I Became a Plague Doctor in a Romance Fantasy

122. The Black Death Incident Winds Down

****

Ah, those boors.

I glanced sideways at the priests in the temple.

Even if the Black Death patients were piling up to the point where the temple was busier than ever, isn’t this going a bit too far? If you were going to roll up your sleeves, you should’ve done it last night.

You should’ve asked me earlier. What were you thinking if the patient had died?

The temple healers just looked troubled, but the patient himself seemed resolute despite facing an arm amputation.

“Will it hurt?”

“We’ll do anesthesia, but…”

I couldn’t give the patient a definitive answer. I don’t know how much it will hurt.

It won’t be completely painless, but with the nerves in the arm already significantly damaged… It didn’t seem like he’d endure extreme agony.

As I fumbled with my words, the patient grabbed my arm and asked again.

“Will surgery hurt, or won’t it?”

I scratched my head. After pondering for a while, it still felt hard to say outright.

“I’m not sure how much it’ll hurt. Since it’s dead tissue, it might not hurt much, but we may need to cut into living parts to fully remove the dead ones… Oh, and touching bone with the saw will definitely hurt.”

Though one might expect resistance, the patient appeared resigned—perhaps even determined.

Right now, his fingertips are cold, sensation is gone, and he likely can’t move the hand muscles. He knows his condition best.

This arm has to come off.

“There’s one last decision to make. There’s a riskier option to try saving the upper arm by only cutting off the hand.”

“What’s the difference?”

“The chance of infection after surgery increases, but the likelihood of dying from blood loss decreases.”

The patient furrowed his brow briefly.

“In that case, cut below the elbow. At least having a prosthetic would be better…”

Reconsidering, cutting below the elbow might be better. It’d be easier to attach a prosthetic, and there’s less risk involved with breaking large bones.

I nodded.

Preparations for the surgery were almost complete.

It wasn’t a complicated procedure. Compared to previous surgeries like spleen removal or bone realignment, this wouldn’t be as painful.

I drew a thin incision line on the patient’s arm with a ballpoint pen. Unlike some medieval cases where limbs were sawed off like wood…

That’s kind of horrifying, right?

I had no intention of doing that.

“We’ll cut the skin in this direction so we can suture it closed afterward.”

Istina nodded.

“The arm has redundant blood supply, so we probably won’t need to reconnect vessels. We’ll suture the radius and ulna together to keep them immobile.”

The final explanation was more for the medical staff than the patient.

“Let’s begin.”

We had already done the anesthesia and disinfection. Holding the scalpel, I followed the line I drew and opened the skin. The patient winced slightly but didn’t seem to be in pain.

Looks like the anesthesia worked well. Though this is just speculation, it seems knights or mages don’t respond well to anesthesia, whereas regular people like this patient do.

“Do you feel any pain?”

“No, not really.”

Thank goodness.

Now it’s time to cut through the muscles. Mistakenly slicing a vessel while cutting could happen, so I carefully severed each tendon and muscle layer.

Cutting through muscle feels grotesque, but it’s necessary for healing. I removed the blackened, necrotic tissue.

Done.

Most of the patient’s arm muscles were gone. After taking a deep breath, I began sawing through the radius and ulna bones.

There’s no direct sensation of pain in the bones, but the vibrations would still be transmitted. My arm ached sympathetically, but the patient remained calm.

Seems like the anesthesia took well.

“Ugh…”

“Does it hurt a lot?”

“No, it just feels strange.”

A moment later.

The patient’s lower arm bones were cleanly severed.

I smoothed out the cut surface to ensure no sharp bone fragments remained.

No signs of necrosis were visible inside the arm. Looks like we got it all.

I took silk thread and sutured the patient’s radius and ulna together to stabilize them. The complex part is done; now it’s just cleanup.

“All done. Just bear with me a little longer.”

“Yes.”

I folded the muscles and sealed off the larger blood vessels. Finally, I organized the subcutaneous fat and closed the incision.

