I Became a Plague Doctor in a Romance Fantasy

10th Episode: Graduate Student Istina

****

The surgery went well. Now that I’ve seen the patient, I need to make a record of what treatments were done.

In my past life, at a homeless clinic without a computer system, we used to do medical records this way—making individual brown envelopes for each patient and storing all related records inside.

Wouldn’t it work similarly here?

Istina tilted her head as she looked at me.

“Professor, how do you handle patient records?”

“Hmm… Is there another way? We should prepare envelopes, write down the date, and document everything that happened with the patient on that day.”

Though it’ll be tough, that’s what I plan to do here. I started writing the medical record, beginning with the date.

– Performed surgery to fix the upper arm bone by inserting titanium plates; surgery completed successfully.

– Due to the inability to use general anesthesia, we administered sedatives, painkillers, and local anesthetics simultaneously. Monitoring needed for liver and kidney toxicity, but expecting no issues.

Truthfully, if problems arise in that area, we’d be out of options. The biggest issue is that we can’t conduct blood tests. If we misdiagnose something like renal failure just by looking at symptoms…

It’d be terrifying.

– No allergic reactions or side effects observed from the use of Propofol (IV), Fentanyl (patch), and Lidocaine (subcutaneous injection).

– Patient’s condition stable.

Does Istina have anything else to add?

“How about the patient? Give me a status report.”

“Yes, sir.”

The apprentice healer nodded.

“So, how do you report?”

“Report in this order: patient identity, reason for admission, treatment performed, and current condition. Then discuss what needs to be done next and any concerns regarding patient management.”

Istina nodded and pulled out her notebook.

Back in my previous life, I also did patient reports, and the most important thing about them is this:

If I don’t know the patient’s condition well, I obviously can’t report it to others.

Thus, I need to fully understand all the details before making a report—it’s easier said than done. One small mistake could lead to questions or even reprimands.

“Patient Benjamin, an Academy student who fell off a horse, was admitted due to arm fractures and compartment syndrome. After fasciotomy and bone reconstruction, his condition is now stable.”

That’s correct. I picked up my pen and continued writing the medical record while Istina peered over my shoulder.

– Compartment syndrome suspected. Confirmed and resolved after fasciotomy; under observation.

– Comminuted fracture suspected. Verified through exploratory surgery, then treated by fixing with titanium plating. All fingers currently moving normally.

“So, what’s next?”

“Discharge, perhaps?”

If patients could be discharged just a day after surgery, that would be great—but unfortunately, no.

“It’s a bit early to discharge him. We’ll need to start rehabilitation therapy once the bones start healing. Since both the bones and tendons are damaged, restoring full function will take time and effort.”

This patient isn’t ready for immediate discharge either.

We need to check if the surgical wounds are healing, if the bones are fusing properly, and whether the arm can move freely.

A week should be enough, right?

It depends on how powerful the healing magic is. While the wound might heal within days, we’re unsure how long functional recovery will take.

“Let’s aim for a week. This is our first patient, after all.”

“Yes, sir.”

Istina nodded but didn’t leave. She seemed to have more to say. Her hesitation indicated she had another question.

“If you have more questions, sit down and ask.”

Istina immediately sat in front of my desk, eagerly waiting.

“Professor, I’ve been curious… bones are hard, rock-like materials, right? So, how exactly do they heal and grow?”

“Trees have growth rings too, right? It’s similar.”

“But bones don’t have growth rings?”

Ah… smart girl.

Here’s how bones actually heal and grow. Most of the bone is made up of fibers created by cells and calcium phosphate crystals.

There are several types of cells in bones. Osteoclasts break down bones, while osteoblasts build them. These processes occur simultaneously, maintaining a dynamic equilibrium.

When bones crack or break, osteoblasts work harder. If there’s a protrusion, osteoclasts work more.

As people age, osteoclast activity increases, leading to conditions like osteoporosis.

Generally speaking, what do we call all this?

I briefly pondered word choices. How should I explain this so Istina understands easily?

“Istina, how much do you know about human tissue microstructures? Have you heard of ‘cells’?”

“Not really.”

Cells may be common knowledge to modern people, but historically, before Hooke observed cell structures through a microscope, most people didn’t believe in cell theory. Instead, they thought of human tissues as continuous entities rather than brick-like components.

Let’s try explaining it without mentioning cells.

“Bones dissolve. The components that make up bones constantly dissolve and rebuild, which allows bones to grow and heal.”

“So that’s why bones don’t have growth rings.”

I nodded. Bones dissolve and regenerate, so unlike trees, they don’t form rings. Especially since, except in children, bones don’t significantly change size.

Istina jotted down my explanation.

“So, bones are living parts of the body, not just solid objects like stones?”

“Bones are alive. Didn’t you see the blood vessels inside the bones just now? Haven’t you done any dissections?”

She nodded.

“We don’t do dissections during undergrad. Normally, graduate students do them, but as you know…”

She got kicked out of grad school.

Istina looked a little sad.

“Don’t worry.”

“About what?”

“Study under me, conduct research with me, and crush those unfair standards with your skills.”

“Thank you.”

More importantly, I’ll have to look into anatomy classes later. It’s unacceptable that a doctor who hasn’t done proper dissections is treating patients under me.

****

The first research paper I think I should publish consists of four historical papers from real-world history.

First,

Robert Hooke’s foundational work in microscopy, *Micrographia*. By the way, Hooke couldn’t stain bacteria under the microscope, so he never discovered them.

This will lay the groundwork for observing bacteria.

Of course, seeing bacteria with a regular optical microscope is difficult. Staining or growing colonies is necessary.

Second,

Pasteur’s *Records of Microorganisms Present in the Atmosphere*, sent to the French Academy of Sciences.

Famous for the swan-neck flask experiment, Pasteur disproved the hypothesis that decay and disease arose spontaneously.

This proves that bacteria cause decay and disease and that they can be killed through heat and other methods.

Third,

Hans Christian Gram’s *On the Separation and Staining of Schizomycetes Treated by Drying or Cutting*.

To be honest, I don’t remember the exact title of Gram’s report, but it’s a fact that Gram staining began with that report.

With Gram staining and microscopes, we can directly observe bacteria. From there, classification based on characteristics becomes possible, and eventually, we might find antibiotics suited to specific types.

Fourth,

And finally, Joseph Lister’s *Antiseptic Surgery in Surgical Treatment*. Lister devised methods to disinfect wounds and surgical areas to prevent post-operative infections.

Yes, that’s the same Lister associated with Listerine. With this, we can teach actual hospital practices on how to prevent infections.

So far, this is the structure of my plan to convince the academic community. Here’s what I’m thinking:

Reproduce the four aforementioned papers in this world and submit them to the academic community.

If successful, this world will discover the existence of bacteria centuries earlier and develop antiseptic surgery techniques. This seems feasible.

As long as I write the papers correctly.

****

After quietly listening to me, Istina scratched her head after some contemplation.

“So, you’re planning to write four papers?”

“That’s the plan.”

“Isn’t that too much pressure?”

“We’ll share the workload, teacher. Aren’t we a team?”

No shortcuts. We suffer together.

It’s like solving a puzzle.

We need to publish research as soon as possible so that treatment—and future research—can proceed more smoothly.

Let’s work hard for a few years, Istina.

We can rewrite the history of medicine in the Empire.

Istina already looked exhausted.

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