Parallel World Pharmacy

"Explain the treatment policy... no, let's think together, brother"

Pharma helps and wakes Palais, who fell out of her chair.

Respecting Palle's position as a pharmacist, he took care not to be a one-sided and discreet treatment.

"Oh, oh..."

"Let's make some tea."

Cedric cares and serves warm tea to the pallets and pharmas. Lotte quickly served chocolate. It's a keepsake. Palais finally got comfortable drinking it.

"Are you sure it's Pharma?

"Yes, I am."

"Where did you get that knowledge? You didn't learn that from Eleonor, did you?

"When I was struck by lightning, I had a dream."

Pharma left it as an easy explanation.

Because I thought that if we didn't see material creativity and divine power, we should delude ourselves with it.

Palais can't hide the shock.

"Isn't that the one who took the divine revelation... from what god?"

"I don't know what I'm talking about."

Palle stands up as he can think of. And most importantly, I tried to go outside. Ellen calls on his back.

"Hey where are you going!?

"I'm gonna hit the lightning, too!

"I'm gonna die like that, Mr. Pallet!

Because it's really stupid, and Ellen can't get a scratch in time. But Palais can't do it.

"It's not that easy to hit lightning."

Pharma stopped him from trying to get out while his heart was determined by Palais's entire journey.

"Eleonor, you don't think of anything? The pharmacy we've been learning... what the hell is that? It was pointless."

"It's not pointless. Doesn't that make sense?"

Pharma denied it by covering it from above Palais's words.

"Some of these pills have worked before, right?

"Farma, you're right. But there are more things that don't work..."

Ellen represented Palle.

"Farma, write down everything you've dreamed of. Let us hear it."

"Yeah, that's why I'm doing that now. That's the text."

Farma decided to continue her lecture in front of the two first-degree pharmacists.

"Okay, I'll go on and explain. Leukemia is chronic and acute. It doesn't make the acute longer and more chronic. It's a completely different disease. Chronic is a condition that is causing problems with the hematopoietic stem cells themselves. Acute is a condition in which abnormalities are occurring on the way from hematopoietic stem cells to each blood component, which is the case with my brother?

By making it an issue format, it creates a snag in memory and deepens understanding.

Palle was a brilliant student who quickly absorbed what he said once. "It's acute," Palle replied, "isn't it chronic?," Ellen said the other way around.

"Acute is the right answer. There are two ways to remove this leukemia cell. What do you think that is?

Pharma showed the text's illustrations of blood cells and other components maturing from hematopoietic stem cells.

"Kill leukemia cells doing evil"

Pallet seems to have come up with a way over there.

"Correct. And the other way? Ellen, think about it."

"Surrender, what am I supposed to do?

Ellen gave up fast. We were both stuck in an answer, so Farma gave us an answer.

"Allow leukemic cells to become normal leukocytes"

"Can you do that"

Palle gets excited and embarks on herself.

"Can an abnormal leukemia cell be a normal leukocyte? It was an anomaly, wasn't it?

Ellen wonders if that's okay, and I doubt Pharma's policy.

"Cells that can't be white blood cells are abnormal, so if they can be white blood cells, that's normal."

If you turn all the leukemia cells into leukocytes, that results in removing the leukemia cells. Add an explanation that the agent that encourages leukemic cells to mature into leukocytes is a substance called all-transformed retinoic acid (ATRA).

"Really!?

I think you've gotten smarter, and Ellen nods as she wipes her glasses.

"Wait, isn't it a bad idea to have too many white blood cells in your blood, albeit normal?

Palle was a good guess.

"The blood cells created don't accumulate all the time in the blood. Blood cells have a lifespan. White blood cells die in a few days, too, destroyed in the spleen. But if that doesn't work, I'll have a condition called retinoic acid syndrome."

ATRA, the special effect of this acute myelocytic leukemia (APL), has side effects.

Leukocytes that are stimulated to differentiate (mature) by ATRA from leukemic cells and are made in large quantities can damage blood vessels or cause heart failure, as Palle said.

