episode_0159

Episode 159. I can’t see (1)

****

The Academy bakery was better than I thought. They put butter on the morning bread. Is that how it is supposed to be? I don’t know because I don’t usually buy it.

I bought some when I was giving out blue mold food.

There’s no need for that these days.

“Isn’t this moldy rice?”

“Don’t worry, it’s new.”

Only then did Istina start eating her morning bread as if she was relieved. Surely I wouldn’t give her something she would die from eating, no matter what.

“Istina. Are there any backlogs of outpatients or inpatients? I haven’t been to the hospital for a few days, so I’m sure there are.”

I wasn’t there for long, but it wouldn’t be strange if several patients came to visit while I was out. None of the patients seemed to be hospitalized, though.

“Oh, there were definitely a few people behind in the outpatient clinic. As for the inpatients, there weren’t any people who were going to be admitted before the professor.”

Considering that professors with a good reputation at university hospitals have had their appointments delayed for months, they may not be that busy.

Relatively speaking.

Istina stretched.

“Still, you had a hard time while the professor was out. Do you know that the letters piled up?”

“It must have piled up.”

I sighed.

“I need to take care of the outpatient treatment first. You, read the letters. If there are letters asking academic questions, think about what to say in response.”

“Yes.”

I left the lab, leaving Istina behind.

****

Let’s get back to work.

As the weather gets colder, the number of people visiting hospitals will probably increase. The risk of heart disease increases during the changing of seasons, right?

I waited in the examination room.

There was a knock at the examination room door.

“Come in.”

The first patient who came in today.

A female patient who appears to be of college student age.

That’s a familiar face, but who is it?

-Esabeth Ceruleus.

-Wilson’s disease.

Oh, it was that guy.

It was Princess Erzabeth of the Cerulean family that we met last time. After a rather long and complicated mystery, it was revealed that Princess Erzabeth was actually adopted and suffered from Wilson’s disease.

If there’s anyone who doesn’t remember what that disease is, it’s a disease where there’s a problem with copper metabolism, so copper accumulates in the body. When copper accumulates in the eyes, a peculiar yellow ring is created.

That’s what I was wondering. Was the golden ring surrounding the eye gone, or still there? I expected it to be gone.

“Is that Miss Elizabeth?”

Miss Elizabeth agreed.

“Are you feeling better?”

“Oh, yes. I think I think and move faster than before? Sometimes, I don’t have a hard time getting up in the morning… … .”

I wonder how much medicine is left.

“As I said last time. It is better to avoid foods that contain a lot of copper, such as nuts, seafood, and mushrooms. You didn’t eat them, right?”

“Yes.”

“Let me see your eyes.”

Princess Elizabeth remained silent. I lifted the patient’s eyelids. There were no rings in the pupils, and there was no trace of copper accumulation in the whites of the eyes. There was no trace of jaundice either.

“You must not drink alcohol either.”

“Why alcohol?”

“The patient’s liver is not in good condition.”

“I see.”

Princess Elizabeth didn’t look happy. She must be upset because there are many things she can’t do at her young age. I was at a loss for what to say.

“There are a lot of things that don’t work, right?”

“That’s right. There are a lot of things that don’t work.”

“What… … . Sorry. I wish there was a better way, but it’s beyond my capabilities.”

“There’s nothing the teacher should be sorry about.”

The patient sighed.

“I’ll give you some more medicine. This time I’ll give you some zinc supplements, which will also help your body remove copper.”

“Thank you.”

I looked at the patient’s medical records again.

Come to think of it, it wasn’t just Princess Elizabeth who was sick. I remember that all three children of the Cerulean family were sick.

It remains a mystery whether it was due to ergot poison or just a faking illness.

“But. How is your family?”

“Why the family?”

The princess tilted her head.

“When I went to the doctor, all three of us were sick. I wonder if they got better.”

“That was all a lie.”

I shook my head.

Healthy people don’t pretend to be sick.

Whether it’s a child complaining of a stomachache because they don’t want to go to school, a Munchausen patient harming themselves, or, as in the case of the Cerulean family, pretending to be crazy for the sake of their youngest sibling.

To be honest, I don’t know what logic the children of the Cerulean Dukes had in doing such a thing. I heard it, but I didn’t understand it.

