Journal of an aspiring physician

[Darksider_war]

The illusionarily scarred elven maiden retreated into her small quarters inside Candlekeep's infirmary and started writing the first page of her diary.

"I must say that it's good to have set things straight in my life. Finally my sister is sane again (at least relatively sane), and my hideous scars have been healed by a priestess of Sehanine, Her name be praised. I have also found a wizened human, Mr. Zullo, who is, according to many, the best physician of the entire Sword Coast. Even more astonishing is the fact that now, I, Elenwe Estelda, am his apprentice! Finally someone able to teach me the art of mending broken bodies...I must say, I will probably never be a priestess, but learning how to medicate wounds and heal maladies might bring me a bit close to what a priest can do. No matter, I have to follow strict rules during my apprenticeship and, although I consider my memory perfect, for correctness' sake, I will write them here:

- Always keep my place sanitized and aseptic
- Always obey Master Zullo's commands
- Always inform Master Zullo's of my experiments, for medicine's sake
- Always ask Master Zullo's permission before experimenting.

Those are the four most important rules regarding my apprenticeship, and I hope I will abide them all. Speaking of the fourth rule, I asked Master Zullo's permission for running a singular experiment. I shall write it in a separate journal.

Taking another journal, Elenwe started writing everything she wanted to experiment with.

Journal of Nurse Elenwe Estelda (current date), Experiment one

Reasons for the experiment: While collecting Leeches for Master Zullo's work in the infirmary (using me as a bait for the purpose, a quite painful, yet effective, solution), I realized that leeches' saliva has a peculiar characteristic: it prevents blood's coagulation. Keeping wounds open might apparently not be in a physician's best interests, but some of Candlekeep's medicine books, written by people who performed many authopsies upon victims of heart failure (a thing that even I did, in a controlled environment) might hint at a good way of employing that capability.

According to written authopsies, and to my own personal experience in the field:

- at least 80% of those died of heart failure were fat and lazy people. Their blood tended to be quite thick, certainly most than regular blood of healthy persons.
- There were clots in their blood vessels, mainly near the heart. Apparently, thickened blood has the tendency to coagulate inside the veins, obstructing the heart and causing its failure for excessive fatigue.

Consequently, there must be a direct link between blood thickness and chances to die of heart failure.

Assumptions:

- Leeches' saliva has the capability to prevent blood coagulation, keeping it liquid
- Leeches' saliva could (probably) be used to solve, albeit temporarily, the problem of excessive blood thickness.

Pros of the experiment:

- If my theories are correct, there is potential for a new cure for maladies such as thrombosis and heart failure, that do not require bloodletting.
- At least for now, I intend to use as Netherese Pigs only small animals, such as rats and pigs, with no need to put sentient beings' lives in danger.

Cons of the experiment:

- It will require more focus than my arcane studies
- I will have to touch rats (ugh!)
- Leeches' saliva is hard to get

Modus operandi:

I will temporarily enlarge leeches through magic, so that I may be able to collect more saliva from their mouths. Once enough saliva has been collected, I will run a series of experiments by shutting their saliva inside rats' circulatory system and seeing the results, and with different degrees of purity. I will have to get a lot of distilled water for the purpose. The first series of experiments will be run on regular rats; if I manage to do things right, without killing them all, I will feed the second batch of rats in order to make them fat. If their blood thickness gets to levels similar to those of humans, and the leeches' saliva works, I could consider running field experiments on willing human subjects - AFTER experimenting the hypothetical cure on myself, first. I am already starting to collect rats for the experiment. I only hope that Nurse Abigail won't make too much fuss for their presence in the infirmary.
The real experiment will start tomorrow.

[Darksider_war]

Journal of Nurse Elenwe Estelda, Tarsakh 5, 1347 DR, experiment 1, continuation

The first batch of rats died soon afterwads being injected pure, undiluted leech saliva. The most common cause of death was hypertension and hyperventilation. After this initial setback, I decided to calculate the exact proportions that needed to be used in order to continue the experiment without running low on netherese pigs. The formula has been calculated by mathematics, and a good amount of intuitition mixed with gut feeling (that, since now, never failed me). The correct proportion of diluted saliva to be injected into the rat's blood stream is as follows:

*a complicated mathematical calculation is written soon afterwards*

Basically, for each two drops of leech's saliva five drops of distilled water needs to be mixed.

