Chapter 77: Good Healer (5) |
*
Though it was slightly delayed because of an unexpected emergency patient.
Ayla's clinic field trip began.
“Student Ayla. Today, I will show you in detail what healers do.”
There was a point to be careful about here.
Namely, not to demand medical knowledge from her.
Let's think this through.
Right now, Ayla is a High School Division Seminary student who awakened her divine power less than two days ago.
And the period when one starts to seriously study medical knowledge is after entering the Undergraduate Division's Department of Healing.
Would knowledge about blood vessels this and nerves that really get into such a child's head?
'Of course not.'
You can only see as much as you know.
Even if I were to teach her real medical knowledge here, it wouldn't stick.
So for the time being, I plan to teach only the very basics.
“This clinic also has the disciples of other healers. Among them are students who have already matriculated into the Department of Healing. They could become your seniors or peers, so it would be good to greet them if you meet.”
“Yes!”
On the way to another location with Ayla.
I confirmed one thing.
“Well then, I'll begin the tour in earnest, but Student Ayla, do you happen to know how other infirmaries are run?”
“I know because I sometimes go to deliver a lunch box to my mother's infirmary.”
“I see.”
In that case, the explanation would be much easier.
“Good. Then let me tell you the purpose of this clinic first.”
I led her toward the entrance.
“Various types of clinics exist in each sector. The work of each clinic isn't vastly different, but even so, each one has a specialized function.”
In the past, this one clinic had to handle all sorts of patients.
From mothers in childbirth to children, trauma, internal medicine, surgery, and so on.
A small boarding house had to act as a general hospital.
As a result, an unavoidable inefficiency was occurring.
That's why when building clinics throughout the Capital, I poured my heart and soul into the division of labor above all else.
“The D-1 Clinic in D-Sector mainly handles emergencies, trauma, and high-difficulty patients.”
The D-2 Clinic specializes in obstetrics and pediatrics.
The D-3 Clinic specializes in chronic disease.
The D-4 Clinic specializes in infection.
Besides these, I made sure that each sector had at least one specialized clinic.
“We will go over the details one by one over the course of a year.”
After all, she's scheduled to visit all those clinics over the next year anyway.
I turned right from the entrance.
A sign was hanging on the door leading to a small room.
Emergency room.
“Student Ayla, have you heard of a place called an emergency room?”
“No. I don't really know.”
“Good. Then I'll start by telling you what an emergency room is.”
There are no emergency rooms in this era.
It's a world where if an emergency patient appears, they are simply laid down next to an inpatient.
Is that why?
When I first introduce the emergency room, healers and aspirants always show the same reaction.
Just like Ayla now.
“This place... is?”
Ayla tilted her head.
When a patient arrives at an infirmary, they face one of two outcomes.
Cured.
Or an incurable disease.
Because of the existence of Divine Magic, this is a world where you can often see an emergency patient walk out on their own two feet in a matter of seconds.
Because of that, the existence of a place like an emergency room is bound to feel strange.
“Is this place different from a hospital room?”
“Yes. Some patients have less time than others. This place is for triaging those patients and providing initial treatment so they can be moved to other clinics.”
The emergency room, which occupied half of the 1st Floor of the D-1 Clinic, had a total of 10 hospital beds.
Next to each bed was an instrument stand, and a board for recording the patient's condition was hung at their bedside.
Currently, three beds were occupied.
A worker with a broken arm.
An old man brought in with abdominal pain.
And the fall patient I operated on earlier.
Among them, the fall patient was scheduled to be moved up to the 2nd-floor hospital room.
“Divine Power is a limited resource. Someone might die if they don't receive Divine Magic today, but someone else might have the luxury of waiting for two days. This place buys time for that person.”
The surgery just now is a prime example.
At a typical infirmary, when an emergency patient like the one just now arrives, they pour all their divine power into that patient.
Putting aside whether that treatment is effective or not.
The problem is what happens after that treatment is over.
The healer often has no divine power left to care for the next patient.
In the end, they are left with no choice but to do nothing but watch the patient die.
This was the result of healers clinging to the miracle of Divine Magic and obsessing over a complete cure.
“If we use just enough divine power on the patient from before to keep them alive, we can save the lives of three more such patients today.”
