I Became a Plague Doctor in a Romance Fantasy Novel - Chapter 94



Episode 94. Erectile Dysfunction and Heart Disease

Episode 94. Erectile Dysfunction and Heart Disease

Amy pounded on the lab door and came in before getting an answer. I knew it was Amy even before she opened the door.

Isthina wouldn’t act like that. Too timid, she’d have waited for an answer before coming in.

“Professor.”

“Report on the patient.”

“Ah, yes. I’m here because of the patient. A patient collapsed during alchemy class. Breathing’s unstable, but there’s a pulse. They’re lying on a bed right now.”

“Suspected cause?”

“I don’t know. But since it’s the alchemy department…”

It’s probably poisoning.

They use a lot of toxic chemicals.

“First do a gastric lavage and give activated charcoal.”

“Yes.”

“You know how to do that, right?”

“Uh, what’s activated charcoal?”

“It’s made from charcoal powder. You’ll find it at the hospital.”

“Ah, I understand.”

Amy nodded.

The patient lay peacefully in the ward. No foaming at the mouth, breath a little slow, no symptoms of cyanosis or anything.

A young male patient, looked to be an academy student. No visible signs of external injury, no signs of self-harm.

I checked the patient’s eyes. No nystagmus, pupillary constriction reflex normal on both sides. Dodged the worst, at least, this patient.

If they’ve fainted often before, there might be bruises or scars on their elbows or knees.

I rolled up the patient’s sleeve, but there wasn’t anything there either. Not much to go on, it seems.

Is he in immediate danger of dying?

I checked the patient’s pulse again. The heart seems to be beating alright. No EKG, no blood tests. This is frustrating as hell.

Should I try an epinephrine shot?

While I was mulling it over, Amy came with the gastric lavage kit and activated charcoal. At least he’s still breathing fine. I took a step back, and Amy pushed the gastric tube into the patient’s esophagus.

“Are you sure it’s the esophagus? Not the trachea?”

“Uh, how can you tell?”

“Vocal cords and epiglottis. And the gag reflex.”

I put my finger in the patient’s mouth and pried it open. Looks like the esophagus, yeah. I nodded, and Amy started the gastric lavage.

Actually, doing a gastric lavage on an unconscious patient requires anesthesia and intubation. But there’s no ventilator, and intubation would be a real struggle. Anesthesia is risky, too.

The tail is wagging the dog. So we’re just doing the lavage first because we have to.

In about a minute, the patient opened his eyes. He started gagging with the tube still in his esophagus. Amy was startled and looked at me.

“Uh, what do we do?”

“What do you think? Take the tube out.”

The patient didn’t seem to understand what was happening, and he mumbled curses with his mouth as he gagged. Still out of it, I guess.

Amy removed the gastric lavage tube, and I gave the patient a handkerchief. He coughed and retched, wiping his mouth.

“Ugh, guuurk.”

“We thought you might have eaten something bad.”

“Uhhhgh.”

“Have you ever fainted before? Has anyone around you fainted recently?”

“Ughhh…”

The patient didn’t seem unable to speak, nor did they look like they had a headache. They were just unable to answer because they were gagging and throwing up.

If I’d known they’d wake up this quickly, I wouldn’t have done the stomach pumping. Guess I owe you an apology.

“Have you ingested anything strange recently?”

“No…”

Well, even if it *is* a poisoning, there’s no guarantee it was ingested. They could’ve inhaled something, absorbed it through their skin, or it might not even be a toxic substance at all.

At least they’re awake, right?

“Have you done any alchemy experiments recently?”

“Well, I do them quite often.”

“Any examples?”

“Making pyrite.”

Yeah, there are too many dangerous possibilities to even list them all. I pondered for a bit.

“There’s nothing you put in your mouth, right?”

“No.”

That’s the angle I should try.

Unithiol.

It’s a medication developed to treat arsenic poisoning, but it’s also effective against heavy metal exposure.

“Amy. Get that for me.”

Amy handed me a piece of gauze soaked in alcohol. I wiped the patient’s shoulder with the alcohol and prepared the Unithiol.

“What are you doing?”

“Injection.”

First, let’s try this Unitiol and see if the patient’s condition improves. I took out the syringe and injected the Unitiol into the patient’s shoulder.

“Ah.”

“It’s already over.”

Unitiol is used for exposure to various toxins like mercury, arsenic, heavy metals, and snake venom. If we’re lucky, they can return to their normal life in a few days.

We can figure out the reason for the pain later. Though, we need to think about it to prevent a recurrence, right?

“What’s your name, patient?”

“Bernard.”

The patient was still retching and coughing as if nauseous. I patted Bernard on the back. He looked to be in pain.

Maybe it’s the after-effects of the stomach pumping?

