An Independent Practice (Part 3)
"We're making... an absurd amount of money."
While Alfred served as my primary assistant for diabetic care, Liston was also pulling a major oar.
It was only natural. True to his reputation as the master of amputations, Liston seemed unable to rest easy unless he hacked off an arm or a leg every single day, so he kept right on cutting even after coming here.
Well, he's mainly amputating diabetic feet, so in a sense, that's just part of diabetes treatment anyway.
I drifted into idle thought for a moment, but the bottom line remained: we were raking in serious cash. Even though the wealthy and powerful were disproportionately prone to diabetes, we only saw ten to twenty patients a day at most. In gross revenue, it couldn't hold a candle to our original hospital, but our net profit was staggering.
Truth be told, aside from brewing our own alcohol, we had practically zero overhead beyond labor costs. And since everyone except Liston, Blundell, and me was a student, they weren't even drawing wages yet.
"Tell me about it," I remarked. "At this rate, we're going to be swimming in gold."
"Well... this 'research' of yours will eat up a fair bit of coin, but even so, this is a vast sum," Liston said.
"Good heavens," Blundell chimed in. "If this keeps up, I might lose all desire to deliver babies."
Blundell said that, but in truth, he was merely drawing a handsome performance bonus. Liston and I, on the other hand, had a direct profit-sharing agreement. On top of that, our equity vastly outweighed that of our outside investors, so the coin rolled in at a terrifying velocity. Half the time, I didn't even know how much I was making.
"I thought we were making good money back when we were cheerfully sawing off limbs, but this outstrips even that," Liston mused.
"Is it really that much?"
"It actually makes me uneasy. Look at today. Our day's work wrapped up before luncheon, yet just look at that hoard."
"True enough..."
This was an era without credit cards, to say nothing of health insurance. Even by twenty-first-century standards, our diabetes regimen would likely be categorized as elective, uninsured care anyway. In any case, we collected one hundred percent of our fees in hard cash.
That cash now sat piled atop the dining table in a display of sheer, aggressive opulence. Just looking at that mountain of coin was enough to make a man feel stuffed without touching a bite.
"Still, the chemists are burning through quite a sum," I pointed out.
"Ah... the rotting bread and arsenic business?"
"Yes."
"Will that truly amount to anything...?"
To Liston's eyes, I was merely throwing good money after bad. Frankly, from a pragmatic standpoint, following his lead would have been the sensible course. The man was indulging in luxuries with his earnings, but he was also snapping up plots of land and townhouses. By contrast, I had purchased only a modest parcel alongside him and was chucking the rest into research.
Was it even a dignified, plausible line of research? Not in the slightest. I had no idea how the actual chemistry worked myself. All I knew was that penicillin came from mold and that some arsenic compound was effective against syphilis. If I had known I would end up here, I would have paid more attention to medical history.
Well... not like I had the time to study things outside the board exams back then.
Regardless, I merely shrugged at Liston's doubts. Since I didn't know the exact mechanism either, it was the most honest answer I could offer.
"We give it a shot. I'm still young, after all."
"True enough. I take it... you haven't given any thought to marriage yet?"
"Marriage?"
Marriage, was it...
Counting my previous life, I had accumulated quite a few years under my belt. But strictly speaking in terms of this current incarnation, I was still a teenager.
Besides, I prefer Joseon women...
For reasons I couldn't quite pin down, Englishwomen didn't really appeal to me. There was just something... off. Thinking about it coolly, the fundamental cause was likely the ideological clash between a twenty-first-century mindset and nineteenth-century sensibilities rather than racial differences, but still...
Or maybe it's just because I haven't seen anyone truly pretty?
My social station was rising swiftly enough, but the vast majority of people I interacted with were patients. Harboring romantic sentiments toward a patient was an ethical taboo, so I never looked at them that way in the first place. Moreover, regardless of the era, the severely afflicted were predominantly the destitute—people far too ravaged by disease and squalor to care for their appearance.
"I, on the other hand, am giving it thought," Liston dropped his bombshell.
Come to think of it, it made sense that he would want to wed. Though anachronistic from a modern perspective, there was a well-known quote that held absolute sway in this era.
"It is a truth universally acknowledged, that a single man in possession of a good fortune, must be in want of a wife."
Can he pull it off, though?
The trouble was that desire alone didn't guarantee success. The other party had to be willing as well, didn't she? And unfortunately for our dear Liston...
"Why are you staring at my head?"
"Pardon? Was I?"
"You most certainly were."
"No, not at all. I was looking toward the door."
"There is no one there. Why look at the door?"
"No, really, someone is there."
Lord, if You are up there, please deliver me...
Creak.
Wait. Does He actually exist?
"Eh? Truly?"
"See? Someone's here."
"Did you not see the notice that business is concluded for the day?"
The gentleman summoned by divine intervention was greeted by a growl from Liston, whose temper was flared by the mention of his receding hairline. Normally, even if a person had done nothing wrong, they would apologize and beat a hasty retreat in the face of such a fearsome display...
"Sir Jamie sent me."
The visitor merely stood his ground and uttered those four words.
Instantly recovering his temper control, Liston gave his head a brisk shake and appraised the newcomer. The gentleman had just removed his stark black top hat and handed it, along with his matching overcoat, to an attendant at his side. He wore gold-rimmed spectacles, and the pocket watch in his hand gleamed with the unmistakable luster of solid gold. A pocket watch was an exorbitant luxury in its own right; one glance was enough to divine his lofty station.
