episode_0011

Episode 11. Discovery of Bacteria (1)

****

And… … . the first step of the plan.

It’s a microscope.

Robert Hooke invented the microscope in the 17th century. For the first time, humans were able to see the basic structures that make up living things. Hooke’s microscope helped us discover cells.

Of course, human cells cannot be seen without staining, so specifically, we were observing the plant cell walls of cork.

This is the lab.

Anyway, the thing called a microscope is just two or three lenses. All other parts are just to make it easier to use.

Ah, my throat hurts.

Is there any easy way to make something like this?

“Professor. What are you doing?”

“Oh, welcome. We’re going to make a microscope.”

“What is that?”

To explain a microscope as simply as possible.

“Do you know about magnifying glasses? You can magnify an object by stacking multiple magnifying glasses. If one magnifying glass can magnify an object 10 times, wouldn’t you be able to magnify it 100 times by stacking two?”

“Is that so?”

I don’t know, I’ve never tried it.

I’ve used microscopes before, but I’ve never made one.

“You just need to focus well. The problem is, I’ve never made this before… … .”

Istina thought for a moment.

“Maybe you should ask a watchmaker or optician. If it’s not too complicated, they could probably make it. If it has two lenses, that is.”

Well, then I have to draw a blueprint, right? I don’t have the confidence to do that. Let me first try calculating the focus.

“Will that work?”

“Even if you don’t draw the blueprint, if you explain it this way and that way as much as possible, won’t you get some results?”

That seemed right.

“Do you have a goniometer?”

“I’ll get it for you later.”

In my previous life, I would have just handed over my specimens to the pathology department or the laboratory medicine department without having to look at them directly. Even then, clinical pathologists did most of the staining and preservation of specimens.

now.

Let alone looking at a microscope, I have to make one myself. It’s hard for me, and Istina will have a hard time too.

If we want to keep graduate students for a long time, we need to hire more people as quickly as possible. That way, we can give them more work and prevent them from dying from overwork.

“Istina. Where do you usually get graduate students? It would be hard for you to work alone, wouldn’t it?”

“Uh… …. Wouldn’t it be most certain to find out among the upperclassmen?”

I guess I have to go to class first.

Usually, teaching materials and plans are made by teaching assistants, but since Istina still doesn’t know much, I have to do it myself.

“Istina. You come to class too and listen.”

“Okay, I understand.”

“As for now, I plan to teach in a way that will help with research. The purpose of the research we are conducting is to create healers who know new things. I will also show you as much as possible the experiments we do during the research.”

“I’ll look forward to it.”

What are you expecting, Istina?

Half of the work is yours to do.

****

Was it Benjamin, was it Benjamin?

I think it might be a difference in pronunciation.

Anyway, the student patient was lying in bed. He looked fine on the outside, and fortunately, the swelling in his arm had gone down considerably.

“Patient. Are you feeling better?”

“Oh, I think it’s okay. I can move my arm. It still hurts a little though.”

I looked at Benjamin.

“Please wait one more day to move your arm. You might be able to move it before the bone heals.”

“This. Do you need something like a splint?”

No need. There’s already a steel rod in my arm bone, so adding a splint won’t make it any stronger. Just be careful.

“No, well. Just be careful. Don’t bump into anything, and don’t move too violently.”

The patient nodded.

“Can I go home like this?”

“Discharge is still a bit difficult. There is a risk of infection, and I also have to practice moving my hands.”

Fortunately, it’s an expression that seems to understand.

The hospital, even for a hospital of this era, is a relatively clean environment. The dressings on the wounds are changed daily or several times a day.

“Okay.”

“Patient. Do you have any questions?”

“My arm hurts a little.”

“What… … . That’s it. You cut off your arm and put a nail in the bone, so it can’t not hurt, right?”

Benjamin looked up at me with a look that said, “What kind of crazy person is this?” Ah, I shouldn’t say that. I thought about what to say next.

“If no pain is 0 and the most pain is 10, how much pain do you have?”

