Transfusion, Part Three
"Ugh..."
About forty minutes later, the patient fluttered her eyes open. Her complexion was still ashen and drained of color, but her consciousness was remarkably clear.
"Ah, my stomach..."
She was clearly feeling the pain, which was an immense relief. Not that I had deliberately withheld analgesics just to verify her sensory reflexes—I simply had no suitable medication on hand. In an era like this, what injectable painkiller could one possibly administer to an unconscious patient?
"Drink a little of this first."
"Ah, yes... Ugh..."
Fortunately, although it was abdominal surgery, the bowel had remained entirely untouched, meaning there was no strict physiological reason to fast her. Even so, it wasn't as if I could serve her a proper meal right away. Who knew when complications might arise and force us back onto the operating table? How could I feed her solid food under such precarious circumstances? Medicine would have to suffice for now.
"All right, that is enough for now."
"Mmm..."
Not that I could pour a mountain of pharmaceuticals down her throat, either. As for the precise dosage... truthfully, even I didn't know the exact historical preparations off the top of my head. In any case, if she overdosed and suffered acute gastrointestinal irritation, she would begin hemorrhaging internally. Pale and bled dry as she already was, another bleed would finish her off. She would drop dead on the spot. I suppose we could always perform another transfusion, but...
"I feel so lightheaded... Is this... is this normal?"
Just how much blood had actually flowed from our dear elder brother into the patient? That remained a complete mystery.
I assumed he would be perfectly fine, but apparently not. Then again, how could he be?
While the patient's brother might not have hailed from a lineage quite as formidable as Sir Jamie's, he was still an aristocrat of comparable standing. Consequently, he possessed that distinctly noble, refined countenance—which, in plain terms, meant he looked thoroughly sickly. It was entirely possible he had already been anemic before he ever climbed onto that table. Having dealt with the recent arsenic scandal, I had come to realize that these Victorian elites had been systematically poisoning themselves with lead for ages. And who were they poisoning? Themselves, with their toxic face powders, lead-glazed tableware, and patent nostrums.
Performing a transfusion like this under such conditions... Haaah.
A deep sigh welled up inside me. Even adhering to the first principle of medicine—prioritizing the recipient's safety above all else—was an uphill battle. What was more, how could I possibly screen the brother for pre-existing diseases beforehand? There was an overwhelmingly high probability he carried some variety of venereal affliction. These aristocrats all put on pious faces and pretended to be devout churchgoers, but behind closed doors? If one took a peek beneath the powdered veneer of high society, the depravity was beyond description.
"Drink some water for now, sir."
Still, I had no reason to reprimand the gentleman. Whatever his personal vices, he was an honorable soul who had willingly parted with his own blood to save his sister's life. It wasn't as if I could go around pumping someone else's blood into him to replace it, so hydration was the best remedy I could offer. A brief period of convalescence would see him through. While securing a scrap of meat was near impossible for the slum-dwellers, the nobility rarely had a single meal without it.
"Ah, understood. My head is throbbing dreadfully. But still... goodness."
Massaging his temples as if his skull were splitting open, the brother turned his gaze toward his sister. The floor around the bed was still drenched with the pool of crimson liquid that had evacuated her abdomen. I knew full well it was a mixture of blood and amniotic fluid, but to everyone else in the room? They undoubtedly believed it was pure, unadulterated blood.
"This is truly a miracle..."
"Let us all pray."
Under such circumstances, how could the surviving sister—and myself, the man who had dragged her back from death's door—appear to them? To their eyes, it was nothing short of a divine miracle manifested through human hands.
"Yes. Glory to the Lord," I echoed politely.
In truth, it was entirely my doing... but what would happen if I pointed that out right now? Heh. It wouldn't end well. Definitely not. And so, I quietly blended into the prayer led by Sir Jamie. Naturally, my mind was wandering in completely absurd directions.
