episode_0035

Episode 35. Heart-pounding (1)

****

The Imperial Infirmary.

Violet was muttering to herself. Asterix had left for the Academy, and the other healers were either playing around today or coming in late for work.

Anyway, he’s not there.

When Asterix was in the infirmary, he did everything that happened, even the smallest ones. He was the kind of person who couldn’t stand boredom.

Since Asterix is no longer around, at least one person has to show up on time and keep their job. That person is Violet.

Knock knock.

After a loud knock, the First Prince of the Empire, Manfred, opened the door to the infirmary and entered.

“Sorry for being busy-”

Manfred looked at the infirmary where Violet was sitting alone. The empty desks and seats. Violet scratched her head awkwardly.

“Aren’t you busy?”

“Did I hear that wrong?”

“Where did everyone go?”

“Well, it seems like everyone is busy. Isn’t the academic world so active these days? There’s a fuss about a new theory being announced.”

It’s not like the prince pays the royal healers’ salaries, but there’s nothing good about being offended by the prince. Violet did her best to brush it off.

“Hmm, I see. You’ve worked hard.”

Fortunately, Manfred wasn’t the type to dig into the mistakes of his subordinates. Violet let out a very quiet sigh of relief.

“I heard the medical community is in an uproar these days. Violet, you went on a business trip to the academy recently, right?”

“Yes. I heard Mr. Asterix is completely destroying the academic world.”

The prince nodded.

“I was going to say that anyway.”

“Oh, yes. Go ahead.”

“Did you see the paper I wrote recently? The one Asterix wrote. It’s about epidemic dysentery. The high-ranking officials of the empire are interested in it.”

It was a paper that Violet had also seen.

Well, honestly, I thought it was a great story. Solving the problem was certainly great, but what else was there besides Asterix’s personal ability?

“Like the prince?”

“Me too.”

“Oh, I recently met Professor Asterix. I read his thesis too.”

“How was it?”

“Still, it’s still experimental. Even if it’s true, it’s still too early to draw any conclusions.”

“Some say that this medical discovery will change the academic paradigm and even the way the country operates.”

If Asterix’s thesis is true, if plagues and diseases are, contrary to popular belief, largely solvable and responsive problems, then the way governments deal with them must also change.

“Uh, I don’t know about that.”

“Why, was there something wrong?”

“No, I just don’t know.”

Violet didn’t know.

I think it’s too early to tell. There’s still a lack of experimental verification. In fact, Violet hasn’t even gotten a microscope yet.

That’s the reaction of some officials who saw Asterix’s paper on this epidemic of dysentery.

Really, if a disaster like dysentery could be solved by simply distributing alcohol in water, what have you done so far?

“Please explain the contents of the paper. Violet, aren’t you an expert on this topic?”

“Oh, yes.”

Violet fumbled around and took out the journal from the desk drawer. Where was it?

“That’s the gist of the paper. The cause of disease is particulate matter, and infectious dysentery is transmitted through water.”

****

I pressed my temple. A letter from Prince Manfred. Ah, the lecture will not be easy.

Something troublesome has come up. Giving a lecture in front of the prince? What a hassle. Giving a lecture in front of other government officials as well…

It’s not that it’s meaningless, because the opportunity to influence policy doesn’t come every day. I have blood research to do and patients to deal with.

anyway.

Let’s finish this first and then think about it.

“Istina. Can you get me a pressure gauge?”

“I don’t know. It might be in the lab.”

“Go to the lab storage later and bring one if you can. I’m going to measure my blood pressure.”

“Okay, I’ll look into it.”

The components of a blood pressure monitor are: a stethoscope, a balloon cuff worn around the arm, and a pressure gauge.

You can measure your blood pressure the traditional way, without any equipment, with just a manometer and a stethoscope, but this method requires some practice.

Since I already have a stethoscope, I just need a pressure gauge this time. I can make a balloon band to wear around my arm roughly.

Istina returned from her lab after a long time of searching. An hour or two later.

There was a pressure gauge. A very old-fashioned pressure gauge made of wood, ivory, and mercury.

I think it would be better to wear a mask and deal with it. I think there might be mercury leaking out.

There was also a rubber tube somewhere, and I found something like an inflatable belt. I think it was part of a device that blows air to shake off the dust.

