Blood Transfusion, Part IV
I realized just how terrifying the power of the state truly was. The moment the police—and the London Police Chief himself, no less—took the initiative, problem after problem sorted itself out in short order. First and foremost was the matter of paid blood donation, or rather, the outright peddling of blood.
"It is becoming an ordeal just turning away the crowds," Blundell muttered.
"Good grief. I told them to come only when they actually have an open bleed! What on earth are they doing here?"
"Well... when a man is staring starvation in the face, can you truly blame him?"
"And how in heaven's name are we supposed to draw blood from someone starved half to death...?"
Just as Blundell said, the courtyard was a complete madhouse packed with desperate wretches eager to sell their blood.
"Back! Step back!"
"Do you all fancy an early grave?!"
Had the police not deployed officers to hold the line, we might have been trampled underfoot and needed blood transfusions of our own. That was how massive the mob had grown.
Yet what proved truly astounding was that they had somehow managed to enforce a semblance of order. They had assigned days of the week based on districts and streets, meaning the crowd gathered right now consisted solely of those scheduled for Monday.
And they beat down the purchase price of blood to absolute dirt...
Now, as anyone who knows me can attest, I am genuinely a benevolent man. It isn't just because of my twenty-first-century upbringing; after all, I chose to become a doctor of my own free will, and out of all the possible specialties, I deliberately walked into a severe trauma center. Naturally, I had intended to pay handsomely for blood to offer some relief to London's wretched working class. Besides, it wasn't as if I lacked money. Through one stroke of fortune or another, I kept entangling myself with high nobility and amassing wealth, so I figured I could afford to share a bit of the bounty.
"Eh? Didn't you just say blood replenishes itself naturally on its own?"
That was how the police chief had reacted, and the moment law enforcement stepped in, everything took a sharp turn. Worse, he wasn't the only one.
"Haha, my dear Taepyeong. Does it make a lick of sense for someone to sell blood once and lounge about idle for an entire month? You said they only need about two days of rest, did you not? Then paying them two days' wages will settle the score nicely."
Alfred's father had chimed in as well. Naturally, if this venture were to be commercialized, could I hand it to anyone else? Of course it made sense to entrust it to Alfred's father, but the sheer ruthlessness of his calculations left me stunned.
"Quite right! That's the spirit. Is it because you are the father of the condom... that your commercial acumen is so razor-sharp?"
Duke Jamie had joined the chorus of approval, the police nodded in agreement, and even Robert Liston chimed in that it sounded perfectly reasonable. What could I possibly say against that consensus?
Well... I suppose offering two days' worth of honest wages was still better than nothing. In London, working yourself to the bone only to be swindled out of your pay was a daily occurrence. Perhaps that was why even under such miserly conditions, business was booming beyond belief.
"Clear off, the lot of you!"
"Eek!"
A sharp detonation echoed through the corridor. When I glanced back, there stood Liston. He had punched the brick wall, pulling off the acrobatic feat of bursting the masonry rather than his knuckles. At that display, the mob that hadn't budged an inch despite the constables' furious barking scattered in a frantic stampede.
Liston, indeed. A true swordmaster...
"At any rate..."
Having successfully shattered a section of the wall, Liston marched back inside and took a seat. It wasn't his desk, mind you, but that of an obstetrics professor other than Blundell. There were three chairs in the office: one occupied by me, another by Blundell, and the third now claimed as Liston's rightful throne. No one dared challenge him with a "What are you doing sitting so comfortably in the Obstetrics & Gynecology Annex?" The displaced professor merely glanced in, wore a terrified expression that prayed their eyes wouldn't meet, and quietly slipped out the door.
In the ensuing silence, Liston continued, "They say the military intends to adopt this as well. Matching blood... haha, what a truly marvelous concept."
"Indeed. Quite something..."
"Still, are you content with this arrangement? I know Alfred's father will compensate you handsomely, but this concession strikes me as something immense."
