because it had been torn rather than completely severed.
“Now, shall we finish up?”
After that, I regenerated the severed blood vessels with low-grade Heal.
The remaining vessels were still beyond what Ayla could handle.
Refresh could only regenerate slightly torn blood vessels.
The rest could only be regenerated with low-grade Heal.
After regenerating the vessels and stopping the bleeding.
“Once the swelling in the brain goes down, we’ll cover it with bone in a few days.”
The brain was severely swollen, so I decided to cover it only with flesh and leave the skull off.
Of course, I could have used Heal to reduce the swelling.
But then this priest would have no divine power left for the next patients.
Priorities and focus.
It was an unavoidable choice in a world with limited resources.
“His pupil has returned to four millimeters.”
The decompression had been successful.
“Now, shall we close the scalp?”
It was time to place the peeled-back scalp in its original position and suture it.
“Student Ayla, are you good at sewing?”
“I sometimes help mend my mother’s priest robes.”
“Good. Healers should be good with thread. Watch carefully how I do it.”
I handed the sutures and needle to the assistant healer.
“Assistant Tai, please suture from the left. I’ll take the right.”
“Yes, Director.”
The assistant healer took the needle and began stitching the head, one stitch at a time.
Meanwhile, I sutured the wounds on the right as I usually did.
By the time the assistant healer had finished suturing one incision, I had sutured all the rest.
After checking the tension on the final thread.
“We’re finished. Check the surgical instruments.”
While the other healers checked the used gauze and instruments.
I placed disinfected gauze over the sutured scalp.
Then Ayla carefully asked a question.
“Director... I think this will leave a large scar later. Can’t we finish it cleanly with Heal?”
“Good question, Miss Ayla.”
A surgeon also had to consider cosmetic aspects.
Especially with surgeries on the head, where procedures that left fewer scars had been researched separately.
Treatment was not simply about removing disease. It was the process of returning a patient to daily life.
Cosmetic concerns could never be ignored.
“Appearance is important. But we will not do that now.”
“Why not?”
“Because we need to open it again in a month and put the skull back in place.”
I pointed to the skull soaking in saline.
“And it is better for the scar to remain, so we do not get confused when we put the skull back in later. We will Heal everything then.”
Ayla made an expression of understanding.
“I did not know that.”
“It was a good question, Student Ayla. I hope you will always continue to think of the patient’s perspective first.”
I removed my gloves and left the operating room.
“All right, it’s late, but now I’ll show you around the clinic.”
Author’s Note
A frightening fact.
The patient remains conscious during the surgery above.
Cocaine is not a general anesthetic.
So in the early days of craniotomy, patients could hear every sound of their skull being opened.
It is said that patients who underwent surgery at the time complained of extreme fear.
Truly, the twentieth century was an age when romance was alive and well.
Even today, depending on the circumstances, brain surgery may be performed while the patient remains awake.
Footnotes:
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