Chapter 197: End-of-term exam (2)

My morning routine begins with dawn ward rounds at the Meyer Infirmary.

"Room 305 patient, the drainage volume has decreased."

"Good. Start them on a liquid diet from today."

"Stelle is healthy. She will get her vaccination soon when she reaches one month old."

"Thank you every day, Lord Yulian."

After finishing the ward rounds like that, I had conference time to select difficult case patients.

It was to sort out the difficult patients that other healers couldn't handle, the ones only I could treat.

"A 35-year-old female patient. A patient whose tumor has metastasized to the retroperitoneum, she has claudication in her right leg."

"There's a possibility the tumor has invaded the lumbar plexus. Understood. I will lead the surgery. Please gather the healers for observation."

"Yes, understood, Lord Saint."

"Next is a patient. A 47-year-old male patient, currently hospitalized for a diabetic foot ulcer. The right forefoot is in a state of necrosis, and based on clairvoyance magic, osteomyelitis is suspected to have progressed to the metatarsal bone. Thus, we plan to perform a right lower leg amputation."

"It seems like a common surgery, so what makes this patient complicated?"

"Chronic kidney disease and diabetic cardiomyopathy are strongly suspected. We anticipate that the wound perfusion after the amputation will not be good. Therefore, I would like to ask about the scope of the amputation."

"Aim for a right lower leg amputation for the surgery. However, directly check the calf muscle perfusion before making the skin incision. Just in case there might be a possibility to lower the scope of the amputation. But, if you are even slightly doubtful, do not be greedy and raise the amputation height. As long as you are careful about that, I think Cardinal Wendras can proceed directly."

"Thank you, Lord Saint."

As can be seen from the conference.

As time passed, the occasions where I stood directly at the operating table in the Meyer Infirmary were becoming increasingly rare.

My 2nd year at the Meyer Infirmary.

Lid-opening (craniotomy), liver trauma, limb amputation, plastic surgery, and so on.

It was because healers specializing in leading the surgeries I had demonstrated once were emerging.

Of course, realistically, it is impossible for a full-fledged specialist to be made in just 2 years.

'Even in my previous life, it took me 10 years before I could lead a surgery.'

But this is a fantasy world with kind miracles.

Lacking surgical skills and minor mistakes could be supplemented with divine magic.

Furthermore, most of the specialized healers were in charge of only one surgery.

"This patient has a possibility of undergoing amputation of the hand region as well."

"It would be better to entrust the hand region amputation to another healer."

Literally, 'one' surgery was the entirety of the operations they handled.

Thanks to that, I could have them replace me in just 2 years.

— "I find it hard just to learn one surgery, so how can the Lord Saint devise all these surgeries?"

— "There's a reason he's the Lord Saint."

The feeling of respect from the healers that naturally followed in the process was a bonus.

After weeding out the patients I would handle like that.

After eating lunch, I had a conference lecture time with the Lafavre Sect as promised before.

"There is a 5-step protocol for postpartum hemostasis. Medication, pressure, tamponade, Greater Heal, and lastly, surgical removal of the uterus. Among these, the final 4th and 5th steps must be judged appropriately depending on the situation."

The protocol I taught was slightly different from the methods of my previous life.

Because the miracle known as divine magic existed in this world.

"Surgical removal of the uterus must be carefully decided considering the patient's current condition and future childbirth plans. Even though regeneration exists, not all patients can receive that miracle."

After the Lafavre Sect's lecture ends, it's the Black Magic Defense Studies lecture.

After that ends, afternoon surgery, followed by afternoon ward rounds.

Spending the day frantically, the time for leaving work quickly approached.

"Today is on the leisurely side."

Seven o'clock in the evening.

Sitting in the mansion's office, I handled my duties as Director Schun.

Most were documents stating that a certain research was ongoing, but they had hit a wall and requested feedback.

Once I finished that feedback, only then could I have my free time.

"Still, my schedule has gained some breathing room since the Wounded Soldier Foundation stabilized."

Leaning back in the chair, I let out a sigh.

At that, the shoulders of Perisia, who was checking my schedule for tomorrow beside me, flinched.

"...B-Breathing... room, you say?"

"Didn't Perisia feel that way too? Isn't it much more relaxed compared to a few months ago?"

