The Saint's Diagnosis
In the past, I lacked confidence when it came to obstetrics and gynecology. Back then, it hadn't been long since I’d started dabbling in that field. But having spent seven years caring for expectant mothers in the Limbus Pit, I had reached a level where, while perhaps not a professor of the specialty, I could confidently claim to be a practitioner.
That was why, the moment I heard the news of the Imperial Princess Consort’s four consecutive miscarriages, my mouth began to move on its own. It was never going to be anything else.
"Excuse me, Your Highness the Princess Consort... where is she at the moment?"
"Pardon? Julian? Why on earth would you suddenly ask that..."
"It’s just that I was reminded of other patients I’m currently helping with similar concerns."
A miscarriage is a tragedy that can happen to anyone. It could be due to stress, or it could simply be bad luck. But the moment a miscarriage repeats more than twice, the story changes. Recurrent Pregnancy Loss. That is the diagnosis given when a natural miscarriage occurs two or more times. Once diagnosed with recurrent loss, it becomes necessary to uncover the underlying condition hidden within the mother.
I began to ask the young nobles, who were looking at me in confusion, about the Princess Consort's symptoms in more detail.
"Ah, before that, could you perhaps tell me more specifically about Her Highness?"
"By 'specifically,' you mean..."
"When did the happy event usually fail to come to fruition? Was it before your belly began to show, or after?"
"Uh... I believe it was right after the belly started to show a little."
Judging by Lady Heide’s words, it was closer to a second-trimester miscarriage. That ruled out the possibility of chromosomal or hormonal issues, as those typically occur in the first trimester. This narrowed the candidates down significantly. Cervical insufficiency, uterine malformation, or an autoimmune disease. If it had happened four times, one of these was highly likely. Either way, they were conditions I could handle. After all, I had treated them several times in the red-light district.
"Is Her Highness the Princess Consort attending the banquet today?"
It was Freya who answered.
"Yes, Brother. I understand she is entering with His Highness the Imperial Prince."
"Together?"
"The Founding Festival is also a place to demonstrate the vitality of the Imperial family. Even if Her Highness is feeling unwell, it would be difficult for her to miss this occasion."
"I see."
Perhaps sensing something in my reaction, Eri narrowed her eyes and looked at me.
"Teacher... no, Young Master. Don't tell me you know what the problem is just from hearing that?"
"Hmm. I’d say I know about fifty percent."
"As expected. How does the difficulty compare to our usual patients?"
By 'usual patients,' she meant the people of the Limbus Pit. She must have spoken that way out of consideration for the many ears around us.
"If my guess is correct, the difficulty is low-to-medium. Compared to that patient we saw two months ago, there shouldn't be anything particularly difficult."
"Wow, so it was nothing special. Do you need me?"
"The probability is low, but if you feel any strange energy from the Princess Consort, let me know."
I could safely assume infection was unlikely. Even with an infection, it’s rare to cause recurrent miscarriages at such a consistent stage. Still, just in case, I gave Eri a heads-up.
Perhaps curious about Eri's reaction, Charlotte, who had remained silent until now, spoke up.
"Are you saying you can tell just by hearing this? Was there something I missed?"
"This is neither a problem nor a case, Lady Charlotte. It’s not good to treat a sick patient like a game."
Sigh. Charlotte’s golden hair seemed to lose its luster in a strange way.
That was when it happened.
A fanfare echoed through the banquet hall. All conversation ceased at once, and hundreds of pairs of eyes turned toward the entrance. The voice of the master of ceremonies filled the entire hall.
"His Highness the 12th Imperial Prince, Edmund Eschenbalt, and Her Highness the Princess Consort are arriving——!"
The master of ceremonies shouted with all his might, putting force into his throat. Just as I was worrying about whether I should get him some lemon honey drops later, the main gate opened. Two Imperial Guards entered first, followed by a young man who had swapped his military uniform for formal attire. The 12th Prince, Edmund. The young man with neatly combed brown hair was clearly a soldier at heart. His left hand didn't move as he walked, likely a habit from always keeping his hand on the hilt of his sword.
"He’s right-handed. He doesn't move his left hand because of the habit of always carrying a sword."
Charlotte whispered the exact same deduction beside me. Everyone's gaze was fixed on the Prince. However, I was the only one who sent my gaze not to the Prince, but to the woman behind him. She was following half a step behind him. A silver-gray dress with a lace collar rising to her neck. I scanned the Princess Consort quickly, starting from her face.
