Chapter 36

"Tube?"

Aunt Irene looked puzzled. Garrett gestured the length of his forearm and then brought his thumb and forefinger together to gauge the thickness.

"This thick, this long... and it needs to be hollow."

"Just listen to it directly!" Aunt Irene waved her hand dismissively. "Avi is so small. Besides, you've seen her grow up!"

Garrett was sweating. He never wanted to listen to a heartbeat again, especially not so intimately. If possible, never again!

Seeing his persistence, Aunt Irene rummaged in the kitchen, eventually retrieving a pitch-black hollow tube, handing it over after cleaning. Garrett held it in his hand, realizing it was longer than his entire arm, darkened and bearing burn marks, undoubtedly a blowpipe.

Well, it would have to do for now. Perhaps he'd craft a stethoscope when he got the chance.

Keeping his composure, Garrett aimed one end of the blowpipe at his ear and pressed the other end against Avi. Despite the purpose being to listen to her breathing, the blowpipe's end moved slowly until it reached the strongest heartbeat. Holding it firmly, he listened attentively, occasionally adjusting, his expression growing more serious.

There was a murmur at the heart apex.

Moving to the left edge of the sternum at the second intercostal space, the murmur during diastole became clearer, a distinct mechanical murmur.

Shifting towards the aortic area, the murmur faded. The murmur near the tricuspid area was almost inaudible. Having circled the heart, he moved to the left clavicle, and there, the distinct mechanical murmur resurfaced...

At the left edge of the sternum, second intercostal space, and beneath the left clavicle, a continuous mechanical murmur was heard during diastole. It had a wide conduction range.

Combined with earlier symptomscyanosis, weakness, fatigue, and seasonal coughthere was a strong suspicion...

Patent ductus arteriosus.

One of the classifications of congenital heart disease. Mild cases might exhibit no significant symptoms throughout life, while severe cases could lead to pulmonary hypertension, heart failure, and eventual death.

Garrett closed his eyes firmly. He patiently listened to Avi's lungs once more, ensuring there were no irregular breath sounds, then set the blowpipe down. With a glimmer of hope, he turned to Aunt Irene.

"Aunt, about Avi's condition... has she seen a priest? What did they say?"

His serious demeanor visibly startled the others. Under the oil lamp's light, Aunt Irene hesitated, then forced a smile, sending Avi off to bed. After that, she sighed deeply.

"Bishop said Avi is just physically weak. Rest more and be cautious not to catch a cold... To reach normalcy would require highly advanced divine magic beyond his capabilities..."

They think it's merely physical weakness? Garrett felt a pang of sadness but also a bit of relief. Sometimes, ignorance is bliss... Knowing it's a congenital heart condition, what else could he do?

Heart diseases had been fatal for a long time. Cardiac surgery remained a taboo in medicine for years. Theodore Billroth, hailed as the "father of surgery" in later ages, once cast a "curse" on heart surgery:

"Surgery on the heart is a sacrilege against surgical art. Anyone attempting such surgery will face ruin."

Without life support, cardiopulmonary bypass, basic hemostasis, disinfection, or anesthesia, attempting heart surgery under current conditions would equate to murdering the patient.

Perhaps it's better to let Uncle Karen, Aunt Irene, and others remain unaware and continue living this way.

Garrett reluctantly convinced himself, turning his attention back to Avi. Her cough had stopped, and her complexion improved. The faint purple hue on her toes had faded, turning pink again.

That faint pink, to Garrett's eyes, was the most beautiful color in the world.

Thank goodness! Cyanosis only appears during severe coughing or oxygen deprivation. Otherwise, there's no discoloration! With this level of patent ductus arteriosus, even if it progresses to pulmonary hypertension and severe heart failure, with luck, there's still over a decade!

Garrett breathed a sigh of relief. He tried to suppress his anxiety, gently comforting little Avi, exchanging a few words with Uncle Karen and Aunt Irene, then bidding them farewell. As the door closed behind him and he disappeared into the darkness, Garrett closed his eyes, clenching his fists tightly.

Patent ductus arteriosus is treatable. In his past life, he'd seen countless patients like this and had referred such patients to cardiology colleagues.

This disease wasn't a death sentence, not even requiring significant financial sacrifice for treatment.

For kids like little Avi, in his past life, they'd simply perform an intervention surgery. Plugging the duct between the aorta and pulmonary artery with a device, the entire procedure took just ninety minutes. Heart sounds would return to normal that day, and within a few days, the child would be bouncing around again.

But that surgery was far from easy

It required an ECG to identify heart defects, X-rays to rule out other conditions, echocardiography to diagnose the illness, cardiac catheterization to understand pulmonary vascular resistance and shunting, confirming the suitability for surgery;

It needed guide wires with diameters ranging from 0.88 mm to 0.45 mm, guided by X-ray, inserted through the patient's femoral artery, all the way to the heart;

It demanded a plug made of superelastic nitinol alloy with a high polymer biocompatible membrane, guided by the wire to the ductus arteriosus defect, then controlled to open and block the gap;

Of course, it required contrast agents with high purity, injected into the blood vessels to show blood flow under X-ray, confirming the success of the surgery...

Each step, each detail, was a testament to modern medicine and industrial prowess, the epitome of cutting-edge technology from the Industrial Revolution to the Electrical Age, the result of years of development in science, industry, and medicine, bridging the gap of life-threatening diseases.

But now, here, Garrett Nordmark had nothing.

This was a different world.

No devices, wires, or plugs, no echo-X-rays, no anesthesia, no blood transfusions, no contrast agents...

How could he snatch Avi's life from the hands of death?

Divine magic had proven unreliable. The Bishop had indicated the inability to treat, evidently lower-level divine magic couldn't handle congenital diseases. Magic, magic...

Could magic emit ultrasounds? Could magic generate electrocardiograms? Could magic summon fine wires to enter the human heart and treat defects?

Could magic... allow him to see the mysteries inside the human body?

Garrett didn't know. But he knew that starting tomorrow, he would push open the doors of magic. If he worked hard enough, if his imagination was strong enough, everything was possible!

Within ten years, he had to accomplish all of this!

Uncle Karen, Aunt Irene, little Avi

Wait for me!

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