The mass production of steroids, which was a long-cherished project, had also reached its trajectory.

The social issues regarding morphine had also stabilized to some extent.

But Perisia didn't seem to think so.

"...You have a surgery schedule tomorrow as well, though?"

"Compared to a year ago, the surgery schedule is much lighter, isn't it? The night duty and 36-hour continuous surgeries are gone too."

"That is true, but... Hmm..."

Perisia looked like she had a lot she wanted to say.

But she ultimately didn't speak of it.

It was around the time I was finishing my final evening schedule like that.

Flash.

Someone made contact through the crystal orb placed on the desk.

[Have you had dinner?]

I could tell who it was just from the voice coming through the crystal orb.

It was Imperial Prince Edmund.

Perhaps because it was late, fatigue dripped from his voice.

"Yes, I have just finished my schedule. Has Your Highness eaten as well?"

[Of course. I just finished eating with the Princess Consort and put Stelle to sleep.]

Such a doting husband.

He always made sure to have dinner with his hospitalized wife.

[Ah right, Stelle grasped my finger today. As expected, the feeling of a daughter grasping it is different from a son doing so.]

"..."

[It must be the first finger that child has grasped since she was born. How should I describe the feeling at that moment... For my son, I would lay down my life, but for my daughter, I feel like I could even take lives.]

He casually spat out dangerous words, already showing his doting father tendencies.

Seeing his proud face, I had no choice but to keep my mouth shut.

'She grasped my finger first, though...'

Among newborn reflex tests, there is a test where you give the baby a finger to grasp.

It's called the palmar grasp reflex test, a neurological examination basically performed when a newborn is born.

Because of this test, the first finger most babies grasp is often a doctor's or nurse's rather than their parents'.

'Since he seems to think he's the first, let's keep it a secret.'

Because there was no telling what other weird things this prospective doting father might spout if he found out that fact.

After listening to the Imperial Prince brag about his daughter for about 10 minutes like that.

The satisfied Imperial Prince finally got to the main point.

[Ah, the story ran long. You must have a schedule tomorrow as well, so I'll get right to the main point. The reason I made contact is none other than the Demonic Realm practical training that's right around the corner. Weren't you made the general manager leading the Department of Healing Arts this time?]

"That is correct."

This afternoon.

It was decided that I would be the general manager of the Department of Healing Arts accompanying the Demonic Realm practical training.

Since it was a practical training where all students of the Hero Department were going out, I was the only one who could cope with various unexpected situations.

[I heard that although 2 years have passed, there is no one who can independently proceed with and lead various surgeries like you. That's why it's dangerous, but I would like you to protect the future heroes well.]

"I will put in my best effort."

[As of today, I have also become the general person in charge of the military forces acting as bodyguards for the Hero Department.]

"..."

As soon as I heard those words, I almost blurted out that it was a pity.

Who was I pitying?

Naturally, it was the Hero Department and the soldiers.

'The soldiers will be sweating bullets too.'

At first, they must have been told they just needed to protect the students.

It would be perplexing to suddenly have a three-star general taking command.

[Due to those circumstances, as a commander of the army, there is something I want to coordinate in advance with you, the general manager of the Department of Healing Arts.]

"What is it about?"

[It's because there's a new headache for the army lately. It is none other than dysentery.]

Dysentery.

You can think of it as a type of food poisoning where diarrhea is the main symptom.

It was also a disease that absolutely had to be guarded against when living in a group.

Because usually, when many people live together, food poisoning is what's most feared.

[Of course, after you created this IV fluid therapy, dysentery became not as fatal as the southern fever.]

That would be right.

In the past, dysentery was a fatal disease.

Because there was no concept of electrolyte correction.

The nutrients and electrolytes lost through diarrhea weren't something that could be managed with Heal.

To be precise, it could be recovered with Heal.

It's just that when it came to the scale of an army, it wasn't something that could be managed with Heal.

Therefore, for the army, diarrhea was never an easy opponent.

But after I introduced IV fluid therapy, people dying from diarrhea had long since become a thing of the past.

[So after the IV fluid was created, dysentery was pushed back in priority compared to other diseases in the military. But even then, the loss of military strength was never small.]

That was also correct.

With the combination of Heal and IV fluid, there would be almost no one dying from dysentery.

But that didn't mean there was no loss of military strength.

