Chapter 95

95. How Do You Perform Auscultation? (1)

***

Mint was holding two small spoons. I wonder if there’s ice cream in this world? How do they even make it?

Random thoughts were interrupted. Mint stared at me blankly, then gestured for me to come over.

“Hello.”

“Hey, take a seat.”

Calling me “Hey” every time just because I’m a subject… isn’t that a bit much? I debated speaking up but decided against it—it probably wouldn’t matter anyway. I scratched my head.

“Are you going to keep calling me ‘Hey’ all the time?”

“Yeah. So what?”

Ugh, I knew you’d say that. I lightly tapped Mint’s forehead with my fingertip.

“Ow.”

I sat next to Mint. The Imperial Princess scratched her head briefly before starting to talk.

“I heard an interesting rumor. They’re saying you visited Serulice Manor to prepare for entering high society.”

“I’ve never heard such a thing.”

“Hmm?”

Mint linked arms with me and leaned over slightly, muttering something quietly. She looked happy, so I let her be.

After looking down at Mint for a moment, our eyes met. She blinked and spoke.

“It sounds fun though.”

“I’ve never really thought about it. Even if I did go to those events, I wouldn’t know what to say.”

“I’ll bring you along! Everyone will love you. A lot of people are curious about you, Teacher.”

“I’ll think about it.”

Mint smiled.

“Didn’t the Lady of Serulice Manor admit you into the Academy? Isn’t this your way of expanding connections in high society?”

I shook my head violently.

“No way… Why would I do that?”

“Is that so?”

“Princess, using patients like this is obviously wrong. I’m not crazy.”

“But you torment graduate students all the time.”

I scratched my head again.

“Patients aren’t graduate students. If Istina or Amy got sick, I’d treat them seriously. And actually, graduate students are treated pretty well compared to others.”

“You lack credibility when you say that.”

“…”

“Isn’t it kind of disappointing? Why go through all the trouble of royal inspections and networking with someone else instead of me and Manfred?”

“That’s a misunderstanding. It’s the opposite actually. The Duchess tried setting something up with me, but when it didn’t work out, she just came to the hospital.”

“Oh, good.”

“I don’t know what you think of me, Princess, but I’m not that strange a person.”

Mint let go of my arm and hugged me tightly this time, resting her head on my shoulder. I moved away slightly.

“Why?”

“Feed me some ice cream.”

I grabbed her face with both hands and pulled her off my shoulder. She’s getting spoiled.

“That’s inappropriate, Princess.”

“Hmph.”

Mint adjusted her clothes and sat back down, handing me one of the spoons from the bowl of ice cream. I took it.

“It’s delicious. Try it.”

“Yes.”

The ice cream tasted surprisingly good, even though it reminded me more of sherbet than what I used to eat back home.

Mint looked genuinely pleased.

“I have to check on the wards soon.”

“Ah, is that so?”

“Yes.”

“When will you come back?”

I don’t know. Things are a little less busy lately, but I doubt I’ll have time to hang around before dinner. I also have lectures in the afternoon.

“I’ll see you tomorrow. I’m pretty busy today.”

“Okay.”

There are currently two hospitalized patients: one who fainted after ingesting nitrates, and Erzabet, who’s being treated for Wilson’s Disease.

Fortunately, none of them are critically ill.

***

Meanwhile, in Professor Asterix’s ward.

Bernard was waiting on his bed.

It’s not uncommon for students to collapse or feel unwell during alchemy practice, but apparently, it’s rare for someone to pass out as dramatically as Bernard.

“Did you understand yesterday’s explanation?”

“Yes.”

Of course, Amy and Istina must’ve explained things already. But I don’t trust graduate students.

How do I know what incorrect information they might’ve given to the patient? I almost gave wrong info myself during rounds sometimes.

“I checked the alchemy lab. You used nitric acid during the experiment, which can acutely relax blood vessels.”

“Really?”

“That’s why you passed out during class—because not enough blood reached your brain.”

Bernard nodded.

“What should I do next time?”

“Be more careful. Cover your mouth while experimenting, and wash your hands afterward.”

You can’t exactly tell someone to stop doing alchemy altogether. That’s their chosen career.

