episode_0094

Episode 94. Erectile Dysfunction and Heart Disease

****

Amy banged on the lab door and came in before I could answer. I knew it was Amy even before I opened the door.

Istina wouldn’t do that. She’s so timid that she wouldn’t have come in until she heard the answer.

“Professor.”

“Report patient.”

“Ah, yes. I came because of a patient. A patient who collapsed during an alchemy class. His breathing is unstable, but he has a pulse. He is currently lying in bed.”

“What is the suspected cause?”

“I don’t know. But it’s because it’s a pension department.”

It must be addictive.

Because they use a lot of toxic chemicals.

“First, wash the stomach and feed activated carbon.”

“Yes.”

◦Do you know how to do %◦?”

“Uh, what is activated carbon?”

“Made with charcoal powder. You can find it at the hospital.”

“Okay, I understand.”

Amy nodded.

****

The patient was lying peacefully in the ward. There was no foam at the mouth, his breathing was somewhat slow, and there were no symptoms such as cyanosis.

A young male patient who appeared to be an academy student. There were no visible signs of trauma and no signs of self-harm.

I checked the patient’s eyes. There is no nystagmus, and the miosis reflex is normal and alive on both sides. At least the worst has been avoided for this patient.

If you have been fainting frequently for a long time, you may have bruises or scars on your elbows and knees.

I rolled up the patient’s sleeves, but there was nothing like that. There were fewer clues than I thought.

Are you at risk of immediate death?

I checked the patient’s pulse again. The heart seems to be beating well. But there’s no EKG or blood test. I’m dying of frustration.

Should I try an epinephrine shot?

While I was thinking about it, Amy brought the gastric lavage tool and activated charcoal. Since he was breathing well, I took a step back and Amy pushed the gastric lavage tool into the patient’s esophagus.

“Is that right? You didn’t put it in the windpipe, did you?”

“Uh, how do you tell the difference?”

“Vocal cords and epiglottis. And gag response.”

I put my finger in the patient’s mouth and opened it. It looks like the esophagus is right. I started to tilt my head, and Amy started to lavage her stomach.

In fact, to perform gastric lavage on an unconscious patient, anesthesia and endotracheal intubation are necessary. But there is no mechanical ventilator. Intubation is possible only by force. Anesthesia is also dangerous.

The belly button looks bigger than the stomach. So, I have no choice but to just do a stomach wash first.

The patient opened her eyes after about a minute. She started to retch with the tube still in her esophagus. Amy looked at me in surprise.

“Hey, what should I do with this?”

“What should I do? Take out the tube.”

The patient seemed not to understand what was happening, and was mumbling curses while gagging. It seemed like he hadn’t come to his senses yet.

Amy removed the lavage tube, and I handed the patient a towel. The patient coughed and gagged repeatedly as he wiped his mouth.

“Wow, wow.”

“I thought you ate something wrong.”

“Ughhh.”

“Have you ever fainted before? Has anyone around you fainted recently?”

“Ughhh.”

The patient did not appear to be unable to speak or have a headache. He was simply unable to answer because he was nauseated and vomiting.

If I had known it would happen this quickly, I wouldn’t have done the stomach lavage. I’m sorry.

“Have you eaten anything weird recently?”

“No… ….”

Well, even if it is poisoning, there is no guarantee that you ingested it. You could have inhaled the substance, absorbed it through your skin, or not been exposed to the toxic substance at all.

Isn’t it okay since it happened once?

“Have you experimented with alchemy recently?”

“Yeah, I do that often.”

“Do you have any examples?”

“Making pyrite.”

Well, there are so many dangers that it would be difficult to list them all. I thought about it for a while.

“You didn’t put anything in your mouth, did you?”

“Yes.”

That’s something worth trying.

Unityol.

Although it was developed to treat arsenic poisoning, it is also effective for heavy metal exposure.

“Amy. Give me that.”

Amy handed me a tissue soaked in alcohol. I wiped the patient’s shoulder with the alcohol and prepared the unitiol.

“What are you doing?”

“Injection.”

Let’s try Unitiol first and see if the patient’s condition improves. I took out the syringe and injected Unitiol into the patient’s shoulder.

“Ah.”

“Already finished.”

Unityol is used for exposure to a variety of toxins, including mercury, arsenic, heavy metals, and snakebites. With any luck, you’ll be back to your normal routine in a few days.

You can slowly figure out why it hurts. But you should think about it to prevent a recurrence, right?

“What is the patient’s name?”

“Bernard.”

The patient was still vomiting and coughing as if he was sick. I patted Bernard on the back. He looked sick.

Could it be an aftereffect of gastric lavage?

