Chapter 40

Lu Xiusi opened a medical record, copied down the address, and closed it.

This one can’t be followed up either; let him come back for a follow-up himself.

He was now sitting in Li Si’s clinic, where the owner was organizing freshly boiled instruments, while he handled routine paperwork.

After handing over the chaotic follow-up records to Kraft last time, they received a brand-new set of requirements the next day.

A new reporting schedule was added: reports every five days, and Mingming Tincture was now to be collected every five days. The new plan specifically emphasized “prioritizing patient safety and using it only when absolutely necessary,” aiming to increase the likelihood of voluntary follow-ups.

There were also additional details regarding addresses and possible symptoms, accompanied by a table compiled by Kraft—simply copy it verbatim, designed for foolproof use.

“I think it’s unrealistic,” Li Si said, using tongs to pull a small saw out of boiling water; steam hit his face, blinding him, “What did Kraft say again? In one ear and out the other—they don’t care. If they wake up feeling fine, they won’t come back.”

A clean linen cloth beside him already held a variety of odd tools: scalpels, drills, retractors, various-sized scissors, and a branding iron that looked terrifying.

It wasn’t his first day here; Lu Xiusi was used to it. Compared to Kraft’s gentle methods, much of what was done in this clinic was physical labor.

Amputations inevitably required sawing through bone and controlling bleeding over a large surface area. If Li Si weren’t from a non-martial family like Kraft, he’d have tried using an axe.

During this time, Lu Xiusi developed the skill of remaining calm amid screams and moans, focusing entirely on the materials he needed to review.

Kraft’s foolproof checklist sparked an idea in him: “I think we can shift our approach—list the things patients can feel themselves, without needing special examinations.”

“And then?” Li Si wiped the saw dry and placed it beside the scissors, asking casually.

“Then we give it to the patients to fill out over time, and when they have time to come back, they can bring it along.” Lu Xiusi felt he was a genius—he’d thought of a solution neither Kraft nor Li Si had considered, with the bearing of a lecturer.

“Hmm, well said,” Li Si replied without reaction, continuing his work, arranging dried instruments onto a tray.

Though still skeptical of Kraft’s “microbial theory,” they’d seen a clear drop in wound infections and pus after following it—pragmatists never reject a useful new method.

He needed to prepare several sets of instruments: boiled, placed in trays, wrapped in multiple layers of linen, ready to be opened and used immediately when patients arrived. He was too busy to pay attention to Lu Xiusi.

“So let’s make a few now? Even sailors could take our form, fill it out on board, and bring it back next time they dock at Wenden Port.” Lu Xiusi grew more excited, the logic clearer: “We’ll get feedback much later, and the data will be incomplete—but at least we’ll get something.”

Li Si finished a portion of his work, covered the tray with a lid, wrapped it in linen, and no longer worried about spittle splashing onto the instruments.

He placed the instrument bundle on the shelf, pulled up a chair beside Lu Xiusi, and pressed down on his hand as he reached for the pen: “What you said makes sense, but from my experience, there’s a small problem to solve.”

“What problem?”

“One you won’t realize until you have your own clinic,” Li Si replied evasively. “Who do you think the people coming here for amputations are?”

“Mostly sailors and laborers—we already compiled statistics. Sailors often delay because ship doctors can’t handle injuries; laborers delay because they need to keep working or to save money, until it’s too late.”

They’d already analyzed this after returning from Kraft’s; thanks to the medical record template Kraft provided—which already included occupation—the analysis was straightforward.

“Right, so you know who they are. How many words on this list do you think they can read?” Li Si tapped a finger on Kraft’s itemized list.

Purely technical terms, some newly coined, explained only recently in morning lectures—the ink on the notes was still drying.

“Not just this list—even the simplest book is beyond them. If they could read and write properly, wouldn’t they find a clerk job?”

“Hmm… maybe we could simplify it and explain each item to them?”

Lu Xiusi realized his foolishness but still struggled to abandon his sudden insight.

“Do you think you can fully explain it to them, and they’ll remember to record it faithfully when they return?”

Li Si had considered similar ideas, but explaining medical requirements to people with zero medical knowledge was too difficult—let alone teaching them to accurately record each item on a scale they couldn’t read.

“Even if you had Kraft’s lecturing skill and forced them to understand it on the spot, they’d still need to remember it five or ten days later.”

