They say you get better at anything if you keep doing it.
Even making distilled water—I got better at it over time.
It took less time, and it looked cleaner too.
I'm pretty sure there were no instances where I had to use my fingers out of necessity.
'Hmm...'
Anyway, I approached the patient with the distilled water I had prepared.
Even though I hurried, about 20 minutes had passed, and the patient's condition had worsened significantly.
It would have been good if I could measure their blood pressure, but since I couldn't, I couldn't make an objective assessment.
So, when I say it's bad, I mean it feels bad.
It's a very layman's way of putting it, but...
I've got some experience, so I guess it's better than nothing.
'Can they survive this?'
Even if we do a proper blood transfusion, it seems like it'll take several bags.
By "several bags," I mean 320 mL units of whole blood, so we'd need at least 1 liter.
But so far, only about 100 mL of blood has been given to this patient.
And even that...
Was mixed with other things.
At this point, it's more like poison than blood.
Sigh.
Anyway, I stuck a new needle instead of the one already in place.
I'm not sure how it was placed, but the needle was in a vein near the wrist, which is why.
Plus, the needle was relatively thin.
Considering how sloppy these guys are, I wonder how wide the hole is.
At best, it's probably a 21-gauge needle (the higher the number, the thinner the needle).
'How is the blood even supposed to flow through that?'
Considering that the manual recommends an 18-gauge needle for transfusions, and ideally a 16-gauge, it's almost a miracle the patient is still alive.
The hole is so narrow that maybe only plasma is getting through, not the blood cells.
Well, the antibodies have gone in, so there will be some reaction.
But isn't that better than all the blood cells getting through?
"Ahem. Do we really need to stick another one?"
After I stuck the needle in, Blundell asked.
He wasn't blaming me.
He couldn't.
By now, Blundell had come to see me as a kind of companion or even a mentor.
Not in obstetrics, but definitely when it comes to trying something new.
"Well... if it's not enough, we'll need to give more blood. While we're pouring this in, it might not be ideal."
"Ah... mixing blood and water?"
"Yes. Well... they'll mix inside anyway, but there's no need to do it from the outside, right?"
"Right, that makes sense. You're quite thoughtful."
There was another reason, but it wasn't the right time to bring it up.
I couldn't just stand there, so I decided to play dumb.
It wasn't anything special.
Just thinking to myself.
I'll explain it to the others later.
'In a situation where blood pressure is low... no, these guys don't even know what blood pressure is. When there's too little blood in the vessels, it's hard and dangerous to access peripheral veins... and if you're going to give a large amount of fluid, you need to access a larger vein.'
What I accessed was the jugular vein.
The subclavian vein would have been easier to manage, and better for the patient too... but even I couldn't access a deeper vein in a situation where blood pressure is unknown and the pulse is weak.
If I made an incision with a scalpel, I could find it quickly, but...
That would just cause unnecessary suspicion.
Like, am I showing off?
'And it's better if only blood goes into the blood vessels. Plus, with that clot...
The needle hole is probably blocked.'
Of course, the medical staff at this time would just push through if the hole was blocked.
The clot inside would just slide into the blood vessel, right?
"Sigh."
Just thinking about it made me want to scream.
They say ignorance isn't a crime, but it sure feels like one.
They think they're doing a good job, but they're just killing people.
Drip, drip.
The amazing thing about me is that even while thinking this, I'm still pouring water.
I'm really...
The only one trying to save lives here, seriously.
Just as I was about to cry tears of blood, Joseph spoke up.
"Uh... the patient seems to be moving a little?"
"Huh? Really?"
Good on him for keeping an eye on the patient.
Anyway, looking at the patient, it seemed their consciousness was gradually returning.
This was a critical moment.
The jugular vein is easy to access and works well, but...
If they move, it could be really dangerous.
"Hold them."
"Uh, okay."
So, Alfred and I pressed down on the patient's forehead.
And their shoulders too.
Given how much blood they'd lost and their poor nutritional state, restraining them wasn't too hard.
In fact, it was almost too easy, which was a bit unsettling.
""
With my level of experience, I can tell just by looking at their face whether they're in real pain or not.
Well, actually, it's strange to even think they might be exaggerating at this point.
Anyway, despite their obvious pain, the resistance I felt was minimal.
Plus, their shoulders were so thin.
'Damn... this is just...'
This is why people drop like flies when they get infections.
Maybe what some people in the slums need isn't medicine, but just meat or soup.