A rare, life-threatening side effect.

"Right..."

But the side effects of the medicine are strong. If you are afraid, you cannot be treated.

"That's why. First, take ATRA, which induces differentiation into leukocytes (encouraging maturation)"

Pharma offered his right palm before the two of them.

"Along with that, you are injected with an anti-cancer agent to destroy the leukemia cells"

I also offered my left palm.

In the diagnostic eye, it has been determined that ATRA alone will heal in the case of pallet.

But we want to keep the risk of recurrence as low as possible by using anticancer drugs in combination, Pharma thought so.

"Two treatments, thoroughly beating leukemic cells"

With that said, Pharma put his hands together and his hands together.

"This is the treatment policy for this leukemia."

A detailed dosing schedule will be explained later, Farma added.

If you follow the order from the general flow, the smart pallet will understand. Farma thought so.

"I mean, what do you think?

Ellen asks the conclusion.

"I mean, there's plenty of potential for full healing"

I was relieved Ellen seemed happy to loosen her cheeks. Palais also seemed to have a lot of hope.

Lotte and Cedric also laughed face-to-face.

"Okay, I'm going into remission therapy."

Pharma offers medicine and water to Palais within the pharmacy. An ATRA made into a capsule.

"Drink after each meal from now on. For now, after lunch."

"You drink already!? My heart is ready..."

Even so, Palle drank the medicine offered.

She rubs anxiously around the esophagus.

"Okay, now the treatment has begun. Let's go home, brother, Lotte. Take it easy in the carriage today."

Pallet is prone to brain haemorrhage, so he says he will.

"The bleeding symptoms should improve in a few days after taking ATRA. But until the ATRA comes into play, it's absolutely at rest."

"Just ATRA, don't you have to take anti-cancer drugs and stuff?

Pallet asks Pharma if she forgot to prescribe it.

"Idarubicin is given by injection, let's do this at home"

We should rest and do it in a clean room, not in a place facing the mess, Farma explains. On his way home, Pharma threw an unrelenting question at Palais, who was rocked by the carriage in a tired manner.

"Brother, up, you have a girlfriend now?

"Why are you telling me that now?

"Because it's the information you need"

"You broke up last week. You're the twenty-fifth, you were a good woman, but you're too quiet and unhappy over there. Oh, by the way, they do contraception."

I didn't hear you over there, brother.

Either way, it didn't seem to change that Palle had a full personal life. It may have broken up because Palle thought of her as dying, or maybe she just wanted to break up. Anyway, it was reassuring Pharma that she didn't seem to have any left in Novarut to chase me to the Imperial City.

Hearing about Palle's girlfriend and contraception, Lotte in the same carriage blushed and pretended she hadn't listened.

"Don't hang out with her while you're drinking ATRA. Pregnant her during medication may cause malformations in children"

ATRA was a medication that could be provocative (produce malformations).

Women, as well as men, must use contraception during medication.

"Really? You don't have to worry about me because I'm not here right now."

"About two years."

I can force you to live two years of abstinence, but it can't be life threatening.

and Pharma to teach Palais, but Palais couldn't seem to afford to worry about it.

…━━…━━…━━…

"What, Palle is such a freak..."

Bruno put into his ear Farma's report, which came to the study in anticipation of his return from college. Pharma also explained its treatment policy in detail to Bruno, including what leukemia looks like and what stem cells and leukocyte types are. Bruno, with the basics, grasped Palle's medical condition in a shorter time than he explained to Palle.

And to the point of listening, Bruno was a werewolf.

Farma nods to Bruno's question that you are a life-threatening disease.

"If there's a bleed, we can't even know tomorrow's life. It was a moment of contention, so we're already in the treatment of taking ATRA."

"Well... I knew there was such a blood disease... but there was no way Palais was well"

"Leave it to me, brother."

"Oh. Then you go to therapy, please."

As a father, and as a single pharmacist, I relieve Pharma of my desire to be treated by my beloved son. That improves Pallet's chances of survival.