“Istina, check this out.”

“Yes?”

“See how I finished the bone cuts? Now we’ll close the amputation site by folding the fat layer over the end of the arm.”

Istina nodded.

Almost done.

“When suturing, layers matter. Muscle layer, subcutaneous fat layer, skin layer. Often, each needs to be sewn separately. This time, we fixed the bones, folded the muscle layer and sutured it, and now we’re working on the subcutaneous fat layer—”

The patient looked at me.

“Teacher, can we finish the surgery before starting the lecture?”

“Ah, yes.”

Can’t help it.

Anyway, only the skin closure remains. I pulled the skin over the wound and sutured it with silk thread. It didn’t take long.

“Yes. Truly all done.”

Now it’s just recovery. I stepped back and set down the tools.

The nurses cleaned the wound with saline solution and wrapped gauze and bandages around the patient’s arm.

It was a tough process, but the surgery ended successfully. The patient was still alive and well. His rotten arm lay like a piece of wood in a bucket.

I looked at the patient’s face. Though he frowned, there didn’t seem to be any issues beyond losing the arm.

Well, it’s hard to smile after losing an arm, but this turned out okay. I glanced at the bucket holding the rotten arm.

“Burn that and bring it back.”

“Yes sir.”

Istina carried the bucket away. The patient stared blankly at me.

“Are you feeling alright, patient?”

“My right arm is gone.”

Uh, you shouldn’t forget. Did the anesthesia damage your memory? Maybe a fat embolism caused a stroke. I started to worry.

“That… Do you remember? We had to cut off the arm because it was rotting.”

“Yes, I remember clearly.”

Phew, I thought maybe delirium hit him. Anesthesia sometimes causes mental fluctuations. I sighed in relief.

“What happens next?”

“You’ll need to stay hospitalized for a few days. Once the wound heals, you can be discharged.”

****

Things in the ward were wrapping up.

Patients with no hope of survival had passed away, and no new cases had come in. Mr. Chris recovered and returned home for quarantine.

The plague’s spread ended. Everyone gathered in the conference room at Vinia Castle to report on the situation.

Vinia’s lord, his officials, Commander Rin, the Archbishop, Istina, Hedwig—basically everyone who mattered seemed to be here.

“First, let’s hear from Professor.”

I walked to the front of the room.

Fortunately, Lord Vinia looked much healthier than last time I saw him.

He must’ve slept well yesterday.

His face regained color. Last time, he looked like a zombie. He must’ve heard the plague was contained.

Everyone’s eyes focused on me.

I spoke.

“Our findings indicate most patients contracted the Black Death from flea bites. Fleas come from rats.”

“Yes.”

“We administered treatment to break the transmission chain and exterminated all the rats in the city. Only 15 patients remain in the temple.”

I looked around the room. We used magic to gather and kill every rat in the city. Commander Rin proudly nodded.

“Did it work?”

“Yes. From our house-to-house inspections, human-to-human transmission occurred only among close contacts living together. That’s why the outbreak ended.”

I raised my hand again.

“Excuse me, Lord. If I may, may I add a few words?”

“If it’s a request from someone who saved the city, I’ll do my best to grant it.”

How do I pitch this without sounding like a salesman?

“I’m currently collaborating with the Imperial Palace to create a company that mass-produces medicine.”

“Yes.”

“If lords like yourself cooperate with the research, development, and distribution of medicine, we can help many more people.”

Lord Vinia looked at me.

“Is that what you wanted to ask?”

“Yes.”

“You’re modest.”

I bowed. Lord Vinia nodded and continued.

“Doctor, do you think the medicine you’re making would have been effective against the Black Death?”

“It’s unlikely.”

“So, there’s a possibility it could have been effective?”

“There might be a small effect.”

Though I said it offhandedly, the room buzzed with excitement. Why such a reaction when I said it probably wouldn’t work?

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