"Well..."
Was it truly that massive right now? If this were the era following the invention of proper refrigeration to store whole blood, the transfusion rights would indeed be an astronomical goldmine. But at present...
Granted, the fees charged to patients would be considerable, but transfusion wasn't something you could perform haphazardly on a whim.
"Blood? Receive another person's blood?! Th-this is heresy!"
For starters, not every patient even welcomed the idea. They might rant like that now and sing a different tune when death stared them in the face, but even so... between ideological resistance and the technical difficulty of transfusing large volumes, widespread application remained tricky. Besides, I was utterly hopeless at commercial ventures. My philosophy was simple: business should be left to those with the stomach for it.
"I am sure Senior Alfred will ensure I am treated fairly."
"Ever warm and generous to your own people, as always."
"That isn't true. I am warm and generous to everyone."
"Hahahahaha!"
Liston guffawed as if I had just delivered the punchline of the century. Then, just as abruptly, his face settled back into grave solemnity. And understandably so. I had a fairly good guess why his mood shifted. Earlier, Duke Jamie had muttered something, and it sounded like a rather serious problem had cropped up.
"In truth, isn't all of this owed in some part to Duke Jamie? Of course... the sewer project is still crawling along at a snail's pace, but this blood transfusion... I harbor immense hopes for it. Once this practice takes firm root, we may very well see an end to patients dying from surgery altogether!"
Ah, definitely not.
Transfusion was indeed a paradigm shift—humanity's greatest weapon to delay or reverse hemorrhagic shock. Yet even in the twenty-first century, where we poured blood bags into trauma patients by the carton, survival was never guaranteed. In this primitive era? Utterly impossible.
Still, possessing some degree of tact, I refrained from raining on their parade while even Blundell beamed with unspoken delight. Instead, I changed the subject.
"You mentioned Duke Jamie is having urinary trouble again?"
"Aye. What on earth could be the matter? Between ourselves, the man went so far as to cut off his own bollocks just to piss in peace. Yet... rumors have it he is ready to exhume Harry's grave and burn the corpse to ash."
And who could blame him?
To cut off your own testicles and still suffer urinary dysfunction?
Granted, murdering a man over a surgery you requested yourself, or digging up someone's grave because your bladder was acting up again, was hardly justifiable conduct. But emotionally, I could sympathize. The sheer, unfathomable fury must be enough to burst his veins.
Still, this makes no sense.
The one thing I couldn't comprehend was the recurrence itself. Truth be told—horrifying as it felt to utter such words—hadn't he undergone a procedure that was effectively curative for benign prostatic hyperplasia? Castration was historically one of the most effective, albeit radical, treatments for resolving an enlarged prostate. And it recurred?
What could it be...?
My head tilted involuntarily in perplexity. If his prostate had truly regrown... then Harry died an innocent man. It would mean that whatever that French quack excised was something other than testicles, and male sex hormones were still being pumped out from somewhere.
Yet Jamie's physical state, as I had observed recently, was the very picture of androgen deprivation. Having seen him periodically over the past few months, his beard had steadily thinned out, his muscle mass had dwindled, and even his voice had grown noticeably higher and thinner. For his prostate alone to enlarge under such conditions defied all physiological logic.
"What foul thoughts are you harboring this time?"
"Pardon? Nothing of the sort. I am merely concerned for my patient."
"Then why are you grinning?"
"Well, that's..."
Come on, it was somewhat comical. A man who voluntarily had his own testicles removed. A Duke, no less.
"Do not dare laugh before His Grace. He has been exceptionally touchy of late."
"Oh, naturally. Have I ever laughed in front of a patient?"
"You wear a sinister smirk even while hauling cadavers..."
"Me?"
"So you weren't even conscious of it. And here I thought you did it deliberately to terrify everyone."
Liston leaned slightly away from me.
