episode_0050

Episode 50. The Price of Misunderstanding (2)

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The price of misdiagnosis was high.

I don’t know how much damage Imentia suffered, but the price of freezing a city would not be light.

If you ask whose fault this is, well, maybe it’s the bureaucrats who were frightened by symptoms like hemoptysis and skin rashes and thought of the Black Death?

That’s something Imentia will take care of.

I have to think of a way to help the patients. The most helpful thing right now is to lift the quarantine and give the scurvy patients vitamin C. That shouldn’t be hard to convince, right?

Everyone has their own opinion.

That opinion is usually just an obvious fact to the person who holds that opinion, like the sky is blue and water flows downward.

There are people who cannot be convinced even if the heavens fall apart when it comes to truly important matters.

I hope the people of Imentia aren’t like that. You just have to try it and see, I guess.

I’ll just relay the message to the temple healers and then go convince the mayor.

I rejoined Anatha’s side. Anatha was discussing something important with the other healers in a corner of the temple.

We stood before the priests.

“The conclusion is in, Mr. Anatha.”

“What is it?”

“For those with mild symptoms, it would be better to just give them medicine and send them home.”

“Is that so? Isn’t it dangerous?”

“The epidemic does not appear to be spreading exponentially. Patients who are in good condition to return home are better off going home.”

“Ah… … . I see.”

Anatha nodded.

I thought there would be a backlash, but surprisingly, they seemed to understand quickly. Of course, the temple supplies were running low, and there was a shortage of manpower.

Deep down, I wonder if less critically ill patients didn’t want to hear the advice to just send them home.

“The most contagious disease is the common cold. It is best to send home patients who do not have cold symptoms such as fever, cough, or phlegm.”

The social costs and risks of isolation now seem to outweigh the benefits of isolation and group confinement. We need to end it as soon as possible.

“I will ask the higher-ups.”

“Will it be difficult?”

“It wouldn’t be a big deal if we just had permission… … . I don’t know what the bishop and mayor are thinking.”

“Let me try to convince you. If we run out of supplies anyway, we won’t have a choice. There will come a time when it will be difficult to maintain quarantine.”

Anatha hesitated for a while, but it wouldn’t be Anatha who would make the decision anyway. Anatha seemed to have reached a similar conclusion as me.

The priest raised his head.

“The fruit will arrive soon, so please give one to each patient from now on. They will get better after eating normally for about a week.”

“I really hope so.”

****

Back to Imentia Castle. I bowed my head to the mayor of Imentia. The mayor of Imentia was looking at me with a troubled expression.

“Say that again, Professor.”

I feel like I’m explaining it over and over again.

It’s a bit frustrating, but that’s just how bureaucracy is. The mayor of Imentia is pretty much on the level of a reasonable person. That’s probably it.

“Mayor. Due to the quarantine and treatment efforts, the risk of further spread of the epidemic is not considered to be high. Please send mild patients home first, and lift the curfew and quarantine measures.”

“If it’s true, that’s great.”

His expression was not at all reassuring.

“This is my conclusion after seeing the temple. There aren’t many deaths, but there is a risk of the cold spreading in crowded environments. Weighing the pros and cons, it seems better to lift the quarantine.”

“Please explain to me what happened. I am not a healer and I do not understand what happened at all.”

That could be. I’ve been thinking a bit about how to explain it. The comfort of many people may depend on my choice of words.

“The disease we initially thought was the Black Death was actually the result of three diseases: periodontitis, the common cold, and scurvy.”

“Three diseases?”

“Yes. Periodontitis is a disease that causes bleeding gums, and quite a few people have it. Colds can be common in this weather, and scurvy is a disease that many sailors get.”

“Even if we assume that, it doesn’t seem to explain the whole situation properly.”

I continued speaking for a moment.

“The sailors of the Rosaria, who had arrived a few days earlier, may have been suffering from scurvy. They were noticed by the authorities, and they may have had symptoms similar to the Black Death, such as skin rashes, colds, and coughing up blood.”