“Everyone is fine. I didn’t hear anyone complaining of pain. They didn’t look sick.”

“Then that’s fortunate.”

I should write that down in my medical records.

Still, I’m glad the condition has resolved. It’s been a few weeks already, and the treatment is going well.

“But, on a different note. I saw that professor’s name in the newspaper. There were all kinds of strange articles about it. Is that true?”

It was something worthy of being in the newspaper. There were so many things that came to mind. I scratched my head.

“You don’t have to believe everything the newspaper says… … . There’s bound to be some truth in it. Why would there be smoke in a chimney?”

“Hmm, I see.”

“About here.”

“Thank you!”

Let’s finish. I handed the vial containing the pills to the princess. Princess Elizabeth bowed to me and left the examination room.

Now that I think about it.

I wonder where Princess Elizabeth’s biological family is and what they’re doing. It’s highly likely that they have the same disease as the princess. It’s a hereditary disease.

****

A second patient entered the examination room.

A male patient with a very dark expression. He was slightly turning his head to the left and was looking around excessively. Is it a tic?

or not…….

“Are you unable to see with one eye?”

“How did you know?”

“It looks like that. Please have a seat.”

The patient nodded and sat down with a dumbfounded expression. Asymmetry is always a problem to be considered in medicine.

Patients who are deaf in one ear or blind in one eye always take steps to address the gap. Absolutely.

Whether conscious or not.

Why might one eye be blind?

I thought about it for a moment.

First of all, the most common cause of visual disturbances is the aftereffects of a head injury. In this case, it is likely to return after a few hours.

“What is your name?”

“This is Ethan.”

“Mr. Ethan. Since when has this been happening?”

“One day has passed.”

This is a big deal. If it’s been more than a day, there could be tissue damage. I held back a sigh. There’s no need to add to the patient’s worries.

“Teacher, close your right eye.”

“Yes.”

“How much can’t you see?”

“Uh, half? Something like a black dot… … .”

There are several possibilities. It could be diabetic macular degeneration, it could be head trauma (though it doesn’t seem to be), it could be a blocked artery.

I thought about it for a moment.

“Patient. Have you hit your head recently? Is that a possible cause?”

“No. I fell down yesterday because I couldn’t see. But after I lost my sight.”

This means that head trauma can be excluded.

I thought about it some more.

“Has the patient’s urine output increased recently? Has there been any problem such as foam in the urine or a dry throat?”

“No.”

If it is not a head injury, diabetic retinopathy is the most likely cause. The problem is that it is very difficult to confirm diabetes at this time.

First, let’s assume that there is no diabetic polyuria. Diabetic polyuria usually occurs after diabetic retinal degeneration begins.

I thought about it some more.

“Have your eyes been feeling drowsy lately?”

“No. It just happened one day.”

Diabetic retinopathy is usually a degenerative change, occurring over months or years, but cannot be completely ruled out.

Retinal detachment and other problems can occur suddenly due to diabetes. There are many potential problems.

“Let’s calm down for now.”

“I calmed down.”

“I’ll calm down. I’ll assume that it’s a solvable problem here and treat it, for now.”

“Yes.”

Don’t be too obsessed with the idea that you can’t see an ophthalmologist. Think of it as a way to slowly solve the problem. First, try to see the retina.

“Open your eyes wide.”

I tried to look inside the patient’s eye. I couldn’t see the inside of the retina. Well, if it were wide open, it would look like it was… … .

There is usually a separate device for fundus examination.

“Let’s do it like this.”

“Yes?”

“First, you will be admitted to the hospital. We will carefully check whether you have diabetes or not and whether there are any problems with your eyes.”

“Is this a disease that can be cured? Or do I have to keep living like this… …?”

“I don’t know yet.”

The patient sighed.

First of all, considering that the patient’s pupils are symmetrical and the pupillary reflexes are normal, it doesn’t seem to be a brain problem. It’s a blessing in disguise.

First, let’s solve the diabetes problem.

“Let’s get some urine first.”

“Why have I been urinating since a while ago?”

“You need to smell the urine.”

“Yes?”

The patient was looking at me with a suspicious look. No, what do you want me to do when you need urine for diagnosis? Should I just leave it out of sight?