Chapter 54

Episode 54. Threshold of Pain (2)

***

Istina rushed into the hospital room.

One priest lying down as a patient, one priest who brought the patient, one nurse, Hedwig who’s just spectating, and me.

“Professor! I’ve brought the ropes!”

All eyes in the ward turned to me.

I awkwardly scratched my head… well, ropes might be necessary for treatment sometimes, right?

The priests and Hedwig frowned at me while I tied up the unconscious patient. It wasn’t difficult since they were out cold.

“Istina, can you hold onto the patient?”

“Yes, but why?”

I pulled out a naloxone spray from my pocket. Even though the patient was still unconscious, this would definitely wake them up.

But what happens after that’s the problem.

“Get ready to hold the patient.”

“They’re not moving though…”

“Once the medicine kicks in, they’ll start thrashing around.”

“Why…?”

Why? Because it’s gonna hurt like hell, that’s why.

I sprayed the naloxone into the patient’s nose. Once the drug takes effect, the patient will start thrashing—though with the ropes, they’d only wiggle around. Thank goodness we tied their arms.

‘Heal.’

‘Calm.’

The priest standing nearby fidgeted nervously and cast some staff magic. Honestly, there’s no need; the patient will recover on their own in a few minutes.

It’s questionable whether the magic will even help. I crossed my arms and stepped back.

“Professor! Do we have any sedatives or painkillers?!”

“We can’t use them on this patient.”

“Why?”

Istina looked even more confused. I wanted to explain, but the priest—our patient’s colleague—is making it hard.

“Hey, Priest Teacher, you’re the patient’s colleague, right? Could you step aside so I can explain?”

“But I haven’t done anything wrong!”

“Yeah, sure. Just step aside anyway.”

The priest muttered something and left the room. Istina and Hedwig stood awkwardly, clearly not understanding the situation.

***

The patient is a male priest in his 20s, and his colleague seems to be in a similar condition.

Of course, the guardian didn’t introduce themselves.

“What happened here?”

“Opioid addiction. Drug overdose.”

Hedwig had stepped back slightly from the bed. I glanced at Istina.

“There are many reasons a person could collapse. It could be a heart attack or stroke, but considering the age, that’s unlikely. So why would a young adult suddenly collapse?”

“Injury?”

“No injury here. We need to check their pupils.”

Opioid exposure causes pupil constriction. This patient’s pupils were nearly pinpoints when they arrived at the hospital.

“In short, if someone overdoses on opioids, various bodily changes occur. Heart rate and breathing slow down, and pupils constrict.”

“Oh, I see…”

“That’s why I asked the patient’s colleague to leave. We needed time to think things through. There’s plenty to consider.”

The priest earlier was sent out of concern for the patient, as they likely don’t know yet that their colleague collapsed after secretly taking opioids.

We need to give them time to reflect, and also talk to the patient. Opioid addiction is surprisingly treatable with medical intervention.

We’ll think about it later.

“Where did the opium come from?”

“Probably from the temple. They must’ve used it medicinally.”

“If opium is a painkiller, why does it cause pain?”

A bit complicated, but simply put…

“Opium relieves pain. The problem arises when someone continues to take it even when they’re not in pain—it lowers the pain threshold.”

Naloxone blocks opioid receptors. When we abruptly block the effects of opioids with this, the suppressed pain rushes back all at once.

This kind of pain is hard to manage with painkillers or sedatives. The patient’s pain threshold is already broken, and using more painkillers on someone who collapsed from overuse would be insane.

“Is that so?”

“When we suddenly block the effects of opioids, the patient’s breathing and heart rate return to normal, but because their pain threshold has been lowered, they experience intense pain.”

That’s why I told you to prepare the ropes.

Istina tilted her head.

“When did you figure this out, Professor?”

“When I heard the patient worked at a temple and was in their 20s, I suspected they might have collapsed from consuming medicinal opium.”

Istina nodded, looking amazed. Anyway, let’s move on to the next steps for this patient.

“Professor!”

