Chapter 25
Chapter 25
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Translator: penny
Chapter: 25
Chapter Title: Finally, Pasteur (1)
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Today, it was the clinic again. Thankfully, there weren't many inpatients. Just a few with pneumonia or colds.
On the other hand, there were quite a few outpatients.
"Rizelotte."
First impressions of a patient... well, that's not quite right. But you can glean a few bits of info from their complexion and how they walk in.
For starters, another female academy student, it seemed. Her steps were a bit unsteady, but not to the point of falling.
Her hair was blonde mixed with brown, and her eyes were brown with a reddish tint. Her hair was curled into buns pressed against the sides of her head.
Princess Leia's hairstyle from Star Wars, or maybe a Western-style updo.
Whether on purpose or just overlooked, two strands hung long down her back, between the buns on either side.
That was about the gist of her appearance. The unsteadiness in her steps could have any number of causes.
Dehydration, skipping meals, fatigue, or just being off in general. Her legs didn't seem to be the issue, though.
Judging by her expression as she entered the clinic, it was probably something affecting her daily life. She looked grim and tired.
Different from mere worry or pain.
That was about all I could tell from the outside.
"Yes, go ahead."
"I've been feeling nauseous for a few days now, and it's hard to walk around. When I stand up, the room spins, but it gets better after a few minutes."
A few conditions came to mind.
Dizziness is a common symptom, but not one to take lightly. It impacts daily life significantly, and it often points to nerve or brain issues.
"Open your eyes wide."
First things first: check for nystagmus.
Make sure her eyes aren't trembling. Spontaneous nystagmus could signal something serious like a brain tumor. Alright, let's see.
No trembling.
"When exactly does the dizziness hit?"
"When I get up from sitting."
"Does it happen when you move your head?"
The human head usually auto-adjusts to stay level.
It's not a conscious process. It happens automatically via the cerebellum and such.
When you tilt your head to lie down or turn, the brain knows and compensates.
Dizziness from position changes. Causes could be otitis media or others, but the classic is benign paroxysmal positional vertigo.
In simple terms.
It means sudden vertigo triggered by position changes. "Benign" means no serious underlying issue.
Let's finish the neuro exam first.
"Keep your head still and follow my finger with your eyes only. Yes, good."
Nothing obvious.
"Uh, is it something serious?"
"Doesn't look like it."
It's not serious. Benign paroxysmal positional vertigo is just that—benign. You won't die from it or suffer major harm.
No meds for it. Instead, specific head maneuvers can fix it. It's caused by tiny ear stones dislodging from the inner ear's sensory nerves.
These are called otoconia.
"Have a seat on the exam bed."
"Why?"
"To confirm. Most likely it's otolithiasis. Little stones in your ear have come loose and are rolling around, causing the dizziness."
Rizelotte stared at me.
"Does that even make sense?"
"Yes."
"There are stones in ears normally?"
She looked skeptical.
Fair enough. If you know nothing about inner ear anatomy, you'd react that way. How to explain it?
"I saw them when I dissected one."
"Ah."
Rizelotte nodded.
Obviously, when you dissect a human (donated cadaver), you can see the cochlea inside the ear. And those tiny stones are in there.
"What do I need to do?"
Dix-Hallpike maneuver. No idea why it's named that—Nordic names? Two guys?
Anyway.
This is the differential test for otolithiasis.
"First, turn your head toward the dizzy side. Then lie back like that. I'll support your head, so relax."
Rizelotte followed my instructions.
If it's positional vertigo, nystagmus should start by now. I checked her pupils. Her right eye was definitely twitching. Can she see okay?
"Cover your left eye. How's it look?"
"Hmm, just a bit blurry."
Aha. Interesting.
Even with nystagmus going on, the patient doesn't feel the eye shake? Just some discomfort or blur.
"You can sit up now."
Time to explain.
"So, what's the diagnosis?"
"We've got it. It's benign paroxysmal positional vertigo. What that means is—"
"Positional? I didn't do anything like that."
"......"
Is she an idiot?
"Position... as in posture. You said dizziness hits with position changes, right? Vertigo triggered by body position......"
Sigh.
I turned my head to stifle a laugh. Rizelotte's face turned red.
"Oh. S-sorry."
"It's a mismatch between your head's actual position and what your balance organ tells the brain. No meds. We'll reposition your head to get the stones back in place."
"Okay."
"Sit back down."
Rizelotte sat on the bed again.
"Starting the Epley maneuver. Turn your head 45 degrees to the right. Yes. Now lie back quickly with your head turned. I'll hold it. Wait 30 seconds."
First step done.
"Turn 90 degrees to the left. Look 45 degrees left. 30 seconds again."
Second step.
"Now roll fully onto your left side. Hold for 30 seconds."
Third step complete.
Rizelotte sat up.
"Still dizzy?"
"Nah, not really."
Not sure if it's fixed. Could come back soon. Dizziness tends to recur once it starts.
Still better than migraine or vestibular issues with no cause. Dodged a bullet—no brain tumor here, and I couldn't do brain surgery anyway.
"Meds for severe cases, but not a real fix. If it recurs, repeat what we did. Come back if it doesn't work."
"Thank you."
Rizelotte bowed her head.
Back to the lab.
One last review.
How many times had I mentioned Pasteur's experiment over the past few days? But time, resources, and academic interest were lacking.
Already published three papers, including Estina's. The academy was probably getting tired of me. Needed to wait before dropping another.
"Estina. Pasteur."
She'd heard about Pasteur until her ears bled. I'd recited it like scripture to a cow. She must have it memorized by now.
Estina cleared her throat.
"Pasteur's experiment disproved the hypothesis that maggots or mold arise naturally from organic matter, establishing the principle that life comes only from life. It experimentally proved that sterilized organic matter doesn't decay until exposed to airborne particles, unlike unsterilized matter. The process was—"
Long. Too long.
"Good job."
She knew it cold. I pointed to the swan-neck flask set up in one corner of the lab. Estina turned to look.
"That experiment. We can do it now?"
"Estina. Use your brain a bit."
"Uh, what should I think about......"
My lab uses culture medium pretty often.
Bacterial colonies almost never pop up in fresh medium. Not never, but any that do are from poor hygiene or spores surviving boiling.
Estina blinked.
"We make culture medium in the lab a lot. We boil it to sterilize, right? Nothing grows in the broth until after boiling and exposure to air."
Estina nodded.
"Ah. Yeah, thinking about it, that's right."
"Blame bacteria."
"They die when boiled?"
Spot on. Some heat-resistant ones slip through occasionally, but numbers matter.
"Boil the broth, all bacteria die. Nothing grows until we open the lid and inoculate intentionally."
Touch cooled, sealed boiled broth with a finger, and bacteria grow. Nothing before. Miniature Pasteur experiment—no difference.
"This one's mainly for show, really. We already know—we use that principle with culture media."
Estina sighed.
"This is...... tricky."
"The experiment itself is simple."
Prep was done. Now just run Pasteur's experiment and publish the paper.