"Is there anything I can do? Don't you have anything to prepare or don't you need my hand? Let's do anything."

"Yes. Allow blood to be drawn from those of the mansion's servants whose blood types match those of their older brother. It can be used for transfusions to compensate for deficient platelets and blood clotting factors. I may not use it, but it's for prep."

(If you transfuse my blood outside, you don't know what's going to happen...)

It was a real problem. Worst of all, it can shock you to death. Blood donations from Bruno cannot be used for palletizing, use the blood of non-blood related servants to avoid risks, as blood transfusions of blood relatives may cause the immune response of pallets.

"Uhm. Let's forgive them if we have their consent"

"Then, if chemotherapy didn't work or if it relapsed. You may have to do a hematopoietic stem cell transplant. The type of white blood cells on my father and brother were very rare but consistent with a 1% conformance rate. Also, Blanche is a match. So, if you're going to do a transplant, could you help me first, Father, and then Blanche?"

Father, the probability that the mother's leukocyte type matches that of Palle is unusual, but in aristocratic societies where it is not uncommon, such as inbreeding, the probability of matching is also higher for fathers and sons, Farma discusses. Blanche is only a child, so he is overburdened with blood sampling and wants to avoid being a donor if possible.

"Of course. I told you before that I would not spare my life for the development of medicine and the treatment of patients."

Bruno agrees thoughtfully. I'm glad Bruno is a man of understanding, Farma thinks. I always had spiritual support from Bruno.

"What percentage of your planned treatment is expected to be fully healed"

Ichika-chan. Bruno was prepared, wondering if it would be a few per cent.

Pharma does not cover it up, but communicates the findings as they are.

"If nothing unexpected happens at all and we go on as planned, I think we have a 80 to 90% chance of going into complete remission. Complete remission does not mean complete healing. Leukemia cells are reduced, symptoms disappear, and a normal life becomes possible."

"Ninety percent? Is that what you can expect!

"Yes. Unlike anti-cancer drugs, ATRA works on leukemic cells with sniping, not damaging other normal cells, it can be considered a breakthrough drug. But going into complete remission doesn't completely disappear without one leukemia cell. There's a chance of recurrence."

"That's hard..."

"It's difficult. I can't get my hands on this if I get bleeding in my brain or vital organs during dosing before then. I can't say for sure that we can control the condition… it's not an incurable disease."

It can be said that Pharma is not a doctor and has little clinical experience or knowledge. Based on his background in previous life, he had a stronger aspect as a pharmacist and was better at drug discovery than treatment. So there are some parts of the fine disease that we don't know, and some parts that we have to confront exploration and exploration.

Cancer treatment is not alarming and never optimistic. I have no experience with drugs.

Tighten your mind and hit treatment with your whole body.

"The cooperation of the whole family is essential. You have to be gutsy and treat your brother, who will lose his immunity, so that he doesn't suffer from infection."

"Oh, okay. Let's go for a complete remission of Pallet for the whole family."

Bruno said.

When he resigned from his father's room and Pharma tried to return to his room, Palle left his room and it was there that he stole the servant's eyes and saw the scene heading to a place in the residence of the de Medicis family.

(Brother? Where the hell are you going?

Pharma cares, and I'll take care of it. Ease comes from the way you care about your eyes.

It was the chapel at the corner of the mansion where he went in. There rests the statue of the patron saint. I can't go to the temple because they say no going out, so I seem to pray to the drug god in the chapel of my house.

(You're really faith enthusiastic...... brother. I'm afraid so)

Pharma followed Palais as he entered the chapel.

Palle knelt before the statue of the god of medicine.

Pharma passed softly behind him, who closed his eyes and prayed, hiding directly behind the statue of the god of medicine. I hear prayers.

"Patron god, medicine god. Why... do you make me look like this... did you not have enough of my faith in the drug god, my body was powerless and I stopped hearing about it day after day, it makes it harder for me to breathe, and does my brother's medicine really work? The more I listen, the less I think..."

