Blood Pressure (Part 1)
Blood pressure.
The undisputed core of vital signs.
Think about it. Have you ever seen a medical drama where a doctor frantically yells, "Hey! What's the patient's temperature right now?!"
Whether in an operating theater or an emergency ward, the moment the dramatic string music kicks in—that tense, screeching screee-screee-screee—they will, with near absolute certainty, demand to know the blood pressure.
Even among vital signs, there is a clear hierarchy.
"What are you pondering so deeply?"
We were lounging in the adjoining room, having locked the honorable Member of Parliament inside the glass-walled chamber... well, no, having graciously accommodated him there.
Life after opening the center was truly sweet. Unless something extraordinary happened, our afternoons were completely free, formally designated as "research hours." While our slaves—er, assistants—were slaving away extracting insulin from bovine pancreases, Liston, Blundell, and I were free to take our ease.
Granted, given Blundell's specialty, he had to dash off if an expectant mother took a turn for the worse, but today the weather was mild and peaceful.
"Oh, nothing... I was just wondering if there might be room for improvement in our clinical system."
"Improvement?"
Having been caught lost in my thoughts on blood pressure, I had offered a vague mumble to Liston's inquiry. At the word "improvement," both men turned their eyes on me.
Barely a year ago—no, merely a few months back—such a remark would have provoked immediate arrogance. Improvement? In the medicine of our great British Empire?! Preposterous! It was the sort of brazen nonsense that would have prompted even the benevolent Lord to strike them down with lightning.
"There is always room for improvement."
"Indeed. I ponder that very question constantly."
Was it by the grace of God? Or was it thanks to 'Pyoung Shin'... meaning, thanks to me? I couldn't say for sure, but these two nineteenth-century doctors had undergone a complete transformation.
Admitting that the field was rife with flaws! This was undeniably a splendid development. As the saying goes, metacognition comes before all else. A man who knows his own shortcomings will always grow faster and far sounder than one blind to them.
"I see. As expected of my distinguished elders... truly dependable."
It was no empty flattery; I genuinely meant it. Not that I anticipated brilliant, modern ideas to spring from their nineteenth-century brains right this second. It was simply that they were far more likely to support whatever I proposed.
"Indeed. For my part, I have been contemplating methods to preserve blood," Blundell chimed in.
Now, that would genuinely be a game-changer. Hauling in living people every single time someone needed blood, turning them into walking blood bags... It was... damn it, the more one thought about it, the more horribly inefficient and inhumane it was.
Though everyone kept it hushed up, word had it that when a certain high-ranking aristocrat suffered an accident recently, another hospital botch-jobbed a reckless blood transfusion and killed the patient on the spot. Because of that, Blundell had been receiving an influx of consultation requests, and his pockets had grown considerably heavier. Yet here Blundell was, already dreaming of progress that left those butchers in the dust.
I looked at him with proud, approving eyes. Emboldened by my gaze, Blundell pressed on with his train of thought.
"So, I thought I might try adding a bit of lead to the blood."
"Pardon?"
"A brilliant move," Liston concurred.
"Excuse me?"
Wait... lead? Why the bloody hell lead?! And what did Liston know about it to call it a 'brilliant move'?!
I snapped my head back and forth between Liston and Blundell at maximum velocity. Reading the utter bewilderment written across my face with little difficulty, Liston clapped a broad hand onto my shoulder.
"Ah... Pyoung wouldn't know, would he? You're still young, after all. Haha. I hear they don't drink wine in Joseon?"
"Yes... that's true. But what does that have to do with anything?"
Blood preservation, lead, and wine. Lining them up made it sound like the title of some bizarre postmodernist film. They had absolutely nothing to do with one another! Not a single damn thing! This was anything but elegant!
"Now, now, listen closely. Here in Britain, the connection is quite profound."
Regardless of whether my blood was boiling, Liston chuckled geniality itself and began sketching on a sheet of paper with his fountain pen. His surgical hands being exceptionally deft, the sketch turned out rather decent.
"French wine is wonderful, of course... but terribly expensive. Spanish wine, by contrast, is cheap. So we import vast quantities from Spain... but wine is a delicate creature, is it not? It spoils easily."
"Ah... well, yes."
In an era without refrigeration, countless bottles bearing the name of wine were little better than vinegar. How did I know this? Joseph, my childhood friend, came from a family of winemakers.
"And there exists a secret method to remedy that."
"Ah... I believe I have heard rumors of such a practice."
"From whom?"
"Joseph's father."
"Ah, indeed! Deliveries around London wouldn't require it, but... he mentioned making trips to Ireland and such, didn't he? In that case, he would certainly have applied this treatment."
"What kind of treatment?"
I had caught snippets of it before. But it was an industry trade secret, and since Joseph and I were bound to become physicians, his father had insisted we had no business dabbling in such trivialities.
Truth be told... why drink wine in Britain when there was whisky? I wasn't much of a drinker to begin with, so I had never cared in the slightest. But now, intensely curious about what Liston was driving at, I strained my ears.
Surely he isn't going to claim that wine and blood are identical because of their color... or cite the Bible about Christ's blood and insist it's all the same once it hits the stomach, right?
I took that back. It wasn't curiosity—it was pure, unadulterated dread. I was terrified of whatever insanity was about to spill from his mouth! Having just believed moments ago that these nineteenth-century men were evolving into twenty-first-century intellectuals only made the impending horror that much worse.
