episode_0095

Episode 95. How do you do a stethoscope? (1)

****

Mint was holding two small spoons. I didn’t know there was ice cream in this world. How did they make it?

The meaningless distractions were shattered. Mint stared at me and then gestured toward me.

“Hello.”

“Hey, sit down.”

Even if he is my subject, isn’t it a bit too much to call him “hey” every time? I thought about bringing it up, but it didn’t seem like it would be meaningful. I scratched my head.

“Are you going to call me Ya every time?”

“Yeah. What do you want me to do?”

Oh man, I knew it. I tapped Mint on the forehead with my fingertip.

“Aya.”

I sat down next to Mint. The princess scratched her head for a moment and then began to speak.

“I heard a funny rumor? The teacher went to the Duke of Cerulis’s residence this time to prepare for his social advancement.”

“This is the first time I’ve heard of it.”

“Huh?”

Mint put her arm around mine and leaned slightly to the side, mumbling something inaudible. She seemed happy, so I decided to leave her alone.

I looked down at Mint for a moment, and after a while, I met his gaze with blue eyes. Mint blinked and opened her mouth.

“It would be fun to go.”

“I’ve never really thought about it. If I went to a place like that, I wouldn’t know what to say.”

“I’ll take you around! Everyone will love it. There are a lot of people who are curious, teacher?”

“I’ll think about it.”

Mint laughed.

“Princess Ceruleus was also admitted to the academy by the teacher. Wasn’t the teacher just expanding his connections to advance in society?”

I shook my head vigorously.

“No, how could that be… … .”

“Really?”

“Princess. Of course you shouldn’t use a patient like that. I’m not crazy.”

“Graduate students are just bullying me.”

I scratched my head.

“The patient is not a graduate student. If Istinana or Amy were brought to the hospital, they would be treated seriously. And, to that extent, graduate students are really kind and considerate.”

“What the teacher said is not convincing.”

“Hmm.”

“I was a little upset. Why did you go to Wangjin to try to connect with someone else instead of leaving me and Manfred behind?”

“That’s a strange misunderstanding. No.”

On the contrary, the Duchess was trying to get in touch with me, but when she couldn’t get through, she just came to the hospital.

“Thank goodness.”

“I don’t know what you think of me, but I’m not that strange, Your Highness.”

Mint released the arm she was holding tightly and hugged me again. She rested her head on my shoulder. I stepped aside.

“Why?”

“Feed me some ice cream.”

I grabbed Mint’s face with both hands and pulled her away from my shoulders. I’m getting used to it.

“That’s a bit too much, Your Highness.”

“Hing.”

Mint sat down, shaking off the hem of her clothes. She handed me a spoon that was stuck in the ice cream bowl. I took the spoon.

“It’s delicious. Try it.”

“Yes.”

I don’t know where they got the ice cream from, but it was better than I thought. It was more like sorbet than the ice cream I usually eat in the world, though?

Mint looked really happy.

“I have to go to the ward soon.”

“Oh, really?”

“Yes.”

“When are you coming?”

I don’t know. I’m a little less busy these days, but I don’t think I’ll be able to hang out again before dinner. I have classes in the afternoon.

“See you tomorrow. I think I’ll be busy today.”

“Yeah.”

There are currently two patients hospitalized: a fainting patient who is thought to have ingested nitrates, and Elizabeth, who is being treated for Wilson’s disease.

It’s fortunate that these aren’t patients who will die soon.

****

Meanwhile, in Professor Asterix’s ward.

Bernard was waiting in the sickbed.

Although there have been occasional cases of students collapsing or falling ill during alchemy practice, it is said that it is rare for someone to collapse so openly as Bernard.

“Did you listen to the explanation yesterday?”

“Yes.”

Of course, Amy and Istina explained, but I didn’t trust the graduate students.

How do you know what the graduate students would have explained to the patient? I’ve almost told patients the wrong information many times during my internship.

“I’ve been looking around the alchemy lab. A patient used nitric acid during the lab, which can acutely relax blood vessels.”

“Oh, really?”

“That’s why the patient fainted while listening to the class. It’s because less blood went to the head.”

Bernard nodded.

“Then what should I do?”

“Be careful next time. Cover your mouth when experimenting, and wash your hands after experimenting.”

It’s not like we can tell him not to do alchemy. That’s the profession he chose.

“Teacher. People who did the same experiment didn’t faint. Is that really why you fainted? Or maybe you have another illness?”