So I changed the order.
Instead of pouring 40 units of divine power into one person each day,
I distribute 10 units of divine power to 4 people over four days.
The former saves one person and has to give up on the 3 who come after.
The latter can save all 4 people over four days.
I just changed the order.
With the same resources, the survival rate becomes 4 times higher.
“It's not that big of a deal. Just a simple change in perspective.”
Ayla looked at me with a face as if she'd been struck by a hammer.
It's a familiar reaction.
The healers who first visited this place.
And their disciples and seminary students, too.
They used to react like this when they heard about the existence of the emergency room.
I wonder if it's something to react so strongly to.
Still, whenever I see this kind of reaction, I can't help but feel a sense of pride.
“Next, let's go to the operating room.”
The operating room was connected not only to the entrance but also to the emergency room.
Entering the operating room, I saw a healer in the middle of a surgery.
“It's a fracture patient.”
It was a patient who came to the emergency room after their leg was crushed by a carriage.
The healer was preparing the tools for the patient's surgery one by one.
I was careful not to touch the surgical tools, explaining one by one from a distance.
“All operating rooms and treatment rooms have Holy Water and symbolic objects placed within them.”
It was a measure to conserve even a little bit of divine power.
A pure white statue was mounted on the wall of the operating room.
It was the Statue of the Benevolent Saintess, which could be seen in the Cathedral's treatment rooms.
The Holy Water flowing down from the feet of the saintess statue was running beneath the operating room floor.
Inside that pure white room, two healers placed the fracture patient onto the bed.
“Watch closely, Student Ayla.”
The condition of the leg of the patient lying on the bed was serious.
The wound was contaminated with mud, and the bone was protruding through the skin.
It was an open fracture patient.
“Student Ayla, what kind of treatment do you think that patient needs?”
“Since the wound is under the skin, I think a Greater Heal will be necessary.”
“Well, shall we see?”
The healer anesthetized the patient's wound.
Then, they washed off the mud on the wound with diluted holy water.
The dark red blood and brown mud caked between the torn flesh washed away.
Soon, the sight of crushed muscle tissue dangling was revealed.
“Ugh.”
Ayla flinched her shoulders for a moment.
But perhaps thanks to having overcome the brain surgery, she quickly regained her composure.
The healer then disinfected the patient's wound.
And reached not for a brass cross, but for a scalpel.
“Student Ayla. Do you know what usually happens if you cast Heal on it in that state?”
“I'm sorry. I don't know.”
“If you regenerate the wound while there's contaminated or necrotic tissue, that tissue will interfere with the wound's regeneration.”
Of course, the miracle of Divine Magic can ignore such a trivial problem and heal the wound.
It just consumes more divine power.
“As I said in the case of the patient whose brain was operated on today, Divine Magic is regeneration, not removal.”
That's why before using Heal, one must scrape out the rotted tissue, pus, and various contaminants.
Debridement
A technique from modern medicine to prevent infection and promote wound regeneration.
By performing this technique once, you can conserve divine power.
“I had a bit of a hard time teaching the healers where to cut.”
Debridement isn't a surgery where you simply cut away everything but the prettily colored tissue.
Will this tissue survive?
Will this tissue die soon?
One must carefully scrape, considering the location of blood vessels, blood flow distribution, and even nerves.
The biggest task here is removing the barely visible microscopic bone fragments and bone marrow.
Well, in this world, even if you cut a bit too much, you can fix it with Heal, so the difficulty is lower than in my previous life.
“If you cast Divine Magic after making the wound clean like that, it consumes less divine power and the required level of mastery also drops.”
As I was explaining, I saw a slightly dangerous area.
“Teacher. That looks like a nerve, not a tendon.”
“Ah! I'm sorry!”
“Just a moment.”
I washed my hands and participated in the surgery for a moment.
It looked a bit difficult, so it seemed help was needed.
“This person has a variation in their nerves and blood vessels. A nerve isn't supposed to run here. You should record this and maybe write an academic paper on it for academia later.”
Scrape, scrape, scrape.
The rotted tissue was scraped away with a curette.
“Let's also cut away the living flesh in the shape I've marked. You need to graft in this shape for the blood vessels to be well-distributed.”
