A Shift in Standing (3)
Calling it convenient made me sound a bit devilish.
Devilish, perhaps, but what else could I say? The timing was immaculate.
Right when people were whining about cutting alcohol out of the protocol, someone had gone ahead and injected without it. They probably just squeezed the gland raw and shoved it straight in. Hell, you could inject anything that way and it'd rot like hell...
In any case, a patient had just arrived in critical condition precisely because someone had refused to follow our methods. Frankly, we needed a catastrophe like this.
After all, wasn't this entire protocol something I had unilaterally dictated? Even if I knew the answer from modern medical science, no one else in this era had ever witnessed it. No matter how much weight my words carried, in the quiet corners of their minds, they couldn't be entirely convinced. In this day and age, empirical reality trumped theory. Experimentation was king.
"I tried it, and this happened."
"I tried it, and it failed."
Even at this very moment, countless souls were perishing just so Victorian practitioners could utter those two simple sentences.
"Ahem. Well... very well. Keep up the good work."
"Make sure to keep this strictly confidential," I warned. "The cost of the ingredients isn't the problem—the real disaster is if our secret recipe leaks into the wrong hands."
"Do not fret over that, haha. No need to trouble Liston; I can manage matters on my own end. Besides, it's you and Liston. Most street gangs wouldn't dare dream of crossing the two of you, would they...?"
"Mmm. Well... that's a relief, at least."
The rumors circulating through the back alleys of London regarding me, specifically, were horrifying no matter how generously one framed them. Whispers that I was the mastermind behind the Great Paris Catastrophe, or that I cackled like a ghoul because I loved dissecting corpses so much—that sort of slander was child's play.
Far worse were the tales claiming I had shoved Jack, the infamous mob boss of London, into a green dress, mocked him mercilessly, and placed a shamanic curse on him so he choked to death on his own breath... Or that it was actually Kim Taepyeong who gelded Duke Jamie, and Jamie was so terrified of me that he murdered Harry as a surrogate scapegoat... Or that even Robert Liston was secretly just my subservient henchman...
Experiencing all this in real time proved beyond a shadow of a doubt that the old proverb where there's smoke, there's fire was utter nonsense.
"Pyoung, I think the dog's about to piss."
"Oh. We'd better catch it quickly."
"The boys aren't around, though. We'll have to hold the basin ourselves."
"Should we just skip this batch then?"
"Taepyeong..."
"No, no, never mind. We have to collect it and feed it to him. But do we really still need to make him drink it?"
"Did you not say it yourself?" Liston countered. "We must determine the minimum effective concentration."
"Ah, right. Of course. Sigh."
Just moments ago, I had finished treating a patient whose abdomen was rotting away from a toxic barrage of digestive enzymes and infectious bacteria. And by 'treating', I meant proper medical intervention, not putting him out of his misery. The odds of his survival looked grim, but I had done everything humanly possible. I was exhausted to the bone, yet as Liston pointed out, we had to pin down that baseline threshold.
A human was substantially larger than a hound, so one might assume we had a generous margin for error. But insulin was a volatile weapon. One miscalculated dose of this stuff, and a man drops dead on the spot...
It wasn't as though we were defenseless against insulin-induced hypoglycemia. It required no exotic pharmaceuticals; you simply had to administer sugar. But if the patient slipped into a coma, you had to inject glucose intravenously. And as anyone could plainly see, using a hypodermic syringe anywhere outside our hospital was virtually a death sentence. And what if they were still conscious? There was still a catch: sugar was bloody expensive.
Well, for the time being, the therapy will be exclusive to aristocrats anyway.
Setting aside our convict guinea pigs, who else could possibly afford such care? It was entirely bespoke medicine. Moreover, because we had to extract it from bovine pancreases, yield was painfully meager. With supply trailing light-years behind demand, the price would inevitably soar into the stratosphere. On top of that, a patient needed enough idle wealth to travel to our clinic every single day, receive an injection, and linger for hours to ensure they didn't collapse.
How many people in the twenty-first century could manage such a regimen? In the nineteenth century, the nobility were the only candidates.
