Chapter 297: Nystagmus

Kraft urgently searched his brain for information regarding brain injury, but his brain provided no information that could explain the current situation.

The consequences of central nervous system injury are varied, and changes in the eyes are certainly among them, ranging from vision to motor function, including abnormal pupil size, visual field defects and blurring, and abnormal eye movements.

Typically, patients have a significant probability of drawing one or several of these, depending on the location and severity of the damaged area.

Working backward from anatomy, the source of nystagmus could be localized to several different functional areas: the vestibular system, which perceives posture and position, located in the inner ears on both sides; the oculomotor nuclei, located in the midbrain of the brainstem; and the cerebellum, responsible for coordinating movement, located at the lower rear of the skull.

So, what kind of trauma could strike several functional areas so precisely, causing consistent vertical upward nystagmus despite other symptoms being entirely different?

Believing in such a thing is no better than believing that a falling object from high up happened to loosen an old blood clot or necrotic area in a pedestrian's brain, allowing it to suddenly reperfuse—anyone who believes that should go get their own brain cleared out.

There must be some other reason, a simpler and more direct one, and it is highly likely to be through normal pathways rather than pathological causes. After all, it is absurd for random, different injuries to coincidentally produce a specific, identical pathological manifestation, but if it is some unknown situation triggering a normal, inherent human reflex, then it makes sense.

Just as in a pitch-black dormitory, if everyone's morning alarm suddenly rings, the most suspicious thing is not that everyone, for different reasons, accidentally set their alarms to midnight, but rather to wonder if it is raining or the curtains weren't drawn.

The logical process was somewhat complex, but in thought it took only a moment. Kraft temporarily ruled out intracranial injury as the seemingly most reasonable explanation and turned his attention to considering normal circumstances.

This involves what the physiological significance of nystagmus is.

During accelerated movement, objects in front flash by at speeds far exceeding the norm; to adapt to this, the visual system spontaneously makes adjustments, attempting to counteract the effects of the movement.

Reflected in the eyes, this is high-frequency turning to track the flashing objects.

Imagine sitting on a moving train: the eyes track every tree thrown backward by the roadside and constantly return to center, resulting in what looks like trembling, and the direction of the tremor is exactly opposite to the direction of body movement.

If explained from this angle, the consistent vertical upward nystagmus in deeply comatose patients actually reflects their perception of their own change in position.

【The body is falling】

The clues pointed in a very ominous direction; like hunting, proudly following discovered traces through the mist, only to have not a deer or wild boar appear before one's eyes, but a strange, grotesque form strolling through the forest.

"How is that possible?" Kraft heard himself mutter; no one answered his self-talk. "It makes no sense."

Combined with the abnormal earthquake, one could almost immediately link it to deep-level influence. Yet these are not patients with a clear history of contact; on what basis could they have progressed so quickly to a sensation of falling?

In that slight nystagmus, he seemed to glimpse a harbinger of some incredible thing approaching; though it had not yet arrived, the lingering waves of its passage had penetrated the spatial barrier, stirring the consciousness trapped in deep coma within the mental world.

This kind of influence, requiring no medium, would only occur when the two were close enough.

"This is truly devilry."

It was best to hope the direction of the guess was wrong. He could only comfort himself thus: a doctor who was not a neurology specialist, interpreting based on some textbook knowledge, was ultimately subjective and arbitrary.

What needs to be done now is not to continue dwelling on this question, but to continue treating the patients, and ask them later if they remember perceiving anything at the edge of death—if there is a later.

The monks of the church were also busy; they followed the advice not to move the patients randomly, so they merely prayed in low voices and then lightly touched the patients' foreheads.

In terms of effect, this measure greatly comforted most of the patients who still had consciousness, making them much calmer.

And Kraft began to handle those parts of the more severe cases that were currently treatable.

He checked Kup's puncture effect and the sealing of the puncture site, expressing approval of his technique, and called for this assistant to move the screened patients together, placing them more densely.

Kup watched in amazement as Kraft wove through the narrow gaps between patients, as if he had suddenly become agile.

It was not that the professor was usually clumsy, but his movements had suddenly acquired a guidance beyond visual limitations; even without looking at his feet, he could precisely avoid patients' clothes and flailing limbs.

Kraft lightly squatted beside the patient with a cervical dislocation, had him inhale a small amount of ether kept in the toolbox to relax his consciousness and muscles. Then, with both hands holding both sides of the patient's head, he slowly and steadily pulled upward with stable force.

Long-term study had taught Kup the complexity of the neck; with just a tiny, insignificant amount of force, several vertebrae that looked similar but were actually of different shapes could shift position, and such a slight shift could cause effects ranging from disease to death.

He had also seen standard manual reduction techniques, which required inferring the situation through the positions of bony landmarks on the body surface, then carefully pulling, with the possibility of reduction failure.

However, the purpose of those hands was very clear; there was no back-and-forth adjustment. After traction, they turned a decisive angle, then released and pressed to reduce.

The neck was realigned; the expression on the sleeping patient's face relaxed, and cotton pads were placed on both sides and front and back of the neck, fixed with strips made of thick tree bark.

"This is not standard procedure, just a compromise due to limited time," Kraft pointed out amidst his busyness, noting his own behavior was not worth learning. "Normally, one must honestly search for bony landmarks to locate before carefully attempting."

But he immediately reduced several cases of fractures with obvious limb deformities in the same manner, bandaged and fixed them, attached tags, and instructed on follow-up checks later.

The speed and effect were faster than any situation Kup knew, even more perfect than Kraft himself usually was.

Even the church personnel observing voiced amateur praise; upon learning from Brother Wading that Kraft had saved a colleague with a head injury who was not even from the Dunling University School of Medicine, they expressed rare approval.

As a student and assistant, one should feel honored by the mentor's skill. But Kup only felt an inexplicable emotion arise within him; this emotion was like a shadow lengthened in the night projected onto his soul, and it took him a while to distinguish it as distorted fear.

This fear did not come from the unknown, but from the known. Precisely because he understood, he found it incomprehensible.

Kraft began to shave the hair off the comatose patients, drawing circles on their heads with a pen; some were on the same side as the external injury, others on the opposite side.

A long-forgotten sense of isolation hovered above his head; the room was full of people watching the same scene, yet none could empathize with what he had discovered. An invisible barrier separated him from the crowd, leaving him alone with the incomprehensible phenomenon. Even though he knew rationally he was safe, fear born of biological instinct continued to breed.

Once he realized this, he began to feel something moving around him; a part of that thing, as illusory as a breeze, swayed past his face and through his body, drifting without restraint and constantly touching and tracing things, like a sea anemone of unimaginable size, unconsciously perceiving the surrounding world with its blooming crown of tentacles.

It stretched out in the tide belonging to it, its posture comfortable and free.

"What are you standing there for? Come help me!" Kraft shouted with his back to him. "We have to move this patient back to the clinic; this place can't handle it."

"Okay, okay." Kup shivered, feeling a bit cold. "Will you have time later? I have something I want to discuss with you."

"Of course, let's talk after we finish."