Seems like the priest has regained their senses. We turned our heads toward the lying priest.

“Can you untie these ropes please?”

Sure thing.

***

The patient seemed somewhat better and sat up in the bed. Now we can finally conduct an interview.

“What is your name, patient?”

“Tirielle.”

“You took opium, didn’t you?”

“No, I didn’t.”

“We already know you took opium. That’s why I sent your colleague away.”

“Um… What should I do?”

It’s frustrating, but let’s be patient. The conclusion will come soon enough.

“Do you only use powdered opium as a painkiller at the temple? No, right?”

“No.”

As expected.

This patient is in an environment where opium exposure is unavoidable. If they hadn’t collapsed, we might not have noticed, but now that they have, we need to devise a plan.

By the way, it seems like the temple has quite a lot of opium.

Not only are they giving it generously to patients, but this priest managed to consume it until they passed out without anyone noticing.

“You know, your collapse was due to opium. You need to stop.”

“Oh dear…”

“Change jobs. It’d be better to work somewhere where you’re exposed to opium less frequently.”

It’s a bit unfortunate.

It doesn’t seem like this was their intention to become exposed to opium. Just bad luck. And if this were a modern hospital, we might have had more options.

No solution comes to mind.

“Follow me to the clinic. As for Hedwig and Ms. Istina… go ahead and do whatever you need to do.”

Dismissed.

The patient followed me.

***

Creeeak. The clinic door closed ominously today. The patient stared at me vacantly from their seat in the clinic.

“This doesn’t feel like someone else’s problem, does it?”

“Huh?”

Tirielle, was it?

On the surface, they might look like a trashy addict stealing opium from the temple, but on the other hand…

They could be one of the hardest-working healers, treating the most painful patients, thus being exposed to higher-than-average amounts of opium. We shouldn’t jump to conclusions.

“Motivation is key. Try saying this: ‘I want to live a normal life without drugs!'”

The patient coughed a little.

“Uh, I want to live a normal life without drugs…”

“Good job!”

“Is that all?”

“No, wait a moment. Your determination is the most important thing. While addiction isn’t solely solved by willpower, it’s crucial.”

“Understood.”

“There’s a medication called naltrexone. Taking this will reduce cravings for drugs and prevent you from feeling high even if you take them.”

I placed a glass vial on the desk. The patient reached for it, but I pulled it back.

“Hold on.”

“Yes?”

“There are side effects. This drug will eliminate cravings and the effects of opium, but if you take opium after this, there’s a high chance you could die.”

Tirielle furrowed their brow.

“Why?”

“Many patients keep taking opium because they can’t feel its effects anymore, leading to fatal overdoses. If you lack the willpower or confidence to avoid opium, it’s better not to take this drug.”

The priest sighed.

“So there’s no free lunch, huh?”

“Sometimes in life, there are freebies. This isn’t one of them. This requires sacrifice.”

This is literally life or death.

“Though I failed the test God gave me once, He’s given me another chance. It’s only natural to seize it, isn’t it?”

I placed the vial back on the desk.

Wait, no, I don’t need to give it to them.

“You’ll be hospitalized for a while anyway. Thinking about it, there’s no reason to give you the vial now.”

The priest stared at me like I was strange. Still, I’m right. There’s no point giving them the vial if they’re staying in the hospital anyway.

“But…”

“You can take it when you’re discharged.”

Looks like they’ll need about a week of hospitalization.

***

Hedwig has gone home.

I returned to the research lab with Istina. Thankfully, there’s less work than usual today.

Istina pulled out a notebook and pen and scribbled something down.

“What happened to that priest?”

“They’ll be hospitalized for about a week.”

“Will that cure them?”

I don’t know. This involves psychological and motivational factors.

Medication alone won’t fix everything.

“Istina, one of my students had a birthday a few days ago. What gift should I get?”

“You mean the Imperial Princess?”

I nodded.

Istina tilted her head.

“If it were a regular student, I could offer advice, but with the Imperial Princess, it’s hard to guess what she might desire…”

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