I Became a Plague Doctor in a Romance Fantasy Novel - Chapter 95
Episode 95. How Do You Use a Stethoscope? (1)
Episode 95. How Do You Use a Stethoscope? (1)
From noble mtl dot com
Mint held two small spoons. *I didn’t even know there was ice cream in this world. How did they even make that?*
The meaningless thoughts shattered. Mint stared at me, then gestured for me to come closer.
“Hello.”
“Hey, sit down.”
Even if I’m a vassal, calling me “hey” every time is a bit much, isn’t it? I debated bringing it up, but figured it’d be pointless. I scratched my head.
“Are you going to call me ‘hey’ every single time?”
“Yeah. So what?”
*Ugh, I knew she’d say that.* I flicked Mint’s forehead with the tip of my finger.
“Ow.”
I sat down next to Mint. The princess scratched her head for a moment, then began to speak.
“There’s an interesting rumor going around, you know? That you went to the Serulis Duke’s mansion this time to prepare for your debut into high society.”
“That’s the first I’ve heard of it.”
“Huh?”
Mint hooked her arm in mine and leaned in slightly. Muttering something inaudibly. She seemed happy, so I decided to let it be.
I looked down at Mint for a moment, and after a while, I met her bright blue eyes. Mint blinked, then opened her mouth.
“It sounds like it would be fun to go.”
“I haven’t really thought about it. What would I even say in a place like that?”
“I’ll take you around! Everyone will love you. There are a lot of people curious about you, you know?”
“I’ll think about it.”
Mint smiled.
“They’re saying you got Princess Cerulis into the academy too. Weren’t you just trying to network and get into high society?”
I shook my head fiercely.
“No, that’s absolutely not the case…”
“Really?”
“Your Highness. You can’t just use patients like that. I’m not a crazy person.”
“But you bully your grad students.”
I scratched my head.
“Patients aren’t grad students. If Istina or Amy were rushed to the hospital, I’d treat them seriously too. And honestly, I’m actually really nice to my grad students.”
“You saying that doesn’t make it convincing.”
“Uhm.”
“I was a little bummed, you know? Why you’d go through the trouble of house calls to network with someone else, instead of sticking with me and that Manfred guy.”
“That’s a bizarre misunderstanding. It’s not true.”
Actually, the opposite. The duchess was trying some ploy to meet me, but when her connections didn’t work out, she just came to the hospital.
“That’s a relief.”
“I don’t know what you think of me, but I’m not that twisted, Your Highness.”
Mint unwrapped her arms from her chest and this time, she hugged me tight. She rested her head on my shoulder. I shuffled back a little.
“What’s wrong?”
“Feed me ice cream.”
I grabbed Mint’s face with both hands and pulled her off my shoulder. You’re getting spoiled.
“That’s a bit much, Your Highness.”
“Hng.”
Mint brushed off her skirt and sat down. She handed me a spoon that had been stuck in the ice cream bowl. I took it.
“It’s good. Try some.”
“Okay.”
I don’t know where she got the ice cream, but it was better than I expected. Though, it was more like a sherbet than the ice cream from back home?
Mint looked really happy.
“I have to go check on the ward soon.”
“Oh, is that so?”
“Yeah.”
“When will you be back?”
I don’t know. Things have been a little less busy lately, but I don’t think we’ll be able to hang out again before dinner. I have class in the afternoon too.
“See you again tomorrow. I think I’ll be busy today.”
“Okay.”
There are two patients currently admitted. A fainting patient, suspected of ingesting nitrates, and Erzebet, who is being treated for Wilson’s disease.
Luckily, they’re not in any immediate danger.
Meanwhile, at Professor Asterix’s ward.
Bernard was waiting in bed.
Students occasionally collapsed or got sick during alchemy practice, but it was rare for someone to pass out so obviously like Bernard did.
“You heard the explanation yesterday, right?”
“Yeah.”
Of course, Amy and Istina probably explained it, but I didn’t trust grad students.
How am I supposed to know what grad students told the patient? I almost gave patients wrong info when I was doing my rounds, too.
“I just checked the alchemy lab. The patient used nitric acid during the practice, and that can acutely dilate blood vessels.”
“Oh, is that so?”
“That’s why the patient fainted during class. Less blood went to their head.”
Bernard nodded.
“Then what should we do?”
“Just be careful next time. Cover your mouth when you experiment and wash your hands after.”
I couldn’t exactly tell them not to do alchemy. It’s their chosen career.
“Teacher. The others who did the same experiment didn’t faint, so is it really because of that? What if they have another illness?”
