Chapter 206: Erunt Ducal Family's Secret (4)

The silence in the hospital room stretched on.

The Duke, Duke's Daughter Isolde, even the patient in the bed—

They were all looking at me as if I were insane.

It seemed they needed some time to process what I had said.

So, while waiting, I decided to rewind the story a little.

To roughly an hour before we arrived in this hospital room.

*

Time rewinds for a moment.

Right after the Duke's confession ended in the reception room, before heading to the North Wing to check on the patient.

The Duke asked for my understanding.

“Lord Saint, may I bring Isolde to the place where you will examine him?”

“That is for you to decide, Duke. But are you sure you want to reveal it right away?”

“This time, I want to respect my daughter's choice. Rather than mourning the dead for a lifetime, wouldn't caring for the living put her heart more at ease?”

“Then let's do that.”

It seemed the Duke thought I would not be able to cure the patient.

Divine power doesn't work, and it isn't Demon Disease.

No matter how much of a saint I am, he must think this is beyond me.

“Head Butler. Bring Isolde.”

“Understood, Master.”

The Duke immediately summoned his youngest daughter.

After the Head Butler ran off,

the Duke looked out the corridor window and added,

“Huu... I'm trembling.”

One of the Duke's feet twitched nervously.

Several minutes passed like that.

At last, this story's Juliet appeared.

I could tell at a glance that she was his youngest daughter.

Except for the dark circles under her eyes, she looked exactly like the girl in the reception room portrait.

“Master. I have brought the Young Lady.”

“Father. What did you call me for at this hour?”

The woman wore a navy dress.

It was too bright for mourning clothes, and too dark for banquet attire.

Even without knowing etiquette, one could tell at a glance that she had no intention of attending social gatherings.

“Isolde. There is somewhere we must go together.”

“At this hour of night?”

“It won't be far. We're going to the North Wing.”

“Yes? What business do you have there...?”

“There is something you need to know.”

With that curt answer, the Duke took the lead.

Isolde looked puzzled by her father's attitude, but silently followed behind him.

*

The place we arrived at was the front of a door in the North Wing.

Even before the door opened, a familiar smell drifted out.

'Rax smell.'

It was a smell you could catch in a cleanly maintained hospital room.

The Duke stopped in front of that door.

He placed his hand on the doorknob and turned to look at his daughter.

His lips moved faintly.

They worked busily, trying somehow to complete a single sentence.

But in the end, the sentence was never completed, and his lips closed again.

Instead, he turned the doorknob slightly and stepped aside.

“I'm sorry... that it has come to this.”

The sentence the Duke barely completed was an apology.

An apology for deceiving his daughter for ten years.

And an apology for not being able to tell her the truth himself until the very end.

Ironically, only the one receiving the apology did not know what it meant.

“......”

Isolde pushed open the door and entered.

Beyond her shoulder, the scene inside the room came into view.

A single bed in a spacious room. A single chair beside it.

The chair's backrest was worn smooth.

And on that bed lay a man, staring up at the ceiling.

“You've come, Head Butler.”

“......”

“Could you perhaps change my position for me? From this angle, I can't see Isolde's room window well.”

The man spoke toward the empty air without taking his eyes off the ceiling.

It seemed even moving his neck was uncomfortable.

The Duke's Daughter's gaze, upon entering the room, fixed on the man.

“Da...rian?”

“...That voice... It can't be.”

The man's eyes flew wide open.

And the first thing he said was—

The man closed his eyes.

Then, after a long while, he spoke seriously.

“Isolde. I am a ghost. Hearing a voice I missed, I lingered briefly in this world...”

“Do you think I would believe that?”

“...I was too flustered to think of a plausible excuse, Young Lady.”

Tears fell over Isolde's smiling face.

After that, Romeo and Juliet's time continued for several minutes.

— “You were alive. You were alive... No matter what, I'm so glad.”

— “It took ten years. Ten springs passed without you. Now I can make your scarf again.”

