Chapter 29

29. Severe Trauma Patient (1)

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Beneath the sky, upon the earth.

Though the wind blows and sunlight touches every corner of the Empire’s royal domain, none of it could mend Imperial Princess Mint’s sour mood.

The Imperial Princess, Mint, was deep in thought.

What’s the point of coming to the Academy if all they do is fear me because I’m a princess? All I’ve gotten is less time with someone special… I wish we could just go back to the palace together.

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Looks like my private info got leaked somewhere.

Even in this other world, spam mail finds its way to me.

Maybe the Healing Department at the Academy is just forwarding all the letters addressed to me directly to my desk. Either way, my inbox is piling up with spam. It’s impossible to read them all.

I only open the ones from people I recognize, like Lord of Lapis.

– Professor Asterix, I seek your expert opinion on a public health matter. Please reply at your earliest convenience. Your time is valued, and I will compensate you accordingly.

– Sincerely, Lord of Lapis.

This one needs a response.

Imperial Prince.

– Is Mint doing well? No reply yet.

– You insolent brat, pretending not to receive my letter. This is an official communication from the palace. Respond in no less than two pages.

Seriously? How did he know I wasn’t planning to reply without even seeing my face? Guess there’s a reason why he’s the prince—his intuition must be superhuman.

There are a few letters I have to read since they’re from people I know. But what about the rest? Why are there so many? Oh no… Could these be graduate school applications from eager students?

After sifting through piles of letters, there were no grad school applications. Figures—any student serious about joining the graduate program would’ve visited first.

Sigh.

Then what is all this?

Most of the letters came from healers outside the Academy. Half of them are rebuttals: “Your theories are wrong,” “Can we experiment with your methods?” “Why doesn’t this work?” “This actually makes sense…”

It’s impossible to read them all…

I’ll delegate this task to Istina later.

Anyway…

Though the academic community might be in chaos, work still has to be done. Patients need treatment, and the wards need supervision. If I don’t do it, Istina will have to.

Still, only a portion of patients who visit specifically ask for me. Most come with uncomplicated illnesses, receive healing magic, and leave.

“At least there aren’t too many hospitalized patients. That’s fortunate.”

I muttered under my breath.

As soon as those words left my mouth—BOOM BOOM BOOM! A frantic knock echoed at the research lab door.

BOOM BOOM BOOM!

An urgent knock can mean only one thing.

Istina burst into the room, her head poking in hastily. Internally, I sighed.

“Professor! We have new admissions!”

“Seriously? Did my idle talk act as some kind of flag?”

“Did I misunderstand something?”

“Nope. What kind of patients do we have?”

Istina flipped open her notebook.

“There are several. One patient came in with bruising on the upper left abdomen, complaining of dizziness and blurred vision. Another says they heard a snap in their ankle—”

That sound sends shivers down my spine.

“Just a sec. The one with bruising on the upper left abdomen and blurred vision—how long ago did this happen?”

“We don’t know exactly how long since the accident occurred, but they just arrived at the hospital, professor—”

I bolted toward the ward.

“Professor! The patient is just a bit sleepy after receiving a lot of healing magic and taking pain-relieving herbs—they seem fine—”

“Don’t let them fall asleep! They could die!”

Of course, patients may feel tired or sleepy, but when dealing with massive blood loss, falling asleep can be fatal.

“Was the blanket covering them?”

“The blanket? They’re in the ward.”

Uh-oh.

Never cover a trauma patient with a blanket—it can be dangerous.

“Istina! Go fetch a bucket of water.”

CRASH! I sprinted to the ward.

Hmm, the trauma patient Istina mentioned seems conscious enough for now. Good.

Another young male patient—but older than our typical Academy students.

Judging by his clothes, he doesn’t appear to be common folk.

His complexion is pale, his eyelids drooping, and his gaze unfocused, suggesting sleepiness. The most likely cause? Blood loss leading to decreased consciousness.

The source of bleeding is likely trauma. Though we don’t know which organ is damaged, the spleen is the prime suspect.

I immediately yanked the blanket off the patient and threw it to the floor before shaking him awake.

“Sir! Falling asleep now will kill you!”

“Huh?”

“Wake up immediately!”

“Mmm… I’m so tired…”

No, no, keep those eyes open.

“Could you please state your name?”

