Parallel World Pharmacy

"Then we'll start the conference."

A surgical course for medical dean Claude Shoreak, and a pre-operative conference for several under the Pharma de Medicis gateway, dean of general medicine, began. Until now, although a case review meeting between doctors and medical students has been held in medical school, cooperation beyond the postgraduate level is the first.

Even in his previous life, Pharma had only a few experiences attending joint conferences with doctors, such as post-graduate clinical training, and his affiliation with university hospitals. So I only speak minimally and leave the progress of the conference to Claude's traditional methods.

"This case is an 18-year-old female, 5.3 canes tall and 40 cups bodyweight. The main complaints are cognitive, memory impairment, elevated irritability, history, family history unknown, no abnormalities in limbs and trunk, no metabolic or mental illness, mild numbness and walking disorders"

Claude begins presenting the case as he writes on the blackboard. Claude is not a general unit within the Empire, but uses the international units prescribed by the Holy Nation, as he goes to many doctors and pharmacists.

Incidentally, a wand is a unit of length based on a divine wand, with a wand of about 30 cm. A unit of weight also exists a "cup" derived from the weight of the Holy Grail.

After Claude explains the basic information, Pharma continues.

"The theological examination was performed by me using fluoroscopic theology, which predicted tumor formation of 0.1 cane or less on the right frontal lobe. The contours of the tumor were relatively clear and the area could be identified. At the same time, we did a grasp of vascular travel and wrote up local images of the peripheral blood vessels, the dominant areas of blood circulation, as shown in this figure. There are no findings to note in the blood tests entrusted to the Department of Laboratory Studies. Microscopically, microscopically, high density of tumor tissue resulted from the addition of small incisions and a targeted biopsy of the tumor, with cell nuclei of varying size, chromatin aggregation, and polynuclei and meganuclei, as well as necrotic layers. Genetic testing suggested mutations in p53, CDKN2A deficiency, EGFR amplification, and MAPK pathway. Immunohistochemical tests showed a tumor-specific marker (MIB-1) expression rate of 19%. It is the most malignant fourth stage glioblastoma among gliomas as a preoperative diagnosis from clinical course, theological findings, and pathological findings, and is considered to require rapid surgical treatment."

Hearing Pharma's explanation, there was a lady softly weeping in the front row.

It's Françoise de Savoie, Natalie Blondel's fruitful mother and court pharmacist.

Ellen also sits at the rear of the line.

"There were no findings considered dangerous as preoperative assessments of patients during the perioperative period. I will explain the pathway for the opening procedure and approach."

Once again Claude illustrates the procedure and continues the explanation. In addition to the theological ceremonies that Claude has developed so far in collaboration with the University of Medicine at Novarut, a standard method of initiation has been adopted, almost on Earth, which combines advice from Pharma.

"Above, glioblastoma suspected, an intracranial tumor resection will be performed on this patient beginning March 10. Please discuss this case."

So it was Bridget Le Noir who raised his hands with a refreshing look.

He is an Associate Professor of Surgery, a first-degree physician from Novarut Medical University, and is still the female physician of the youngest Claude disciples. This girlfriend is cheerful and priceless, but the surgery is extraordinarily good, and the fat is on board.

She wears the white coat introduced this year like a gown.

As Claude, the medical director, was also the chief samurai physician, he was basically a nominee for Claude, who resided in the palace and had assigned several lectures to Bridget.

Continental doctors are also rated primary, secondary and tertiary in the same way as pharmacists.

In this world, physicians are all surgeons, whatever the difference in specialty, who perform surgery.

The School of Medicine is surgical only and includes a wide range of practice disciplines including general surgery, orthopedics and brain surgery.

The first degree doctor is an aristocratic doctor who takes the doctor god as his patron saint. He serves the royal nobility of every nation because he has the protection of the medical god and is rare. The number of people is small.

Secondary doctors are aristocratic doctors of other attributes. Mainly treat, amputate and resect injuries and diseases. Active as a military doctor during the war.