— “God. I'll do anything. If this is a dream, please don't let me wake. No, even if it is a dream, please let me have the same dream tomorrow.”

— “But wait. If it's ten years, that means there were 3,650 days to say something? Then until now, for whom did I spend all that time...?”

Isolde's reactions changed in real time.

First acceptance, then depression, next bargaining, and soon anger.

For a healer, there was no choice but to feel something off about that order.

I felt that way too, and so did the other healing arts student in this room.

“The five stages of grief? But if that's it, the order is reversed...?”

Jenny muttered to herself.

“Then in this case, should we call it the five stages of resurrection experience?”

Nice.

The five stages of resurrection.

I don't know if it has any clinical meaning, though.

“It's strange. It doesn't make sense. I went to the funeral. I saw the coffin. I threw dirt on the grave. But now this person is lying here breathing... What in the world...”

After Isolde finally entered the denial stage,

at last I had the chance to examine the patient.

As I approached the patient, I recalled the facts I had learned from the conversation earlier.

'First, confirm he cannot move his neck.'

The patient did not move his neck throughout the conversation.

More precisely, it was right to see it as couldn't.

'His speech wasn't slurred. His facial expression is fine too.'

If that's the case, it's more likely a problem with the neck nerves than the brain.

That alone greatly raises the treatment odds.

If it were a brain problem, there was a chance it would be something I couldn't handle.

Especially if it were Parkinson's or ALS, I would have had no answer.

For now, at least.

But this time, I could set aside that worry.

“Hello, Sir Darion.”

“It's Darian. But forgive me, who are you, Teacher...?”

“I am Yulian Nihilrit. The world undeservedly calls me the Black Saint.”

“A saint...?”

Darian's pupils moved busily.

Judging by his reaction, he must have kept up with outside news while lying in bed.

Did he read newspapers? Or did the Head Butler read them to him?

I wanted to ask out of curiosity, but that wasn't what I should be doing now.

“I was asked by the Duke to come treat Sir Darian.”

“You mean to treat me?”

“Yes. So from now on, please follow my instructions carefully.”

“Yes...”

I immediately began a neurological examination on the bewildered Darian.

First, I pricked various parts of his body with a needle.

“Do you feel this?”

“Yes. I feel it.”

“Then here?”

“That feels a bit dull.”

“How about below this?”

“I can barely feel it.”

For now, sensation cut off between the collarbone and nipple.

Next was the motor examination.

“Try shrugging your shoulders.”

“I can.”

“Try bending your elbow.”

“I can.”

“Try bending your wrist back.”

“I can.”

No. His wrist isn't moving.

Apparently he thinks his wrist is moving.

'Confirmed: there's no feedback.'

After that, I also performed various reflex tests.

DTR, Inverted Radial Reflex Test, Shimizu Test, jaw reflex... etc.

'Ugh. There's a hell of a lot to check.'

These were techniques I learned over the shoulders of the neurology people when I was in the emergency room.

Neurological diseases often can't be confirmed by imaging tests alone, so there are a huge number of physical examination items.

Anyway, after countless neurological examinations, a conclusion emerged.

'Shoulder, possible. Elbow, possible. Below wrist, all lost. Lower limbs, all lost.'

The boundary line is clear.

This made cervical spine damage—specifically damage between C5 and C7—highly likely.

'Considering divine power doesn't work, disc herniation is possible too, but...'

I considered cervical disc herniation as well.

But the odds were low.

Cervical disc herniation can cause quadriplegia, but it rarely leads to quadriplegia this severe.

Not zero, but you could say it converges on almost zero.

In a situation where other diseases remained, it was not an attractive diagnostic candidate.

'It isn't Demon Disease either. Then with high probability it's a mechanical problem... So it is that after all.'

After giving a provisional diagnosis, I instructed Jenny.

“Miss Jenny. Please use clairvoyance on the neck bones from this direction. Yes. Left to right is correct.”

“Understood. Since you said to focus on the bones...”

Jenny placed the black board against one side of the patient's face and began sending divine power from the opposite side.

“Purification.”