“Kylas Kaperfield. Uh… I was training at the Academy’s practice arena… Gah…”

His level of consciousness keeps fluctuating.

This patient is dying.

Truthfully, it doesn’t matter who he is. What matters is that he entered with upper abdominal trauma and shows signs of impaired consciousness.

At least I got his name.

Istina returned quickly. She placed a bucket of water beside me, and I promptly splashed it all over the patient.

“What the—!”

“Time to wake up!”

The patient—and everything around him—was soaked from the water assault. I grabbed a towel, ignoring everyone’s bewildered stares.

****

There was good reason for this.

During World War II—or maybe WWI—who knows. Anyway, during wartime when gunshot wounds were rampant, battlefield medics discovered something peculiar: soldiers left uncovered survived more often than those wrapped in warm blankets.

Why?

For several reasons, but the main one is this: warmth activates the parasympathetic nerves at the body’s extremities.

When peripheral blood vessels dilate due to warmth, blood flow to vital organs like the brain and heart decreases.

Combine that with major blood loss, and the brain receives insufficient blood flow, making the patient feel sleepy. If they succumb to sleep, they die.

This patient likely has internal bleeding, judging by the location of the bruise. It’s probably the spleen.

“Is a patient with a torn Achilles tendon more urgent than someone feeling sleepy?”

“A torn tendon won’t kill them.”

Even if it’s the Achilles tendon, with crutches, they’d still be able to walk eventually.

On the other hand, internal bleeding and subsequent loss of consciousness can lead to death within hours.

The patient, shivering in his wet hospital gown, stared at me in confusion.

Sorry about the cold shock, but staying awake could save his life. I checked his pulse with my fingers on his neck. 18 beats in 10 seconds.

Seems normal… or maybe slightly fast.

“Are you more alert now?”

“C-cold…”

“Stay awake.”

Thinking about it, I really need to create a blood pressure monitor.

I need to check the patient’s blood pressure.

Unfortunately, in a suspected internal bleeding case, I realized we lack a blood pressure monitor. His blood pressure must’ve dropped due to injury.

Is there a way to measure blood pressure without equipment?

Let me think.

What substitutes for blood pressure? Pulse? Nope. Pressing the wrist harder might reveal differences… but unlikely.

Let’s rethink blood pressure. Blood pressure is arterial blood flow pressure. Normally, we check both systolic and diastolic readings.

Hold on, why do we check blood pressure? Isn’t it to ensure the patient isn’t lacking sufficient blood flow?

Ah, there is an indirect method. I tried checking the patient’s wrist pulse but couldn’t find it.

People vary, but you generally need a systolic blood pressure above 80 to detect a wrist pulse.

There’s another indirect method—not arterial but venous pressure. Press the jugular vein to determine where the pulse is palpable.

I pressed the patient’s neck with my index finger. The jugular pulse was detectable 3 cm above the sternum. Estimated central venous pressure: 2 mmHg.

Blood pressure is low.

Pale skin, impaired consciousness, absence of wrist pulse, reduced central venous pressure—all evidence points to severe blood loss.

There’s only one option.

“Patient, you need to make a choice.”

“What choice?”

Ideally, Mr. Kylas should regain full awareness before deciding, but given his impaired consciousness, any decision made will likely be half-asleep.

A life-or-death decision.

“To put it simply, there appears to be internal bleeding inside your body. If we leave it untreated, you won’t survive until tomorrow.”

“Really?”

“Healing magic has already been used. If you refuse surgery, we’ll do our best to maintain your life using healing magic and medicine until you fall asleep.”

“Um, it’s not that bad—”

Strange. If the spleen ruptured, the pain should be excruciating. Maybe the initial pain subsided or was masked by healing magic or medication.

That’s irrelevant right now.

“I believe surgery is necessary. However, I cannot guarantee survival or success, and the procedure will definitely have side effects.”

“Or I die if I don’t have surgery?”

I carefully chose my words. Sometimes doctors give patients the illusion of choice when presenting medical options…

Well, even if I held a knife to their throat, the choice wouldn’t be much different.

Not having surgery means certain death.

Will you have surgery?

Basically, I’m just asking if they want to die.

The patient helplessly nodded. Fine… let’s start the surgery as soon as possible.

Saving lives absolves all sins.

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