Chapter 82
“…Archbishop.”
“What is it, Helmuth?”
A serving priest approached Archbishop Rylik, who had been in the middle of saving patients.
“I-I hear Mr. Isa pulled it off.”
“What are you talking about?”
“They say he saved the three patients whose abdomens had been pierced….”
The archbishop checked his watch without meaning to.
10:41 a.m.
It had been about an hour since the patient with the black flag was sent off.
“Heh heh….”
I have no idea what kind of magic trick he used.
Shun Isa had actually done it.
In a situation like this, with resources and time, everything was in short supply.
“He says he’ll save the fifth patient soon too, so keep sending more patients.”
“He really didn’t use Regeneration?”
“He says low-tier Heal will be enough…. Ah, he says the healers assigned to him are about to run out of divine power, so he’d like a few priests who can use Low Heal.”
Of course we should send them.
The words rose to the archbishop’s throat.
He was creating a miracle nearly on par with Regeneration with nothing but a low-tier Heal.
There was no reason not to send them.
In fact, if anyone asked who wanted to go, the priests would compete for it.
He didn’t even need to look far.
The serving priest reporting to him right now looked restless and fidgety.
“I-I… Archbishop….”
“Helmuth, go ahead. Learn as much as you can there, and be sure to tell me about it.”
“Thank you! Archbishop!”
Seeing his excited attendant priest, the archbishop gave a wry smile.
It was only natural to react like that.
Divine magic was, after all, just a branch of magic.
That was why, just like any mage tower or noble house, each clinic had its own secret methods.
Depending on what symbol, catalyst, nerve or tissue, and principle they used, the results of divine magic differed as well.
Even the treatments specialized by sect were a little different.
So healers trained at those clinics to learn those secrets, and in some cases they even sent spies to rival clinics to steal them.
Even in an emergency like this, some clinics refused to let outside healers in.
There was no need to say how exclusive the clinics were.
But Shun Isa was different.
‘It was as if the other healers were the ones who wanted to learn from him.’
No, that wasn’t a guess—it was probably fact.
Normal clinics strictly forbid a healer from joining a rival clinic when they leave.
But Mercur Clinic was different.
It doesn’t block people from coming in, and it doesn’t hold people back when they leave.
They didn’t even need to send spies to other clinics.
If someone said they wanted to learn, they were welcomed with open arms.
Ironically, because of that, applicants competed so fiercely that even people who wanted in couldn’t get in.
In any case, Shun Isa’s actions were on a completely different level from other healers.
‘Huh…. Maybe our priests should be the ones to watch and reflect on themselves.’
Thinking that, the archbishop began selecting the priests to send to Mercur Clinic.
If it were up to him, he wanted to fill the place with his own people.
But that would be insulting Shun Isa’s noble goodwill instead.
So the archbishop randomly selected healers who had some breathing room at the site and dispatched them evenly.
‘Heh heh. I’m getting too old, and I still want to join them.’
If it were up to him, the archbishop wanted to naturally blend in with that group too.
He also wanted to learn many things as a healer,
and as a man of faith, he wanted to witness a miracle.
Of course, he didn’t put that into practice.
He still had work to do here.
“Helmuth. Be sure to learn a lot and come back to tell me all about it.”
“Understood, Archbishop.”
Just like sending someone off to study in the Holy City.
He smiled with satisfaction watching the attendant priest climb into the carriage in high spirits.
Clatter-clatter.
After sending the priests off to D-1 Clinic like that.
The archbishop checked the black-flag patients once more.
And then,
“Isa, can you save a patient whose lower jaw and a quarter of the head are missing?”
[Is the brain still intact?]
“It looks like only the skull is broken and the brain is still there.”
[It’s a little difficult, but it’s doable. Please classify patients with preserved brains in head-trauma cases, or patients with destroyed lower jaws, as red and send them over.]
“Understood.”
[Ah, and when you send them, be sure to send them lying face down.]
“…Understood.”
Even as the archbishop answered that, he still looked somewhat hesitant.
A patient with a shattered lower jaw and an exposed brain.
Why would such a patient be classified as red?
How on earth was he planning to save someone like that?
Countless questions tangled and piled on one another.
But he set the questions aside.
A genius chosen by God must have methods I don’t know about.
With that thought, the archbishop resumed sorting the patients.
***
After starting to reclassify the patients that had been marked black into red.
