Chapter 50

Episode 50. The Cost of Misdiagnosis (2)

****

The cost of misdiagnosis was immense.

I don’t know exactly how much damage Imentia suffered, but freezing an entire city like this couldn’t have come cheap. Not even close.

If you ask whose fault it is, well… Was it the bureaucrats who panicked at symptoms like hemoptysis and skin rashes and immediately thought “Black Death”?

That’s something for Imentia to sort out on its own.

What I need to focus on now is helping the patients. Right now, the best course of action would be lifting the quarantine and giving vitamin C to those with scurvy. Persuading them shouldn’t be too hard, right?

Everyone has their own opinions.

And those opinions? To the person holding them, they’re as obvious as the sky being blue or water flowing downhill.

When it comes to truly important matters, there are people who won’t be persuaded even if the heavens split in two.

I hope the people of Imentia aren’t like that. We’ll find out soon enough when we try.

All I need is for someone to relay the message to the temple healers while I go persuade the mayor.

I rejoined Anata. She was deep in discussion with other healers in a corner of the temple.

We stood before the priests.

“We’ve reached a conclusion, Anata-san.”

“What is it?”

“It’s best to send people with mild symptoms home after giving them medicine.”

“Is that so? Won’t that be dangerous?”

“The plague doesn’t seem to spread exponentially. Patients who are stable enough to return home will likely recover better there.”

“Ah… I see.”

Anata nodded her head.

I expected some pushback, but she seemed to understand pretty quickly. Makes sense though, considering the temple’s supplies are running low and manpower is stretched thin.

Deep down, they probably wanted to hear that less critical patients could just be sent home.

“The most contagious disease is the common cold. It’s best to prioritize sending home patients without fever, cough, or phlegm.”

Right now, the social costs and risks of maintaining quarantine outweigh the benefits. We need to end this as soon as possible.

“I’ll check with higher-ups.”

“Will it be difficult?”

“It should be fine as long as we get permission… but I’m not sure what the bishop and mayor think.”

“I’ll do the persuading. After all, once supplies run out, we’ll have no choice anyway. It’ll become impossible to maintain the quarantine.”

Anata hesitated for a moment but ultimately realized she wasn’t the one making the final decision. Looks like she reached the same conclusion I did.

The priest looked up.

“Fruit will arrive soon. Distribute one piece to each patient starting now. If they eat normally for about a week, they should recover.”

“That would be wonderful.”

****

Back to Imentia Castle. I bowed deeply before the mayor of Imentia. The mayor stared at me with a troubled expression.

“Please explain again, Professor.”

Here we go again.

It’s frustrating, but bureaucracy is like that. At least the mayor of Imentia seems reasonable. Hopefully.

“Mayor-sama. Due to our efforts in quarantine and treatment, the risk of the plague spreading further appears minimal. Please consider allowing mild cases to return home and lift the curfew and quarantine measures.”

“That’s fortunate if true.”

He didn’t look the least bit relieved.

“This is based on my visit to the temple. While there haven’t been many deaths, there’s a risk of the common cold spreading in overcrowded conditions. Balancing the pros and cons, it seems best to lift the quarantine.”

“I’m not a healer, so I don’t understand the situation at all. Please explain clearly.”

Fair enough. I carefully considered my wording – people’s lives might depend on it.

“Mayor-sama, the disease we initially thought was the Black Death is actually a combination of three illnesses: periodontitis, the common cold, and scurvy.”

“Three diseases?”

“Yes. Periodontitis causes bleeding gums and affects quite a few people. Colds are common this time of year, and scurvy often strikes sailors.”

“But even assuming that, it still doesn’t fully explain the situation, does it?”

I continued explaining.

“A few days ago, the crew of the Rosaria arrived suffering from scurvy. They caught attention from authorities, then caught a cold as well. Their symptoms – skin rash, colds, hemoptysis – likely resembled the Black Death.”

“I see.”

“So the authorities searched for patients with similar symptoms. Probably focusing on those matching the Rosaria crew – mouth bleeding, coughing, phlegm, skin rashes.”

The cause of misdiagnosis: fear, ignorance, and good intentions. Though, isn’t it true that most human errors stem from these three?

The mayor still looked perplexed but slowly nodded his head.

“So…”

“In the marketplace, many likely had periodontitis due to poor hygiene. Quite a few people were probably coughing with bleeding gums.”

“So… Initially, we mistook people on the Rosaria who had both scurvy and colds for the Black Death. In the city, we mistook those with both periodontitis and colds for the Black Death. Is that what you’re saying?”

“Yes.”

The mayor groaned and massaged his temples. Just thinking about it must be stressful.

“Complicated. Without your explanation, I’d have never known… sigh.”

“So… What’s the solution?”

“The treatment for scurvy is normal meals including vegetables and fruit. For severe cold symptoms, we can administer symptom-relief medication, though there’s no real cure.”

“What about periodontitis?”

“Periodontitis is chronic and also lacks a definitive cure. Simply brush your teeth regularly. It’s not fatal though.”

The mayor pondered for a long time.

“Professor. To summarize what you said… All we need to do from now is distribute lemons properly, and we’ve done everything we can?”

“Yes.”

“Terrifying. How much has the city suffered because of the authorities’ incompetence…”

I didn’t see it that way.

“Well, perhaps it’s precisely because we’ve fought plagues in the past that we were able to establish such quick and efficient countermeasures. This time, the plague being influenza was just pure luck.”

This wasn’t empty flattery.

Imentia had records of fighting the Black Death before, which allowed them to establish rapid countermeasures. Had it truly been the Black Death, even these measures would have been insufficient.

“Professor. How quickly can we expect this situation to resolve?”

“The crew of the Rosaria will start recovering after a few days of normal meals. Most colds should clear up within a week.”

“One last question.”

“Yes?”

“What’s the best way to explain this situation to ordinary citizens or bureaucrats? How much should we explain?”

I don’t know either… Isn’t this more of a political issue than a medical one?

“Well, like this. Doctors cannot lie to patients. The principle remains that patients decide their own treatments.”

“How idealistic.”

“But aren’t patients less knowledgeable than me? While I shouldn’t lie or force anything, I also see no reason to hide what I wish for.”

“Hmm…”

“Generally speaking, it’s best to tell the truth without hiding anything. That said, there’s no need to phrase things disadvantageously.”

“Understood.”

After bowing to the mayor, I left the meeting room. Hopefully everything turns out well. He seemed reasonably rational, so he should listen well.

****

Things progressed faster than expected. Makes sense. Since the quarantine started quickly, it should end quickly too.

A carriage full of lemons arrived at the temple, and the mayor’s soldiers began distributing them house by house.

Most of the quarantined patients received a few lemons and four days’ worth of comprehensive cold medicine before returning home.

Only the original patients and the most severely ill remained at the temple. All this happened two days after we arrived in Imentia Castle.

There’s something I feel like I’ve forgotten… but maybe it’s just my imagination. The hospital probably handled any remaining issues. I don’t know what I forgot though.

Hopefully it’s nothing major.

****

Mint. The empire’s premier daughter. A princess worthy of the title “Above Ten Thousand Things.” Everything in the world was beneath her. Her veins flowed not just with blue blood, but golden blood. And she possessed magical talent too.

Such things might improve one’s mood… sometimes! Regardless, everyone has desires beyond what they already possess.

With a somewhat bored, irritated, tired, vaguely hopeful, or simply complicated expression, she stared at the calendar.

It’s not like Mint’s wishes were extraordinary…

Or maybe they were?

How many days has it been already?

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