“Couldn’t they find someone literate to read it for them later?”

Li Si leaned back in his chair, utterly unimpressed by this half-baked suggestion: “They won’t come for a free follow-up, but you expect them to pay someone to read it for them? Or do you want sailors to find someone on a ship to help them fill out this form?”

“Alright, you’re right,” Lu Xiusi abandoned the tempting idea.

He put away his pen and paper and flipped to the next medical record—surprised to find a follow-up note attached.

The record belonged to a baker who, drunk and barefoot, stepped into a ditch and was cut by shell fragments thrown by some cruel soul, leaving a deep wound. He delayed for weeks until a large patch of black gangrene on his foot required amputation.

He missed his five-day follow-up but showed up on day twelve.

“If I remember right, this is new, isn’t it?”

“Let me see?” Li Si leaned over to examine the selected note. “Yes, though late, at least it’s here.”

“I wonder when this will ever end. It’s useful, but takes too much time—writing it all gives me a headache.”

“It probably won’t ever end,” Lu Xiusi said as he read. “Kraft said every patient must have a full medical record, plus progress notes.”

This follow-up was written using Kraft’s latest checklist, arranged head-to-toe for readability and memory: symptoms of mental state, breathing, digestion, urine, and feces.

Many entries read “unknown”—like urine and feces color, since the filthy latrine didn’t support such observations.

Besides those unknowns, Lu Xiusi spotted one alteration: in the mental state column, “drowsy” had been blacked out and replaced with a diagonal slash meaning “none.”

“This was changed?”

Lu Xiusi lifted the paper, pointing to the blackened area for Li Si.

“Yes, I recall. He said he’d been waking up later, harder to rouse,” Li Si straightened up and took the note. “I accidentally checked ‘drowsy,’ but then realized it wasn’t that severe.”

“No note in the remarks.”

“Subjective feelings like this aren’t reliable enough, are they? Everyone feels extra sleepy sometimes, and his overall mental state was fine,” Li Si leaned back.

“Alright, I’ll mention it to him when I hand in the record,” Lu Xiusi slipped the paper back, straightened it, and stood.

This was the last one for the day. He gathered the entire stack, bid Li Si farewell, and returned to the academy to submit his report and collect his next five-day supply of Mingming Tincture.

The earliest diluted batch in the clay jar was nearly gone; in half a month, he’d need to brew another.

It wasn’t just Kraft who had become busy this month—entirely the Medical Academy had been set in motion by him, expanding courses and procedures around the new surgical method.

So many tasks couldn’t be handled by one person, so portions naturally fell to Lu Xiusi and Li Si.

Li Si’s clinic had effectively become the primary source of information on Mingming Tincture’s effects on adults; Kraft couldn’t spare time to visit often, so he entrusted it to Lu Xiusi—the one who’d received the most instruction.

Lu Xiusi didn’t resent it; he understood the benefits. With this experience, a lecturer position at the academy was all but guaranteed.

With visions of a bright future, he carried the latest records back to the academy, entered the professor’s room—now temporarily occupied by Kraft as his office, where everyone knew to find him.

“Here are the new cases from the past five days, plus a twelve-day follow-up from an earlier case,” Lu Xiusi placed the stack on the desk corner, glancing at the mountain of paper covered in neat, dense script. A packed schedule lay beneath the inkwell.

Kraft wasn’t well—Lu Xiusi had heard recently. Overwhelming duties, coupled with strange patients who crushed morale, left no one in good spirits.

The room reeked of frustration and exhaustion; the man at the desk was shrouded in gloom—interrupting him now was certainly unwise.

But duty compelled Lu Xiusi to speak up: “There’s a small issue here. Li Si says it’s trivial, but I think it’s worth mentioning.”

“Attention to detail is good. Go on…” Kraft’s voice was hoarse. He grabbed the nearby teacup and gulped down cold barley tea, choking on it.

He quickly covered his mouth, but a few drops splashed onto freshly written text, smudging several ink spots.

“It’s not a big deal—a patient said he’s been waking up later, harder to rouse,” Lu Xiusi said, preparing to leave. He thought it was insignificant, but felt obligated to report it.

“What?”

Unexpectedly, Kraft ignored the ruined manuscript, stood up, and called out to Lu Xiusi: “Which record? Where does he live? Let’s look.”