The tertiary physician is also a civilian physician and barber who extracts teeth, bleeds, removes swelling, and belongs to the barber surgery guild.

By the way, this time, the civilian population is undereducated and not one of them is enrolled in medical school. Only aristocratic medical students will be enrolled in the Saint-Fluve Imperial School of Medicine this fiscal year. This contrasted with the Faculty of Pharmacy.

In that context, Bridget just gives Pharma a go.

"Did you say clairvoyant theology? Did you go to a brain biopsy, an invasive test, just to predict clairvoyant theology? That's no different from traditional divination."

"You're right."

Pharma responds instantly.

"I see you feel so confident in the arms of divine art. You are the one who went up to the head court pharmacist at that young age, so we know that you are a very talented man of divinity. But the chronic mind does not benefit the patient. Sometimes the diagnosis didn't work, did it?

"There is no confirmation that there has been an error in the previous diagnosis and treatment"

Pharma has a predictive cheat capability at Claude's place called the Eye Examination Eye, but only God knows if the Eye Examination Eye Results were correct.

Based on the name of the disease, the prescribed medication, which I thought would be indicated from the pharmacist's point of view, worked. His knowledge was based on the best on earth, but he was sometimes unable to control his pathophysiology.

I just have that fact. Then Bridget gave a sweet voice, "Heh..." I didn't always like it, I guess I tried to do a young dean.

"Such an irresponsible thing would make me frightened."

"Keep your mouth shut, Mr. Bridget. We're not just medics, we're medical theologians. What's wrong with using divine art to provide the best medical care? Besides, the biopsy I did showed that the tumor actually existed."

Claude's defense went in. Claude, who has a doctor god in his patron saint, also uses some divine arts during surgery.

"As a result theory, that might have been correct. But theology is influenced by the skill of the surgeon. What's the point of divine art that can only be used by one person around the world? Didn't Dean de Medicis want to carry out health care reform so that even civilian doctors and pharmacists could diagnose and treat them so that they didn't have to rely on divine arts?"

Deviations and things, but Farma thought her opinion was the best.

"You're right. But this divinity is something I've learned by chance, and it's not easy to pass on."

"Then it's just a solitary craftsmanship."

Bridget revealed her discomfort. Pharma's eyes shine sharply, as if he had anticipated it.

"So I think I can show you something close to it"

Pharma simultaneously removed the mess and the glassware from the bag and a single photograph.

It was a Lentgen photograph of the bones of a person's hand, called an X-ray tube.

"This is an electromagnetic radiation launcher, and this is a picture of its emitted electromagnetic radiation passing through the human body and detecting it. Teachers have been listening to my lectures, so now you know who they are, even when it comes to electromagnetic radiation, and you know how it looks."

A photograph of Farma handing it to the participants in the front row circles the meeting room.

Bridget rounded her eyes and took the picture from Pharma, and Claude said, "Wonderful!," he applauded with exaggerated action. Bridget asks questions half-heartedly.

"If we improve this, we'll be able to diagnose it even if we don't have clairvoyant divinity?

"Just as Dr. Le Noir said. It doesn't make sense unless it's a technology that can be used by everyone, so I'm preparing a prototype device. I just can't wait for the time it takes to develop it right now, so I'm going to take care of it with divine art this time."

"Don't do it, Professor Kid!

Bridget whistles all the time.

"I might not stop. Le Noir, you have a bad mouth. Professor de Medicis, if you'll excuse me, I'll tell you later."

Claude stands around like Bridget's guardian. My hands rose from the other doctors.

"Clairvoyant photography is groundbreaking and we look forward to technological development. to go back to considering the procedure, is that a success story?"

"I don't have any experience in humans, but in the experiments we've been doing in medium-sized animals since last week, eight out of ten cases are surviving a week without a divine drug."

Claude was preparing for the opening surgery in a week, with a burning blade.

