Chapter 11

11. Discovery of Bacteria (1)

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And so… the first step of the plan.

The microscope.

Robert Hooke invented the microscope in the 17th century. Humanity could see for the first time the basic structures that make up living organisms. Hooke’s microscope helped discover cells.

Of course, since human cells can’t be seen without staining, what he actually observed were plant cell walls in cork.

This is the research lab.

Anyway, a microscope is essentially just two or maybe three lenses. All the other parts are just there to make using it easier.

Ah, my throat hurts.

Isn’t there an easier way to make these?

“Professor, what are you doing?”

“Oh, good timing. I’m going to build a microscope.”

“What’s that?”

If I explain the microscope as simply as possible…

“You know magnifying glasses, right? It’s like stacking several magnifying glasses to enlarge the target. If one magnifying glass can enlarge something by 10 times, then two together can do 100 times, right?”

“Is that so?”

I’ve never tried making one myself, though I’ve used microscopes before. But I’ve never built one.

“It’ll work if we adjust the focus properly. The problem is, I’ve never made one before…”

Istina thought for a moment.

“Should we ask a watchmaker or optician? If it’s not too complicated, they should be able to make it. With two lenses, at least.”

Hmm, if that’s the case, I’d need to draw up plans. Though I doubt I could do that. Let’s try calculating the focus first.

“Will that work?”

“Even without detailed blueprints, if we explain thoroughly, something usable might come out of it, right?”

That does sound reasonable.

“Do we have a protractor?”

“I’ll fetch one later.”

In my past life, all I had to do was hand over samples to pathology or diagnostic departments. Even then, clinical lab technicians did most of the sample preparation and preservation.

Now…

Not only do I have to use the microscope, but I have to build one from scratch. This will be tough for both me and Istina.

We really need to hire more graduate students soon if we’re going to keep this operation running long-term. That way we can delegate tasks and avoid burnout.

“Istina, where do we usually find new grad students? You must be tired working alone, right?”

“Hmm… checking among senior undergraduates would probably be most reliable.”

Looks like I’ll have to teach some classes.

Normally teaching materials and syllabi are prepared by TAs, but Istina still has much to learn, so I’ll have to handle it personally.

“Istina, you should attend the lectures too.”

“Ah, understood.”

“In my thinking, I want to structure the lectures to support our research. Our ultimate goal in this research is to train healers with new knowledge. We’ll demonstrate as many experiments as possible during the lectures.”

“I look forward to it.”

Look forward to what, Istina?

Half the work falls on you, you know.

****

Was it Benjamin or Benjamine?

Probably just a difference in pronunciation.

Anyway, the student patient lay in bed. On the surface, they looked fine, and fortunately the swelling in their arm had gone down significantly.

“Are you feeling better, patient?”

“Yeah, I think I’m okay. I can move my arm now, though it still hurts a bit.”

I looked at Benjamin.

“You should wait another day before moving your arm. Moving it too soon might prevent proper bone healing.”

“Do I need some kind of splint?”

Not necessary. There’s already a metal rod in the arm bone – adding a splint won’t make it any stronger. Just be careful.

“No, just be careful. Avoid bumping it and don’t move it too vigorously.”

The patient nodded.

“Can I go home like this?”

“It’s still too early to discharge you. There’s still a risk of infection, and we need to practice moving your hand.”

Fortunately, they seemed to understand.

This hospital, even for this era, maintains a relatively clean environment. The wound dressings are changed daily, sometimes multiple times a day.

“Understood.”

“Patient, do you have any questions?”

“My arm still hurts a bit.”

“Well… considering we had to cut into your arm and insert a metal rod, it’s natural that it would hurt.”

Benjamin gave me a “what kind of lunatic says that?” look. Ah, I shouldn’t have said that. I thought about how to phrase my next words.

“On a scale from 0 to 10, where 0 is no pain and 10 is the worst pain imaginable, how much pain are you experiencing?”

“Uh, about 3?”

Though it may seem primitive, asking for a pain score out of 10 is the simplest and most efficient method for assessing pain.

A score of 3 isn’t severe pain, but…

Still, we should keep in mind that ideally pain should be at 0. Even a score of 1 can be enough to disrupt sleep.

Let’s prescribe acetaminophen for now.

“For mild pain, I’ll give you acetaminophen. It’s a mild painkiller that should reduce the surgical site pain somewhat.”

If we talk brand names, it’s just Tylenol.

I turned to Istina and handed her a bottle of acetaminophen. She carefully took it.

“Give the patient three pills a day.”

“Yes. Does it matter if it’s before or after meals?”

It doesn’t.

“Have them take it after meals.”

Istina nodded.

“Istina, did this patient have a fever?”

“No, they didn’t.”

They could still develop one. There’s no reason to reconsider giving Tylenol. We also need to prevent swelling in the wound.

“Keep an eye on it, Istina. If the swelling worsens, the stitches could burst or cause necrosis. That’s why we’re prescribing anti-inflammatory medication.”

“I see.”

I thought some more.

Should we use prophylactic antibiotics?

This patient underwent surgery in an operating room without positive pressure ventilation. There’s a significant chance dust or contaminants entered the wound.

Turning back to the patient:

“There’s a possibility dust entered the wound during surgery, so we’ll administer cefazolin to prevent bacterial infection.”

Now that I think about it, we should have given prophylactic antibiotics before surgery. Not essential, but better as prevention.

“What’s that?”

“It’s called prophylactic antibiotics. To prevent bacterial infection of the wound – umm… this medicine will prevent the wound from rotting.”

The patient nodded.

Thinking about it, other people probably just see me pulling things out of thin air. I removed the air bubbles from the cefazolin syringe.

“Here comes the injection. We’ll be administering 2 grams of cefazolin. It might sting a bit.”

I injected the cefazolin into the patient’s opposite arm. This should eliminate most infection risks. The patient winced slightly.

I closed the needle cap and put it in my pocket.

Time to wrap up.

“Patient, are there any fingers on your injured arm that aren’t moving?”

“No, none. Though moving my fingers still hurts a bit.”

I examined both of the patient’s hands. The operated side showed all five fingers moving properly.

What else should I check? Ah, I haven’t checked for rhabdomyolysis yet. It could be a complication from compartment syndrome.

“Has your urine color changed at all?”

“No, why?”

I briefly considered my wording.

“If there was muscle damage from compartment syndrome, products from muscle breakdown could appear in your urine, potentially causing kidney damage which would change urine color.”

“What does that mean?”

Istina was also looking at me blankly.

Thinking of an easier explanation… though even in my past life, I wouldn’t omit details just to simplify.

If the patient or guardian asks for clarification later, I can explain again. It’s important to provide accurate information.

But how to phrase it simply?

“In short, if muscles are damaged, those products can appear in urine. Since your urine color hasn’t changed, that’s fortunate.”

It was disappointing.

If we could run blood tests here, we could see numerical values for rhabdomyolysis indicators, kidney function, and infection markers.

“One more thing, patient. Your fingers don’t contain muscles – they move due to muscles connected to your arm. So moving your fingers will cause arm pain.”

“I see.”

“Take a look.”

I showed the patient the tendons on the inside of my wrist. Istina tilted her head in confusion.

“These tendons connect from your fingertips all the way to the muscles in your arm. Since the surgical site is around here, moving your fingers will cause pain.”

Benjamin nodded. That should be sufficient understanding. It’s not a complicated concept.

“Well, I’ll take my leave, patient. It’s fortunate that the surgery and recovery seem to be going well.”

The student lying in bed nodded. Istina followed me out of the ward.

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