Wouldn't it be difficult to call a patient who has diarrhea round the clock a useful asset to the fighting force?

Therefore, dysentery was still a headache for the military.

[And I foresee this becoming a headache in this practical training as well.]

"A wise judgment. Then, should I prepare a countermeasure for dysentery?"

[Ah, that won't be necessary. The medication for dysentery has already been developed by the military.]

"Ah, I've heard of it before, so I know."

Was it 1 year ago?

There was a cure for dysentery created by the military.

"The name was Emetine, right?"

[Yes. It's a medication the army made taking inspiration from your methods.]

Originally, folk remedies for dysentery existed from the past.

It involved brewing or chewing on the roots of certain plants, a method usually used by natives or soldiers who had rolled around on the frontline for a long time.

[Didn't you discover Quinine using the methods of the southern beastkin? So the army also extracted a component called Emetine using the same method.]

If it were the army of the past, they would have left folk remedies alone, telling the individual soldiers to figure it out and use it on their own.

But after getting a taste of the impact Quinine had on the frontline, the military had no choice but to change its stance.

They no longer ignored it just because it was a folk remedy, nor did they neglect it just because it came from a common soldier.

'At the time, when I heard the army had created Emetine first, it felt like a shame.'

Because it felt like one of my fortuitous encounters meant for freeloading, following Quinine, had been snatched away.

Well, thinking about it, it was a natural progression.

People are not fools.

If I hit a huge success with Quinine, wouldn't it be natural for them to want to copy it?

So at the time, I had to be satisfied with merely having involvement in naming it Emetine.

[In a way, one could say it's a medication you made. Because it directly applied the extraction method you used when you made Quinine.]

"Compared to the time I made Quinine, it is a medication made with a much more refined extraction method. How could I dare snatch away the accomplishments of other alchemists?"

[Your humility is too much. You made that when you were 8 years old, didn't you? If you were to make Quinine now, wouldn't it be much more refined?]

"..."

I couldn't bring myself to deny it.

If I could have opened the Library of Memory back then, my first medication wouldn't have been Quinine, but Chloroquine.

Besides, I was a bit awkward with another world-style alchemy at that time.

But if it were now, I was confident I could make medications in a much more refined manner than that.

[I went off on a tangent for a moment. So what I want to say is, I would like the Merkur Trading Company to urgently mass produce that medication.]

I understood.

So, he was suggesting we make preparations in advance before the students suffer from dysentery.

As a commander, it could be said to be considerable foresight.

However, I had a doubt.

"But why the Merkur Trading Company of all places? Is there no stock of the medication in the army?"

[That's right. We made it, but since it wasn't actually adopted, we didn't make a lot.]

"It must be because of the cardiotoxicity and arrhythmia side effects."

[You know right away even if I only say a little.]

There are side effects to Emetine.

Namely, cardiotoxicity and arrhythmia.

Getting arrhythmia means it puts a strain on the heart muscles.

Because of this, the patient must lie in bed and maintain absolute rest throughout the entire administration period.

But for soldiers who have to endlessly march and engage in battle, absolute rest is impossible.

In other words,

"A medication that must be taken lying down cannot be a medication for an army that has to walk and fight."

[Yes. So there isn't much stock in the army.]

Even if they are treated with this medication anyway, that soldier would have to lie down because of the side effects.

Naturally, you couldn't expect the effect of reducing the loss of military strength.

So the military didn't bother making such a medication.

[But students are different, aren't they? Since it's an exam anyway, it would be better to use this medication.]

But the practical training exam didn't require calculating military strength.

Because the students went to take an exam, their circumstances were different from the army's.

[So I want to adopt Emetine as the official medication for the practical training and use it on students who develop dysentery.]

"I have understood your words."

But the answer I gave was the exact opposite of what the Imperial Prince expected.

"But as the general manager of the Department of Healing Arts, I cannot use Emetine as a cure for dysentery."

[Why? Is it perhaps because of another side effect, vomiting?]

"Not that, but because our trading company is currently proceeding with another dysentery medication project."

[...What?]

I introduced two piping hot medications that had just passed their clinical trials.

They were medications called Promomycin and Metronidazole, respectively.

"They are medications used for amoebic dysentery. Compared to Emetine, the side effects are far fewer and the effects are good as well."