Keeping this formula in mind, I created another dose of solution, and shut it inside a rat's blood stream. The results proved indeed to be good: the rat did not die, nor did he show any symptoms besides fright for being used as a test subject. I applied a small wound to his body, and indeed his blood seemed more thin than usual. I had to apply a small cloth to the wound though, otherwise it would have not closed with time.

Conclusion: the new formula seems indeed to work. At least, with this particular TS. I will have to run the same field test on a couple of rats, and see how do they react, before I can move on to the next phase of the experiment. Wether this research of mine is capable of yelding useful results, or is just a waste of time, is up to Master Zullo to decide.

P.S: running low on rats. If the next batch dies, I will have to task someone with providing me a few new TS.

P.P.S: still enough solution for 3 rats more before I will need to prepare some more.

[Darksider_war]

Diary of Acolyte Elenwe Estelda, 10 Tarsakh, 1347 DR

I'm glad to have settled things with Candlekeep. I got the chance to speak with Guide Wendel and we come to an agreement. I shall serve both the order of the Secret Keepers and Candlekeep, making sure that things best left forgotten remain such. I am happy with this solution: Candlekeep might in fact be the safest place of the entire Sword Coast in which to keep lore best left forgotten. And that is the most important thing. This solution also allows me to continue with my medical experiments under the tutelage of Master Zullo. Speaking of tutelage, now I am an Acolyte, which means that I must attend to my duties regarding the keep and the other full fledged avoweds. Since the infirmary is my main occupation, that won't drain too much time from my experiments. Or my studies, for that matter. The journal of my experiment must be updated, and now that I work as a nurse, I also have to keep detailed reports of our patients' health.

Journal of Acolyte Elenwe Estelda, 10 Tarsakh, 1347 DR

Report on patients' health:

Tormin, Nolan
Human, Male, Tethyrian ethnicity
Height: 5'9
Weight: 210 lbs
Age: approx 30 winters
Diagnosis: Nolan Tomin is a former soldier of the Baldurian/Amnian war. Hailing from Beregost, he served under the Baldurian's Army during the war. He got wounded by an arrow to the knee during the battle of Beregost, and his recovery had been entrusted to Dr. Zullo ever since. While Dr. Zullo did indeed a pretty fine job in mending the wounded's knee, he was dismissed from the Infirmary 1 week ago, having being given a musk-based paste to apply to his wound in order to avoid any complications. Of course, the patient did not do as asked, citing as justification the fact that the balm "made his leg itch". As a consequence, the wound soon got infected, developing into gangrene. He at least had the good sense of returning to us as soon as his wound started turning black. Unfortunately, the infection was aggravated by a poor personal hygiene and the usage of dirty clothes of poor quality, constantly rubbing the wounded tissue. There was no other cure for the ailment but amputation. I sawed off his interested leg (namely the right one) while Dr. Zullo made sure that the anesthetic would do his job. After two days from the operation, the patient is no longer under risk of death (gangrene can still be lethal even if removed due to very severe fevers being consequence of the infection). The patient, though, did not take the amputation good, and in fact, spews insults at me each and every time he occasion presents. Anyway, he's out of any danger. The sooner a cleric will regenerate his lost limb, the better.
Personal Observations: I'm starting to hate this guy.