Still, with the fortune we squeeze out of their pockets, we'll have to fund a cheaper alternative down the road.
The Hospital Director was already lost in grandiose fantasies of wallowing in mountains of gold. Just the other day, he promised to construct a private research facility exclusively for our inner circle—myself, Liston, and Blundell. And where? In Kensington. Do you have any idea what real estate costs in Kensington...?
"Pyoung?"
"Ah, yes, coming."
"Right, who's holding the beast?"
"I will."
"Mmm."
"Do you want to hold him, Robert?"
"No, no. I can't seem to find my gloves. Won't do, won't do."
"Alright, here goes."
"Hmph."
In any case, if only to secure that gilded future, I caught the urine from the hound treated with our titrated insulin. The fresh harvest was promptly delivered to our resident Urine Sommelier—the convict reborn as a grand connoisseur of bodily fluids.
"Ah, another trial today, Doctor! I almost worry I'm growing too healthy under your fine care, haha!"
Chattering with cheerful ease, the man tipped back the glass and swallowed the dog urine in one hearty draught.
Honestly... it was nothing short of miraculous that he hadn't deduced the truth by now. Then again, as he had just declared, his physical condition really had improved. A London dungeon was, without exaggeration, the most foul, pestilence-ridden pit on the face of the earth. Merely being hauled out of that cell and housed in our clinic was enough to restore color to a dying man's cheeks.
It had gotten to the point where the warden who initially delivered the rogue without knowing the details had grumbled with bitter indignation: "A scoundrel like this doesn't deserve such luxurious lodgings!"
Calling it 'luxurious' was a bit rich. His quarters sat directly adjacent to our anatomical dissection hall. Did it reek? Of course it did. No matter how fanatically we scrubbed and disinfected every square inch of the facility, there was no completely banishing the stench of putrefying human flesh. Soaking the cadavers in formalin helped, but we didn't have enough to pickle every corpse. Although, there was no need to preserve them all anyway. Formalin-treated specimens were reserved for teaching anatomy, while the fresh corpses supplied by the police were used strictly for surgical drills. And curiously enough, the supply of bodies from the constabulary was growing larger by the week.
The warden, who had initially grumbled with such resentment, had broken into a broad grin the instant he learned the convict was required to drink several glasses of dog piss every day: "Oho! Urine...? Now that is a truly diabolical punishment. Oh, his face will be a sight to behold once you finally break the news! That bastard was a holy terror in this district... As expected of a gentleman one must never make an enemy of."
Small wonder the jailer was delighted. Dog urine, of all things... It had to be a historic milestone. Even the most sadistic monarchs of antiquity had probably never devised a torment quite like this: compelling a felon to drink canine urine every day for well over a fortnight, in quantities large enough to satisfy his entire daily hydration.
"Still tastes a bit sweet, sir."
"Bloody hell."
"Now, don't look so crestfallen, Doctor! Truly... it's hardly my place to say, but seeing fine gentlemen like you at your labors convinces me the British Empire is marching toward greatness!"
"R-right. Quite."
I was nearly beginning to feel guilty. I couldn't tell whether the rogue was being genuine or simply buttering us up, but he kept blabbering about how he felt like he was doing something noble for the first time in his wretched life.
"Do we care?" Liston muttered under his breath.
"Fair point."
Considering the atrocities the bastard had committed, forcing him to eat manure wouldn't have been out of line. Whenever my modern conscience wavered, good old Liston was always there to steady my moral compass.
Through these steady tastings, we finally managed to identify the baseline concentration where the hound's urine ceased to yield any sweetness. I say 'baseline' because the threshold varied slightly depending on the size of the animal. In any event, I decided to designate this the Safe Dose. And the ceiling at which any dog collapsed upon injection, I termed the Danger Dose.
Perhaps because the terminology was delightfully intuitive, Liston grasped it immediately.
"Splendid. Then we ought to begin administering this safe dose to human subjects."
"Yes."
"Still, a dog is tiny and a man is large. Will such a modest quantity even have an effect?"