Blood transfusions... It's not something we can just perform willy-nilly anywhere right now.
For blood transfusions to become truly viable, identifying blood types was crucial, but so was preserving blood over long periods. Bluntly speaking, using living human beings as biological blood bags wasn't a sustainable practice. Even people who might casually donate blood in a modern clinic would likely turn tail and bolt if asked to hook their veins directly into a dying patient like this. Of course, nineteenth-century folk were made of far sterner stuff than twenty-first-century moderners... so perhaps not all of them would flee.
First, let's talk to Blundell. Yes, we should introduce it gradually starting from the Obstetrics & Gynecology Annex. We can't just scramble around calling bystanders to draw blood on the spot every time. At the very least... hmm. Yes, that's the way.
And what about medical students? They were an entire breed fueled by an unhinged passion for saving lives. Colin was living proof. The lad had volunteered his own healthy tooth without a murmur of complaint just to demonstrate the efficacy of anesthesia. Back then, it hadn't even been just Colin; nearly every medical student in the theater had raised their hands, begging for their molars to be extracted. If I told them they needed to donate blood for the advancement of medicine, how would they react? Without a doubt, they would form an orderly queue around the block. In fact, my chief worry would be preventing them from volunteering too often and dropping dead of severe anemia.
"I couldn't help but notice that you looked rather consumed by unholy thoughts during prayer."
Once the prayers concluded, we entrusted the patient to the midwife and nurses and stepped out into the hallway. Liston sidled up beside me with a sly, knowing grin.
"Ah, no, not at all. Nothing of the sort."
"Did you pray, then?"
"Well, I..."
"Speak honestly, lad. It's not as though I wouldn't understand. If I had just pulled off a successful surgery and a blood transfusion in one go, I wouldn't be in the mood to mumble prayers either."
"...I didn't pray, no."
"What were you pondering, then?"
"Well... I was wondering if we might round up some of the more fool—er, good-natured medical students and place them on a duty roster as living blood bags."
"Blood bags. Good heavens... that truly sounds like something straight out of your mouth."
Straight out of my mouth? What on earth did he mean by that? As I stared at him in utter bewilderment, Liston sighed, an expression of quiet resignation washing over his face.
"You don't even realize how macabre that sounds, do you? At any rate, there is no denying it is a brilliant idea. However... did you not say the blood clots into solid clumps if it isn't a proper match? A family member would surely be the safest wager."
"In principle, yes... but you saw him earlier, didn't you? Look at how he's staggering down the corridor even now."
"Ah, that gentleman? He does appear exceptionally frail."
"Even so, he's probably healthier than most laborers. As the Scriptures say, blood is life itself. We are demanding a portion of that life force—can an unhealthy man endure such a sacrifice in the first place?"
"Ah... so you intend to siphon that vital essence straight from our medical students instead?"
"Must you frame it so grimly? We can simply space out the donations. Once their vital essence replenishes, we draw another measure, and so on."
"John William Polidori would have positively rejoiced to hear such talk."
"Who's that?"
At my question, Liston gave another weary, resigned look before parting his lips in defeat.
"Have you never heard of The Vampyre?"
Wait, why was a vampire coming up here...?
"Oh, was he a doctor?" I asked. It certainly sounded like a proper English name. The only vampire I knew was Count Dracula, and he was Romanian.
"I suspect you are about to ask if you might meet him, but alas, you are out of luck."
"Don't tell me he's dead? Someone from the distant past?"
"Well... had he lived, he would have been a few years my senior. But he passed away quite some time ago."
"What a pity."
If he wrote about vampires, he must have harbored a profound fascination with blood. In that case... while absurd in the twenty-first century, he might well have conducted blood experiments in this era. Given that 'William' was his middle name, he was likely a man of considerable means, too.
"Oho..."
"I shall check my study when I return home and lend you the volume."
"Much obliged, Brother Robert."
