What Happened to His Nose? [1]
“A title...?”
To put it bluntly, what on earth would Liston know about such things?
It would be a grave offense to say it aloud, but consulting Robert Liston on matters of nobility and peerages was pure foolishness. If anyone I knew possessed a keen understanding of the subject, it was Sir Damien. Yet, going straight to His Grace the Duke and asking, “People are talking about granting me a title, so what should I do?” would hardly look like an innocent inquiry. It would reek of solicitation.
“Well, Hospital Director, sir. What should we do?”
“I will refrain from asking how you heard of this in the first place,” the Director muttered.
And so, we had brought our dilemma to the Hospital Director. He let out a series of heavy sighs before clapping Liston firmly on the shoulder. It was by no means an affectionate gesture of praise; the blows landed with sharp, resounding thwacks. Liston did not flinch in the slightest, which made the Director's intent momentary ambiguous, but his grumbled addendum that he didn't even want to know made things abundantly clear. I had worried he might simply wash his hands of the affair and walk away, but fortunately, I had become far too indispensable to this hospital for him to brush me aside.
“Professor Pyeong,” the Director began, his round face turning uncharacteristically solemn. “It is an undeniable fact that your standing is rising at an astronomical rate.”
Even the formidable Liston held his tongue this time. It seemed something had transpired between the two of them previously. Still, even setting that aside, the Director was a surprisingly reliable counsel in moments like these. A man without sharp wits could never have risen to his current height, especially given his humble origins. We simply listened in silence.
“To be candid, though I haven't spoken of it openly, eyes have been drawn to you from all corners ever since your demonstration of surgical anesthesia. Not all of those eyes were friendly. In fact, plenty harbored outright hostility. That is only natural, given your different race.”
“I understand.”
“I appreciate you taking it so sensibly. I intercepted a good deal of trouble on my own authority. Of course, since you spent your days trailing behind Liston, direct physical harm was difficult to pull off anyway. The stroke of fortune was that you operated on Sir Damien almost immediately afterward, and even caught the eye of the Princess. With all that, the threat of foul play has dwindled considerably.”
“That is comforting to hear.”
I offered polite acknowledgments to keep the conversation flowing. Perhaps it was my ingrained Confucian manners, but sitting mute while an elder spoke always stirred a faint pang of guilt. I had once worried the cultural divide might cause offense, but no elder seemed displeased when treated with proper deference. The proof was right there: the warmth in the Director's gaze when he looked at me stood in stark contrast to the exasperation he directed at Liston.
“Good grief,” the Director groaned, shooting Liston another deliberate sigh before resuming. “Now it is diabetes. As for diabetes... well, while a few convicts have it, every last one of them is an underworld kingpin or a notorious heavy, aren't they?”
“Ah... yes. So I have been told.”
“Indeed. I find your audacity astounding, truly. By all accounts you are no bare-knuckle brawler, yet you dared to feed those brutes their own urine... Regardless, among the general populace, the vast majority of diabetic patients are men of immense wealth and influence.”
“Hmm. That seems very likely.”
I nodded repeatedly. Part of it was polite concurrence, but most of it stemmed from genuine agreement. In the twenty-first century, diabetes had become a condition disproportionately afflicting those of limited means, but throughout nearly all of human history, it had been a rich man's affliction. Back in Joseon, only the royal court and high-ranking yangban nobility ever suffered from it; the common folk had neither the diet nor the luxury to contract such a malady. Joseon was a harsh land where starvation was a constant shadow, so it was only natural. And while the nineteenth century had grown vastly wealthier thanks to the Industrial Revolution, that wealth was neither shared equally nor was there any pretense of trying to do so. Karl Marx had not turned to radicalism out of boredom; communists did not simply manifest from thin air.
“Your name will spread among them like wildfire,” the Director said. “No, it has already spread. If the Prime Minister himself spoke such words, then the matter is practically settled.”
“So... will I receive a title?”
Not that I harbored any intention of becoming a communist myself. I had already witnessed the future. Their hollow promise of equality was doomed to collapse; human beings seemed fundamentally wired to do nothing at all if rewards were distributed equally regardless of effort, suffering, or talent. Under these circumstances, a title—a peerage in the British Empire? A hereditary lordship was far beyond my wildest dreams, but even a knighthood would be an extraordinary—
“You cannot take a title.”
“I cannot?”
My burgeoning hopes were punctured in an instant. For a fleeting second, I wondered if the old man was acting out of jealousy, but his expression betrayed no petty envy.
“A peerage in the British Empire is a position of staggering weight. You realize that, do you not?”
“Yes, of course. It is immense.”
Indeed, one did not need to restrict it to Britain alone. A European noble was treated as nobility wherever he set foot. Even in an era where the rule of law was sinking its roots deep into society, modern court records still showed judges twisting verdicts the moment a nobleman entered the fray.
“Because it carries such weight, the competition for it is fierce, and those who already hold titles keep relentless watch over one another. Even Lord Jamie and Sir Damien may not see eye-to-eye on this.”
“Ah...”
“Their political sympathies align closely enough that they might take you under their wing. But powerful aristocrats possess equally powerful adversaries. The moment you are branded as their creature, you inherit every single one of their enemies.”
“Then that would hardly do.”
“Precisely. It would not do at all. You would face unimaginable social obstruction. It would ruin you.”
“Understood. I shall decline it, then.”
The picture was crystal clear. It was a poisoned chalice. It was no different from a young doctor being fast-tracked into an executive chair by the president of an academic society—only to become the prime target of every resentful senior professor until he was thoroughly crushed.
“Good. I am glad you possess such wisdom. By refusing, though it may sting at first, you will curry favor with many powerful individuals.”
“That makes sense.”
