Chapter 65
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Translator: penny
Chapter: 65
Chapter Title: If It Doesn't Exist, Make It
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From a modern medical standpoint, congenital heart defects were no longer incurable diseases.
With precise diagnostics and the right surgical equipment, even a child could be restored to a normal life.
But all those prerequisites applied only in a modern environment.
The heart surgery I knew from my past life required, at minimum, the following.
First, a cardiopulmonary bypass machine.
A device that circulates blood throughout the body even while the heart is stopped during surgery, preventing oxygen deprivation from damaging the brain and organs.
In other words, a machine that temporarily takes over the heart's role.
Next, an oxygenator.
This device pulls blood out of the body, saturates it with oxygen, and sends it back in. It works in tandem with the bypass machine as the core equipment for mechanically sustaining the patient's life.
Third, cardioplegic agents.
Not drugs to destroy the heart muscle, but precisely formulated ones to intentionally and safely halt the heartbeat.
No precise suturing is possible while the heart is still beating.
Fourth, specialized micro-suturing instruments.
Standard needles and thread won't do.
Threads thinner than hair, needles barely visible to the naked eye, and hand techniques allowing zero margin for error.
Operating on the heart isn't sewing flesh—it's stitching life itself back together.
Finally, a fully sterile operating room.
The heart is an organ extremely vulnerable to infection.
Even a speck of contamination means the patient dies of sepsis, no matter how successful the surgery.
That's why modern surgeries are performed only in spaces where even the air is controlled.
The problem was that none of this existed in this world.
No machines, no drugs, no micro-instruments, not even a solid concept of sterility.
In short, impossible by conventional methods.
But.
I was someone who had actually opened a heart in my past life, and this was a world with the variable of magic.
And above all, I already had a track record of saving lives beyond this world's common sense.
If there was no orthodox method, I'd create a substitute.
"First, Piel will handle the cardiopulmonary bypass."
Piel's eyes widened.
"M-Me?"
"Yes."
I nodded without hesitation.
"Your power isn't just a simple shield. It's an ability enhanced for the very concept of 'blocking.'"
Piel was a shield warrior. It wasn't limited to swords or magic.
It was a force closer to severing the world's 'actions'—impacts, pressures, flows, collapses.
"When the heart stops, blood circulation stops too."
I pointed to my chest.
"We need something to take its place. We have to mimic the heart's job in another way."
"...With a shield?"
"Exactly."
I took a short breath.
"Create a shield that envelops the heart. Not rigidly fixed—but a barrier that repeatedly contracts and relaxes like a heartbeat."
Piel's eyes changed.
"The barrier won't press directly on the heart itself, but it'll subtly expand and compress along the vessel entrances."
In other words, artificial pulsation pushing steady pressure into the aorta and pulmonary artery.
Not a perfect bypass, but enough to deliver blood to the brain and vital organs.
"Maintain it only while the heart is stopped. You can do it, Piel."
"...I'll try!"
A short reply, but I could tell she was already visualizing it in her mind.
Next, the oxygenator.
This time, I looked at Aira.
"Aira."
"Yes, Master Lucas."
"From now on, you'll be the monitoring equipment."
Aira was a deficiency awakener.
Her senses were so acute they were described as 'housing a god.'
A body that took pain as payment for absurd volumes of information.
"Your senses can pick it up."
I said lowly.
"The sound of blood flowing. The rhythm of the pulse. Even how much oxygen seeps into the body with each breath."
In the modern world, that would be checked with pulse oximeters, blood pressure cuffs, ECG monitors.
But there were no machines here.
So—
"During surgery, report Family Head Alain's status without missing a beat. Irregular heartbeat, weakening blood flow, shallow breathing—everything."
Aira nodded.
"I can sense it. ...No, I will."
"That'll do."
I summed up briefly.
"Piel handles circulation, Aira monitors oxygen and vitals."
Cardiopulmonary bypass and oxygenator.
An absurd combination by this world's standards, but as a doctor, the conditions were met.
Now, how to safely stop the heart.
I turned to Princess Evelyn.
"Your Highness."
"Yes."
"Once surgery begins, stop Family Head Alain's heart on my signal."
For a moment, Evelyn's expression hardened.