"At any rate, the matter of the blood bags—we ought to put it to the test. Since we must find compatible blood, we will need several students on duty at any given time."
"Yes. And if that proves insufficient..."
When had that thought crossed my mind again?
"Wouldn't there be plenty of people willing to sell their blood?"
"Sell blood? Ah... in such a manner?"
"Indeed. If the blood doesn't match, we reject it. If it matches, we pay them. Since this is an emergency safeguard against fatal hemorrhage, wealthy patrons would pay whatever price we ask."
"Selling blood... A truly devilish notion. Yet utterly brilliant. Aye, noble houses and wealthy industrialists would have no reason to refuse."
I fancied I heard Liston mutter 'I knew it' under his breath, but seeing as the subject had been broached, I saw no harm in pursuing it. Trading in human blood might sound chillingly callous, but nineteenth-century London was an unmitigated den of horrors. I could guarantee that the moment word spread that one could make a fortune by selling blood, men would come lining up in droves, rolling up their sleeves. In a world where honest labor barely earned a pittance, it was only natural. After all, London was a city where corpses were routinely bought and sold. Compared to grave-robbing, selling blood was practically an act of saintly charity. At the very least, it involved informed consent.
"Thank you, doctor. It is entirely thanks to you that my granddaughter-in-law was spared."
While Liston and I were deep in our conspiratorial plotting, Sir Jamie approached to offer his gratitude. When else in my life would I receive such heartfelt deference from high nobility—and a man of ducal standing, no less?
"Oh, you flatter me far too much, Sir Jamie."
"No, no. You are truly... Well, seeing how things have unfolded, regarding those sewers you mentioned—I shall exert even greater influence on the matter. While an overhaul on a grand scale may take time, I will ensure matters improve from their present wretched state."
"I am profoundly grateful, sir."
"And please, take this. It is a modest token of my appreciation."
"Why, haha... thank you very much."
Being a grand aristocrat, he was not the sort to repay a life-saving debt with empty pleasantries. Not only had he pledged to scratch my most persistent itch regarding municipal sanitation, but he also slipped me a substantial purse of money.
Nor did the matter end there.
A few days later, I was introduced to an exceptionally powerful man in London. Compared to the high nobility, his lineage might have been modest, but to commoners, few figures in the metropolis commanded greater terror.
"A pleasure to meet you. I have heard a great deal about you from Dr. Liston. The name is Jonathan Cake."
"A pleasure to meet you as well, Commissioner."
The London Police Chief. Even though I hadn't committed a single crime, standing before him gave me an instinctive chill. I glanced back toward Sir Jamie with an inquiring look. Having saved his family, I was certain he wouldn't repay kindness with malice, so I wasn't truly worried—merely intensely curious.
Still, there's nothing bad about having ties to the police.
After all, no one provided a more reliable, stable supply of fresh cadavers than the London Metropolitan Police. On top of that, they were unmatched when it came to tracking down missing persons. Even now, they were scouring the alleys for Hugh, the sailor whose testicles I had castrated. His disappearance had been entirely foreseeable. Having received a hefty sum of hush money, why would the fellow remain in such squalid slums? In all likelihood, he had squandered every penny on liquor, gambling, and women—the endless vices teeming in Victorian London—and was now begging on some filthy curb.
"Ah, the reason I arranged this meeting is quite simple," Sir Jamie chimed in smoothly. "Constables and officers sustain injuries with alarming frequency, do they not? While we already rely on your hospital's aid in such emergencies, I began to wonder... what if we could administer blood to them, just as you did for my granddaughter-in-law?"
"I have heard the accounts, Dr. Pyung," Chief Cake said, fixing me with an authoritative gaze. "From what I understand, it is nothing short of revolutionary. What say you? Impart your expertise to our police surgeons, and... I shall ensure you are handsomely compensated."
While my mind had been wandering, the matter of blood transfusion had somehow snowballed into an endeavor far grander than I had ever anticipated.