“Teacher, other students doing the same experiment didn’t faint. Is it really because of that? Could there be another illness?”

I thought about it.

“I don’t know. Maybe you’re more vulnerable than others, or maybe you fell asleep during class, or perhaps your heart is weak or your blood pressure is low.”

There could be various possibilities. In severe cases, it might involve strokes or cerebral vascular issues, but that’s the worst-case scenario.

It’s more likely that there’s nothing serious. Generally speaking, mild illnesses are far more common than severe ones.

“Is there no medicine for it?”

“There is, but is this your first time fainting?”

“Yes.”

“Have you ever experienced migraines, either recently or before passing out?”

The patient shook his head.

“Is there anyone in your family with similar conditions, or anyone who passed away before 50?”

“I don’t think so.”

No migraines, no history of fainting, no family medical history. A clean slate. Actually, sometimes a perfectly healthy patient makes me nervous.

If only we could find a major issue, then I’d know I didn’t miss anything and could rest easy…

Of course, from a doctor’s perspective, the patient should always be healthier.

“This seems to be due to exposure to toxic substances, and since the cause is clear, no immediate treatment is necessary.”

“Is that so?”

“If this happens again, come straight to the hospital. We’ll figure out a solution then.”

Bernard looked a bit worried.

“Since we know the cause, avoiding it should prevent future incidents.”

“Understood. When can I be discharged?”

“Tomorrow morning. If you want, you can leave now, or stay another day.”

It should be fine either way.

“Are there any other tests we can run?”

“Hmm… Let’s try auscultation.”

***

I held the auscultation device and listened to the patient’s heart. Auscultation is quite an art form.

Laypeople might be able to tell if a heart is beating or not.

Less experienced medical professionals may identify which part of the heart has problems.

Experienced practitioners can determine specific issues with the heart, differences in heart tones, breathing sounds, and some can even auscultate joints or the brain.

For the record, I can’t do those advanced things.

I can only assess how badly different parts of the heart are affected. That’s what I’m doing now.

Istina, who had just arrived for her shift, watched me intently from behind.

“So, you’re auscultating the patient’s heart to check for issues?”

“Yeah.”

“You already concluded it was caused by the drug, right?”

“There might still be underlying conditions. It’s possible the patient is more vulnerable compared to others, leading to the fainting episode.”

Actually, the patient asked for further tests, so I’m checking. The chances of finding a problem here are slim, and the likelihood of solving it is even slimmer.

“Professor, what cardiac diseases could potentially cause fainting and be detected through auscultation?”

Good academic curiosity…

“Istina, auscultation is done with the ears, right?”

“Sure.”

“Can you hear properly if someone keeps talking beside you?”

“Ah, sorry.”

Heart auscultation involves five points: starting from the top/right, the aortic valve, pulmonary valve, Erb’s point, tricuspid valve, and mitral valve. You can detect issues in these areas.

“The patient’s heart sounds…”

“Yes.”

“The mitral valve seems a bit loose, or rather, there’s a slight regurgitation sound. It doesn’t sound like a normal heartbeat.”

Bernard frowned.

“What should we do?”

“There’s not much we can do. It doesn’t seem to be causing any immediate disease.”

It might be unnecessary worry.

Mitral regurgitation is fairly common—about one or two people out of a hundred might have it. While it could increase fainting risks, I believe the primary cause was still the medication.

“Don’t worry. It’s not fatal. As long as you avoid the drug, you shouldn’t experience symptoms.”

Bernard stared out the window instead of replying.

This is a common reaction from patients when receiving bad news. Even though I said everything’s fine now, it’s hard for them to casually accept having an untreatable heart condition.

***

Finding a disease through auscultation felt good, but not being able to solve it was somewhat frustrating. Fortunately, it hasn’t caused any major problems yet.

“Professor.”

“Yeah.”

“Could you systematically explain how to perform auscultation? I’ve seen it multiple times, but I still don’t fully understand.”

“Alright, let’s do that.”

I should compile it into a booklet and distribute it.

Thinking about it, I should start by sharing modern stethoscopes. After all, healers in this world usually just press their ears against patients or use wooden tubes.

Even though I’ve made stethoscopes, I haven’t really tried spreading their use widely yet.

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