Pharma thinks it's reliable.

"May I?"

Now the question from Françoise.

When it comes to my son's surgery, it would be kind of you to want to reveal any questions. Pharma and Claude finally gave Francoise and Natalie glioblastoma notice a few days ago to agree to surgery and treatment. They both looked like they couldn't hide the shock, but it made me belly up that there was nothing else to focus on. Françoise is also scheduled to participate in the treatment as one of the pharmacists.

"Thank you so much for putting together such a massive and challenging system to perform the surgery for my daughter this time. Thank you, teachers, for your patience."

Françoise expressed gratitude by holding an on-the-spot meeting for a few seconds.

"There are two questions, divine drugs have appeared in the drug management of perioperative pharmacists, but it is my first ear that those two divine drugs exist, and I am afraid that you will use precious divine drug resources. I heard that Divine Medicine breaks down quickly, but how could the Temple have been kept stable for hundreds of years? Will it also not interact with the existing medicines used by Professor de Medicis"

"Answer the question. I cannot tell you from my mouth that the details of the Divine Medicine will be classified by the Holy Nation, but I can only procure a small quantity that has no problems with quality, but only this time. Prior evaluation and confirmation of the existence of interactions between divine drugs and drugs is done through literature and theological analysis."

It's a painful valve, but Farma's not lying.

I had no idea I was going to formulate it, the doctors and pharmacists on this occasion would never dream of it. Ellen looked like she was in trouble and glanced at Pharma. Only she knows the truth on this occasion.

"Is it possible to disclose the composition, etc. because it involves the confidentiality of the Holy Nation? What do you do when you don't have access to God's medicine?"

Bridget strikes after Pharma, who has shown a gap. I can't even disclose it, but there's no point in disclosing what only Pharma can make. So Pharma said:

"Surgery is possible without divine drugs, the success rate may not change either. but this is my first brain tumor removal procedure, which I will use in case of unforeseen circumstances."

"If God's medicine is available, it's decided that you should use it every time, but what about it, actually?

"Naturally, the Divine Medicine resources created by the patron saint are limited, but"

Pharma has not dared correct the misunderstanding, but Bridget and others do not know the current state of Pharma, so they misunderstand that the divine drug being procured this time was made by the past drug God.

But Pharma takes the misconception backwards.

"Consuming that limited amount of divine medicine quickly bottoms out and medical technology is not popular. I think it would be best to establish a technique that combines with or does not rely on general purpose divinity that can be used for any use of divinity."

"Indeed."

"I can't help it."

The doctors and pharmacists agreed with each other. The truth is that we have to.

"As a pharmacist, what can I help you with during surgery?

The Pharmacists asked me a question.

"Ask the pharmacist joining the surgical team for medicinal management during the perioperative period. These include the management of medicines such as anesthetics, temperature control, intraoperative preparations and the proper use of postoperative analgesics. For more information, we will speak at tomorrow's departmental meeting. I know this is going to be a challenging surgery, but let's do our best to save her life. If there are no further questions, we will now close the meeting."

Thus, while unable to dispel the anxiety, the Preoperative Joint Conference adjourned.

◆

At last that morning arrived.

I woke up in the hospital room. Natalie was blinded outside by opening the hospital room window. Outside the curtain, the sun rises over the sumptuous streets of Saint Fleuve, with bright colors.

Good morning, Natalie Blondell.

"The morning sun is beautiful. Professor."

Without turning around, Natalie responds to Pharma as she looks out the window.

Farma lined up next to Natalie at the window.

"Looks like it's going to be a beautiful day and tomorrow, spring is just around the corner"

"I'm going to burn it in my eyes just for today"

Natalie exposes herself inside her anxious chest to Pharma, who brought her preoperative medication.

"If you watch the sun so much, your eyes will burn. You should see it again tomorrow. Well, you were on a hunger strike because it was before surgery."