I performed an additional excision, taking the graft into consideration.
After finishing the debridement to some extent.
I once again stepped back from the operating room and returned to Ayla.
“I'm sorry. I'll continue the explanation.”
In the meantime, the healers put down their scalpels.
Next, the healers began nailing the bone.
Tack! Tack!
It was the stage of fixing the broken bone with a metal plate.
“We're going to temporarily fix the bone like that. Since a Minor Heal can't connect bones and nerves, we have to rely on natural healing.”
After fixing the bone like that.
The healers put down the hammer and nails and picked up the brass cross.
The two of them took turns casting Minor Heal.
Then, the blood vessels and some tissues regenerated.
As soon as they confirmed the blood vessels had fully regenerated, they stopped the Heal.
“Just like the previous surgery, we're going to stop the operation here. There are still patients who need divine power.”
They don't close the wound.
If you try to forcibly close a large wound, it can actually tear.
So, we plan to close it very slowly over several days.
Bringing skin or muscle from other tissues, attaching it, regenerating it.
If you repeat that, you can replace the miracle of a Greater Heal with Minor Heal.
Of course, I didn't explain the specific details to Ayla.
Graft surgery is still a high-difficulty area for her to understand.
Before long, the patient, whose open wound was packed with a sponge soaked in holy water, was moved out of the operating room.
The priests who finished the Heal switched with other priests and then headed to the Prayer Room located on the 3rd floor.
Because unlike magical power, divine power isn't a resource that recovers just by eating well and getting plenty of rest.
When depleted, it had to be replenished through prayer like that.
“Well then...”
I looked at the clock, and it was already time for lunch.
Before buying Ayla lunch.
I asked her a question.
“How was it, Student Ayla? Your impressions of our clinic?”
“...”
Ayla was dazed for a long time and said nothing.
***
After that day, Ayla's clinic tour continued for a while.
She observed obstetrics and pediatrics diseases at the D-2 Clinic. She also saw the methods for treating infectious diseases at the D-4 Clinic.
During the tour, there was a time when Ayla had a question.
“But all these treatments must be expensive, does the trading company cover all the costs?”
“Something like that, Student Ayla.”
Of course, we are receiving money.
The healers don't come all the way down to a place like this to work for free.
However, it's not a cost that the poor can afford.
“We only receive the minimum possible cost from the patients. The rest is subsidized by the Merkur Trading Company.”
“Then... does the clinic operate at a deficit?”
“Almost all of them do.”
There are some places that sometimes run a surplus.
But the deficits of the other clinics are enough to make that meaningless.
The expenditure the trading company is enduring because of the clinics right now is by no means small.
“Then why do you keep operating them?”
A good question.
In fact, this is a question that the executives of the Merkur Trading Company also ask periodically.
A person's tune changes after they get what they want, don't they say?
Originally, the Clinic Support Program was a project started with the lesson learned from the accidental discovery of Viagra.
It was to reduce the cost of clinical trials by conducting them on patients through the clinics.
However, their minds tend to change after actually seeing the clinics' deficits.
— “Director Schun. Must we really do this?”
Whenever that question comes up, there's a line of reasoning I use to persuade them.
“Student Ayla. Do you know what's needed to develop medicine?”
“Knowledge... isn't it?”
“Yes. Knowledge is necessary. But knowledge doesn't appear out of thin air.”
Knowledge isn't something you get by digging in the ground.
It all comes from having data.
And the Clinic Support Program holds a very important position in this aspect of data.
“The reason patients can receive treatment cheaply is because those people permit us to use their information as we please.”
The clinics don't provide these treatments to patients for no reason.
The patients' residences. Family relationships.
What they eat, what work they do, who they meet.
What they did several years ago, what they plan to do in a few days.
They receive this kind of treatment in exchange for providing all that personal information and allowing us to handle it as we see fit.
For reference, even people who are reluctant to give their information to wizards because of black sorcerers,
didn't find it strange to reveal everything from their trivial daily lives to their secrets to clerics.
I guess it's because it's an era where the concept of confession is deeply rooted in daily life.
They don't mind at all handing over their personal information to a clinic staffed by healers.
Well, since we'll guard their secrets as strictly as a confession, perhaps it's not a complete misunderstanding.