“Then, patient. Please take the medicine we gave you and wait a moment. We will find out more about your illness and return as soon as possible.”

Bernard nodded reluctantly.

****

Amy scratched her head as she left the hospital room.

“But aren’t there other causes of fainting besides arsenic poisoning?”

“That’s true.”

There are many, many things. Let’s consider all the possible causes of fainting, outside of the context of the alchemist.

Vasovagal syncope, arrhythmia, psychogenic syncope, hypotension, etc.

“It would be nice to have an electrocardiogram. Then we can check if there is an arrhythmia.”

“What is an electrocardiogram?”

“There is.”

I heard that a hundred years ago, there was a way to measure electrocardiograms by immersing hands and feet in salt water. It was interesting, but… … .

I don’t even know how to make it.

“Have you heard of orthostatic hypotension?”

“No.”

“When you get up from a seat, your blood pressure drops momentarily as your posture changes. The blood flow to your brain decreases, so you might collapse. Or it could be due to psychological stimulation.”

Amy nodded.

“But this patient doesn’t seem to have fainted due to a specific stimulus. He just fainted while listening to a class. You said that other people thought he was sleeping, right?”

“Okay. Just a moment.”

Suddenly, for no apparent reason, he collapsed while still conscious. All the conditions presented in this patient were hypoglycemia, cardiogenic syncope, and arrhythmia.

Neither one was good. For such a young patient to have hypoglycemia or arrhythmia was likely a familial disease.

Psychogenic fainting is not a good thing either. There is no clear treatment for such a disease.

“Let’s go check out the pension lab. There might be some disease-causing substances there.”

“Yes!”

We’re moving toward that. We need to see what the patient was doing just before he collapsed. Maybe he was exposed to some kind of toxin.

****

I decided to go and see the pension science lab with Amy. This time, before entering the research building, I meticulously wore a mask.

Luciana, who introduced herself as Bernard’s senior and friend, was guiding us.

“Miss Luciana. Long time no see.”

“Hello.”

“What’s going on?”

“Ah. Who was that? Anyway, I was in the same class when that student collapsed. I was the teaching assistant for that class.”

“You’re working hard.”

“Yes. I’m also having a hard time trying to graduate as early as possible. I feel like I’m going to collapse.”

“Well, I want to graduate early. Is it going to go as I wish? The professor made it so?”

“Yes.”

The professor is a good person. He even helps the graduate students who are trying to run away to graduate quickly…

By the way, I looked around. There was nothing special about the lab, and it had already been cleaned up, so there weren’t many traces of experiments left.

“Luciana. Since that student collapsed here, who hasn’t done any experiments again?”

“Yes. I just organized it.”

I turned my head towards Amy.

“Amy. Don’t you smell something?”

“Uh, well… … . But it smells? It smells like a bathroom, I don’t know what it is.”

I think I know what it is.

I took off my mask for a moment, and as expected, there was a sharp, foul smell. There was a slightly sweet smell mixed in, but overall, it was an unpleasant, strong smell.

That’s it, that’s it.

“Luciana. What kind of experiment were you doing here?”

“I don’t know either.”

“If you could guess by smell?”

It was a rather unusual request, but Luciana sniffed for a moment and then frowned.

“Uh. Isn’t that the separation of metals? It smells like the acidic substance used to melt metals.”

My thoughts were similar. The drug used in the experiment was probably nitric acid. The drug that caused fainting was probably nitrogen oxide produced from nitric acid.

“Do you know what it is?”

“It’s nitric oxide. When you eat nitric oxide, your blood vessels relax, your blood pressure drops, and you can become more susceptible to fainting.”

It also helps with erectile dysfunction. These days, there are many better drugs than nitric oxide, but in the past, it was often prescribed for this purpose.

Additionally, it is also used to treat heart disease.

It can relax the cardiovascular system and stop ischemia in the cardiovascular system. A representative example is nitroglycerin. It is used as a drug to relieve acute chest pain.

If a normal person consumes excessive amounts of this substance, their blood vessels may relax, making them vulnerable to fainting like the patient we saw earlier.

If you’re unlucky, you’ll actually faint. I guess we can consider the mystery solved?

“Oh. Really?”

Amy and Luciana looked at me as if they were hearing about it for the first time. After all, not many people have actually tried nitric acid.

Our patient is a bit of a strange case.

“Go and tell the patient. He collapsed because of the experimental drugs, and he should be more careful from now on, like wearing a mask or ventilating the room.”

“Yes.”

It seemed like no further treatment was needed, and that was the end of the situation. Amy rushed to the ward, and Luciana breathed a sigh of relief.

Right, I had some questions for you, Miss Luciana.

“But. Where are you going after quitting graduate school?”