When Pharma heard Palais's thoughtful words, he learned that Palais was only sifting to his temperament in front of his family, but that he was feeling quite sick and painful.

Cancer treatment will not work if the patient gives up living. Pharma devised how he could cheer up Palle. And

(I'm not the one who can inspire my brother... he has to be the drug god)

Pharma touches the god statue while hiding behind the god statue of medicine. As soon as his hand touches him, the statue glows blue and white and reacts. The statue of the god, made of the same material as the sculpture of the temple, reacted to the signs of Pharma.

Palle jumped up because the meds in front of him God's statue suddenly began to glow.

"Become!?

Farma, who watched such a pallet from behind the statue of God, created a substance of sulphur fluoride 6 in it with both hands round, mixing it with 20% oxygen and inhaling it slowly together.

And speak to Palle in a relaxed tone.

"Palle......, can you hear me"

A low voice of majesty emanated from the statue of a deserted chapel.

Palais, who felt like the idol had spoken, looked up at the idol in surprise.

"Ko, this is...... medicine god!?

I've always seen you.

Pallet rubbed his head against the floor. 6 When he inhaled sulphur fluoride and spoke out, his voice would be low. the opposite of helium gas.

"I know there is no mistake in what God, the patron saint, does, but why did you give the angel to my brother, not to me? What is this trial for..."

Even I wanted to be enlightened, like my brother, and Palle swallowed the words.

Thou shalt not be able to heal. Overcome the illness, survive it, and become an excellent medicine... '

Before he could finish hearing everything, Palle lost consciousness trying to wake up. Pharma came out from behind the statue and supported Palle.

"orthostatic hypotension?"

Pharma guided himself to Palle.

The next time Palle woke up, it was morning. He wakes up flattered on the bed.

"Was it a dream...?

Palle dropped his shoulder disappointingly.

"Hmm?"

But the fact that it was not a dream could be confirmed by a blue bruise on both knees that would have been done when I knelt in the chapel.

"Medicine God came to my dreams too...?

Pallet felt the twitching and emotion creeping up.

"Ha, right!

Palle noticed in retrospect of the heavenly revelations. The mysterious medicine God's revelation, the meaning of the words "Thy healing cannot be done by thee". Sure, neither injection nor blood sampling can be done to my own arm. Patients with this disease cannot be treated on their own. So I am trying to give Pharma a heavenly revelation and put him on healing for Palle.

"To bail me out...... so give Pharma, not me, an enlightenment!? Is that what happened?"

Let's try not to give up just a little bit more, for the sake of shelter and encouragement from the patron saint. That's what I reconsidered. It was Palle.

"How are you feeling today?

Pharma came the afternoon of the second day of illness, preparing anticancer drugs and injections for Palais.

"I don't feel bad about it. But I don't even feel better."

"I saw the results of the morning blood draw. Little by little, the number of leukemic cells is starting to decrease. Induction of differentiation of leukemic cells by ATRA is beginning to work properly"

Pharma encouraged Palais.

"Big brother. - How are you? You want me to be able to train you in divine arts?

Blanche also came to the Palais room wearing a hat on his mask and apron, disinfecting his fingers, applying infection control and accompanying Pharma.

"I'm sorry I can't enjoy you guys."

Palais speaks of strength, but there is no tension in that voice.

"Starting today, start administering the anti-cancer agent Idarubicin additionally. Beat it because some of the leukemic cells may be resistant to ATRA. Unlike ATRA, a molecular-targeting therapeutic, anti-cancer agents are cytotoxic. So we kill leukemic cells, we kill normal cells."

"Kill normal cells...... you say?

"There may be side effects, be prepared for that"

After administration, side effects that appear in a few days are nausea, vomiting, stomatitis, bone marrow suppression, hair loss, etc, Pharma says. When it comes to side effects, it doesn't all come out, depending on the condition of the individual's body. Some people are perfectly fine, some suffer, Farma tells them. All told of the risks, Palle sighs.