While talking to Natalie, Farma struggles from late at night to give her a divine drug that she has formulated with Bruno, and also uses sedatives.

This divine drug brings absolute coverage to her life today and for a few days.

Farma asks, watching as Natalie drinks up a glass of blue god medicine.

"Are you feeling any worse? The discomfort."

"No. My body is pounding, I feel calm"

Natalie slowly grated her chest.

As for the efficacy of divine drugs, they also have the effect of calming anxiety.

"That's good, stay positive."

"I need a favor from the professor. I can't give it to you directly because it makes my mother sad. If it doesn't work, can you keep this?"

Inside the little box Natalie handed to Farma, there were several letters in it.

They each have their nicknames on them, and it seems to be a suicide note addressed to their mothers, relatives, and friends.

When I came back, there was also the name of Pharma. The ink is seeping and I guess it's because of the tears. Farma did not hinder Natalie's feelings and received them with a mysterious face.

"Okay, then let's keep this. I want to give you something, too. I planted it last fall because it bloomed beautifully, so look at it."

Pharma decorated the hospital room window with a vial of Crocchus hydroponics with yellow flowers.

"Professor, did you grow ornamental flowers? It's surprising because there's an image of only growing herbs."

"Well, I'm not even a pharmacist in private. And look, I asked your mother if you liked flowers."

"Does this flower mean anything to you?

"I do."

Pharma cheers on, but doesn't specifically say it from his own mouth.

"Do you have one?"

"None of us, we don't know tomorrow. But you're not supposed to die today."

"... if you say so much, you can truly take the clarity"

"That's the intention. I'll see you in the OR room next time."

That's what Pharma said to cheer Natalie up, and when she hit a ton of cobwebs around her heart, she shook one hand flinchingly and left the hospital room.

Natalie was annoyed to see that strange gesture like a pantomime.

"You know what?"

She kind of went crazy and blew it out small and gently glanced at Crocus' petals with her fingers.

Natalie remembered Crocus' flower words.

Pharma said, "Trust me."

"Oh man, I hate it. I really hate it. What if I said something that important, with a proper mouth?

That's what Natalie said, but she was smiling during the bundle.

◆

Natalie Blondel's surgery was performed on March 10, 1148 at 9 a.m. at the Hospital Affiliated to the School of Medicine, Imperial Medical University of Saint Fluve. Because the operating room is glazed, many medical students come to visit with their notebooks and cameras. Adequate lighting was also ensured in this operating room to keep the hand bright, utilizing mirror reflections and light collection.

Furthermore, with regard to the hygiene of the operating room, it is nearer to sterility in advance due to the superimposition of the sanctuary of the epidemic and the purifying divine art of Claude.

Natalie Blondel takes two divine drugs created by Pharma, takes a supine position, and is fixed to tighten her head with three hardware. The scheduled incision site was shaved on the spot, the cranium was disinfected with popidone iodine followed by general anesthesia with rapid introduction with venous anesthetics with alcohol followed by marking of the frontal lobectomy line. Because intubation and inhalation anesthesia cannot be under-equipped, artificial respiration and inhalation anesthesia send gas sprayed with inhalation anesthetics inside the bag valve mask in time.

The combination and quantity of anesthesia is investigated beforehand by Pharma with a medical eye in mind, and management is performed by Pharma and a specialist physician in training as an anesthesiologist.

Honestly, including Pharma, anesthesia management experts are also equal to not being in this world. Therefore, he asked Ellen to help, who could use an eye exam as well as Pharma. She spent several days training Pharma so that her pulse, abnormal oxygen saturation, body temperature, respiratory count and all other vital abnormalities could be grasped. Since only EEG cannot be detected by the diagnostic eye, I was asked to remember the colour and area that changes due to pain stimulation and decided to apply an awakening level with it.

If you use the eye for a long time, she will wear out, so once every few minutes, have it permanently done in a way that instantaneously searches for anomalies.

