A Hospital in Another World?

Chapter 505: Intestines Hanging Outside the Groin

Being skilled at hemorrhoid surgery or even as a dung scooper, the Oakwood Hospital had certainly made its name.

No longer were the visitors limited to wealthy businessmen Garrett originally knew, or the desperately poor, or those from the poorhouse who were so sick they were brought directly for experimental treatments.

The magicians were also generous with their money. A potion for minor injuries cost 50 gold coins, one for moderate injuries 300 gold coins, and for severe injuries 750 gold coins—

Would you dare offer only 300 gold coins for the services of a level five dual-class priest and mage, a disciple of a legendary mage, when seeking his unique treatment?

You should at least offer 100 contribution points, or, if money is an issue, any strange magical materials or equipment could also be considered as payment.

Garrett didn’t haggle over the money, but the patients’ dignity was important—

After all, if a mage had treated your backside and he had a promising future, you might meet him again in other circumstances. For your own honor, you’d better pay more for the consultation.

Thus, Garrett’s Oakwood Medical Research Institute somehow managed to break even. And now, patients with conditions untreatable by conventional healing spells were also showing up—

That noon, Garrett looked up from a bloody behind just as he was about to cast a cleansing spell, only to be hurried out of the room.

"Mother!" the man interrupted anxiously.

He was tall, well-built with broad shoulders, and his hands bore thick calluses—a clear sign of a warrior’s life.

Garrett couldn’t tell his exact level, but Bernard quickly approached, standing protectively close to Garrett.

The old woman shrank further. Garrett waved dismissively at the barbarian and approached with a smile, bowing slightly to the old woman:

"Madam, what seems to be the discomfort?"

"My mother’s stomach hurts a lot! It’s painful and bloated—"

The man’s voice dropped, seemingly reluctant to let others hear: "The caregiver said she hasn’t had a bowel movement in two days... It’s been like this several times before. Drinking healing potions doesn’t help, and even temple treatments only provide temporary relief. It’s been particularly bad recently, Mage, sir..."

Mm, constipation, abdominal pain, bloating. First consideration would be bowel obstruction. As for the severity and cause, and whether there are other structural abnormalities, further examination would be needed.

Constipation is heavily influenced by lifestyle habits and isn’t something that can be fixed permanently with a simple spell... Garrett thought this as he smiled warmly and reached to help the old woman:

"Madam, let’s do a check-up first... Stand here, yes, stand straight, don’t move... Tsk, it’s hard to see clearly here..."

And it was the key area that was hard to see. The waist was covered in layers of shadows that at first glance appeared to contain keys or something similar—perhaps a sewing needle? Scissors? An awl? Flint?

Unable to succeed in peeling the old woman’s skin, Garrett had to help her into his office and called in two female nurses to assist her in changing clothes.

Any metallic items under the clothes, whether buckles, belts, keys, or other oddities, were all taken off and handed to her son.

Seizing the opportunity, Garrett took some time to chat with the patient’s family.

He learned that the old lady was 62 years old, had four children, two boys and two girls (though their genders weren’t relevant). The person accompanying her was her eldest son, a level six knight. Of course, the old woman herself was not a professional.

She was generally healthy, had never suffered serious illnesses, and had never undergone surgery (the patient’s relative: What’s surgery?). She loved meat as much as vegetables and could eat a pound of vegetables a day as long as she wasn’t constipated...

As they talked, the nurse assisting the old woman to change came out, clearly exhausted from the effort. Garrett managed to escape the knight’s presence, pulled out his Endless Ink Pen, and conducted an X-ray on the old woman—

Having a portable light source was beneficial. Garrett mentally applauded the [Detect Magic] spell:

In another life, a doctor would write an order, push the patient to queue for payment, queue at radiology, get an X-ray, and then push back to wait for radiology to develop the images. If it wasn’t marked as urgent, it could take hours...

He concentrated and looked closely. The upright plain film showed multiple step-like air-fluid levels in the abdomen with the obstructed proximal

small intestine and the air-fluid levels fixed above the pelvic symphysis; the supine film showed the same signs.

And in the groin area, outside the ligament, he could see a loop of intestine filled with air, its blind end pointing towards the obturator—

After examining both positions, Garrett had a general idea. He asked the old lady to lie down, ready for a physical examination:

"Madam, curl up your legs, good, just like that. Now, the right leg as well—"

Garrett stood by the bed, speaking softly as he leaned forward, his left hand resting on the old woman’s right calf, gently pushing to guide her.

Before he even applied much force, the man exclaimed, "Ouch!"