"You're a strong drug... but does that work? I can't believe there's such a drug in this world."

Although Palle agreed that she would be treated, she leaned down as if she was disgusted.

"Oh. Then rest and don't leave this mansion during the administration of anticancer drugs starting now"

"You've been in jail for a long time?

"No, not all the time, but at dosing. From now on, hematopoiesis is suppressed by anti-cancer agents. In other words, the decrease in white blood cells makes it easier to infect all pathogens. I kept the whole mansion clean, so it's relatively safe inside."

"Clean inside the mansion...? How."

During Palle's bedtime, Pharma was developing an epidemic sanctuary with a medicinal scepter. Bacteria in the air, a divine technique that kills viruses. This is why the de Medicis family turned it into a giant sterile ward.

"How did you kill the entire pathogen of the mansion?

"No, the..."

Pharma teased me to explain next time.

"Anyway, well, it's safe in the mansion. When you really want to go out, go out with me."

(The sanctuary around me is supposed to kill bacteria and viruses in the air)

Pharma, who unfolds the sanctuary unconsciously, is like a walking sterile chamber.

"Why with you?

"Oh, no, I'll escort you because you shouldn't change suddenly"

"Don't take care of me..."

Palle said smudged.

"Not only my little brother, but I'm sure he'll take care of me, too, right?

Blanche pinched his mouth from the side.

"Oh, you, too."

Palle stroked Blanche's head. Eh, and Blanche strains his chest.

"Don't say it smells like water, we're family. It's each other. Brother, if I get sick, please."

"Oh, let it be. Even so, it hurts the last two years that I can't do anything as a pharmacist..."

"My brother's smart, so I can get it right back. Plus, it's not like you can't even go out because you repeat your medication and rest."

"Pharma. While under house arrest on treatment, I'm free"

"Ellen said she was coming to see you and see you. Why don't we play a game?

Farma has pharmacy business, so it looks like Ellen will accompany Palle some days during the day.

"Let me read your pharmaceutical books in my spare time."

"Okay, read it. Because I write more and more."

If studying pharmacy is to inspire Palais, Pharma thought to hurry and write the text.

"But there's only one good thing about getting this disease. Now we know the suffering of people with difficulty who could not learn from any kind of training."

Pharma was shocked to see if there was such a way of thinking.

Palle was completely, regaining his positivity before he could.

"Not every pharmacist can be a patient."

That's what I told him. Palle had a good smile. That's dazzling, Farma thinks.

"I study everything."

"Let's work together, brother"

Pharma began to sleep in the Palais room alternating with Bruno.

To cope with a sudden change. It was on day 4 of remission induction therapy with ATRA in combination with an anti-cancer agent.

In the middle of the night, Pharma woke up with a bad feeling.

Running over to Palais, something's wrong with her breathing. Palle was just groaning painfully.

"Brother!

Soon after I get lost, I use the eye exam.

In both lungs of the pallet, I saw light.

(You're out...!

The side effects of ATRA (all-transformed retinoic acid) occurred. As Palle was concerned, large amounts of leukocytes differentiated simultaneously from leukemic cells by ATRA may cause blood vessels in the lungs.

That caused lung bleeding.

Lung bleeding can be difficult to breathe and fatal.

Pharma put her hand on Palle's mouth.

"" Oxygen synthesis ""

Feed oxygen into your lungs to help you breathe. At the same time, start steroid pulse therapy to reduce inflammation caused by leukocytes by urgently administering large doses of steroids in pallets prepared for side effects.

Pharma has become horrified while he has only been treated alone.

(If the bleeding doesn't subside... death?

I might lose my precious family.

The color of light on Palle's lungs is purple.

It was the color of wandering on the boundary of life and death. Gradually, the light becomes reddish.

To call Bruno, I rang the handbell I had left on my pillow. We need manpower.

"Don't turn red! Live...!

Pharma screams at Palais.

Under his hand, it was as if he could hear one life to follow.