"Ah... ahh."
Judging by his pale, drawn complexion, this was undoubtedly the headache patient Sir Jamie had mentioned earlier. I hadn't caught all the particulars, but he was supposedly a Member of Parliament. And if he was one of the men plotting an atrocity on the scale of the Opium War, he had to be high up the ladder.
Feeling an abrupt pull of gravity upon my brow, I bowed deferentially.
"Well, well. Welcome, sir."
Glancing to my side, I saw Liston bowing just as deeply under the influence of that very same gravity. Of course, given his sheer height and towering bulk, his bowing looked more like a gentle swagger, but fortunately, the man before us was of such high breeding that such insolence didn't even cross his mind.
"Indeed. I appreciate the warm reception despite your clinic being closed. It appears you were in the midst of a meal... Shall I wait?"
He chuckled faintly and waved a hand, but something told me scarfing down food in front of him would be a terrible idea. Not that I had harbored any lingering attachment to food since being reborn in this world—especially after arriving in London. What was the point of choking down British cooking anyway?
"Not at all. I shall examine you at once."
"Just as brisk and decisive as I was told. A true Saint Pyeong. Every bit the honorary white man."
I wondered how many insults could be packed into a single sentence. If I followed my temper, I would have planted a fist squarely in his face. But I had to swallow it down. What choice did I have? He was a grandee of the realm.
...Then again, a physician plotting to beat his own patient was problematic enough in itself. Just how had my life come to this?
"You mentioned suffering from a headache?"
Naturally, being an authority in the art of feigning composure, I managed to pose a perfectly professional question. The Member of Parliament—now my patient—nodded. His face was so deathly pale that he looked genuinely miserable, which softened my urge to strangle him.
"When did this begin?"
"It has been... quite some time."
Quite some time. Such a marvelously imprecise expression. Still, no matter. I could work with this.
"Would 'quite some time' mean several years?"
"Good heavens, no. A month or two."
"A month or two... Hmm. Is the headache your only symptom, or have you experienced anything else?"
"Mmh..."
The patient's eyes flickered with interest at my line of questioning. Small wonder. Unassuming as my questions might seem, this was a twenty-first-century clinical history taking. Systematic history taking had only been standardized for a few decades in the modern era, so an interrogation like this was entirely alien to nineteenth-century medicine. Naturally, from a patient's perspective, the difference in rigor was immediately apparent.
"I cannot say for certain... though occasionally I feel a touch dizzy."
"Was that dizziness present before or after your bloodletting?"
"That... I cannot recall. It may have been after. Does that have any bearing?"
Does it have any bearing? It has every damn bearing in the world.
He said he was treated at our hospital, didn't he?
I yearned to wring Gemmell's neck, but my hands were tied. Even within the same hospital, I could have put him in his place if I wished, but the Hospital Director had been lavishing so much patronage on me that stabbing his staff in the back was out of the question.
"I see. So the headache is your primary complaint, correct?"
"It is."
"And it has persisted for about two months."
"Precisely."
"Haaah..."
So, where did that leave us? In the modern era, I would have measured his blood pressure, ordered a CT scan if anything seemed off, or prescribed analgesics while monitoring his condition. General surgeon though I was, I knew perfectly well how to manage a headache. But here...
Dear God...
I had absolutely nothing. I couldn't even measure his blood pressure. The state of this era was even more abysmal than I remembered.
"Is it that difficult?" the patient pressed, misinterpreting my stunned silence. I had no idea how much blood they had drained from him, but the man was so pale he looked ready to collapse. I wanted to help him. I genuinely did... but my hands were tied.
"I must tell you that taking immediate action right this second would be exceedingly difficult."
When Sir Jamie first brought up the headache, I had brimmed with confidence. But face-to-face with the patient, the list of treatable headaches in this era was depressingly short. If it was a simple tension headache or migraine, medication was the only recourse, and our pharmacological arsenal amounted to little more than willow bark tea. I had dumped that research onto the chemists as well, but heaven only knew when they would yield results. Bloody bastards...
In the end, that leaves surgery... An epidural tumor? A subdural hematoma? Sinusitis? Wait... a subdural hematoma...?
An instinct struck me. A terrifyingly perilous instinct. If I was wrong, I would crack his skull open only to say, 'Oops, my mistake.'
Cold sweat beaded on my neck, but that was just the reality of nineteenth-century surgery.
"By any chance, did you strike your head a month or two ago?"
"Uh...?"
The sudden reaction came not from the patient, but from the attendant standing beside him. The moment my eyes snapped toward him, the attendant snapped his mouth shut, realizing his blunder. But the Member of Parliament tapped him on the shoulder, prompting him to speak.
"Well... after a parliamentary session back then, his lordship bumped his head against the carriage doorframe while alighting. Uh... now that I think about it, the headaches began shortly thereafter."
Are you an idiot? Shouldn't you have led with that?! Am I asking for too much here?
Hit head, followed by headache. The cause and effect couldn't be more glaringly obvious.
"Come to think of it, so it did," the MP agreed casually.
Seeing that even the patient was taking it in stride, I decided against giving them a tongue-lashing. Instead, a single, terrifying thought seized my mind.
I really want to crack his skull open.
Now, how on earth was I supposed to package that suggestion so he wouldn't take it as a murder threat?