The clinical trial results were also excellent.

At this level, it was to the extent that there would be no problems using it right away.

Seeing this, the Imperial Prince beyond the crystal orb let out a dry laugh.

[Is it a coincidence?]

"Rather than a coincidence, it should be seen as one of the medications we were already making just happening to be a hit."

The medications the trading company is currently developing aren't just one or two.

Because if there's a disease that seems like it would yield a profit, we are rummaging through mold first.

Like that, the projects currently ongoing at the headquarters and branches alone amount to dozens.

There was no reason a cure for dysentery wouldn't be one of those lucky hits.

Hearing this, the Imperial Prince made an expression of disbelief.

[No, I'm just curious, but how on earth are you able to proceed with so many projects?]

"You are under a misunderstanding. These medications are not medications I develop. They are medications developed by the alchemists belonging to the trading company."

People seemed to think that whenever the Merkur Trading Company made a medication, I had made it all.

But I didn't directly make these medications.

"I merely provided the direction, and it was the other alchemists who brought this medication to completion."

Medications requiring large-scale screening are all proceeded with like this.

A representative example is antibiotics.

Do you know how many types of mold there are in the world?

Who knows which one of them is harboring what kind of medication?

Furthermore, the world is different, so the molds harboring them are also different.

Therefore, I changed my method.

Instead of checking in front of a flask one by one myself,

I just set the direction like, 'Filter out germs with these properties, using this method, in this order.'

'I only have one body, and there are too many medications to make.'

This is all for optimization.

I can't pour out my youth making various antibiotics, can I?

It's not just one or two medications that need to be made.

So, I was merely taking the title of first developer in each field.

First developer of antibiotics.

First developer of the Demon Disease cure.

First developer of the diabetes cure.

Securing only these kinds of titles, I wanted to focus solely on the areas of the world that were yet to be pioneered.

So I just left bothersome parts like screening to other alchemists and healers.

A few words, one short theory.

If I just threw these things out there, the alchemists belonging to the trading company would figure it out and make it from there.

In a way, it was no different from an automated production process.

Hearing this explanation, the Imperial Prince expressed his doubt.

[Exactly how far does that direction go? How far were you involved in this medication?]

"After designing the research method, it's just to the extent of providing feedback right then and there if they get stuck."

It's not even difficult advice.

Cultivate the actinomycetes in the soil, and find the substance that kills the amoeba causing dysentery.

At this time, you just need to classify and find two substances: one that will act inside the intestines, and one that will act inside the tissues.

What if it's difficult to use the medication as is?

Then shift the position of the nitro group, and if you attach a hydroxyethyl group, it will be stabilized.

"...It's only contents like these."

[I don't know much about it, but if you designed the research and got involved in the most crucial bottlenecks, isn't it practically you who made it?]

"But the person in front of the microscope at the time of discovery wasn't me, was it?"

Originally, the most important thing in a medication is finding out where to extract its base substance from.

And for the sake of efficiency, I left that most crucial stage to other alchemists.

Despite that, I wasn't shameless enough to say that even their credit was mine.

'Rather, I should be more careful with things like this.'

A tiny stigma is bound to soil the fame built up so far.

Since I had already secured the "first" titles, there was no reason to intentionally create a 'paper theft' controversy.

Even in the 21st century, putting your name wrongly on a single academic paper could send you falling into the abyss in an instant.

"For me, just having my name put up as the second author is more than enough."

[Then you set the research direction, supported the experimental environment and even the capital, and then you're saying you're yielding the first author spot to that alchemist?]

"It would be hard to agree with the word 'yielding'."

But for someone who does all the bothersome research and develops the medication in my stead, shouldn't I at least do that much for them?

And at first glance, it seems like the researchers are getting a free ride, but in reality, the one freeloading is on this side.

My body stays still, and I just said a word or two, yet the result comes out on its own.

Furthermore, it's also me who gains the fame and profit from that result.

If this isn't auto-hunting, then what is it?

Because of that, handing over the first author spot to the researchers wasn't strange.

Since in reality, I only provide the catalyst, and the ones truly making the discovery are them.

"Anyway, I will have these medications prepared for the students. While we're on the subject, should we supply them to the army first as well?"

[...I will make sure to speak well of it to the army.]

"Understood."