The field kept sending more and more rare cases of every sort.
“Male patient in his twenties. Massive head and facial destruction caused by a monster’s claws, with multiple comminuted fractures and bone loss of the mandible and skull. In particular, a large skull defect of about 9 × 11 cm has been confirmed in the right parietal and temporal regions, with the brain directly exposed. The left mandibular ramus and body are comminuted and missing, and the oral soft tissue is also severely torn, exposing the airway.”
This patient had taken a hit to the head.
A patient whose jaw and skull had been destroyed.
Normally, someone like this should be classified as black flag.
But after operating with Aila, I thought red would be fine.
“You anesthetized him with cocaine, right?”
“Yes, he’s been anesthetized.”
Surgery started immediately.
“Student Joel.”
“Then I’ll call time out. 12:08. Then let’s begin surgery.”
First, I checked the tongue.
Normally, the tongue is a structure supported by the lower jawbone and the hyoid bone.
At this time, the genioglossus, a muscle attached to the mandible, pulls the tongue forward,
while all the other muscles pull it backward.
In a situation like this, what happens if the mandible disappears?
‘No matter how much force you put into the tongue, it’ll curl backward.’
With the lower jaw gone, there’s no force pulling it forward from the front.
The tongue curls backward under gravity.
And then the tongue blocks the throat and the patient suffocates to death.
That’s why I told them to send the patient face down.
So it wouldn’t curl backward under gravity.
The direction of gravity is changed to the patient’s front.
Of course, this is only a temporary measure.
In the end, I needed to solve this first.
“Hold the tongue steady.”
Suture the tongue to create a loop and secure it forward.
And so that the patient can breathe even if the tongue curls back, create a hole in the neck with a tracheostomy.
Then insert a tube so they can breathe.
“Now let’s deal with the head.”
What to do with the head is the same as usual.
Skull opening (craniotomy)
Just apply it a little.
The missing skull edge is sharp enough to stab the brain, so I shave it down.
Incise the meninges to relieve the cerebral edema.
However, there was one difference from the usual craniotomy.
“Isa, there isn’t enough skull and flesh to cover it….”
said Kou, a healer who had observed countless craniotomies in the past.
That was right.
This patient currently lacked the bone and flesh to cover the brain.
“Could we perhaps use divine magic here….”
“No need. Goldbeater’s skin, please.”
Goldbeater’s skin
It’s the cloth goldbeaters use.
It’s the cloth laid over gold leaf to protect it while it’s being hammered for gilding.
We’re going to cover the head with this.
And later, once the brain swelling goes down, we’ll replace the skull with iron and use skin from the buttocks and thighs for the scalp.
In a world with divine magic, transplantation is so much easier.
Snip-snip.
Cut the cloth to fit the brain and attach it.
Then, to keep cerebrospinal fluid from leaking out, cover it again with oil-soaked silk cloth.
“Now let’s work on the lower jaw.”
This part isn’t difficult either.
Just cobble together the leftover Goldbeater’s skin we just cut out and some wire.
To put it more specifically, so it doesn’t sound like I’m being too casual,
“Aila, Refresh.”
“Y-yes! Refresh!”
First, remove the necrotic tissue without hesitation,
then wash it once with holy water.
“One more Refresh.”
“Refresh!”
Then cover the wound areas with scraps of cloth so germs can’t get in.
Finally, wrap the wire in a figure-eight pattern to secure the remaining jawbone,
then tie the tongue down by binding the remaining jawbone and the tongue together with thread.
With that, today’s surgery for this patient is done.
Tomorrow and the day after, we can reconstruct the lower jaw.
We’ll have to think about whether to use ribs or the steel jawbone made by the dwarves.
Anyway, surgery’s over.
“Please sign out.”
“I’ll sign out. Total surgery time: 38 minutes, 12:46.”
38 minutes.
That was a pretty decent amount of time.
About the time you can spend on one patient in a typical code black situation.
Originally, this was a major surgery that would easily take an hour.
The neck is full of blood vessels and structures, so it’s an area where blood just pours out.
You can’t see anything, so you end up spending half the surgery just stopping the bleeding.
But with divine magic, we could shorten surgery time this much.
‘Of course, that was also thanks to the teams doing a good job.’
I looked around the operating room.
Joel and the other healers, who were now used to surgery, simply nodded calmly.
