I Became a Plague Doctor in a Romance Fantasy Novel - Chapter 87



Episode 87. The Cause of Malingering (1)

Episode 87. The Cause of Malingering (1)

We moved to the drawing room of the mansion.

The first princess, Emily.

Miss Emily had changed out of her earlier pajama-like clothes, and into proper attire. The butler had been reassured and sent away temporarily.

What should I even talk about first?

“Oh, right. I think some cosmetics can be bad for you. Especially white powder.”

“Really?”

“Yeah, like lead. Lead is bad for your body. Cosmetics with lead in them should be banned, but there are still people making them.”

It’d be hard to expect regulations at a level similar to the modern day. Emily stared at the ceiling, as if she could see her own vanity upstairs.

“I see.”

“How long have you been sick?”

Meaning, how long have you been faking it? Emily must have understood it that way, too. The patient pondered for a moment before answering.

“About a month.”

“Why did you do that?”

A direct question. Emily glared at me. Maybe I should have asked more indirectly.

“I don’t want to tell an outsider right now. More importantly, how did you know?”

There were plenty of clues.

First clue, for starters.

“From the wound on your hand. That’s a wound from your teeth, from sticking your fingers in your mouth, touching the back of your throat to induce vomiting multiple times.”

“Ah.”

Amy examined the back of her hand.

As if she was seeing the wound for the first time. It’s a wound that formed over days, so maybe she didn’t think much of it.

Second clue.

“You hid books under the bed, didn’t you? I’m guessing you hid them, books you normally study with, or read for fun, so your family would think you’re acting crazy?”

“Ah… so you saw that.”

The third clue.

“For a crazy person’s room, it’s clean. Of course, it could be because it’s cleaned often, but also, the butler doesn’t seem scared of the patient.”

There’s no rule that people have to go crazy nicely. If she’d overturned a bookshelf once, her family would have removed it from the room. There’s a reason psych wards have soft, furniture-free rooms.

Emily closed her eyes.

“I feel like I’m being haunted.”

“Isn’t a healer someone who fights against disease? Catching ghosts is part of my job.”

Emily tilted her head.

“You’re right, I suppose.”

“So, why did you do it?”

The reason she came up with is important.

There must have been a valid reason, at least in this patient’s head, to feign madness in front of her family and force herself to vomit.

“Um…”

“I’m not trying to grill you. If it’s hard to talk about, you can think about it some more.”

“Okay.”

Emily shut her mouth.

It was frustrating, but I held back my annoyance.

There’s almost nothing to gain from confronting a patient. Especially a psychiatric patient. Better to build rapport or give her some time to think.

“If it’s because of anorexia or compulsions related to eating, there’s medication to relieve the compulsions, and if you’re feeling nauseous, there’s medication for that too.”

The patient shook her head.

“No… Like you said earlier, I did throw up on purpose, to act crazy. I’ve seen ghosts at home too…”

What’s with the ghost talk now? Do I need to add hallucinations to her symptoms? Or is this just an extension of her acting? I debated my word choice a bit.

“You saw ghosts?”

“Yes.”

Let’s just keep that in mind for now.

“Your parents are having a very hard time. How about you do what you want, Miss Emily, but also consider ways to alleviate their worries?”

I thought that was a decent gamble, but Emily’s reaction was lukewarm. Why?

“There’s no way they’re having a hard time.”

See? Definitely mental illness. Separately, I can tell Emily has some kind of psychological aversion to the Duke and Duchess. I don’t know the reason yet.

Actually, it’s a bit premature to jump to conclusions. Maybe Emily has a legitimate reason to blame her parents, when all is said and done.

“Think about how they must feel right now. Three of their children are bedridden. At this rate, the Duke and Duchess will drop dead from stress first.”

“Yes…”

Emily slowly nodded.

I know the vomiting was fake, but it’s too early to be sure about everything. Like I said before, healthy people don’t pretend to be sick.

My conversation with the eldest daughter, Emily, ended at that point. She was a much more frustrating person than I’d expected.

Seriously, just speak clearly. But I didn’t have time to just wait for answers, so I left her for the time being.

“Istina.”

“Yes.”

“Go to the garden and see what flowers are there. Also check when they were planted.”

It’s just a matter of going and getting the flowers.

Istyana nodded. But then immediately wore a look that said she was curious.

“Yes. But, didn’t we already conclude that the eldest daughter was just pretending to be sick?”

