"Was he a patient of Dr. Zemel?"
"Yes."
"Hmm... This is going to cause quite a stir.... Have you contacted the family?"
"No, I don't even know this patient's name."
"Ah."
After the situation was roughly sorted out, Blundell approached and asked.
Perhaps it was because Dr. Robert Liston had entrusted us to him in his absence, or maybe he was impressed by the abilities I had shown so far—I couldn't tell. But in any case, he was diligently looking after us.
"For now, admit him under my care. It's not like anyone will know anyway."
"Yes."
There was a computer system, but it was a mess. Everything was managed on paper, and even that was disorganized. It was said that over ten patients fled without paying their bills every month. Yet, there was no effort to track them down.
So, if we admitted the patient to a room where Zemel didn't frequent, there would be no need for strict admission procedures.
"The problem is... there's a high chance this patient might die again."
Blundell was still looking down at the pale patient. Compared to when we took him out of the coffin, his complexion had improved slightly. But no matter how active his blood-forming functions were...
...
He had lost a lot of blood. Since we hadn't replenished the blood itself, the patient's condition was far from good, to say the least.
'His pulse is fast.... Blundell is definitely right. But how does he know so well?'
Instead of just staring, I was holding the patient's wrist. Earlier, the pulse was too weak to feel at the wrist, but now it was strong enough to measure.
'120 beats per minute..... Even at rest, this level means... The blood volume is still insufficient. But I can't tell if it's getting worse or not.'
...
Is this the start of an infection?
Fever?
There was no fever. In fact, his body temperature was slightly lower than normal.
But that doesn't necessarily mean there's no infection. Fever is, after all, our body's defense mechanism against viruses or bacteria. There's no way he had the strength left for that.
'Still, we need to give him more.'
I was already done, and I was staring at the central venous line I had clumsily secured. It was more like a needle than a catheter, so thick it could almost be called a blade. Someone had to keep an eye on it. Even if the patient regained consciousness, it wouldn't be fully intact, and if he moved it carelessly, he could die from it. That couldn't happen.
"Wait a moment."
As I was thinking this, Blundell called out to me while I was holding the pre-boiled and distilled water.
I turned to look, and Blundell was staring at the IV fluid. It was so shoddy that it was hard to call it IV fluid, but... he was staring at it.
"That thing."
"Ah, yes."
"Were you thinking of using that instead of blood?"
Then he asked a question that, by my standards, was obvious, but considering it was the 19th century, it was quite progressive.
"O..."
I nodded helplessly, and Blundell looked impressed.
"Yes, that method..... Huh. So that's... Hmm. But wouldn't there be a problem? Water mixing with the blood that's supposed to flow through the vessels."
He continued with his questions, and it seemed like he had been pondering this issue for a long time. Did he know something?
Well, it wasn't an easy question to answer.
"Hmm... I'm not sure. Since we can't give blood right now... I thought we'd at least give him water."
"You don't seem like the type to do something without a reason. There must be some logic behind it, right?"
Me?
Blundell looked serious. So did I.
The reasons were different.
I was now pouring water into the patient's central venous line through a funnel. It couldn't be too fast. There was no reason to rush. We had already passed a critical point.
"The reason is... Well, in my opinion."
Having Blundell by my side was, in a way, a blessing. This task, which was likely to be futile—an aspiring surgeon pouring water—wasn't exactly a pleasant thought.
Having to slowly control the entire process of pouring water, and even having to do it all myself? It was bound to be a tedious and painful time, but the conversation with Blundell made the burden feel a bit lighter.
"Blood is, after all, a liquid, right?"
"Yes."
"Water is also a liquid."
"Yes."
"If the two mix, wouldn't it still be blood, albeit diluted?"
"But there are liquids in the world that don't mix easily, like water and oil."
"Ah."
I needed to rephrase that.
It wasn't necessarily a relief.
It wasn't intentional, but I felt something tap my throat.
Water and oil, huh?
Then is blood like oil?
No, come to think of it, there is oil in blood.
The term "hyperlipidemia" exists for a reason.
"When blood flows out, don't we wash it with water? I've seen it. They mix quite well."
"Ah, I see. So that was your reasoning. Yes, that makes sense... To replenish the missing blood... Hmm."
I couldn't exactly explain it that way, so I had to come up with a somewhat lacking answer. Still, Blundell looked impressed.
Even a diluted truth is still a truth, right?
For a scientist whose job is to explore truths, a glimpse of 21st-century knowledge must have seemed like a mystery.