A white image in the shape of the patient's bones began to appear on the black board.

The Erunt Duke and his daughter watched as if it were wondrous.

“So the pre-painted ink on the black board is erased to draw the image. You're using the fact that divine power is absorbed at different rates by different tissues to perform clairvoyance.”

“I heard Meyer Infirmary's healing techniques were on another level, but I didn't expect it to be this much.”

Thus, with the two people's admiration as background music, I waited for the result.

“The result is out, Professor.”

“Thank you, Miss Jenny.”

I took the result sheet she held out.

The result was as expected.

There was a problem with the neck bones.

And a very big problem at that.

'...Honestly, I'd been roughly guessing even before the physical exam.'

Just looking at the patient's outward appearance gave me a rough answer.

His neck was a little shortened, and there was a slight protrusion that couldn't quite be called an Adam's apple.

The moment I saw that, I thought there was a problem with his neck bones.

The problem was, I just couldn't believe it.

'How is he alive?'

Before the test, I'd considered other possibilities, but now there were no options left.

In the end, I set my course that way and asked one last question about the patient's past.

“Sir Darian. Have you ever received an impact to your neck or head in a subjugation before you collapsed?”

“No. I returned from that subjugation without a single wound.”

“Not wounded—were you ever hit by an attack? Including ones you blocked.”

“Including... ones I blocked?”

Darian's gaze rose into the air.

The gaze that had been retracing old memories soon stopped.

“A Mantis-type Demonic Beast... once attacked my neck.”

“Specifically, how were you hit?”

“A scythe flew over the trees. Aimed at my neck.”

Gasp!

Isolde, who had been listening nearby, swallowed her breath.

As if soothing her, Darian quickly added an explanation.

“Fortunately, I blocked it with Fighting Aura in time. At the time, it ended with just bruises.”

“So that's the cause.”

“Yes?”

Darian's pupils wavered.

“But that happened a year before I began to collapse. Isn't that incident too long ago?”

“Yes. Rather, it was precisely the passage of one year that produced this result.”

“What do you mean by that...?”

Where should I begin explaining?

After organizing my thoughts for a moment, I called the Duke's people.

It was to tell them the result now.

“Duke. I have identified Patient Darian's illness.”

“What illness is it?”

“The patient's neck is currently severed inside. A kind of... it is no different from a beheaded state.”

“What do you mean? Can you explain in more detail?”

I nodded.

If I said he was alive while beheaded, anyone would be bewildered.

I felt the same amazement right now.

“Eleven years ago, Sir Darian's neck was attacked by a Mantis-type Demonic Beast in the Demonic Realm.”

First, the beginning of the case must go back not ten years, but eleven.

People were focusing on ten years ago, when the symptoms began.

The true cause was one year before that.

“Fortunately, Sir Darian wrapped himself in Fighting Aura in time, so it ended with bruises. Thus Sir Darian was left to recover naturally without treatment.”

Eleven years ago, divine power was precious.

It would have been a waste to use Heal for mere bruises.

The problem was that the visible wound was not everything.

“But because of that attack, Sir Darian's neck bones became quite unstable. They probably had small cracks or torn ligaments.”

At the time, neither neurological examinations nor clairvoyance divine magic had been developed.

Even now, there aren't very many healers capable of this.

So people must have treated those bruises as trivial.

Just bruises—they must have thought time would solve it.

“After that, Sir Darian would have lived no differently than usual. He would have walked around as usual, done rough exercise, worn a heavy helmet on his head, and ridden horses.”

Then he went out on subjugations, fought, and took some headbutts.

The damage would have accumulated slowly like that.

Without the cracked bone ever getting time to recover.

And the moment that damage crossed the threshold.

“Then at some point, the neck bones could no longer bear the weight and collapsed. That is the cause of the paralysis that began ten years ago.”

Snap! The neck bone would have broken and dropped.

Is this possible?

Except for a neck bone breaking and dropping, this kind of thing is surprisingly common.

Living without even knowing a neck bone is cracked, then suddenly it blows up years later.

