Since the consultation began, Garrett Nordmark had been pondering incessantly on how to treat the condition.
Through questioning, physical examination, auscultation, and two magical scans of X-rays and ultrasonography, the diagnosis had become clear: mechanical intestinal obstruction caused by roundworms, incomplete but chronic—had it been acute, the young lady wouldn’t have lasted this long.
Normally, such cases fell under gastroenterology; even in the emergency department, it would be handled by internal medicine. Only when complications like strangulation, perforation, or necrosis arose, one would be rushed to the surgical emergency department.
But why hadn’t they acted sooner?
Nevertheless, in this alternate world, there were no IV fluids, no tubes, no medicines. Garrett Nordmark assessed the severity of the intestinal obstruction in his mind, analyzing possible outcomes and complications, then turned to Elder Wood:
"Elder, what approach would you take?"
"I... am uncertain." Elder Wood frowned, pondering for a while before shaking his head.
The cause of the young lady’s abdominal distension lay in something sinister within her belly—the chaotic life signals Garrett had noted earlier. If it were up to him, he’d employ divine magic alongside medication to eradicate these threats, then ease her pain, provide warmth, and massage her abdomen to aid expulsion. But with her belly so distended...
After a moment’s thought, he continued shaking his head:
Iris Meinlan grew paler as she listened. Gone was the flush from Garrett’s touch, replaced by sheer dread. Clutching the sleeve of the female knight’s garment, she shook her head desperately:
"Sister, I don’t want to die—I don’t want to die, waaah..."
Seraina whispered soothingly as she held her. The old mage glanced at his daughter, then at Elder Wood, troubled and uncertain, pinning his hopes on Garrett:
Garrett already had a plan formulated. After hearing Elder Wood’s strategy, he made some local adjustments. Opening his notebook, he quickly sketched an anatomical diagram of the abdomen and began to explain:
"Elder, Master Tolga, take a look. The young lady’s condition is mainly due to many worms entangled in clusters, blocking here—"
He marked a few dark spots on the lower part of the ileum:
"Mostly in this area, not entirely obstructed, but severe nonetheless. If I were treating her, I’d start with gastric and intestinal decompression and lavage—extracting some stomach contents from both ends to create space in the intestines, then using divine magic to eliminate the worms.
Elder Wood mentioned using divine magic with medication to kill the worms, which is correct. However, there’s a risk of divine magic deviating slightly or medication doses being too high and harming the intestines."
"Hmm..." Elder Wood pondered. "It’s possible. Please continue."
"Previously, when we couldn’t see the blockage through her abdomen, divine magic might have veered off course. But with [Detection Magic] now available, could we pinpoint the treatment location with magical guidance to minimize intestinal damage?"
"It’s possible!" Elder Wood brightened at the idea. Garrett turned to the old mage:
"Her distended belly indicates the severity inside. Like balloons, her intestines are stretched thin. After divine magic treatment, if the worms gather, struggle, or move randomly, they could easily burst or compress the intestines, leading to ischemia and death. If I encounter this, I’d have to open her abdomen, remove the blockage, and repair her intestines. In worst-case scenarios, a portion of the intestine may need removal..."
"Wouldn’t that kill her?!" Master Tolga blurted. Garrett shook his head:
"As long as divine magic eases her pain and she feels no pain during the procedure, I’m 70% confident I can save her."
"Just 70%?" The old mage looked disappointed. "What about the other 30%?!"
Still, 30% remained... Garrett fell silent, then pulled out another piece of paper: "Hold on..."
Scratch scratch scratch, scratch scratch scratch scratch scratch. Informed consent for intestinal obstruction surgery... He wrote, replacing medical jargon with layman’s terms. The risks alone took up a good twenty or thirty lines:
During surgery, anatomical changes may alter the procedure;
Injury to nerves, blood vessels, and nearby organs;
Postoperative complications like peritonitis, abscesses;
Heart issues like arrhythmias, heart attacks, failure, sudden cardiac arrest...
After filling the paper, Master Tolga’s face darkened upon receiving it:
"So... many risks?" He shook the form, almost wanting to stick it to Garrett’s face:
"All this from opening her abdomen?"
"It implies these are possible outcomes." Garrett patiently explained, as he had done countless times in his past life:
"Read it carefully, ask if you have any questions. If you understand and accept, sign here. No signature, no surgery, but rest assured, I’ll assist Elder Wood in preliminary treatment."
The old mage gripped the form tightly, his fingers digging in. He glanced around, at his daughter’s pale face, then Elder Wood’s furrowed brow, and finally sighed:
"Let’s treat her first! Signing can wait until abdominal surgery is necessary!"
Elder Wood rose with his oak staff, turning to Garrett:
"You mentioned... gastric and intestinal decompression. How’s that done?"
Garrett gave an awkward smile.
In his previous life, it was simply inserting a gastric tube and suctioning. But in this world, no such devices existed.
"That... Elder, Master Tolga, we might need your divine magic and magic to help with that..."