Instead, the new healers sent by the archbishop were speechless.
It was a fairly satisfying reaction.
‘Good. Watch my surgery and spread it far and wide.’
That way, the burden of having to do this one-man show alone will be lessened.
And if those people can adapt this surgical method to divine magic and develop it further, even better.
And if they spread Shun Isa’s name far and wide, even better, even better, even better.
“Then shall we move to the next operating room?”
Thinking that, I threw off my surgical gown.
The shirt under it was soaked through with sweat.
“…I’ll change clothes first and come back down.”
Not only the shirt, but the inside of the crow mask was full of sweat.
If it were up to me, I’d want to take off the mask too.
But the problem was that I couldn’t take it off because of Shun Isa’s status.
‘Should I install some kind of air-conditioning function later?’
I wonder if I should at least enchant it with something like ice magic.
Then I felt a warm sensation from behind me.
When I turned my head, I saw Aila casting Refresh on me.
“…Aila?”
“No… well… you looked a little tired, Director Isa… if that was a waste of divine power, I’m sorry….”
“No, it’s fine. Thank you.”
Waste, my ass.
I feel like I’ve used Refresh almost hundreds of times by now.
Yet she still seemed to have plenty of divine power to spare.
At this point, it was safe to say she possessed divine power nearly on par with a high-ranking healer’s.
‘Well, at this point, I should say she’s awakened the talent of a saintess.’
Besides, I think Aila could go beyond a high-ranking healer and even aim for the saintess position.
So a single Refresh is nothing.
If anything, if it can reduce my fatigue, shouldn’t she use it freely?
“Are you okay? I’m worried I may be pushing you too hard.”
“I’m fine, Director Isa.”
“I’m glad. Then I’ll go change clothes and come back, so you should rest a little too, Aila.”
“Yes! Director Isa!”
The healers and students saw me off as I walked to my office.
***
And so, a week passed.
The patients with abdominal injuries had their organs reconstructed and their abdomens closed.
The patients with head injuries had their skulls and jawbones reconstructed with ribs.
And then there were the ones whose esophagus had been hit by corrosive poison, whose lungs had been pierced, whose hip bones had been smashed, and so on.
Anyway, there were truly all sorts of patients.
The most memorable among them was the electrocution patient.
‘Wow, he survived that?’
He was an A-rank adventurer who got into an all-out duel with a lightning-spewing monster and was brought in roasted to a crisp.
Normally, by principle, we wouldn’t treat a patient like that because the chance of recovery is low.
But since most of the patients had already been treated and we had room to spare, and because he was a superhuman with high strategic value.
I put my hopes on him and treated him.
And after a week.
‘Divine magic really is the best.’
We saved him in the end.
Strictly speaking, I didn’t save him alone.
I only did the initial treatment, and the priests poured low-tier Heal on him every day.
In the end, he survived.
Still, my initial treatment alone was genuinely top-notch, so my share of the credit was by no means small.
‘I’m hitting a career high in another world.’
A high-voltage electrocution patient is the kind of high-difficulty case that would make the news if you saved them in trauma surgery.
If this had been in my previous life, I would’ve published it in JTACS, the Journal of Trauma and Acute Care Surgery.
Then I could’ve become a professor right away.
…The more I think about it, the more unfair it feels.
Well, of course, in my previous life that would’ve been impossible anyway.
In the end, it was saved thanks to divine magic.
And there was another contributor besides me.
“Mr. Kou. You’re the one who saved this patient.”
“No, Director Isa. I only did what you taught me.”
“Even so, I can’t manage blood sugar this well.”
Our blood-sugar specialist healer, Kou.
This man brought the electrocution patient back from the River of the Dead.
Electrocution patients have every cell in their body seared, so they develop a systemic inflammatory response.
As a result, the body continuously secretes cortisol and catecholamines, which causes blood sugar to spike sharply and the inflammation to worsen even more.
In situations like this, the most important thing is blood sugar control.
And Kou was the one who managed that.
“Please have Mr. Kou keep caring for that patient until the end. I need to see the others.”
“Understood, Director Isa. Please get some rest now.”
“Yes, good work.”
It was a shame, but I handed my career-high patient over to Kou.
That patient would now return to normal life quickly, just like the others.
Once I just kept the emergency patients who came in during the first few days alive, the rest was easy.
As long as they were still breathing, we could bring them back with the miracle of divine magic.