Since all electronic medical devices used on modern Earth do not exist here, ask Ellen to report any significant life-threatening abnormalities to the patient before they occur.

It's an emergency if the whole body starts to change red as well as Blondell's head.

Prognostic predictions of the diagnostic eye vary from moment to moment. The decision that surgery can save lives can be overshadowed if it fails. Even if I used Divine Medicine to exalt a few days immortally, it would be the end of a roll if I had a prediction of dying afterwards, which is why I can't be distracted.

So the vital monitor trusts Ellen and leaves it entirely to Pharma to guide the tumor to Claude and turn to supporting the surgery by giving specific instructions.

I am not overconfident of my own abilities and cannot reach them without a division of labour.

"Now, the 18-year-old female site will undergo a right frontal lobe intracranial tumor removal. The scheduled surgery time is four hours. Best regards,"

When Claude declared so, he entered the scalp incision of the marked area.

Using Pharma's diagnostic eye to predict the surgical results for all surgeons, he said he was only likely to succeed with Claude's machete, so he had a hard time pulling down Associate Professor Bridget, who would bite him to let him do it, even if it was not, and turning him around to his assistant.

Claude has a female with crystal stone, which can turn the female into a small wand and become a theological output device. I guess you're controlling the bleeding with theology, placing the female at a right angle to the epidermis and gently and sharply incising. The scalp should have plenty of blood circulation, but it doesn't bleed surprisingly. Claude had explained beforehand that bleeding was only minimal because it was gently covered with a film of divine power to protect the wound.

Run with words. That's right, Farma was afraid.

Still, Bridget definitely boils the scalp clipping, scissors gauze on the wound edge and suspends the dura.

Claude continued to lift the incised skin valve to draw an arc, and used a detachment for the dura to make an incision of the muscle layer, which also finished surprisingly smoothly, the skull would then be placed into a bone cut. The doctors I was visiting brought sighs.

"That's the chief samurai."

"Hey, you're just getting started, don't tell me."

Claude had such an answer in his normal tone as the voice of praise rose. Though he whispers lightly, he keeps concentrating.

He takes it to the drill and perforates some small holes (barholes) in the bone surface, cutting them with a thread saw in between. Pre-perforated ones are also utilized during brain biopsy. Bridget prevents bone shards from splashing by administering saline as appropriate.

"Come on, let's go to the desired tumor, show me around."

While Pharma shows a transparent model of Blondel's head, he also takes care of the location of the blood vessels and navigates precisely where the tumor is. Claude incised brain parenchyma and white matter and approached the tumor on the scheduled route.

"This or... Sure, white matter and color are different. Tumors."

Peripheral detachment will be performed in females leaving the entire periphery of the tumor in a safe zone. Claude advancing incision of the right anterior frontal cortex follows Pharma's instructions. It was decided that surgery under awakening was a good idea to maximize function, but since the location of the tumor was not a language or exercise field, it did not have to be performed under awakening. Although Claude's divine technique allows the bleeding to be controlled, the bleeding point from the severed end is crushed by Bridget with coagulation hemostasis.

Claude took a breather when he finished the operation. While hydrating, Claude is calm himself, not a single sweat.

"All right, the extraction operation is over. Will this remove them all, Professor Farma? Look."

Farma peeks into the back of the excision chamber instead of Claude, who let his body go, and puts his finger in the excision chamber to make sure that there are no stiff tumors left.

"Yes, I'm pretty sure this is it. I was wondering if the removal rate was 99% certain. Then turn the resected tumor to a rapid diagnosis."

This time to search pathologically for tumors at the severed end. No pathologist yet, but a department with combined laboratory and pathology functions is up.

While awaiting rapid intraoperative diagnosis, Pharma uses an enlarged vision in addition to the diagnostic eye to check with care for tumor remnants. Look in detail, but the glowing part is nowhere.

I'll check with Ellen, just in case they think the extraction range is adequate. I'm thankful I can double check now.

Take it with one surgery without additional resection, aiming for root healing.

