Children again.
Children who seem to have congenital diseases.
Iâm not a pediatrician, nor a pediatric surgeon, and definitely not a pediatric cardiologist... Iâm an emergency medicine doctor, and not even one specializing in pediatric emergencies!
But Garrett couldnât just say, "I donât want to see this" or "I canât examine this." When a patient has exhausted all other options and you are their only hope, as a doctor, you must face the challenge head-on.
Viscount Elwin, whose lands are in the northwest of Nevis City. This family is renowned for their bravery, and a simplified version of their "Golden Lion Sword Technique" is widely taught in the militaryâthis information came from one of those parties, whispered into Garrettâs ear.
However, the current Viscount Elwinâs eldest son, or rather, the next family head, is quite frail. At an age where other children can run and jump around, just a bit more exertion leaves him short of breath and heart pounding. Any more, and heâd just collapse.
How could he become a knight or inherit the family business like this?
Although Garrett didnât understand why nobles in this world felt the need to become knights to inherit their familyâs glory, it didnât stop him from listening to the attending knightâs chatter while examining the patient:
A little boy, sitting quietly in front of him, hands crossed on his lap. His complexion pale, cheekbones lacking any flush, lips and nails not showing any cyanosis. It seemed, even with a congenital disease, it wasnât terribly severe.
Garrett felt slightly reassured. He took out a grass seed, exhaled a bit of natural power to transform it into a stethoscope, and smiled at the boy:
"Come on, take off your jacket, let me listen to your heartbeat..."
Please donât be Tetralogy of Fallot, please donât...
Obediently, the boy began to take off his jacket. The small knightâs outfit, made of velvet, had tightly fastened copper buttons which made it somewhat difficult for him to remove. His movements were slow, but he didnât pause or ask for help.
Garrett watched with a smile. Once the boy had removed his jacket, revealing a soft white silk undershirt, he picked up the chest piece of the stethoscope to place it but was stopped by the knight:
"What is this?"
"A stethoscope. It lets us hear the sounds of the heart and breath."
Garrett handed it over generously for inspection. After the knight examined it carefully for a while, he handed it back to Garrett to proceed:
"Hmm... the first heart sound is accentuated... pulmonary artery second heart sound is enhanced..."
"Second heart sound... fixed splitting... now breathe in... out... hmm, not influenced by respiration, still split..."
"Left sternal border second intercostal space, grade 2-3 ejection systolic murmur... diastolic seems fine..."
"Breath sounds... breath sounds normal..."
The knight paced anxiously next to Garrett, straining his ears to catch the muttered words, but he couldnât make out a single oneâand even if he did, he wouldnât understand their meaning.
After a while, watching Garrett put down the stethoscope and lean over to write in the record, the knight couldnât contain his impatience and urgently asked:
"Can it be treated?"
"... Further tests are needed." Garrett glanced at him, crouched down to eye level with the boy:
"How about we step outside a bit? Let me use this tool to check your chest a bit moreâ"
As he spoke, he took out an ăEndless Ink Penă, dazzlingly golden and studded with diamonds, catching the boyâs eye who reached out to touch it, then quickly withdrew his hand. Garrett smiled at him:
"This is a prize from my ăEmerging Mage Awardă. Stay still, let me finish the examination, and then you can touch it, alright?"
The boy nodded vigorously. Garrett gave a slight smile and lifted the ăEndless Ink Penă behind the boy, activating X-ray magic:
Hmm, the heart is enlarged, primarily the right atrium and right ventricle... prominent pulmonary artery segment, increased pulmonary vascular markings, hilar dance sign visible...
Based on the auscultation and X-ray findings, it appears to be a presentation of an atrial septal defect, of course, further differential diagnosis is needed. If itâs just an atrial septal defect, itâs not difficult to treat, an interventional surgery should suffice~~~
Garrett breathed a sigh of relief, his expression easing as he retracted the ăEndless Ink Penă, handed it to the boy to hold. Soothing him to lie still, he completed the echocardiographic examination and sternly turned to the knight:
"It can be treated."
"How? Using that vine,
inserting it into the heart?... What exactly is young master Chris suffering from? How are you certain?"
The knight unleashed a barrage of questions. Garrett patiently explained, planning to start treatment once he had the knightâs signed consent, but after waiting a long time, he got a reply:
"Master Mage, could you please write a statement for me to take back to the family head? Inserting a vine into the heart sounds too risky, I canât decide this without the family headâs permission!"
Well... thatâs somewhat reasonable. Itâs a headache when parents donât come themselves to see about their childrenâs health, but you canât really argue with nobility.
Back in my previous life, it wasnât unusual for secretaries or neighbors to bring someone in, with the family still miles away...
Garrett, in a good mood, copied the medical record for him. The knight flipped through it from beginning to end, then back again, ensuring each diagnosis was based on investigation, and immediately raised the next question:
"You say you saw these things, how do you prove it?... We canât see them!"
...Thatâs a good question. Garrett inhaled and exhaled, just about to answer, when the boy cheerfully replied:
"But Uncle Hart, we arenât mages, of course, we canât see!"
Such sensible children really brightened oneâs mood. Garrett spread a smile, feeling his blood pressure drop by 10 mm Hg, comfortably returning to the most relaxed range. He turned to the knight, calmly saying:
"The things seen in the meditation images can be manifested and taken back for your family head to see.âăDetection Magică, ăUltrasound Detectionă, one chip for each test, can be activated by magical power, each for 50 contribution points."
What, bought from the Alchemy Workshop for just 10 contribution points?
Please, are the tests cost-free, or is the recording cost-free? That golden box used for recording, a legendary design, handcrafted by a level 16 grand mage, depreciation costs havenât even been factored in!
Hospital drugs sold at zero markup? What is that? Besides, Iâm not selling drugs, Iâm selling the films!
100 contribution pointsâcurrent market exchange rate, 400 gold coinsâis nothing for a viscountâs territory. Including the examination fees, the knight promptly paid 500 gold coins, taking the medical records and films back home. Two days later, he returned:
Canât understand.
Of course, X-ray and ultrasound images are gibberish to the untrained.
Garrett had to write an additional explanation, again explaining what a healthy heart looks like, what part young master Chrisâs heart is missing, and what consequences that leads to. The knight, with the explanation in hand, dashed off...
And two days later, he came speeding back:
"How can you prove that thereâs a part missing, causing the blood in the heart to divert to the side?"
This...
Garrett was baffled. You canât understand the echocardiogram, and I canât lend you the Spirit of the Contract, so...
Do I need to perform a cardiac catheterization?!
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