'Should I sell condoms to raise money for that?'
Of course, I'm in no position to do that.
I'm just a freeloader myself—what do I know about meat and soup?
99
Regardless of my thoughts, the patient was blinking in pain.
Where does it hurt?
Their stomach?
Common sense would suggest that's likely.
But...
"How are you feeling, patient?"
"Patient, this is Dr. Blundell. How are you?"
I asked to check.
The patient responded to Blundell's voice.
Of course they would.
People naturally respond better to familiar voices.
"Ah... my stomach...
My stomach..."
"Ah, yes. You just gave birth, so your stomach might hurt."
"But... why does my back hurt so much?"
"Your back?"
"Yes, here..."
I stepped back for a moment and watched them talk.
My expression probably wasn't great.
Back pain...
Especially in the lower back...
Even though their hands weren't moving well due to the pain, they were pointing there.
"Hmm. Why does your back hurt? Oh, and you have a bit of a fever. Did anyone not wash their hands? No, it's probably too early for a fever."
Blundell, while talking, seemed to notice the patient's temperature and turned around.
He tilted his head in confusion.
It takes time for a fever to develop from an infection, so he must have known that much.
"Ugh, ugh."
Then the patient vomited, and his face darkened.
He clearly didn't know the reason.
But he knew it wasn't good.
"Hmm. Should we give more blood?"
In the midst of this, Blundell suggested something ridiculous, so I stepped in.
"Well, let's just keep giving water for now. Giving more blood would be too much. The patient seems more conscious than before."
"Hmm. But I think we need to give more blood."
"No... let's wait a bit."
What should I do!
While I was thinking, someone came in and spoke.
A savior.
"Professor Blundell, there's a patient who's about to give birth."
"Ah, I'll see them later."
Getting rid of this quack who's killing patients is the real savior, not some miracle worker.
I watched Blundell leave and then turned back to the patient.
The patient was trembling, pointing to their back and stomach.
They occasionally pointed to the IV in their arm, but with four people holding them down, it didn't seem like they could do much.
'
Anyway, to summarize the patient's symptoms:
Chills... abdominal pain and back pain. Wow... this is...
This is textbook stuff.'
With so much blood coming from the uterus, it was hard to confirm, but there was probably some hematuria too.
Damn.
It would be great if we had a urinary catheter, but we don't have the materials to make one.
The only material we have is iron, and you can't make a urinary catheter out of that.
OFL...
Wait, maybe we could have made one.
'A lot of these guys don't care about the patient's pain at all.'
If the patient can't urinate, wouldn't they think of shoving an iron tube in?
Surprisingly, they've known about the structure of the bladder for a long time.
'Ugh.'
The thought gave me chills.
I wouldn't be surprised if there's a torture device somewhere in this hospital.
Of course, that thought didn't last long.
I was the only one who knew what these symptoms meant.
'Acute hemolytic transfusion reaction...'
In modern medicine, this is more of a reference point than anything else.
It's what happens when you transfuse the wrong blood type, like ABO incompatibility.
Doing something like this is a clear medical error, and in most countries, this kind of mistake is impossible.
Even in the military.
That's why they engrave blood types on dog tags.
It's to avoid these kinds of complications...
"Let's keep pouring water. Joseph, can you make more water?"
"Huh? Will pouring water help? Shouldn't we give more blood?"
"No, let's stick with water for now. Let's do what we can."
"Uh..."
"Hey, just do it, okay?"
"Uh, okay."
Treatment?
There was no treatment.
All we could do was keep pouring water.
Well, besides that, we could give a diuretic to help remove some fluid...
But we don't have any diuretics, and even if we did, we shouldn't give them.
Why did we give blood in the first place?
Because they lost too much blood, so their blood pressure dropped.
In a backed-up situation, making them urinate more would just be another form of murder.
Drip, drip.
Anyway, I started pouring water with all my might.
Holding onto hope that it had been about 40 minutes since the transfusion.
Usually, something happens within 15 minutes.
The fact that it's delayed...
Maybe my fluids are working?
Maybe they're diluting the blood more than I thought?
'But the amount given was quite a bit... Now I remember. Even 20-30 mL can cause an acute hemolytic reaction...?'
But hoping for the best is too naive.
While pouring water, I called for the family.
Then I had them talk to the patient.
What should they say?
It didn't matter.
I just didn't want there to be any regrets.
Even in a familiar era, losing a family member, especially a wife, is too terrible a thing to bear.