“All three of their children are saying they’re sick. We need to look into it. Even if the conclusion is that they’re pretending.”

“Isn’t it likely some personal matter? Lovesickness, or not liking her arranged marriage partner, or strict parents…!”

Isn’t that too obvious?

“Well, just go get the flowers first. If you want to ask the servants anything, do it on your own.”

“Yes.”

Istyana took a cloth wrapping and went out to the yard. Now, I need to go see the second daughter… What could be the problem there again.

I looked at the head butler.

“Sir, is it alright if I ask you a few questions too?”

“Yes. Um, let’s go to the kitchen.”

I followed the butler.

We sat at a small table in the corner of the kitchen. The butler was sitting at the table with a relatively bright expression. Still, the butler probably knows this family’s situation best.

Because the patient’s answers are weird.

“What is your name?”

“Please call me Anderson.”

“Mr. Anderson. You’re not ill, are you?”

“Am I getting a checkup, too?”

It was a question I asked out of habit, really.

“If you don’t have it, it’s okay. Have any of the patients ever sneezed from pollen or anything like that?”

“Pollen? I don’t know. I have seen them sneeze sometimes when they leave the house.”

– Sneezing when leaving the house.

“Regarding Miss Emily for now. Has she been stressed recently, or had anything that might have upset her? Like a broken heart.”

The butler hesitated for a while, then shook his head. What I was curious about was the reason for that hesitation. It had to mean he thought of something.

“She went on a blind date a month ago.”

“Ah. What did she say?”

“She just said it was fine.”

What the, maybe it really had little to do with anything medical. If I were to give a medical diagnosis, it would be something like an eating disorder and symptoms of depression.

“Does she wear a lot of makeup?”

“No. She hardly wears any.”

That’s a relief. Emily does use lead-based makeup, but it didn’t seem like that was causing the symptoms.

“That’s bad for you. Tell her to buy new makeup without lead.”

“Yes.”

“And get rid of the flowers too. She’s already not feeling well, and who knows what might add to the symptoms.”

“Okay. I guess so…”

“Let’s go see the second child now. What was it…this one, you said, has seizures, right?”

“Yes.”

“Is there any possibility it’s faking?”

“It doesn’t seem like it, from what I’ve seen. The seizures were surprisingly intense. In physiological terms, it’s called epilepsy, right? I looked it up.”

I nodded.

“It could be epilepsy, yes.”

We arrived at the door of Erissa, the second daughter of the Serulis Duke’s family. I paused before entering.

The second princess, Erissa.

“Does the Duke’s family only have three daughters?”

“Yes.”

“That’s peculiar.”

I’d heard talk like that before. People working in nuclear power plants, they said, only have daughters. The male Y chromosome is more vulnerable to radiation.

Was there radiation exposure nearby? Maybe, just maybe, the basement of the mansion had high radon levels. Probably nonsense, but…

Even I think that’s a bit much. Let’s just see.

I knocked on the door.

From noble mtl dot com

“May I come in?”

“Ye-es…”

Her voice was quiet, but she said I could come in. I entered the young Miss Erissa’s room.

The second daughter of the Serulis family definitely looked a bit younger than Emily, the one I’d just seen.

“Is the examination okay with you?”

“Yes.”

This patient was said to have seizures, right? I need to start by considering the type and cause of the seizures.

Let’s think about how to distinguish a real seizure from a pseudo-seizure. Generalized epileptic seizures are usually accompanied by severe confusion before and after, loss of consciousness, and a loss of avoidance response to danger.

A pseudo-seizure, simply put, is a seizure done on purpose. In the case of pseudo-seizures, a reaction to avoid danger usually remains. It’s rare to see injuries or urination during a seizure.

By the way, the correct term used these days is psychogenic seizure. But pseudo-seizure is shorter, so let’s call it that here.

What medical personnel tend to forget is that just because it’s a pseudo-seizure doesn’t mean it’s not an illness.

A pseudo-seizure is also a symptom of something. It’s not a seizure caused by epilepsy, but because something hurts, they’re having a pseudo-seizure.

“First of all, I’ve heard that you often have seizures. Did you notice any cause that you remember?”

Erisa stared at me with a blank look. Like she was saying, “What are you talking about?” Uh-oh, looking at her, it’s pretty clear she’s about to lie down again–

Just as I suspected. Erisa twisted her body grotesquely and then fell to the floor as if she’d collapsed. I sighed.

Now, how should I wake her this time? Should I try to insist that an enema is good for epilepsy…?