“Huh? You substitute the cost with something like that?”
However, Ayla tilted her head as if she couldn't be convinced by this explanation alone.
I guess it's because this is an era that doesn't know the importance of personal information.
It seemed she couldn't grasp the value of this data.
So I told her the logic that the Guild Master and the other directors were able to definitively understand.
“Student Ayla. To make a medicine, you need to know which patient has which symptom, right?”
“Yes. That's right.”
“But let's say most of those patients only visit our clinics. Then, would other trading companies that aren't ours really be able to make medicine?”
We have purchased patient data at a cheap price.
Of course, the data of each individual patient might not be that expensive.
But what if that becomes tens, hundreds, and then most of the patients?
Other trading companies can't engage in pharmaceuticals without the data our company has.
It's not for nothing that pharmaceutical companies in the 21st century sign R&D cooperation contracts with large hospitals.
— “Research and Development is something that cannot be converted into simple numbers. But development often holds a value greater than what is written in numbers. Do you still think this business is useless, Directors?”
When I persuaded them with this logic, the other directors and the Guild Master were convinced at once.
Since it means our company is seizing a power that cannot be bought with money.
In the end, thanks to this support program, the trading company and Director Schun were able to secure both a good image and profits at the same time.
'I do feel a bit of guilt for misusing the Misunderstanding Genre like this.'
I felt sorry for deceiving the patients a little, but I rationalized it by thinking they could receive appropriate, high-quality treatment at a low cost.
“Do you understand now?”
“No... no matter how I think about it, I don't understand why this is a benefit to you, Director Schun. Aren't you sacrificing too much...?”
“It's by no means a sacrifice. On the contrary, I am always indebted to the patients.”
It seems Ayla is once again gravely mistaken about something.
This isn't the first time for such a misunderstanding, so I decided to leave it be.
“Since we're on the topic, let me show you a prime example.”
It just so happened to be time to visit the research-oriented clinic.
Since the topic of data came up, it seemed like a good idea to use that place as an example.
“Shall we go to the D-3 Clinic today?”
*
The D-3 Clinic is a clinic centered on chronic disease.
And when it comes to chronic diseases, there are diseases that our company typically manages.
Gout. Diabetes.
And erectile dysfunction.
The D-3 Clinic is a clinic that mainly cares for such patients and conducts research based on their data.
Our trading company collects data from the chronic disease clinics in each sector, including this one.
And based on that data, we are continuously improving our medicines.
As an aside, I'm also collecting data for the black magic paper I'm writing as Yulian in this way.
“Let's go in.”
The D-3 Clinic had a different atmosphere from D-1 right from the start.
How should I put it? Instead of the unique tension of the emergency room, the comforting smell of daily life wafted through the air.
In the waiting room, old people sat side-by-side with blankets on their laps.
In one corner, a healer was lifting a patient's foot and examining a wound.
“Oh, that Beastkin is?”
“Ah, the one who guided Miss Ayla, right? He's a patient here, too.”
In the middle of it all, I saw Wangcho too.
He was getting severely scolded by a Gout Specialist Healer.
I heard he thought he could get his medicine more easily if I wasn't watching.
Not a chance.
On the contrary, a healer even more sharp-tongued than me ended up in charge of him.
— “Instead of being in pain like this every time, it seems like cutting it off once and regenerating it would be another option.”
— “Hieeek! I'm sorry! I'll take good care of it, so just not that!”
It's a bit of a mood-killer to see a big shot from the underworld who controls D-Sector and E-Sector acting like that.
I continued the conversation as we passed the consultation room where Wangcho was being treated.
“Student Ayla, the patients here aren't emergencies. They are people who will come here tomorrow, the day after, and even a month from now.”
“So the healers take care of those people every time?”
“To be precise, they manage them. What these people need isn't a single miracle, but consistent care.”
Because diabetes and gout are diseases that can't be helped even with Heal.
They are cared for consistently in this way.
And as consistently as they come, the data also collects consistently well.
The clinics that rarely operate at a surplus were also these kinds of clinics.
The medicine sells as medicine, and the data is collected as data.
Above all, this is also where we primarily sell Viagra.
“Now, shall we look at a diabetes patient today?”
I took Ayla and went deeper into the clinic.