All we had to do was heal them in order of rank and send them to the battlefield.
That A-rank adventurer was a precious strategic resource, so he’d be the first to receive high-level divine magic.
So as long as they were breathing, the rest would somehow work out.
‘Maybe I should get some sleep.’
The immediate crisis was over.
I should be able to sleep soundly tonight.
I headed to my office, which also served as the on-call room.
When I opened the office door, I saw Aila and her friends fast asleep on the sofa.
‘So they really didn’t go home after all.’
They’re truly excellent students.
They’d been by my side helping me for a whole week.
They probably didn’t have any obligation to do that, but they contacted their families and stayed here to save patients.
Sometimes their parents even came to the clinic and brought lunch boxes.
This is why I like an era where romance is still alive and breathing.
Just then, Aila rubbed her eyes and sat up on the sofa.
“Mm… Director Isa?”
“Student Aila. Why are you up?”
“Ah, well….”
She checked the clock.
Then,
“It was time to cast Refresh on the patients….”
“You’ve been doing that all this time?”
I hadn’t known, since I’d been in the operating room the whole time.
She nodded at that.
“Yes… I thought it might help…. Right, I should’ve asked permission….”
“No, you did really well.”
In the end, the most important thing before and after surgery is stamina.
A doctor’s skill only matters during surgery.
In the end, what determines survival is the patient’s stamina.
That’s why doctors check whether you’re eating well and exercising before and after surgery.
‘No wonder. Even for a misunderstanding fantasy, the survival rate was absurdly good.’
It had to be like that, with Aila casting Refresh every day.
It felt like I’d found another piece of hidden logic in a misunderstanding story.
Or not? Does the grammar of misunderstanding stories not work that way?
Anyway.
“All right, Student Aila. I was just about to do rounds too. Want to come with me?”
“Yes! Director Isa!”
I started walking alongside Student Aila.
I made rounds while checking the patient details organized by the other students.
“Ah, Mr. Theodore. How’s your abdomen? Is digestion going well? The wound… hasn’t reopened. Your recovery’s going well too. You know Student Aila? Ah, she cast Refresh on you every night.”
“You’re Cordelia’s betrothed, right? You’re worried you might end up unable to have children, is that it? Tell them not to worry. We preserved the uterus, so once they recover, it’ll be fine. Thanks to Miss Aila, we were able to avoid removing the uterus.”
“Mr. Casimir, you woke up yesterday, right? Do you remember where you are? Ah, this student looks familiar? What? She looks like the angel that appeared in your dream… Delirium, maybe…?”
I thought the last patient seemed a little off.
Fortunately, it was just a misunderstanding.
He’d unconsciously remembered Aila’s nightly visits in the form of dreams.
After finishing rounds like that,
I took Aila to a place other than the office where her friends were.
The conference room.
Sounds grand, but it’s really just a space where I’ve thrown a desk and some supplies.
“I have a gift I want to give you.”
There, I took out five medals.
They were each for Aila and her four friends.
“These are for the honorary healers of our guild. I wanted to hold a proper award ceremony too, but I don’t think we’ll have the capacity for that for a few months.”
“M-me?”
Aila pointed at herself, eyes wide.
She looked back and forth between the five medals on the desk and me.
“I… I really didn’t do anything… Compared to the other healers, I only cast Refresh… that’s all….”
“Hmm. Student Aila.”
“Yes!”
“Do you remember the fact I taught you at D-3 Clinic back then?”
“Small, trivial facts gather together and become knowledge….”
“That’s right.”
There was something I emphasized over and over back then.
The personal information of each patient may not be worth enough to get the treatment fee reduced.
But when all those countless bits of information gather together, they produce one research result.
And when those research results pile up, they become knowledge.
Knowledge that can’t be replaced even with a fortune.
And that logic leads to what I’m trying to say now.
“Student Aila. Why do you think miracles happen?”
“Huh?”
“People think miracles only happen when a great being intervenes.”
But my view is different.
“But I think differently. A miracle begins with all the trivial things.”
“All the trivial… things?”
“Yes.”
In trauma surgery, you can witness countless miracles.
From the heart-shot patient I keep dredging up as an example,
the patient who fell off a motorcycle and had the front half of his body ripped off,
and even the patient who fell on a Bukhansan hiking trail and broke his neck.
