episode_0183

Episode 183. I hugged you (4)

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Infective endocarditis with mitral regurgitation.

It was a disease I had seen once after coming to the Academy. I thought I would give my student the opportunity to diagnose infective endocarditis.

“Take a listen.”

“Yes.”

I stepped aside. Linea auscultated the patient’s chest with a serious expression.

I circled the points I needed to auscultate with a pen. You shouldn’t draw on a patient, but it would erase right away when I washed it.

There are five points on the heart to auscultate, but the fifth point is the most important.

This is the point where the left ventricle, which sends blood to the whole body, is located. You can hear the sound of the left ventricle’s valve.

“Lower left side of chest. This is where the mitral valve is. Can you hear the sound of blood flowing back?”

“I think I hear something strange.”

Linea didn’t answer clearly. After all, it wasn’t something that was easy to understand just by listening to a stethoscope once. It was a process that required practice.

“A disease called infective endocarditis. A disease in which bacterial clumps form in the membrane inside the heart.”

“Really?”

This time, the patient looked serious and thought quietly. Linea looked at the booklet as if it was a novelty and then opened her mouth.

“How do you know that?”

“The patient currently has a low-grade fever, had a bacterial infection a few days ago, and can be heard refluxing blood from the tricuspid valve.”

“What is the cause?”

The patient had suffered a streptococcal infection in the throat a few days earlier, and it was suspected that the inflammation had spread to the lining of the heart via a cavity.

There was no way to prove it clearly. Either take blood for a blood culture, or-

Oh. Come to think of it, blood collection for blood culture could still be done. There are a few things that are needed, but it’s possible to try.

I looked around.

“Let’s draw some blood. Regardless of the blood culture results, we need to treat with antibiotics, but… … .”

Still, I could try. I disinfected the patient’s arm, my hand, and the syringe again with alcohol, and then drew blood from the patient.

I’m going to put this in a culture bottle. If I’m right, it’ll confirm streptococcus infection. If not, it’ll be treated with broad-spectrum antibiotics, right?

“The patient has heart disease. We will monitor the patient closely, and you must tell us immediately if you feel even the slightest pain.”

“Can I die?”

I sighed.

“Uh… …. Don’t worry. We’re watching, so you won’t die.”

“That’s fortunate.”

Still, it is a dangerous disease. If left untreated, there is a very high chance of death or permanent damage. It is fortunate that it was discovered now.

I took the antibiotic injection out of my pocket.

The best way is to initially use broad-spectrum antibiotics and then change the drug according to the type of bacteria causing the infection after culture.

Well, we don’t know if the cultivation will be successful.

“If you feel pain, tell me right away. I’m going to go now, and the nurses will check on the patient every two hours-”

Linea left the sickroom. I scratched my head, why did she leave before I could finish speaking?

“Did I do something wrong?”

“No. That’s how it was originally.”

The patient looked at me with a puzzled expression. I had nothing to say.

“You’re not a weird person, are you?”

“You’re not a human, you’re an elf.”

Well, this person was my patient, not Linea’s patient. I said goodbye to the patient and followed Linea out of the hospital room.

****

When I thought about Linea becoming a professor, seeing patients and teaching students, I felt uneasy. There were many unusual things about her.

On the one hand… … . How many doctors have personality disorders? Most of them aren’t pretty elves. That might not be a big deal.

We left the sickroom behind and returned to the examination room. Linea was holding a pencil and busily writing something down on her clipboard.

It took longer than expected because a patient came in suddenly. But at least we saved a person’s life.

“Why did you leave early?”

“Ah. Weren’t you just finished talking?”

Linea answered with her eyes wide open.

That’s right. I did finish talking. He’s not a student, he’s a fellow professor…

“It doesn’t really matter. But it’s better to show a professional attitude to the patient.”

“I will keep that in mind.”

The elf healer shuffled through the paper.

“That’s amazing. I was wondering what it meant when they said there was something wrong with the valve. Thanks to that patient, I was able to auscultate it right away.”

I nodded.

Right, there was something I was preparing earlier.