I thought about it for a bit.
“I don’t know either. Maybe the patient is particularly vulnerable, or maybe they were just dozing off during class and fainted, or maybe they have a weak heart or low blood pressure.”
There were a lot of possibilities. At worst, it could be a stroke or a problem with the brain’s blood vessels, but that’s the absolute worst case scenario.
It was more likely that it wasn’t a serious illness. Generally speaking, less serious illnesses are more common than serious illnesses. That’s obvious, though.
“Is there no medicine for that?”
“There is, but… is this the first time they’ve fainted?”
“Yes.”
“Has the patient experienced a migraine, either usually or before this fainting spell?”
The patient shook their head.
“Any family history of similar illnesses, or anyone who passed away before the age of 50?”
“I don’t know.”
No migraines, no history of fainting, no family history. A clean patient. Actually, sometimes a clean patient worries me.
If I could find one big problem, I’d at least feel like I hadn’t missed anything…
Of course, that’s just me as a doctor. The patient, naturally, is better off feeling less pain.
“It seems like this time it was due to exposure to a toxic substance, and the cause is clear. It doesn’t look like you need treatment right now.”
“Is that it?”
“If this happens again, come straight to the hospital. We can think about solutions then.”
Bernard looked a bit worried.
“Since we know the cause, I just need to avoid that.”
“Understood. When can I be discharged?”
“Tomorrow morning. If you want, you can go now, or you can stay another day.”
I figured it would be okay either way.
“Isn’t there anything else we can test?”
“What could there be… Want me to listen to your chest?”
I picked up the stethoscope and listened to the patient’s heart. Auscultation is quite the art.
A layperson can probably tell if the heart is beating or not with a stethoscope.
A less experienced medical professional can probably figure out what part of the heart is having a problem.
An experienced one can tell you what kind of issue is happening where in the heart, the quality of the heart sounds, the breathing sounds, and even, in severe cases, some people can listen to the joints or even the brain.
For the record, I can’t do that kind of thing.
I can only figure out *where* in the heart, and *to what degree*, something hurts. That’s what I’m trying to do now.
Istina, who had come to the ward for work, was staring at the back of my head with a serious expression.
“So. You’re using the stethoscope to try and figure out if the patient has a heart problem?”
“Yep.”
“But you already decided it was due to the medication, right?”
“There could be an underlying condition. It’s possible that they have a vulnerability compared to others, which is why the fainting occurred.”
The truth is, the patient asked for more tests, so I’m checking. The chances of finding a problem here are slim, and the chances of fixing it are even slimmer.
“Professor. Then, what kind of heart diseases that could potentially cause fainting, can be detected just with a stethoscope?”
Being studious is a good thing but…
“Istina. You know the stethoscope uses your ears, right?”
“I guess so.”
“How am I supposed to hear anything if you keep chattering next to me?”
“Ah, I’m sorry.”
A cardiac auscultation is performed at five points. Starting from the top/right: aortic valve, pulmonic valve, Erb’s point, tricuspid valve, mitral valve. You can hear if there’s a problem in these five areas.
“Listening to the patient…”
“Yes?”
“The mitral valve seems a little loose, I guess, there’s a sound of mitral regurgitation. It doesn’t sound like a normal heartbeat.”
Bernard frowned.
“What do we do?”
“There’s not really anything I can do. It doesn’t seem like it’s causing any immediate problems.”
Maybe it’s just needless worry.
Mitral valve regurgitation is pretty common, one or two in a hundred have it. It’s possible the mitral valve regurgitation increased the risk of fainting, but still, my opinion is that the cause was the medication.
“Don’t worry. It’s not a fatal illness, and if you avoid the medicine for now, you shouldn’t have any symptoms.”
Bernard looked out the window instead of answering.
It’s a reaction I sometimes see from patients when I give bad news. Even if they’re okay right now, it’s hard to just brush aside the news that they have an incurable heart condition.
It was good I found the illness by listening with the stethoscope, but it was a little depressing that there wasn’t a way to fix it. It’s a relief it hasn’t caused any major issues yet.
“Professor.”
“Yeah.”
“Could you organize and explain how to do auscultation systematically? I’ve seen it done several times, but I still don’t really understand it.”
“Ah. Sure.”
I should organize it into a booklet and distribute it somewhere.
Thinking about it, I need to start by handing out modern stethoscopes.
Originally, the healers in this world would just put their ear directly to the patient or use something like a wooden tube.
I made stethoscopes to use, but I haven’t really put in the effort to spread them around, have I?