Trauma surgery is where patients like that survive at roughly a 30 percent rate. (Assuming they arrive in time.)
At that point, all the conditions that save those patients are trivial.
Does the wound get infected?
Is that tiny blood vessel still alive?
Are there scratches on the internal organs?
Is this person young?
A patient can die from a tiny hole, and with just the slightest miss, a patient can survive.
And when all of that comes together, a 30 percent miracle happens.
This time is the same.
“Your Refresh may seem trivial to formal healers.”
It only restores fatigue and controls tiny amounts of bleeding.
But if it can be cast almost infinitely and without restraint, the story changes.
That Refresh gave patients the stamina to wait for surgery,
stopped minor bleeding during surgery and shortened the operation time,
gave us the basis for deciding which organs to save and which to give up on,
and gave patients the stamina to recover quickly after surgery.
“So even if a single Refresh can seem trivial, when all of that comes together, it’s a miracle.”
Isn’t it said that the devil is in the details?
All those little things come together and create the miracle of patients surviving.
In that sense, Aila’s share in this “miracle” was by no means small.
“Most of all, thanks to the Refresh you cast in the middle, I was able to keep going.”
Well, after all, the reason I was able to avoid collapsing for a week was thanks to her.
Since I’ve died from overwork before, I know people can die while working.
When it comes to death by overwork, there’s no telling who goes first.
“So take them. You too, Student Aila, and your friends. You truly helped me a lot.”
“…Thank you, Director Isa.”
Aila took the medals for her friends as well.
“And this is a personal gift from me to you, Student Aila.”
And one more on top of that.
I handed her the cloak worn by the healers affiliated with our guild.
A white cloak decorated with gold thread.
No one wears it while working because it’s cumbersome, though.
But it seemed the cloak meant something different to Aila.
“…I really appreciate it, Director Isa.”
I draped the cloak over her shoulders.
That brought our little ceremony to an end.
“I look forward to your future achievements, my disciple.”
“Director Isa… no, Master, I’ll do my best not to shame your reputation.”
I gave her shoulder a light pat, and we headed back to the office.
A few days after that.
While the smell of blood from the square at the North Gate still rose up from the sewers.
The imperial capital was filled with people in mourning.
Depressing newspaper headlines were laid out in front of their homes.
— Northern Subjugation Expedition 2000, catastrophic damage confirmed
— Rescue-team deaths more than double those of the assault force
— Front beyond the wall shifts to defense for now. Emergency reinforcements for the wall garrison mobilized
The appearance of mutant monsters.
That was enough to make humanity tremble in fear again.
This was a history that had repeated for a thousand years.
Just when humanity began to adapt somewhat to the monsters, all hope would be brutally crushed by suddenly appearing mutant monsters.
Heroes, knights, and nobles would be wiped out all at once or suffer permanent disabilities,
and humanity would hide passively behind the walls until the damage was repaired.
And when a new generation once again headed beyond the walls, they would have to face monsters that had grown stronger over many long years.
Those who had repeated this tragedy for ages thought it would be the same again this time.
Until one piece of news came through.
— About 2,000 wounded. Of those, around 100 dead. Far below the expected death toll.
Both the Imperial Court and the military.
Had estimated the death toll of this failed expedition at 1,200.
Divine power has its limits.
So it naturally tended to be concentrated on high-ranking people, who were precious strategic assets to humanity.
They considered it unavoidable even if some were abandoned in the process.
In fact, some of the patients saved like that would even die from an unknown fever.
As a result, even if the death rate among the wounded approached 50 percent, they still thought it was the way to keep the front line intact.
But.
— Of the roughly 2,000 wounded, about 100 were returned to the front first, in rank order.
The number of deaths was far too low.
Not 1,200—only 100.
The lower-ranking superhumans hadn’t been sacrificed just to concentrate divine magic on the high-ranking ones.
Even the high-ranking superhumans hadn’t been sacrificed.
Nor had their return to the front been delayed.
And on top of that, there was hopeful news that the wounded and those with permanent disabilities might somehow return again in the far future if they received divine magic.
This was a miracle.
People immediately began taking interest in the source of that miracle.
And amid that attention, the archbishop made a shocking announcement.
“All of this is thanks to the ‘Black Saint’ and the ‘Saintess of the Lantern.’”
Saint and Saintess.
In the Empire’s bleak times, at news of a new miracle,
the whole world’s attention turned to the two of them.