"How does Ellen look?

"I don't think there's any leftovers, there's no glowing areas, but I didn't use a microscope to look at them."

"There are limits to pursuing the remnants of a cell unit..."

Fifteen minutes later when he was waiting, he was informed of a decision by a specialist physician.

"The prospect is that there will be no tumor at the severed end. No additional resection required"

"Thank you"

All right, I'm just saying, Pharma answers.

"Carmustine biodegradable polymer substrates will be placed to prevent recurrence and administration of tumor-targeted radioactive antibodies will be performed"

"All right, let's just say we leave this phase to Professor de Medicis"

Pharma is in charge of this operation. Carmustine inhibits transcriptional replication of tumor DNA and suppresses tumor cell proliferation. Radioimmunoantibodies are the best antibodies for tumors that Pharma has found by thorough genetic examination of specimens in preoperative biopsies, radioactive materials that specifically bind to the tumor and radiate gamma rays that have furthermore been bound to the antibody, will kill tumor cells that may have been scattered throughout the brain.

"Okay. Close wound, close your head. We're going from the depths."

Claude sutures the dura and keeps it closed so that the medullary fluid does not leak with the fibrin paste provided by Pharma. It was a bloodless surgery, so Drain's detention doesn't seem necessary either. The bone pieces and bone margins were stitched together and fixed with thread, and the subcutaneous was carefully successively stitched from both ends of the skin cut, and the epidermis was also closed with a medical stapler.

"Exit. Good luck."

Ellen and Pharma check the general condition of Blondell with the diagnostic eye.

Taking over from Claude, Pharma transitions to post-operative management of anesthesia. Until she wakes up, for 20-30 minutes, she won't lose her mind. As for infection of the wound, you don't have to worry too much as long as Pharma is expanding the sanctuary, but be aware of the signs of infection.

"Total surgery time was 4 hours 41 minutes, bleeding volume was 50, good luck, everyone"

I missed Claude leaving the O.R., and Pharma said so and tightened, then breathed a softly relieved breath.

"Fortunately, your predictive abilities were accurate. Professor de Medicis"

Bridget put words on Pharma that she didn't know whether to be sarcastic or praiseworthy.

◆

Awakened from general anesthesia, Natalie noticed her mother and Pharma peering into her full view.

"Do you see me? Good luck with your surgery."

Françoise held Natalie's hand and Farma carefully watched how Natalie was doing for post-anesthesia awakening evaluation. The procedure around here was often unknown to Pharma, so it is helpful to have accurate materials available online.

"You took all the tumors. They let me pick up my life."

"Great...... thank you"

Natalie brought her head and thanked Pharma, who looked next to Françoise.

Pharma nodded with a light smile. Bringing her neck, she also saw Josephine in the hospital room with other doctors, pharmacists, and Emerich involved in her postoperative management. Natalie learns that she has completed the surgery with the help of many humans and repeats again.

When I heard that Natalie had awakened, Claude appeared slightly in the hospital room with her white coat woven over her surgical coat whether she had been called by a junior physician.

"Hey, I'm so relieved you woke up."

"Me too, gentlemen, thank you"

Natalie looked into each and every one of her eyes and bowed her head as she blurted and cried.

"I think it was a difficult surgery, I gave up half of it, not to wake up again"

"You should rest a little. Tell me when it hurts. I want you to let me know if you have any anxiety, because I'm on your side all the time today, and pain management is my responsibility and yours."

I blindfolded Natalie as Pharma stuck in words.

"Professor de Medicis"

"What?"

"I feel like I can live tomorrow because the crocus at the window looks a little pretty"

Natalie finally said that in a plundered voice.

"That's good. I'll give you a blue rose hung upside down in the spring."

"Now," make it impossible, "is it? I hate that kind of distraction from the professor."

"That sounds like a compliment."

She laughed when she saw Pharma unwind, relaxed and eventually began to rest calmly.