“Oh, 3 points?”

Although it may seem a bit primitive, asking someone how they would rate their pain out of 10 is the easiest and most effective way to assess pain.

If it’s around 3 points, it’s not severe pain.

One thing to keep in mind, though, is that pain should normally be at 0. Even if pain of 1 doesn’t seem like much, it can still be enough to keep you awake.

For now, let’s just prescribe acetaminophen.

“If you are a little sore, I will give you acetaminophen. It is a weak painkiller, so it will reduce the pain at the surgical site.”

If you look at the product name, it’s just Tylenol.

I turned to Istina and handed her a bottle of acetaminophen. Istina took the bottle carefully.

“Give the patient three pills a day.”

“Yes. Does it matter if it’s before or after a meal?”

does not exist.

“Served after meals.”

Istina nodded.

“Istina. Did this patient have a fever?”

“There was none.”

There may be a fever. There’s no reason to change your mind about giving Tylenol. You also need to prevent the wound from swelling again.

“Watch carefully, Istina. If the swelling gets worse, the stitches could burst or die. That’s why I prescribed some anti-inflammatory medicine.”

“I see.”

I thought about it some more.

Should I take preventive antibiotics?

This patient underwent surgery in an operating room without positive pressure ventilation. There is a high possibility that dust or other substances entered the operating room.

I turned my head towards the patient again.

“There is a possibility that dust entered the wound during the surgery. We will administer cephazolin to prevent bacterial infection.”

In retrospect, it might have been better to administer prophylactic antibiotics before surgery. It’s not mandatory, but it’s preventative.

“What is that?”

“It’s a preventive antibiotic. It prevents the wound from getting infected with bacteria. – Um. This medicine will prevent the wound from rotting.”

The patient nodded.

Come to think of it, it must have looked to other people like I was pulling stuff out of thin air. I pulled the air bubbles out of the Cefazolin syringe.

“An injection will be given. Two grams of Cefazolin will be given. The injection will hurt a little.”

I injected the patient with cefazolin in his other arm. There’s almost no risk of infection with this. The patient squinted.

He closed the cap on the needle and put it in his pocket.

Now it’s time to wrap things up.

“Patient, do you have any fingers that don’t move on your injured arm?”

“Nothing like that. It still hurts a little when I move my fingers though.”

I looked at the patient’s two hands. All five fingers on the operated side were moving well.

What else should I check? Oh, I didn’t check for rhabdomyolysis. It could be a complication of compartment syndrome.

“Has the color of your urine changed?”

“No. Why is that?”

I pondered my choice of words for a moment.

“If there has been muscle damage from compartment syndrome, muscle breakdown products from diseases such as rhabdomyolysis may have appeared. In this case, kidney damage can change the color of urine.”

“What does that mean?”

Istina also looked at me with fierce eyes.

I’ve been thinking about an easy explanation. Just like in my past life, I don’t omit specific details just because I’m explaining things in an easy way.

If the patient or guardian asks for an explanation again, you can explain it again. It is also important to provide the content in detail and accurately.

But. How can I easily change that?

“So, if the muscle is damaged, it can come out in the urine, but fortunately, in the patient’s case, the urine color is the same.”

It was a bit of a shame.

If we could have done a blood test here, we could have seen the rhabdomyolysis levels, the kidney levels, the infection levels, all in numbers.

“Patient. Let me explain one more thing. There are no muscles in the fingers. The fingers are all moved by muscles attached to the arm, right? So, if you only move your fingers, your arm will hurt.”

“I see.”

“Look at this.”

I showed the patient the tendons on the inside of her wrist. Istina tilted her head.

“Here, it extends from the tendons of the fingertips to the muscles of the arm. Since the surgical site is around here, it will hurt even if you just move your fingers, right?”

Benjamin nodded. I think he understood this well enough. It wasn’t difficult at all.

“I’ll take my leave now, patient. I’m glad that the surgery and recovery are going well.”

The student lying in the hospital bed nodded. Istina also followed me out of the ward.