“Okay then, patient. Take the medicine we gave you and just wait a little bit. After we figure out what’s wrong, we’ll be back as soon as possible.”

Bernard nodded with difficulty.

As Amy left the patient room, she scratched her head.

“But, aside from arsenic poisoning, aren’t there other things that could cause fainting?”

“Yeah, there are.”

There really are a lot of things. If we ignore the alchemist context and consider all the possible causes of fainting.

Like vasovagal syncope, arrhythmia, psychogenic syncope, or hypotension.

“It would be good to have an ECG. Then we can check for arrhythmia.”

“What’s an ECG?”

“Yeah, I’m here.”

I heard that a hundred years ago, they had a way to measure ECGs by having the patient’s hands and feet submerged in salt water. That piqued my interest, but…

I have no idea how they even did that.

“Have you heard of orthostatic hypotension?”

“No.”

“When you stand up, your blood pressure drops momentarily as your posture changes. This can decrease blood flow to the brain, and you can faint. Or, it could be from psychological triggers.”

Amy nodded.

“But, it doesn’t seem like this patient fainted from a specific trigger. She just collapsed during class. And the others said they thought she was sleeping?”

“Right. Hold on a sec.”

Without any particular reason, suddenly, she lost consciousness, while still somewhat aware. Low blood sugar, psychogenic fainting, and arrhythmia – those are the only conditions that fit the bill here.

None of them were good. For a patient this young to have low blood sugar or arrhythmia, it was highly likely a hereditary condition.

Psychogenic fainting wasn’t good either. Because there’s no clear cure for that kind of thing.

“Let’s go take a look at the alchemy lab. There might be some substance there causing this.”

“Okay!”

We headed that way. We need to see what the patient was doing right before she collapsed. Maybe she was exposed to some unique toxin.

I decided to go check out the alchemy lab with Amy. Again, before entering the research building, we carefully put on our masks.

Luciana, who introduced herself as Bernard’s senior and friend, was guiding us.

“Luciana, long time no see.”

“Hello.”

“What’s going on?”

“Ah. Um, who was it, anyway, when that student collapsed, I was in the same class. I’m the TA for that class.”

“You’re having a rough time.”

“Yeah. I’m pushing to graduate as fast as possible, so I’m suffering, too. I feel like I’m going to collapse myself.”

“Hmm, just because you *want* to graduate early, doesn’t mean it’ll happen. The professor’s going to let you do that?”

“Yeah.”

*The professor seems like a good person. Helping a grad student trying to escape get out fast….*

Anyway. I glanced around. The lab wasn’t anything special, and it was already cleaned, so there weren’t many signs of the experiment left.

“Luciana. Since that student collapsed here, no one else has done any experiments, right?”

“No. I just cleaned up.”

I turned my head towards Amy.

“Amy. Don’t you smell something?”

“Uh, I don’t know… a sweet smell? Sort of like a bathroom smell, I can’t really tell what it is though.”

I think I know what it is.

I took off my mask just for a second. Yeah, that’s it, a sharp, acrid smell. There was a hint of sweetness mixed in, but overall, it was a foul and overpowering odor.

That’s it, *that’s* it.

“Luciana. What kind of experiment were you doing here?”

“I don’t know either.”

“Based on the smell, can you guess?”

It was a somewhat odd request, but Luciana sniffed the air a bit, then scrunched up her face.

“Yeah. Isn’t that, like, metal separation? Smells like the acid stuff used to melt metals.”

I thought something similar. The drug used in the experiment was probably nitric acid. The one that caused the fainting was likely nitrogen oxide derived from that.

“Do you know what it is?”

“Nitrogen oxide. If you ingest nitrogen oxide, your blood vessels dilate, blood pressure drops. You become more vulnerable to fainting.”

Also cures erectile dysfunction. These days there are better drugs than nitrogen oxide, but it used to be prescribed a lot for this purpose back in the day.

It’s also used to treat heart disease, too.

It can stop ischemia in the cardiovascular system by relaxing those vessels. Nitroglycerin is a prime example. It’s used as a drug to eliminate acute chest pain.

If a normal person ingests too much of this stuff, their blood vessels will dilate, and they could become susceptible to fainting like that patient we saw before.

And if they’re really unlucky, they might actually pass out. The mystery’s solved, wouldn’t you say?

“Ah. Is that so?”

Amy and Luciana looked at me with eyes that said they were hearing this for the first time. Well, it’s not common for people to have ingested nitric acid.

Our patient is a bit of an odd case.

“Go tell the patient. That they collapsed because of the drugs they were using in the experiment. Tell them to wear a mask or ventilate the place better going forward.”

“Yes.”

No further treatment seems needed, so that wraps things up. Amy rushed back to the ward, and Luciana let out a sigh of relief.

Right, there was something I wanted to ask Luciana.

“By the way. Where are you going after you quit grad school?”