'Purple reticular spots on the upper clavicle, confirmed.'
Livedo reticularis was visible. She seemed to have tried to cover it as much as possible with makeup and the lace collar, but the spots were too large to hide completely. Next, her ring-clad hand caught my eye.
'Her fingers are slightly swollen.'
The subtle edema was enough to make the ring dig into her skin. The possibility of an internal medical condition had increased. Finally, I checked with Eri.
"How is it? Anything strange?"
"No? She looks fine."
"As expected. So it’s not an infection or a hematological issue."
According to the diagnosis of Eri, our expensive bone marrow verification device, I confirmed it wasn't that either. This alone was practically an 80 percent diagnosis. But I wanted to raise the probability even higher.
'I want to ask about her urine...'
I wanted to check for foamy urine. But my social skills weren't so broken that I would ask about that in the middle of a party. I knew well enough that if I asked something like that, I’d be sent straight to the guillotine. So, I decided to check for other symptoms with Charlotte’s help.
"Lady Charlotte. Do you happen to have plans to greet them?"
Charlotte, who had been poking at her sorbet, feeling dejected at my earlier remark that it was 'a disease, not a case,' looked up.
"Yes? Ah, yes. It would be against etiquette not to present a gift."
"Then, when you present the gift and share a brief greeting with Her Highness, please offer her a cold drink if possible."
"Is it necessary?"
"It is necessary for the diagnosis."
"Understood."
Vitality returned to Charlotte’s face, which had been downcast until just a moment ago.
"But you must tell me the diagnostic process later?"
"It’s not knowledge that would be useful to you, Lady Charlotte."
"But I can refer to the method of observation."
"If that’s the case... I understand."
Charlotte put down her spoon and stood up. She immediately linked her arm with mine. Hmm. It didn't feel quite as soft as I had expected. It wasn't that there was nothing there, but compared to Eri, it felt lacking. With such blasphemous thoughts, we joined the procession to give our gifts to the Imperial couple.
"Let’s go, my fiancé."
She looked strangely excited. Perhaps she was thrilled because the process of finding the disease felt like the process of finding a culprit.
The presentation of gifts began with the lower-ranking families. We, who received treatment equivalent to a Marquis family thanks to Charlotte, stood at the end of the line. Baronets, Barons, Viscounts... the gifts prepared with the utmost care by each young noble were placed before the Prince. Rare medicinal herbs, magic stone crafts, intricately carved jewelry. They showed the utmost sincerity that could be prepared with their own pocket money. Charlotte, glancing at those gifts, whispered.
"Isn't the gift we're giving too excessive?"
"I wonder."
Charlotte probably wanted to say that the gun we were giving was an ecological disruptor. But if my diagnosis was correct, the gift we were giving was far more significant than a mere 'gun.'
"Thank you."
"Hmm... Baron Adel... I shall remember."
"Yes, thank you for your hard work."
At the front of the line, the 12th Prince replied in the same tone every time. It was a polite but emotionless voice. It was understandable, given that he had lost a child four times and was on the verge of being forced to break off his engagement with his beloved. The smile on the Princess Consort sitting beside him was also crumbling as time passed. Watching this quietly, it was soon our turn.
"Lady Charlotte Hausen of the Marquisate of Hausen, and Young Master Julian Schnabel of the Barony of Nihilit."
Following the master of ceremonies' announcement, we approached the Prince. Charlotte paid her respects first. The angle of her bow, the position of her fingers holding the hem of her dress, the timing of raising her gaze—everything was flawless. As expected, this person really could do it when she wanted to.
"Representing the Marquisate of Hausen, I offer this gift prepared with wishes for Your Highness's health and good fortune."
Charlotte signaled the attendant. What the attendant presented was the rifle I had prepared. As the rifle case wrapped in red silk opened, the 12th Prince’s eyes changed. It was a special rifle for hunting magical beasts. It was a custom firearm with a gold-plated magic-conducting barrel and a stock decorated with silver thread. Ten bronze magic bullets were neatly placed in separate slots, and each bullet was worth a regular knight's monthly salary. At the appearance of a gift that no man could ever resist, the Prince, who had been expressionless until now, felt his lips twitch.
"...Truly a fine piece."
Of course it was. It was an item I had obtained by pouring in my weekly income from selling vaccines and insulin.
"The Marquisate of Hausen's pocket money seems to be larger than mine."
The 12th Prince gave a bitter smile. We didn't bother to correct that misunderstanding.