That's why, after a traffic accident, even without symptoms, they take a CT first.

Because you can have no symptoms and then suddenly go years later.

Then, the Duke, who had been listening to the explanation, raised a question.

“But I don't understand. If the bone was cracked, couldn't Divine Magic heal it?”

“It could. If it were the acute stage.”

If it had been immediately after being struck by the mantis's scythe, Greater Heal could have handled it.

Surprisingly, Divine Magic's judgment is lenient.

Slight misalignments receive some correction.

But if it progressed slowly over a year, it's a bit different.

“As I explained, it is an illness that progressed quietly over one year. Inside, the two neck bones would have remained misaligned, repeatedly rubbing and healing.”

To explain in more detail,

erosion and remodeling of the abnormally contacting bone surfaces progressed; this caused bone spurs and callus formation, deformation of the endplate and vertebral body, and eventually a malunion formed in a crushed, interlocked shape.

However, since most healers wouldn't understand even if I explained this, I used another metaphor.

“Think of it as candles. If you tilt two candles against each other, the wax runs down and they stick together.”

This patient's bones are in that state.

Malunion.

The neck bones, having repeated fracture and recovery over many years, are stuck together.

“Because the two bones became stuck together in a misaligned position, Divine Magic was useless.”

Rather, it was like blowing on stuck candle wax to make it cool faster.

“And that is the result.”

I showed the bone image to the father and daughter.

If it were a normal illness, someone without medical knowledge would have difficulty recognizing it.

But this image didn't require such consideration.

It was clear enough that even a layperson could tell what the problem was.

“This is...”

The Duke, understanding what the image meant, lost his words.

I know how he feels.

He must be wondering how this is alive.

I felt the same when I saw this patient's Adam's apple protruding.

Wondering why this was alive.

'Is he sturdy because he's a superhuman? Or is he just lucky?'

In theory, at least, he can be alive.

As long as the blood vessels and nerves are intact, the rest of the structures can be however they are.

Still, there should be limits, no?

How can this be alive?

The more I thought, the more amazing it was, and my eyes kept drifting to the result sheet.

Then, the Duke carefully told me what he had understood.

“Then, should I take it that his neck is severed and has collapsed?”

“You may see it that way.”

The Duke bit his lip.

“Then that means there is no hope.”

“...Sniff.”

At the Duke's declaration, Isolde burst into the tears she had been holding back and collapsed.

“Then... then. There's no hope, is there. If his neck is severed, how can a person... how can that...”

While watching the two people's reactions, the one who was flustered was me.

I hadn't even spoken about the prognosis yet, so why this reaction?

If his neck was severed and he was already dead, that reaction would make sense.

But he's alive and well right now.

Then now we just need to treat him, don't we?

“...Um, Duke's Daughter? I haven't finished explaining yet.”

“I'm sorry, Lord Saint. Give me a moment to collect myself...”

“That's not it—I was trying to say that since his neck is severed, we just need to reattach it.”

“...Yes?”

No, let's think about this common-sensically.

By my previous life's standards, this condition is indeed serious.

Human recovery has limits, and therefore humans cannot return to how they were before injury.

That's also why most severe trauma, including spinal damage, has such a poor prognosis.

But this world is different.

In a kind world where you can recover if you cut out your intestines well enough, there's no reason to create a funeral atmosphere over a slightly misaligned neck bone.

“B-But his neck is severed... How can you operate on his head?”

“?”

Is he asking me?

Me, someone who opens skulls like eating meals?

“Duke, how much do you know about surgery?”

“I know from news from the central region. I heard it is a technique that expands existing healing magic, which excises the injured area, to the torso.”

That's not wrong...

Then suddenly, I felt a sense of unease in the conversation.

'Could it be?'

To identify the source of that unease, I questioned the Duke.

“Duke. Have you ever heard of a craniotomy?”

“Craniotomy? What is that?”

“Then have you heard of jaw reconstruction surgery or bowel anastomosis?”