Just as my sense of wounded innocence was mounting, Duke Jamie arrived at the hospital. In truth, it was exceptionally rare for a nobleman of his standing to grace a hospital in person. In this era, house calls were the universal standard for high society. And rightfully so—hospitals back then possessed no specialized equipment, facilities, or trained auxiliary staff.
In my case, however, the sheer arsenal of surgical instruments and transfusion apparatus had been steadily multiplying. If I were to make a house call without prior intelligence on the patient's condition, I would practically have to charter a moving company.
"Mm, gathered here, are you?"
Fortunately, Duke Jamie was considerate enough to understand my logistical constraints, which was why he had traveled here in person. When I noticed two figures entering, I realized Sir Damien had accompanied him.
"Having heard his tale, it struck me that my own son suffers from similar symptoms," Damien explained before I could even inquire after the purpose of their visit.
Indeed, high-born gentlemen possessed a certain refined decorum. Perhaps there really was a distinct breed among kings, ministers, and generals after all? To think a dog like Harry and a gentleman like this were both classified as human beings... Well, the French being inherently inferior was an established fact anyway.
"What manner of symptoms are you experiencing?" I managed to ask, brushing aside my drifting thoughts.
"I feel the urge to pass urine constantly," Duke Jamie answered, scowling darkly.
Small wonder. If he had cut off his balls for nothing... The sheer humiliation would ruin him if word ever leaked out. After going through all that trouble to debut in high society sporting his proud green garments...
Ah, that green dye. Arsenic...
Those bastards are still wearing it, aren't they?
Duke Jamie, having witnessed people dropping dead with his own eyes, had sworn off the deadly fashion, but it seemed the rest of high society couldn't bear to abandon it. Well, if more of them dropped dead, so be it. At any rate, Duke Jamie was evidently terrified of rumors slipping out, judging by the considerable number of guards stationed outside the door.
"And what of the volume of urine?" I asked, praying silently that this wasn't a recurrence of benign prostatic hyperplasia.
Duke Jamie tilted his head, looking puzzled. "That is the strange part. It is voluminous. It was never like this before."
"Voluminous?"
"Aye. It flows in great quantities."
Observing Duke Jamie's response, a sudden realization struck me. Duke Jamie was advanced in years. His testosterone had evaporated. He ate well and abundantly. Given that profile, there was one particular condition he was ripe to develop.
"Do you happen to feel thirsty frequently?"
"Well, when one discharges so much, thirst naturally follows."
Surprisingly, these nineteenth-century men weren't completely oblivious to the correlation between water intake and urinary output. And his statement wasn't technically wrong. In a healthy adult, drinking large amounts of water naturally leads to frequent urination. But with diabetes mellitus, the mechanism was reversed.
Because glucose spills into the urine, osmotic diuresis draws vast amounts of water along with it, inducing polyuria; and because so much fluid is dumped through the bladder, intense polydipsia—thirst—ensues.
"I suspect a particular ailment. Still, to be certain, shall we examine the size of your prostate?"
"Ah."
Duke Jamie squeezed his eyes shut, realizing the inevitable ordeal had arrived. He had to despise it. Though no matter how much he hated it, surely it couldn't match how much I loathed doing it. Steeling myself, I performed a digital rectal examination.
It's small... Castration truly does work wonders. If another patient relapses, should I give them a thorough explanation and just lop them off?
The efficacy was genuinely staggering—enough to put twenty-first-century pharmacology and therapies to shame. At any rate, this confirmed the prostate was not the culprit behind his urinary woes. Which left diabetes.
How on earth do I diagnose diabetes here?
Blood glucose levels... In my previous life, a simple prick of a lancet gave an instant reading, but here, poking him would yield nothing but blood.
Diabetes... literally 'sweet urine'—sugar in the urine.
If that were the case, wouldn't it taste sweet?
...Do I taste it myself?
Perish the thought.
Before I even realized what I was doing, my gaze had already drifted toward Senior Alfred.