"Don’t, don’t! Mother says whenever she curls up her right leg, her thigh hurts!"

Garrett nodded silently, as expected. His smile remained gentle as he quietly asked:

"How long has the thigh been hurting?"

"Not... not long... just a bit..."

The old woman’s eyes darted away, uttering a few words and glancing at her son. Garrett had seen this behavior often enough; usually, it meant something serious was being kept from her son.

Hmm, likely quite severe, she didn’t want to bother her son, hadn’t told him...

Garrett thought for a moment, persuaded the knight to leave the room, then returned to continue questioning. He learned that the old lady had been suffering from constipation for over two years, with intermittent relief and relapse.

Regarding the thigh pain, it had persisted for more than half a year and had worsened in recent days. The leg could not be curled at all; bending it only increased the pain...

"Madam, can you feel a lump here at your right groin, where your body and right leg meet?"

"What?" The old woman’s voice rose sharply, then fell again, tinged with panic and embarrassment:

"You young man, how can you ask... ask about that area..."

Garrett was bemused. By this stage of the consultation, he was considering an obturator hernia causing the bowel obstruction—

An elderly woman, multiple childbirths, pelvic floor muscles and ligaments would degrade significantly; long-term constipation put a lot of pressure on the pelvic floor muscles and ligaments.

At this point, if the peritoneum is sparse and presents a defect, and the pelvic floor muscles and ligaments fail to support it, part of the intestine can herniate, causing incomplete bowel obstruction.

And because the obturator canal is narrow and the surrounding tissue is tough, it’s difficult for the herniated contents to return on their own. If the cause isn’t identified clearly, temple treatments focusing only on constipation and pain indeed wouldn’t be effective...

I’m not trying to take advantage of you, madam!

"In the name of the God of Nature..."

He sighed, pulling an oak staff from his pocket and transforming it into a staff of eyebrow length, the leaves at the staff’s tip gently swaying. Garrett raised a hand, his palm open beside his ear, a faint light flickering from palm to fingertip:

"Madam, I’m asking these questions purely for diagnostic purposes. If you’re uncomfortable, shall I call your son back in, or perhaps a female priest?"

The credibility of the God of Nature seemed to hold some weight. The old woman watched the light for a while, then looked at the leaves on the oak staff, and her expression finally relaxed somewhat. Garrett seized the moment:

"Madam, how about this: I’ll turn my back to you, and you check yourself... Carefully, please! It’s very important!"

Rustling sounds came from behind him. After a while, the old woman breathed a sigh of relief, her voice weak as she replied:

"No... nothing..."

But the X-ray clearly showed something. Garrett rubbed his forehead:

Troublesome. To confirm the intestinal obstruction, and more importantly, to check for arterial and venous compression and the blood supply to the lower limbs, an ultrasound would be best. But it remained to be seen if she would allow it...

Ah, Seraina and Miss Anita Winvey, although they had learned ultrasound spellcasting from him, weren’t yet proficient in interpreting the images. He’d have to do it himself!

Garrett communicated with the old lady, who, as expected, refused; he then opened the door to speak with her son, who also refused. Left with no choice, he had to propose a surgical option:

"First, we’d make a small incision here at the groin, insert a few tendrils to push the displaced section of intestine back into place. Then we’d need to examine the intestines, as the obstruction has lasted a long time, we must ensure there’s no ischemia or necrosis. Finally, we’d repair the peritoneal defect..."

He explained each step, and the old lady’s face grew paler with each word. By the end, she was nearly faint

ing, leaning on her son and shaking her head vehemently:

"We’d better not treat it... Albert, let’s not do it, not treat it..."

Garrett exhausted all his persuasive skills, including explaining that "the whole procedure would be under the control of a tranquility spell, you won’t feel pain," "without surgery, the intestine might decay," but to no avail. The old lady was too fearful, too non-compliant...

In the end, Sir Albert simply bought two tubes of enema and hurriedly left with his mother. Garrett escorted them from the office to the front door of the lobby and down the steps, repeatedly reminding Sir Albert:

"If your mother’s stomach pain intensifies, remember to seek treatment! You must seek treatment!—You can come here, or to any temple, any mage’s medical research institute! In the worst case, the intestines can decay! I’ll be here tonight!"

He did as he said, not returning to the mage tower that night, instead staying at the hospital. Around midnight, one or two in the morning, Sir Albert came knocking on Oakwood Hospital’s door with his mother:

"Magician Nordmark! Magician Nordmark, are you there?—Help us!"

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