I thought about it for a while.

“I don’t know either. The patient may be particularly vulnerable, or the patient may have fallen asleep during class and passed out, or the patient may have a weak heart or low blood pressure.”

There are several possibilities. Seriously, it could be a stroke or a cerebrovascular problem, but that’s really the worst case scenario.

It was most likely not a serious illness. Generally speaking, non-serious illnesses are more common than serious illnesses. That goes without saying.

“Isn’t there any medicine for that?”

“Yes, but is this your first time fainting?”

“Yes.”

“Patient, you have never had migraines before or after you collapsed this time, right?”

The patient shook his head.

“Does anyone in your family suffer from a similar illness or pass away before the age of 50?”

“I don’t know.”

No migraines, no history of fainting, no family history. A clean patient. In fact, sometimes I worry about clean patients.

If I could just find one big problem, I’d feel relieved that I didn’t miss anything…

Of course, this is also from the doctor’s perspective. Of course, the less pain the better for the patient.

“This time it appears to be due to exposure to a toxic substance, and since the cause is clear, it doesn’t seem like treatment is needed right now.”

“Is that so?”

“If this happens again, come to the hospital right away. We’ll figure out a solution then.”

Bernard looked a little worried.

“Because you don’t know the cause. You just have to avoid it.”

“Okay. When will I be discharged?”

“Tomorrow morning. If you want, you can go now, or you can stay in bed for another day.”

I thought it would be okay though.

“Is there anything else I can check?”

“What could it be… … . Should I take a stethoscope?”

****

I held a stethoscope and listened to the patient’s heart. Auscultation is also a very difficult art.

The average person can use a stethoscope to tell if the heart is beating or not.

Inexperienced medical professionals may be able to determine which part of the heart is problematic.

Experienced medical professionals can auscultate the heart to determine if there is a problem, what the bowel sounds are like, what the breath sounds are like, and even in severe cases, joints or the brain.

By the way, I can’t do that.

I can only figure out where and how the heart hurts and the degree. That’s what I’m trying to do now.

Istina, who had arrived at the ward, was looking at the back of my head with a serious expression.

“So, you’re auscultating the patient to see if there’s a problem with his heart?”

“Yeah.”

“You decided it was because of the medicine, right?”

“Because you may have an underlying disease. You may think that you fainted because you are more vulnerable than other people.”

In fact, we do this because the patient asked for more tests. The chances of finding a problem here are slim, and the chances of the problem being solved are even slimmer.

“Professor. So what are some heart conditions that can potentially cause syncope and can be detected by auscultation alone?”

Academics are good, but… … .

“Istina. You know that Cheongjin is listening to your ears.”

“I guess so.”

“Can you hear me if I keep talking next to you?”

“Oh, sorry.”

Auscultation of the heart is done at five points. From the top/right, the aortic valve, the pulmonary valve, the Erb point, the tricuspid valve, and the mitral valve. You can listen for problems in these five areas.

“After listening to the patient.”

“Yes.”

“I should say the mitral valve is a bit loose, but I can hear the sound of the mitral valve regurgitating. It doesn’t sound like a normal heartbeat.”

Bernard frowned.

“What should I do?”

“There’s nothing you can do. It doesn’t seem to be causing any immediate problems.”

It might be a needless worry.

Originally, mitral regurgitation was a common disease that one or two out of a hundred people had. Although mitral regurgitation may have increased the risk of syncope, I still think the cause was the drug.

“Don’t worry. It’s not a fatal disease, and if you just avoid the medicine, there won’t be any symptoms.”

Instead of answering, Bernard looked out the window.

This is the reaction I sometimes see in patients when I give them bad news. Even if they are feeling fine now, it must be hard to just ignore the news that they have an incurable heart disease.

****

It was good that they found the disease through auscultation, but it was a bit disappointing that there was no way to solve it. Fortunately, it hasn’t caused any major problems yet.

“Professor.”

“Yeah.”

“Can you please organize how to do auscultation systematically? I’ve seen it several times, but I still don’t quite understand it.”

“Ah. Okay.”

I should organize it into a booklet and distribute it somewhere.

Come to think of it, maybe we should start by handing out modern stethoscopes.

Originally, the healers of this world would just put their ear to the patient when examining them, or some would use something like a wooden tube.

You’ve made and used a stethoscope, but you haven’t made any efforts to spread it widely?