"If you add lead to wine, the sourness vanishes and it turns sweet. It doesn't rot."
"Uh... is that so...?"
"Indeed. In truth, does not lead possess such wondrous properties? A truly marvelous metal."
"What... what kind of properties?"
Liston's explanation completely defied my expectations. Not that it filled me with hope, either.
Lead... Why does lead make wine sweet? I was intellectually curious, but I sure as hell had no desire to taste it.
Lead poisoning... Because I knew all too well just how horrific it was. Even in the twenty-first century, roughly one million people still died every year from lead poisoning. And that was after monumental global regulations; back in the mid-twentieth century, tens of thousands of children died annually in the United States alone from lead toxicity.
"Look closely," Liston said, gesturing toward somewhere in the room.
I say 'somewhere' because I couldn't for the life of me tell what he was pointing at. What was this? Why was he pointing at our clinic walls?
"Observe this radiant white hue."
"Ah, yes, white is lovely. But what does... wait, surely not...?"
"Indeed, it contains lead. That is precisely why the color remains so immaculate. Look even closer. Even when splashed with water... it is entirely waterproof, is it not? It does not rust. Well, since this is wood, one should say it doesn't rot."
"Uh... uh-huh."
My hands began to tremble. My tongue tied itself in knots. I was genuinely terrified.
Wait, then...? This entire clinic... all this white paint is lead?!
No, wait. Outside the building... there was white paint everywhere across London. All of that... was lead paint...?!
Come to think of it... holy shit! In a city that rains as constantly as London... I always wondered how the painted surfaces endured without peeling off!
My heart began thumping wildly against my ribs. This wasn't a panic attack. Panic disorder meant feeling a mortal dread in an irrational situation. Compared to that, my current reality was... this was...
"Are you truly that astonished? Does Joseon not make much use of lead?"
Seeing my wide, saucer-like eyes, that was Liston's casual remark. Blundell wore an equally nonchalant expression. No, worse—he looked excited.
"Indeed. That is why I intend to add lead to the blood."
"A splendid notion, haha!"
I had to stop this. That was literal, man-made lead poisoning. Frankly, considering my painted surroundings, I had probably absorbed a fair share of lead into my own system by now... but pumping lead-saturated blood straight into a human being's veins was a completely different beast!
That was straight-up murder.
"W-Wait a moment!"
How in the world had my thoughts on measuring blood pressure devolved into this catastrophe? Right now, I really wanted to know my own blood pressure. God only knew how high it had spiked...
"Hmm?"
"What is it?"
"That lead..."
"Yes?"
"It's a fine metal. A very fine metal indeed."
"Do you think adding it to blood will really prevent it from clotting?"
"Who knows? One never knows until one tries, does one?"
Ah. He hadn't tested it yet. Thank God.
It would almost certainly coagulate anyway. And if by some nightmare it didn't, I could step in and stop him then. While I couldn't conjure up a plausible lie on the spot right now... Who was I? I was Kim Taepyeong, master of bullshit.
"I see. By all means, give it a try."
"Yes. Absolutely. One must experiment with everything. Current transfusions are far too imperfect, no matter how one looks at it."
Let's look on the bright side. Think positive. At least Blundell was thinking along these lines at all. Though... I had a feeling I would start having seizures whenever I saw the color white from now on.
To think I had been living my life enveloped in lead... Could there be lead in other things besides paint?
Knowing these bastards... there definitely is.
This was the nineteenth century. These people were capable of anything. Look at arsenic alone—they had committed things with it beyond anyone's wildest, most deranged imagination.
"Ah, by the way. What were you pondering earlier?"
It felt as though a tempest had just swept past. And that was no exaggeration—when lead poisoning entered the conversation, it wasn't a mere gale, it was a bloody hurricane.
My mind had briefly checked out, but naturally, I was the only one shaken. Our nineteenth-century gentlemen remained the epitome of tranquility. Liston, extraordinary specimen that he was, hadn't even twitched a facial muscle.
Not that it mattered—he'd be shivering in his boots soon enough if I showed him someone dying from lead toxicity...
Next time there's a condemned criminal, I should ask them to send him our way.
Being a rational man, I couldn't subject just anyone to such a fate, so I decided to bide my time. More importantly: blood pressure. The lead scare had driven it completely out of my head, but it was vital.
It wasn't as if this was my first day in this backwards era. I had grown as accustomed to their madness as a man could get. Smoothing my features back into an untroubled expression, I addressed Liston.
"You are familiar with the concept of pressure, are you not?"
"Of course. What do you take me for?"
"Pressure refers to a force exerted against something, does it not? Like this."
"If you ask me, you're the one who ought to exercise and build some muscular strength."
Pretending to stay calm was proving exhausting. To look at Liston, one might mistake him for a purely physical brute, but his tongue was shockingly sharp. Still, looking at that imposing visage served as an immediate cure for any rising temper, so I forced myself to ignore the jab and pressed on.
"Would there not also be pressure exerted upon our blood vessels?"
"Ah... I wondered what you were getting at. That is called blood pressure."
"Huh?"
"What, you didn't know? That was done over a century ago. In fact, I believe they measured it not far from here."
"I-Is that so?"
"Indeed. But what on earth is the point of measuring it?"
"Ah."
I stared at Liston, my face a portrait of multi-layered shock.
Liston? As always, he wore a look of brazen nonchalance. Blundell looked just as unbothered.
Once again, I was the only one left utterly flabbergasted.