“To be frank, Lord Jamie only brought it up in passing because the topic arose. If you actually accepted, it would put him in an awkward position as well. If he drops a hint, just speak up directly in front of him.”
“How should I frame the refusal?”
“Simply state that your contributions are not yet worthy of such high honor. Say that your abilities fall short, or something of that nature. He will take the hint. Lord Jamie may have sliced off a piece of himself, but he is a sharp man. A man of decisive action.”
“Indeed... one does not hold the title of Duke for nothing.”
While ascending to the dukedom was primarily a matter of hereditary succession, position invariably shapes the man. Moreover, securing the inheritance in the first place required outperforming a swarm of ambitious siblings. I didn't know the full details, but when I had previously gone to deliver Lord Jamie's grandchild, the family dynamics had looked exceedingly tangled, with factions bickering behind closed doors.
Knock, knock, knock.
Having opened the dialogue with the Director, I took the opportunity to chat a little longer. The man was perpetually busy, and I had been swamped dealing with diabetes and hospital affairs. We also needed to establish a more systematic approach to diabetes treatment going forward. For now, we had struck an arrangement with the police to keep using the convict sommelier, but a prolonged research period combined with an endless parade of varied 'juices' risked raising suspicion.
“We can simply recruit others,” the Director suggested casually.
“From among the prisoners?”
“No. In my view, skilled craftsmen are best.”
“You want to feed it to ordinary laborers?”
“We will pay them handsomely. Why shouldn't they?”
“Ah... is that so?”
Urine was technically sterile, wasn't it? Would drinking it truly harm a man's constitution? I wasn't entirely certain, but then I considered the alternative.
Where do ordinary factory workers usually labor?
Arsenic.
Lead.
Mercury.
White phosphorus.
Bloody hell... compared to inhaling toxic fumes and handling lethal chemicals, wasn't drinking a bit of urine vastly preferable? If anything, this could practically be considered welfare and workplace improvement!
“That is a brilliant idea.”
“Splendid. I shall calculate a fair wage for them.”
Such productive conversations were impossible with Liston. Left to his own devices, he would simply propose:
“We'll just snatch a few off the street.”
Or worse:
“What about those French baguette-munchers? Practically the same as convicts.”
“Oh?”
While that idea carried a certain dark appeal, paying steady wages was far superior for ensuring consistent consumption and reliable taste assessments. Of course, relying on human taste buds couldn't be a permanent solution, so I had already commissioned several chemists to develop a simple chemical assay for detecting sugar in urine. Given the fortune to be made from diabetic therapies, spending a fraction of the profits on research and development was a negligible expense.
Knock, knock, knock.
Right in the middle of our crucial discussion, another knock rattled the door. Who could it be? In the presence of the Hospital Director, Robert Liston, and myself—a shaman hailing from distant Joseon—who dared interrupt?
“Confound it, who is making such a racket?” the Director barked in irritation.
Unlike in the twenty-first century, gaining an audience with the hospital director was no trivial matter, making the intrusion all the more grating.
“It's me, sir! Colin...!”
It was a familiar voice. Colin was normally a remarkably cautious and deferential fellow. For someone who knew proper etiquette to shout so urgently outside the door meant something serious had happened.
“If a patient is in pain, tell them to wait,” the Director instructed in a grave, authoritative tone.
It was a reasonable command. In this era, when a patient suffered... well, suffering was simply the baseline state of illness. Did rushing into treatment increase their chances of survival? Neither doctor nor patient harbored any great confidence on that score. Even among the nobility, many preferred to endure their suffering quietly at home and pass away with dignity rather than summon a physician.
“The patient is my elder brother!”
“Ah, is that so? Come in, then.”
Family, however, changed the equation entirely. Whether granting VIP treatment and intervening prematurely was truly the right course of action remained a separate question.
With me here, things will turn out differently.
I possessed the means to alter the grim trajectory of nineteenth-century medicine. If the condition was truly too severe to touch, I was capable of making that call myself.
Upon receiving permission, Colin came bursting through the door with a clatter of hurried footsteps. The Director, Liston, and I turned our eyes toward him. His face was wound tight with anxiety, starkly different from his usual composed demeanor. Given that his brother was the casualty, such panic was only natural.
“He is the brother I am closest to, and it seems he was involved in a battle.”
“A battle...? Is he a seafaring man?”
“Yes, sir.”
“And he survived?”
The inquiry might have sounded callous to an outsider, but sustaining wounds aboard a naval vessel in this era was almost universally fatal, making the Director's surprise entirely justified.
“Yes, but his nose was injured.”
“His nose...? Must it be amputated, then?!”
The instant the prospect of amputation arose, Liston's voice swelled with boyish excitement.
“It seems it has already been cut off, sir.”
“Then the business is already finished, is it not?”
Liston's enthusiasm deflated the moment he learned the severed tissue was already gone.
“No, no! His nose was sliced clean off!”
“Exactly my point. It is over and done with.”
“Did you not repair a man whose jaw had been cut off previously?”
“Ah... reconstructive work is dreadfully dull.”
Even the mention of facial reconstruction drew only a disinterested shrug from Liston. The man was obsessed with hacking things away. He was tailor-made for oncological resections. As for me? My inclinations were rather different. While I certainly had preferred specialties, one couldn't afford to be picky when the state of surgery was in such absolute shambles.
“Where is he now?” I asked.
“Ah, yes! He is currently at our residence... but if you summon him, he will come at once!”
“Then tell him to come. I will examine him myself.”
“Thank you, Professor! Thank you!”
Besides, this was Colin—the young man who had sacrificed his own tooth, consumed fecal water, sampled urine, and endured every trial without complaint. And he would likely have to endure many more in the days ahead. Putting him further in my debt was an opportunity too good to pass up.