"Even if it proves insufficient... we can't very well blast them with a massive dose from the start and send them to an early grave, can we?"
"True enough. Indeed... there is no reason to kill a man needlessly, convict or not. Besides, passing from this doesn't hurt, does it?"
"Mmm. I suppose not."
"Then nobody would be satisfied. Not the constables, nor the victims."
"Th-that is true."
His reasoning was remarkably twisted, but at least he agreed. A painless death being unpalatable to Victorian sensibilities... what an exquisitely period-appropriate sentiment.
The reason this grim topic arose in the first place was that one of our experimental hounds had perished that way. It hadn't been intentional; a breakdown in communication between Liston and me had resulted in the poor creature receiving a double dose. Granted, establishing toxicity parameters required finding the lethal ceiling anyway, but the hound had slipped away just like that. Silently...
I had felt rather downcast about it, but Liston had evidently drawn a completely different conclusion: if insulin kills a man, it grants him far too gentle an end.
"Well, shall we wait over there?"
"Yes, let's."
We received fresh deliveries of bovine pancreases every single morning. Eventually, we would hire dedicated labor, but for now, to preserve ironclad secrecy, we worked our most trusted inner circle to the bone. Who, you ask? Who else could it be? Alfred and Joseph, naturally. Colin? Colin was currently occupied with distilling pure alcohol. And Blundell? Blundell was buried up to his ears in the homework assignment I'd handed him: deducing what made certain blood compatible with others.
Who knows? At this rate, he might actually stumble upon something revolutionary...
The odds were less than one in a thousand, of course. The realization that blood types existed wouldn't occur until much later. Karl Landsteiner wouldn't uncover the first real clues until 1901—the turn of the twentieth century. The nineteenth century and the twentieth... It sounded like a mere step across the calendar, but the conceptual chasm was staggering.
Well... as long as he grasps the absolute necessity of pre-transfusion cross-matching, that will suffice.
As anyone knew, nineteenth-century men refused to believe anything until they had tested it with their own two hands. Prior to this, even attempting a transfusion was a nightmare. Drawing blood cleanly was nearly impossible, and delivering it was harder still. Blundell had attempted the procedure more than anyone else alive, but even his method amounted to slashing a donor's vein, catching the trickling blood in a brass cup, and trying to force it into the recipient's vessel before it coagulated. How could one ever collect a viable volume like that? It clotted into useless sludge long before it reached the patient's heart.
With my direct donor-to-recipient setup, however, a substantial volume could be transfused smoothly. But if someone attempted that without proper caution? They'd die. In the worst case, both donor and recipient would end up in wooden boxes.
Still, I gave him plenty of warnings... Blundell would be meticulous. What the quacks at other hospitals might do, on the other hand, was anyone's guess.
"We've arrived!"
"Good. And the patients?"
"The patients... Ah, the convicts. They are waiting outside as well."
"Excellent. Let's extract the serum swiftly and dose them with this batch."
"Understood. Let's make haste!"
Joseph and Alfred rolled in, hauling a heavy handcart loaded to the brim with pancreases. The organs had probably begun to spoil on the journey over. They'd likely started turning back at the slaughterhouse, too. But what choice did we have? Could I conjure a refrigeration plant out of thin air? Hardly.
Put your faith in alcohol and acid.
Surely that would sterilize it well enough... right? Clinging to that desperate optimism, I began processing the diced organs with our weakly acidic alcoholic solution.
As I gathered the resulting extract, Liston strolled over and peered through the frosted window at the dozen or so 'patients'—convicts—loitering in the yard outside.
"By the way, Pyoung."
"Yes?"
"How do you intend to conduct the evaluations? How can one taster possibly drink the urine of all those men?"
"Oh, that's no problem at all."
"No problem?"
"If a single man had to drink all of it, he'd be bloated to bursting, wouldn't he? Not to mention his palate would become confused."
"And... so?"
"We have five more convicts waiting in the back courtyard. Petty thieves and drunkards. Rather than releasing them with a reprimand, the magistrate agreed to commute their sentences in exchange for urine-tasting duty."
"Oho. Now that is a stroke of brilliance."