Chapter 20

Episode 20: Dispatch Duty of the Plague Doctor (3)

***

Already, night had arrived.

But the horse of illness doesn’t sleep just because it’s night, so neither can we retreat to rest.

I’m about to die from all this. I did hear earlier that there was some guest room at Lapis Castle or whatever, but I never got a chance to leave the relief station.

All I managed was a quick nap on a hammock-like thing in the corner. Istina was standing and dozing off.

Just another day at the office.

Anyway, ER is always on a three-shift rotation.

How can you go home when people keep dying right beside you? Thanks to my diligent efforts of force-feeding alcohol to my patients, none of them died… yet.

Thinking about it makes me feel sick. It’s unacceptable that someone could die just because they didn’t drink enough water—but that’s exactly what happened yesterday, I’m sure of it.

What can I do? I may not be able to sleep, but I can’t clone myself either.

“Oy, the sun’s up, Istina! Time to work!”

“B-but last night…”

Several people died overnight.

Was it from lack of sleep, or emotional exhaustion? Istina’s hands were trembling slightly. I looked at her.

“Did any of our patients die?”

“No.”

“Then don’t think about the others. You’ll ruin your health.”

A hospital is a place where people come to die as well as heal. Of course, deaths are unavoidable. Last night, we ran around like dogs on steroids.

Still, with the sun up, we finally have more hands available. I’m hoping the number of incoming patients has decreased today.

“Will the number of patients drop today?”

“Please let it drop!”

We don’t know yet.

I hope pouring vodka into every well last night had some effect, though the results aren’t clear yet. We’ll see soon enough.

Still, several patients under my care seem likely to be discharged by the end of today. If things stabilize, maybe I can go home.

“Professor Asterix. Could you please come to the conference room? The Lord requests your presence.”

The plague doctor in his white robe.

It was Hedwig again. Did something improve? Did the number of patients drop dramatically?

Hedwig’s face was obscured by the beak-mask, but I imagine they’re just as tired as us. The relief station has become a literal battlefield.

“What’s the matter?”

“We’re going to discuss future strategies.”

“I’ll head over immediately.”

I nodded.

I should check in anyway—I don’t even know how much quarantine work needs to be done today. Also, I need to verify if the bureaucrats of Lapis actually did their jobs.

Did they do well?

***

We quickly arrived at the conference room inside Lapis Castle. As usual, it was bustling with people, all looking exhausted—clearly they worked hard through the night.

That’s a good sign, right?

“You’re busy.”

Though he gained some new dark circles overnight, the Lord of Lapis greeted me enthusiastically. Apparently, there was progress last night.

“Let’s cut to the chase. We patrolled the market all night and mapped out the distribution of patients. Just as you said, the plague spreads centered around specific wells.”

“Yes.”

“So you agree? Cholera is waterborne, caused by contaminated drinking water. Clean water is the solution.”

“That seems correct to me. The policy appears to be working too.”

The Lord of Lapis nodded.

“Since everything checks out, let’s proceed as you suggested. How far along are we?”

I was worried about this.

When John Snow first proposed the fecal-oral transmission route for cholera, government officials admitted his countermeasures worked but refused to believe his theory.

For stupid reasons. The idea that cholera originated from fecal contamination was simply too unpleasant for society at the time to accept.

But reality must be faced, right?

Luckily, the Lord of Lapis seems to trust me. He’s already hopeful that the number of new cases will drop significantly today.

“We poured pure vodka into the wells, but it’s only a temporary fix. It’ll probably evaporate within a day or two.”

“What’s the next step?”

We need multiple solutions.

“We need to find the source of contamination. Digging new wells might help. Encouraging people to boil their water before drinking would also be beneficial, especially for children. Installing sand filtration systems near the wells would be ideal too.”

In England, there were temporary orders advising against drinking unboiled water. Whether people followed them is questionable, but brewery workers reportedly avoided cholera altogether.

“Distributing beer, ordering boiled water consumption, installing filters at each well, and emphasizing that hydration treats epidemic dysentery should suffice. At least for now.”

The Lord of Lapis nodded.

“Is there a more fundamental solution?”

“Well, now that we’ve identified the problem and response measures, it’s better than before. A deeper solution requires further thought…”

Improving the entire sewage and water infrastructure system. But saying that might just get me yelled at, right?

Firho the teacher scored another point today.

Of course, Firho went further, advocating for democracy, tax cuts, infrastructure expansion, and road improvements.

Which labeled him a revolutionary.

I thought carefully before speaking.

“Epidemic dysentery arises from overlapping issues: malnutrition, poor water sanitation, polluted water sources, and inadequate hygiene.”

The Lord of Lapis’s eyes narrowed slightly.

“Yes.”

“There is a fundamental solution, but it will require significant time and money.”

He clearly didn’t want to hear that.

“Understood.”

“That’s a discussion for later. Sand filtration alone can solve most problems. Don’t worry too much.”

“But what exactly is the principle behind sand filtration? We’ve prepared according to your instructions, but…”

It’s simple.

Filtering water through sand. Bacteria are tiny particles, but does filtering water through sand really catch them?

It does.

The mechanism requires some explanation, though it’s surprisingly complex.

Bacteria trapped in the sand form biofilms. Ironically, bacteria cannot pass through biofilms created by other bacteria.

This creates a semi-permeable membrane that even bacteria can’t penetrate. Strange but true—the filtration power of sand purifiers comes from these bacterial barriers.

Activated carbon plays the role of adsorbing fine particles. For those unfamiliar, think of it as charcoal.

Anyway…

We moved to a workshop inside Lapis Castle. With their current technical skills, building sand purifiers isn’t difficult.

No special technology is required.

“Professor, can sand and charcoal really purify water? Enough to filter out bacteria?”

“Absolutely.”

I already spent a lot of mental energy explaining this topic. Repeating it now feels tedious.

Public servants truly worked all night. Several sand purifiers were already completed. When water flows through…

Purified water does come out. Assuming, of course, that the buckets holding the water and the pipes dispensing it aren’t contaminated.

Still, it’s far better than nothing.

“This seems successful, doesn’t it?”

“Indeed. It works well.”

It’ll take about a day for biofilms to form inside the sand purifiers. How dramatic the effect will be remains unclear.

***

And then, the next morning.

As mentioned earlier, the median incubation period for cholera is about a day. If our measures were effective, the number of patients should decrease by now. Have they?

“Still, it’s much quieter than before.”

“Don’t say that. Here comes a patient.”

We opened the doors of the relief station—and…

Not a single person was lined up outside. No one came overnight seeking treatment.

“What is this…?”

Istina gasped, but it’s too early to relax. More people will likely show up later today. Just because no one was waiting at dawn doesn’t mean anything.

“Does this mean it’s solved?”

“Seems so… How did you know?”

Future knowledge.

Textbook stuff, literally.

“Follow the logic. We hypothesized that epidemic dysentery spreads through water.”

“Right.”

“We proved this hypothesis by analyzing the geographic distribution of patients. Then we purified all the city’s water sources, leading to this result.”

Istina pondered this.

“It’s almost ridiculous. So many have died from epidemic dysentery, yet the solution was this simple.”

What’s simple about any of this? After pulling three all-nighters, I can barely walk straight.

---