Samantha
Human, female, Illusk Ethnicity
Height: 5'6
Weight: 170 lbs
Age: 20 winters circa
Diagnosis: this young girl hails from a family of farmers just outside the walls of Baldur's Gate. They have brought her here yesterday with great haste and a worried look after she started suffering some disturbing symptoms. After a medical examination done alongside Nurse Abigail, I diagnosticated the current symptoms: painful seizures and spasms, diarrhea, paresthesias, itching, mental effects including mania or psychosis, headaches, nausea and vomiting. Usually the gastrointestinal effects precede central nervous system effects, i.e. the girl is likely to vomit before suffering of hallucinations. Symptoms also include acute itching of the hands and feet, rash, and chest pain. In short, Samatha suffers from "Saint Olyn's Fire". Her parents did the right thing in sending her to us as soon as the first symptoms manifested. Her illness is in its early stages and it is likely to be cured without limb loss.
Recommended cure: keep her well fed, well cared, and her hands and feet always treated with the usual herbal balm to prevent gangrene. That should work.

Tamara
Human, female, Tethyrian Ethnicity (not sure about that)
Height: about 5'1
Weight: about 147 lbs
Age: 16 winters circa
Diagnosis: she had been treated from her wounds before me entering service inside the Keep as a Nurse. Anyhow, she clearly exibits signs of physical torture all over her body. I wonder what kind of scum would dare to hurt such a small, innocent girl in such a vile way. As much as the physical wounds have been treated (remarkably enough, also, I must admit), she till bears the psychological scars of the ordeal she suffered. Also, the time spent in bed has weakened her muscles, so she needs a bit of re-education.
Personal notes: experience and type of psychological trauma very similar to my own a few years ago. I will do my best to make herself comfortable and to give her eyes the spark of life they once had. I recommend to avoid speaking of music (for some reason the topic makes her uneasy), and speaking of sad things in general. She does seem to respond well to the presence of my familiar, Max the rabbit, so I will use him as a therapy. She also responds well to flowers.

[Darksider_war]

Journal of Acolyte Elenwe Estelda, 10 Tarsakh, 1347 DR, Experiment 1, Continuation/2

The initial cure for normal rats proved indeed a success. Keeping that in mind, I overfed the rats in the cages, making sure they would not move while I fed them fatty foods like cheese, bacon and the like. After 3 days they got pretty fat, their blood thick and viscous. This was the ideal condition to simulate the health of human subjects.

It is unfortunate to say that the original concotion did not work on the first rat. This has probably to do with the different level of blood thickness of the subjects. I had to recalculate the proportions, but because of the haste I wrote a 3 that looked like an 8, and this messed up the entire operation. Using the wrong proportion as a basis, I created a new solution that proved to be too powerful. The rat was lucky to survive the injection, which proved to be almost lethal. The rat's blood was, however, incredibly thin, and this gave me the idea of an ideal scale of blood thickness (more about it at the end of the journal).

After realizing the mistake, I corrected it and created a new serum, to be injected in the second fat rat. The operation was indeed successful: the rat did not show any ill side effects after the injection, and its blood was almost as thin as that of a healthy rat.

*after the last paragraph a quick mathematical calculum of the proportions used for the solution follows*

I tried the solution on the remaining rats and, I got to say, it was a complete success. The remaining rats did not suffer any ill side effects and their blood thickness reverted to normal. Soon, it will come the time to test the solution on humans.

Speaking of the various grades of blood thickness, I developed a scientific scale for the purpose. Here it is as it follows:

Elenwe Estelda's blood thickness scale

Grade 1 - Very thin blood, more fluid than water. Common symptoms of such thickness include headaches, short breath, lack of skin pigmentation.

Grade 2 - mildly Thin blood, like water. The regular blood thickness usual to humans, elves, halflings and gnomes (dwarves are out since their blood is usually thick and their bodies don't give a damn about it)

Grade 3 - mildly Thick blood, like oil. This thickness starts to cause problems in the subject. Common symptoms include hypertenxion, short breath, headaches, and being prone to heart failures.

Grade 4 - very Thick blood, like the white of an egg. Symptoms very similar to Grade 3, only more severe.

Grade 5 - extremely Thick blood, like tar. Symptoms very similar to grade 3 and 4, only extremely severe. Safe bet that subjects with Grade 5 blood thickness are going to die very soon.

In case you were wondering, Master Zullo, the TS' blood thickness grade was about 3.