"But how much did you give? The water, I mean?"
"Ah..."
This question was also quite impressive.
It might have been a casual question, but...
How much water did you give? That's something even 21st-century university hospitals ask all the time.
You have to replace what's lost.
In other words, you need to balance IN & OUT.
This was a truly important concept.
"About 2 liters. If we add this... it'll be around 3 liters."
"3 liters."
It's been a long time since we figured out how much blood is in the human body.
Isn't that an easy thing to know?
Even in anatomy labs, drawing blood is a common task.
It's not specifically for dissection purposes.
Humans have been slaughtering animals since ancient times, and they knew very well that drawing blood delayed decay.
"Even if this patient lost a lot of blood, it's unlikely he lost 3 liters... So wouldn't that be a problem?"
Oh.
This guy kept surprising me today.
He understood the concept of replacing what's lost?
Or not?
Is that something anyone who can think should know?
'No, no.....?'
I shook my head, thinking of Joseph and Alfred.
No matter how busy they were with exhuming bodies, they never asked questions like this.
They weren't even here now.
They were tired and had gone home.
Those kids...
Blundell, who looked to be in his late 30s, was rubbing his sleepy eyes but still holding his ground.
"But since the concentration is diluted, isn't it unavoidable?"
"Wouldn't further dilution make things worse?"
"Well, this is just my opinion."
Would it be too arrogant to say Blundell was admirable?
I continued speaking, thinking it wasn't.
This guy deserved to know more.
'And Blundell is an obstetrician, right?'
Would mothers just die from infections?
No way.
Humans have large heads, so maternal mortality rates are inherently higher compared to other animals.
If the baby didn't turn, it was almost certain death.
Cesarean sections solved that, but they weren't yet common.
Anesthesia had just become possible, so it wasn't widespread.
'How many people die from bleeding?'
Thinking about it, it wasn't a coincidence that Blundell had been pondering this issue for so long.
Obstetricians are inevitably exposed to massive bleeding, regardless of expectations.
The placenta is essentially a blood clot, isn't it?
Issues like placenta previa could cause massive bleeding.
In this era, without blood transfusions or trauma patients necessarily coming to the hospital, Blundell might have seen more patients die from bleeding than anyone else.
"When we found the patient earlier, his pulse was undetectable."
"Pulse? Ah, this thing? What is it?"
"This pulse... What is it, really?"
"Hmm."
I wasn't planning to explain the concept of blood pressure right now.
It wasn't possible, and it might even be dangerous.
I just wanted to give him a hint.
"I've been thinking."
"Yes, what have you been thinking?"
"When blood moves through the vessels, doesn't it hit the vessel walls?"
"Hits the walls?"
"Yes. It only happens in the arteries. Think about the arteries in the dissection lab. Aren't their walls thicker? Did God make them that way for no reason? Isn't it because the blood keeps hitting them?"
Of course, I made an effort to prove my burning faith during the explanation.
I'm not sure if it had an effect, but Blundell was listening intently.
"Hmm...
Hits... Yes. That's one way to think about it."
"If you can't feel it well, doesn't that mean there's not enough blood?"
"Yes."
"But what about now? You can feel it, right?"
"Hmm. We've replenished it. But still, it's weak... Ah. So does that mean we can give more? That's strange. Why is this happening?"
Blundell looked genuinely confused.
And rightly so.
How could he possibly understand the complex structure of blood vessels?
That's something that would only be revealed with much more advanced microanatomy.
He was probably imagining copper pipes with water flowing through them.
There's no way he could imagine that the water we're giving is entering the body through osmosis.
It's not that Blundell is incompetent—it's just the limit of the era.
The science of this time was generally underdeveloped, and each field was isolated, preventing comprehensive progress.
"I don't know... But this pulse, shouldn't it be strong enough to at least match that of a healthy person?"
"Yes, that makes sense. Hmm. Your reasoning is quite sound. Hmm. If we could apply this to our patients... that would be great. Hmm."
Blundell kept nodding.
Meanwhile, I finished pouring the remaining water and covered the needle with flour paste.
It was far from sterile, but now that the blood pressure was starting to return, leaving it uncovered would cause blood to leak out through the hole.
And we couldn't just pull it out and reinsert it every time we needed to give water.
That wouldn't do.
"Then I'll keep an eye on this patient overnight."
"Alone?"
"Yes."
"Alright. I'll stay too.
If something happens, let's discuss it like we did just now. I'm not just saying this—I feel like something I've been pondering for years is finally being resolved."