I injected the blood I just drew into a culture bottle. If I’m lucky, I’ll be able to find the bacteria circulating in the patient’s blood.

Linea was mumbling something, as if trying to sort out the questions in her head.

“But. What is infective endocarditis?”

“Endocarditis caused by bacteria.”

“Is it contagious?”

“No.”

“Why isn’t it contagious?”

It’s a sharp question. While it’s not completely impossible, person-to-person transmission of infective endocarditis is not a consideration in most cases.

“Well, for bacteria in the heart to travel to another person’s heart and cause problems, it has to go through quite a few steps.”

“That’s true… … Then why does the valve sound strange?”

“It’s because bacteria grow on the valve. It’s to the point where it causes structural problems in the valve.”

Linea frowned.

“Then, if we open the patient’s heart now, will we see clumps of bacteria on the valve?”

It sounds scary, but it’s true.

When the heart is opened during infective endocarditis, bacterial structures can be seen. In a modern hospital, this would be seen with an echocardiogram.

“As expected… … . I did well to follow the professor to the clinic today. I learned a lot today.”

“You should have come as a graduate student.”

“Doing it twice is a bit much.”

Linea, who had been smiling all along, answered this firmly. I let out a sigh.

The elf healer turned his head.

“Oh, was this scroll there before too?”

****

I looked at the elf healer.

As a result of working together today, I expected that being with Linea would be hard, but it was better than I thought. What I felt was… … .

Healers are generally similar people.

It’s rare to have the opportunity to hear a completely different perspective, and Linea was able to provide that.

Well… … . There will be many people who don’t want a new perspective, so we’ll have to adjust it well. But it’s still a strength that can be used.

I think I was thinking too negatively.

‘I don’t want to keep working together, though.’

Anyway, I’m tired. My graduate students listen well when I talk to them. They don’t show any special behavior in front of patients.

anyway,

Linea opened the letter.

There was a letter in front of my office. That’s strange. Is there anyone who would send a letter to my office? Is there a reason for that?

Was this sent by the patient’s family?

I opened the letter.

-The weather is cold these days, so take care of yourself.

-My brother is sick.

-After breaking up with her fiancé, she said she had a fever and heart pain. I was worried that it might be a serious illness, so I sent her to the Academy Hospital.

-I’m sorry if I wasted your time with something like a private affair, but I can’t help but feel a little uneasy, so I’m writing to you.

Linea tilted her head at the letter.

“Thank goodness I don’t have a heart attack.”

I was a bit curious. Why did this patient break up with her fiancé? I didn’t ask.

-I’m sorry for always asking you to do this.

-Thank you again. If Professor Asterix asks you anything of me, I will do my best to make it happen.

-Laplania, Baron of Lapis.

I rolled up the letter and put it in my bag. I received a blank check from the Baron of Lapis. I should think about what to ask for.

Come to think of it, didn’t they give a similar answer when they visited because of the cholera epidemic?

You gave me two blank checks.

I don’t know if Ms. Laplania is naive, just being cliche, or if she thinks I won’t make any unreasonable demands.

I need to scold him.

****

Amy was shuffling through papers in her lab. Due to the aftermath of the overseas conference, there were a lot of people coming to see Professor Asterix.

There will only be a lot for the time being.

The healers who came from abroad all seemed to want to see Professor Asterix at least once. Several of them have already come and gone.

It’s normal to be busy before and after conferences, but this was the first time I’ve seen scholars harass their lab colleagues after the conference.

A saint who is practically stalking Professor Asterix. An elf healer.

I don’t know what the professor is doing.

I think we were walking to the ward earlier, together with the new professor, the elf healer.

‘It would be nice to be a professor.’

Well, it wasn’t a bad thing.

Linnea’s career wasn’t on a level comparable to Amy’s. Elves live much longer than humans.

Linea may look young on the outside, but she was actually a healer who had completed her doctorate and had several years of clinical experience.

It’s not something to be jealous of. If you were jealous, Amy should have finished her PhD too – Ah. I feel bad saying that to the professor, but honestly, it was horrible.