"Wait. Won't stopping the heart... kill him?"
"Normally, yes."
I nodded.
"But that's only if it stops uncontrollably."
The heart wasn't just muscle. It beat via electrical signals.
"Stopping the heart is closer to temporarily blocking those signals than destroying the muscle."
In other words, the heart itself stays alive, just immobilized.
Modern medicine calls it induced cardiac arrest.
"Piel will maintain blood flow in the meantime, and Aira will monitor oxygen levels."
"So... he won't die?"
"No, the cells remain alive, so no risk of death."
I looked Evelyn straight in the eye.
"What Your Highness needs to do is simple: an ultra-precise spell targeting only the conduction system, not the whole heart."
Sinoatrial node, atrioventricular node.
Just briefly sever the heart's electrical circuits.
"No need for strong mana. If anything, it has to be pinpoint accurate."
Evelyn wasn't a powerhouse mage.
But her mana control was genius-level.
"...I can do it."
A short, confident reply.
"Release it the moment I signal the heart's stopped."
"Understood."
That settled the roles for the three of them.
Now it was my turn.
"And I'll make the micro-suturing tools myself."
Scalpel.
Forceps.
Micro-sutures and thread.
Heart surgery wasn't about brute force.
A millimeter's error meant life or death.
"Can't order custom ones."
I shook my head.
"This world has no concept of 'surgical instruments.' Demanding this precision verbally is impossible."
Which meant I had to craft tools fitted to my hands.
The silver lining: ever since treating Piel, I'd been whittling scalpels in my spare time.
Weight balance.
Blade angle.
The subtle resistance when twisting the wrist.
All familiar in my hands.
My hands reacted before my eyes did.
"The Raltos family will provide workshop space."
Surgery to save their Family Head.
Reasons abounded. I mentally reviewed once more.
Sterile environment.
Circulation substitute.
Oxygen monitoring.
Cardiac arrest.
And my hands.
From here, it was the surgeon's domain, not planning.
"First, secure a sterile room."
I issued orders immediately.
"A sealed space without windows. Unused rooms are best—basement if possible!"
To reiterate, the heart differed from trauma.
Trauma could be pushed through with recovery, but the heart's survival hinged on the environment.
Treating Piel and Aira had worked with wound cleaning and on-the-spot sterilization.
But the heart was the most vulnerable internal organ.
One infection, and perfection meant nothing—the patient died.
So I compromised on nothing.
"Purify every bit of air in that space. Purification magic, herbal fumigation, barrier wards—whatever works."
The key was one thing.
A space where no bacteria could survive.
"Floors, walls, ceiling. Not a speck of dust."
"Yes, sir!"
"We'll summon every mage in the territory right away!"
Orders given, people sprang into action.
Thankfully, this was the Raltos family.
Resources, manpower, cooperation—all flowed without hesitation.
I scanned the surroundings briefly before continuing.
"Prep time: one week."
A short, firm declaration.
No one objected.
Time for the Raltos family to assemble a full surgical environment.
Precisely one week.
Enough to finish tools, stabilize the setup, and let everyone master their roles.
In other words, surgery in one week.
And so.
With roles assigned and timeline set, I finally noticed the shift in how people treated me.
Not as Argent's bastard, but as the surgeon who could save their Family Head.
The result, perhaps.
I was escorted to a room in the Raltos manor far too grand for 'guest' status.
VIP quarters.
Ceiling, bed, window dressings—all leagues beyond the Argent annex I'd known.
I dazedly took it in, then a thought struck me.
...The places I've lived were straight-up trash by Four Great Houses standards.
A bitter smile escaped.
Piel and Aira got the same.
No longer slaves, but treated as saviors of the Family Head.
They were assigned rooms and told to rest alone for the day.
Left alone, I was honing my surgical tools when—
Knock knock.
I thought it was dinner service at first.
Time had flown by unnoticed.
Opening the door revealed a Raltos servant.
"Master Lucas Argent. Someone wishes to see you... now."
I tilted my head.
"Now?"
"Yes. If you'd follow me?"
Polite tone, but the intent was clear.
This wasn't dinner or courtesy.
I set down the scalpel and exhaled slowly.