“Forgive me, Lord Saint.”

The Duke raised his hand and stopped me.

“I am a mage, not a healer. As a commander, I have minimal background knowledge, but I don't know the details. And this is the South. News is slow compared to the center.”

I see.

Only then did I realize the source of the unease.

The South does not yet know the high point of surgery.

Thinking about it, it was natural.

Medicine is fast to distribute, and using it doesn't require very high proficiency.

Once made, you put it in a box and load it on a carriage, and that's it.

Of course, dosage adjustment is also a skill.

But that's something healers can learn without coming to me specifically.

But surgery is different.

Surgery is not a skill you can learn by reading one book.

To produce one skilled surgeon, one must learn directly from a teacher.

And currently in the Empire, the only place producing those surgery specialist healers is Meyer Infirmary.

The healers who came from there are active in the center, and those who learned from them again are spreading in the center, but

for that wave to leave the center and reach other regions would take years.

'It seems the Duke family's healers were unable to show the high point of surgery.'

The corner of my mouth twitched.

It was a sensation I had forgotten.

Lately, the reactions around me have been too boring.

Even when I succeeded in surgery, people only reacted with, 'Ah, there is such a surgery. As expected of the Saint.'

Was it because they were so used to the surgeries I showed?

They no longer seemed surprised by opening skulls.

'Anyway, the central people's brains are too soaked in dopamine.'

For me, it was regrettable.

Responding to the expectations of people who believe in me is satisfying, but

overturning the expectations of people who doubt me also has its own sense of accomplishment.

But in the center, I rarely got to taste that accomplishment.

So it was a sensation I had forgotten...

'Should I do a little dramatization after a long time?'

The people of the southern Ducal Family had awakened that sensation after a long while.

I spoke to the stunned people.

“May I now tell you the treatment plan?”

“Tell me... please.”

“The patient is currently in a state that can be treated immediately with surgery. The bones are stuck together, so I will cut them and return them to the correct position.”

I continued explaining while pointing at the bone image.

“However, judging from the current state, the sixth cervical vertebra is severely twisted and needs to be removed. In this state, even Divine Magic would be meaningless.”

“Then you mean to remove one neck bone?”

“Yes. After removing the bone, I will place a leg bone in its place.”

The material will be our all-purpose spare bone, the fibula (calf bone).

Aren't you familiar with it?

Yes. That's right.

It's the area we pull from during jawbone reconstruction surgery.

Since a person can still walk without one leg bone, it's frequently borrowed when bone is needed.

“Is there any part you don't understand?”

“...Rather, I want to ask.”

Perplexity flashed across the Duke's one right eye.

“Just where exactly was I supposed to start understanding?”

“If it's difficult, you can see it as removing the stuck neck bones, then using a leg bone to reconnect the severed neck.”

“Hm. So I understood correctly. That makes it even harder to understand.”

Isolde nodded beside him.

It seemed the southern people were still unfamiliar with surgery.

Compared to that, my party from the center understood the surgery without difficulty...

“Freya. Did I understand correctly? His neck is severed, so why is he alive, and why can it be reattached? Has a new Divine Magic I don't know about appeared?”

“Older Sister. These things are understood not with the head, but with the heart.”

“Oh, Lady Freya is right. I was foolish to try to understand.”

Understood...

“Jenny. Just in case, I'm asking—are surgeries like this common at Meyer Infirmary?”

“No. It's my first time seeing it too. I doubt even the high-rank healers have seen this.”

“Then is this familiar?”

“How could it be? But I thought opening the head was the most dangerous surgery I could see. It seems I was naive.”

......

And Isolde, who had overheard our conversation, cautiously asked me.

“Could the black magic treatment method you developed, Lord Saint... be this?”

“It has nothing to do with Life Magic.”

“Not even an application of Necromancy Magic? Then what magic is it?”

Hearing the answer, Isolde became even more confused.

After that, I explained a few more times, but no one understood this surgery.

In the end, I gave up on making the guardians understand and simply had to obtain their consent for the surgery.