I think this world had about the level of technology of the 18th century. Oh, and if you think about things made with magic or magical tools, there might even be things from the 20th century.

Anyway, I don’t know what this was. The source of the parts isn’t really important.

The important thing is that I was able to make a simple blood pressure monitor after struggling for half a day. Now all that’s left is to try it out, but where should I try it?

“But how do you use this?”

“Sit down first. Put this on your arm.”

It’s a bit complicated to explain.

Istina sat with the rope wrapped around her arm.

“Do you know what pressure is?”

“I know.”

“So, blood moves through blood vessels at a relatively constant speed and pressure. I want to know at what pressure the blood moves.”

“Yes.”

“The heart beats, right? When the heart beats, that is, when it squeezes blood, the maximum blood pressure is reached and then goes down. This is the systolic and diastolic blood pressure.”

I’m starting to wonder what you’re talking about.

“Oh, yes.”

“Now we will place the stethoscope over the brachial artery and listen to the blood vessel.”

I put the stethoscope in my ear.

“Normally, there is no sound, but when the blood vessel is pressed with pressure higher than blood pressure, the blood does not move and there is no sound either.”

“Aha?”

“Now, I’m going to press the band around your arm with an air pump, uh… … Let’s see. Normal systolic blood pressure is around 120, so it’s good to raise it to around 150. If you’re suspected of having high blood pressure, 180.”

I increased the pressure on the balloon band around my arm to 150.

It’s easy to miss, but when the cuff pressure is between systolic and diastolic blood pressure, the blood vessel moves and presses against the cuff, causing subtle pulses in the pressure inside the balloon cuff.

In fact, if you just observe it carefully

“I don’t really know what you’re talking about.”

“You can’t hear the sound right now. If you slowly let out the air from the band around your arm, there will be a point where you can hear the sound of blood flowing again.”

I focused on the sound of the stethoscope. Oh, I think I can hear it. Is it an equipment problem?

“Yes.”

“That’s systolic blood pressure. If you keep lowering it, the blood pressure in the blood vessels will be greater than the pressure of the air band, so blood flow will not be blocked? But there will be no sound. That’s diastolic blood pressure.”

Just now, Istina’s blood pressure measured in the brachial artery is about 130/90. Was there anything to be nervous about?

Istina frowned.

“I have no idea what you’re talking about!”

****

Should I explain in more detail?

I took out a piece of paper and a pen.

“It’s not difficult at all.”

“Yes.”

“Look. You hear the noise caused by the eddy currents that occur when the pressure inside the balloon band surrounding the arm is between the diastolic and systolic pressures of the artery. There is also a sound that occurs when the blood pressure equals the pressure inside the balloon band.”

“It’s difficult.”

Graph. It’s a bit of a difficult concept, but wouldn’t it be easier to understand if you represented it as a graph?

The pen moved across the paper.

“Look. Let’s represent blood pressure as a wave function over time. The x-axis is time, and the y-axis is pressure. Blood pressure can be represented as a wave function that moves between the high point, systolic blood pressure, and the low point, diastolic blood pressure. If we start from 150 and lower the pressure inside the band around the arm at a constant rate, can we draw it as a straight line graph?”

Only the blank stares returned.

“Uh… ….”

Should I just not explain it? At this point, it doesn’t seem like it’s a problem of detailed explanation.

In the first place, has Istina ever heard of pressure, laminar flow, or vortex flow?

However, I can’t tell Istina everything about the high school curriculum. How should I tell her?

“Then think about it simply, Istina. You have to be between the highest and lowest blood pressure to hear a sound. This is just a process of checking where the sound starts and ends.”

“I’ll just memorize the process.”

That’s a method, I nodded. Isn’t it meaningful to have tried?

“Still, won’t it get better as you write your thesis? If you draw graphs related to the topic, you might understand it.”

“That must be it… … .”

Although the background mathematical and physical concepts are important, you don’t use them directly in clinical practice. You can only publish research if you understand them.

Next to Istina was Cadeva’s preserved heart in a vial.

The heart seems to be heavier than the alcohol, as it is closer to the bottom of the bottle than to the top.

“Oh, I’ll try anyway!”

Istina’s fighting spirit was rekindled.

Right, that’s how I become a graduate student. Is there anything in the world that a graduate student can’t do?

“ Mr. Lee. Put an elephant in the refrigerator.”

“Yes?”