"Since I have received such a good gift, let us talk for a moment. I haven't had many opportunities to build ties with the Marquisate of Hausen."
When the 12th Prince signaled the attendant, two chairs were quickly prepared to the side. It was a courtesy for the rank of a Marquis family. Unlike other families, he was establishing the Marquisate's prestige by exchanging a short conversation. Of course, it was also a reward for gifting such an expensive gun.
"Thank you, Your Highness."
Charlotte sat down naturally. I sat down as well. Up close, the Princess Consort's condition was even clearer. The dark circles covered by powder were visible first, and the color of her lips, created with rouge, was far from a healthy red. The fact that she looked like she was struggling to maintain her smile suggested that just being in this place was an ordeal for her.
It was a face I had seen dozens of times in the red-light district. The face of a mother who had lost her child without even being able to hold it in her arms was no different, whether in the Imperial City or D-Sector. Perhaps the Prince also knew the Princess Consort's condition, as he kept glancing at her.
At that moment, Charlotte said to the Princess Consort.
"Your Highness, aren't you thirsty from sitting for so long? Would you like a glass?"
"Thank you, Lady Hausen. Actually, I was a bit thirsty."
With a strained smile, the Princess Consort nodded. Charlotte signaled the attendant. What the attendant brought was a champagne glass placed on ice. It was a refreshing glass with dew on its surface. But Charlotte didn't stop there.
"Congel."
Charlotte whispered the incantation in a voice only I could hear. She chilled the glass one step further and handed it to the Princess Consort. The Princess Consort took the glass. And her thin, pale fingers wrapped around the cold glass. Charlotte and the Princess Consort continued their small talk while holding the glass in one hand. Thirty seconds passed.
'Good. Just as I thought.'
The moment the Princess Consort set the glass down on the table, her fingertips, which had turned white, caught my eye. Raynaud's phenomenon. It is a symptom where the fingertips or toes turn white due to cold or psychological changes. It was also a symptom commonly seen in autoimmune diseases like rheumatoid arthritis. I summarized it once. 'Four consecutive recurrent miscarriages. Purple spots above the clavicle. Finger edema. And Raynaud's phenomenon.' At this point, I could guess. It was a sequence of typical symptoms that any doctor, regardless of their specialty, would recognize.
'I should consider ninety percent to be correct.'
Of course, I would have to run tests to fill in the remaining ten percent. I would need to perform a Wassermann test, a coagulation time test, and a urine protein test. But, 'I can't resist the performance.' A doctor who is full of confidence just from deduction before even running tests. This is like Sherlock Holmes, and I can't resist that. Of course, that Sherlock is right beside me now, but wouldn't the 'misunderstanding' correction take care of the rest? I’ve lived like that until now, and it has worked out well.
'Let's go.'
I decided to go big once again. I took a breath, steadied my heart, and opened my mouth.
"...Looking at this gun, I’m reminded of when I caught that guy in the South."
"Your Highness."
"What is it, Young Master Nihilit?"
"Actually, this is not all there is to the gift I have prepared."
The 12th Prince’s hand stopped on the barrel. "I have prepared a separate gift for both Your Highness and the Princess Consort."
Curiosity appeared in the 12th Prince’s eyes. He had already thought the gun was an impressive enough gift, but there was more? That was roughly the feeling. "Ha. I know the Marquisate of Hausen has plenty of pocket money, but what else have you prepared?"
Expectation was buried in his voice. It was a voice that sounded as if he were expecting me to have prepared something like a transforming robot. On the other hand, the Princess Consort didn't seem interested. To someone for whom just sitting in this place was an ordeal, what meaning could a gift have? I smiled, taking in the excited man and the indifferent woman in one view.
"I will gift you both a happy event."
"...A happy event?"
The 12th Prince’s head tilted slightly. It was an expression that showed he hadn't immediately grasped the context of the word 'happy event.' So, I said it directly.
"I am saying I will gift you a baby."
The 12th Prince’s head stopped. As if time had frozen, he remained exactly like that. The Princess Consort’s indifferent eyes also wavered for the first time. The reactions of the two attendants standing behind the 12th Prince were also worth seeing. One began to tremble so hard that the hand holding the tray shook, and the other looked at the person next to him as if doubting his own ears. And the young nobles in the nearby seats, who had been listening in, were looking at me with their mouths hanging open as if their jaws were about to drop off.
At the center of all those gazes, only Charlotte was looking at me with an intrigued expression.