“That’s right.”

“So the authorities went out to find patients with similar symptoms, probably similar to the hospitalized Rosaria sailors. They probably looked for symptoms like bleeding from the mouth, coughing, phlegm, and skin rashes.”

The causes of misdiagnosis. Fear, ignorance, and good intentions. After all, most mistakes people make, not just misdiagnosis, are caused by these three.

The mayor still looked displeased, but he nodded slowly anyway.

“So.”

“Considering the sanitary conditions of the streets, there must have been many people with periodontitis. This means that there must have been quite a few people coughing and bleeding from their gums.”

“So. At first, we mistook a person with scurvy and a cold at the same time on the Rosaria Lake for the Black Death, and in the city, we mistook a person with periodontitis and a cold at the same time for the Black Death? Is that what you mean?”

“Yes.”

The mayor groaned and pressed his temples. Just thinking about it must be unsettling.

“It’s complicated. If the professor hadn’t told me, I would have never known… … . Really.”

“So. What’s the solution?”

“The treatment for scurvy is a normal diet including vegetables and fruits. If the cold symptoms are severe, medications may be given to relieve the symptoms, but there is no specific cure.”

“Periodontal disease?”

“Periodontal disease is a chronic disease, and there is no clear treatment. You just have to brush your teeth regularly. It is not a fatal disease.”

The market of Imentia pondered for a long time.

“Professor. If I summarize what you said, does that mean that if we just hand out lemons from now on, we’ve done everything we can?”

“Yes.”

“It’s horrible. What a huge price the city has paid for the incompetence of the authorities… … .”

I didn’t think so.

“Well, maybe it was because we had experience fighting past epidemics that we were able to come up with quick and efficient countermeasures? It was just luck that this epidemic was the flu.”

It wasn’t just a simple lip service.

It may be that Imentia was able to quickly come up with countermeasures because it had a record of fighting the Black Death in the past. If it had really been the Black Death, even this much would not have been enough.

“Professor. How soon can we expect this situation to be resolved?”

“The crew of the Rosaria will start to feel better after a few days of regular eating. Most colds will be cured in a week.”

“Last question.”

“Yes.”

“How would you explain this situation to ordinary people or officials? How much should you explain?”

I don’t know about that.

Isn’t this a political issue rather than a medical one?

“Oh, that’s it. Doctors can’t lie to patients. The decision on what treatment to receive is also up to the patient.”

“That’s ideal.”

“But the patient doesn’t know better than I do, right? I can’t lie, I can’t force it, but I don’t think I need to hide what I want and say it either.”

“Hmm.”

“In principle, it would be best to tell the truth without hiding anything. If you do that, there seems to be no need to express it in a disadvantageous way.”

“Okay.”

I left the conference room after greeting the mayor. I hope the results are good. Well, he seemed like a reasonable person.

I wonder if he’ll listen to me.

****

Things went faster than I thought. Well, the quarantine was quick, so the lifting of the quarantine should be quick too.

A cartload of lemons arrived at the temple, and soldiers from the market began going from house to house distributing them.

Most of the patients who had been isolated in the temple were given a few lemons and a four-day supply of cold medicine and returned home.

Only the original patients and the most critically ill patients remained in the temple. This happened two days after we arrived at Imentia Castle.

I feel like I’ve forgotten something. Is it just my imagination? The hospital probably took care of the hospital business. I don’t know what I’ve forgotten.

I hope it’s not something big.

****

Mint. The most powerful daughter of the empire. A princess worthy of the title of “the best in the world.” The whole world was beneath her. Her veins were filled with blood that was blue, even golden. She even had magical talent.

Those things might make you feel better, though! Anyway, there are things you want regardless of what you already have.

I looked at the calendar with a bored, annoyed, tired, hopeful, or just a somewhat complicated expression.

It’s not like Mint wants anything great.

No, is that really that great?

How many days has it been already?