Chapter 257: Save Abel!
Chapter 257: Save Abel!
Hi dear readers! I’ll be away on holiday for the last time before my wife’s third trimester and can’t fly anymore so the releases for the next 2 weeks will be on Wednesdays and Sundays only! Apologies in advance if I don’t reply Discord or approve comments promptly.
Editor: Tseirp
Away from the royal castle.
Ryo was summoned by Queen Rihya after the audience.
“Ryo, what you are about to learn can’t leave these four walls.”
Rihya said, and Ryo nodded silently.
Then they went to the next room.
The room contained a large bed….
“Abel…”
King Abel the First was lying on the bed.
Ryo felt weak and drained of energy all of a sudden.
His chest was rising and falling faintly…so he was alive.
That’s right, though he was alive…his face….
His face was that of a very sick person that even Ryo, who has no specialized medical knowledge, could tell.
His cheeks were hollowed, the skin stiff, and his lips were chapped…and he was severely weak…that it looked like…he was at death’s door.
“Abel…”
The second time he called him in that manner was…truly feeble.
At that moment, Abel opened his eyes.
“Ryo…you’re looking…awfully good in that outfit…aren’t ya?”
Abel complimented Ryo in the duke’s formal attire, albeit in broken sentences.
His voice sounded really pitiful.
“Abel…”
Ryo’s third time calling his name was…very faint, weak, and…sad….
“I’m sorry, but…looks like this is…it for me…. I leave Noah…and the Kingdom…to you…”
He had Ryo come up to the castle to entrust the prince and the Kingdom to him.
The first prince, Noah, was still very young.
Queen Rihya would assist him as regent, but if Ryo, the premier duke and the leader of the nobles, supported him, he would be in a stronger position.
To entrust these to him, Abel called Ryo….
“I haven’t seen you in six months, and now this…”
Ryo’s voice remained weak.
It was only natural.
It was impossible for him to sound like his usual self in a situation like this.
“But…that was fast…I sent out the summon request…just yesterday…”
“I just happened to be in the Rondo Forest. So I got here early.”
“…”
Abel was vaguely aware just how far the Rondo Forest was.
He and Ryo had once walked all the way back to the Kingdom territory.
How could he come so quickly when he was so far away?
“Well…that doesn’t matter.”
Of course, Ryo didn’t tell Abel about Gri-gri, either.
He was going to tell him eventually, but…in this situation, ‘eventually’ may never come….
Then he suddenly wondered.
In ‘Phi’, there is such a thing as magic.
With light-attribute magic spells, one can recover from all sorts of conditions.
For injuries, use <Heal>.
For poison and disease, use <Cure>.
Ryo turned to Rihya, who was standing behind him.
Rihya must have understood why Ryo looked at her.
And she shook her head slightly.
Rihya’s <Cure>, someone who was even called a ‘saint’, didn’t work…?
During the past three years, Ryo’s alchemy had advanced considerably.
Learning alchemy also implied learning magic altogether.
That is because alchemy can be said to be a method to manifest magical phenomena with alchemy tools.
Therefore, one must have a profound knowledge of magic.
Specifically, he deeply studied recovery magic, especially <Heal> and <Cure>.
That was because he thought it would be convenient if he could create alchemy tools that could exercise those recovery-type magic.
But upon research, he also found out that it is quite difficult to reproduce light-attribute magic through alchemy.
Well, that’s a subject for another time….
In the course of his research, he understood that <Cure> apparently promotes recovery from poison and disease by strengthening the human immune system.
That strengthening attained with light-attribute magic is so horribly violent that…Ryo still has a hard time accepting how it is possible to realize what can almost be called instantaneous recovery through Heal and Cure….
Nonetheless, <Cure> greatly strengthens the function of white blood cells and their lymphocyte subtypes.
The natural killer cells and T-cells.
In other words, the fact that <Cure> didn’t work could only mean that the body doesn’t recognize whether whatever is causing the illness is something to be neutralized or eliminated.
Ryo looked back again and asked.
“Rihya, what is the diagnosis of Abel’s illness?”
“We don’t know. He’s been examined by people in the Central Temple who are experts at using Cure, but all they can tell is that…it’s an incurable disease from ancient times.”
Rihya’s voice was weak as she answered.
There were no tears, as if she had already accepted Abel’s death.
“Ryo…sorry about this…but I think it’s time…”
Abel said all that…but Ryo shook his head repeatedly.
<Cure> doesn’t work…white blood cells and lymphocytes aren’t attacking…and the body looks very sick….
There was such a disease on Earth…and even Ryo knew about it, the most famous deadly disease in Japan….
“Cancer…”
Why do people lose so much weight when they have ‘cancer’ in the first place?
There are several reasons….
First, cancer cells are pretty much energy gluttonous cells.
Therefore, they break down fat for energy, and the proteins that make up muscle are broken down into amino acids, which the cancer cells use as nourishment for growth….
The body is deprived of both fat and muscle…and more than it can replenish with a normal diet….
A condition called ‘cancer cachexia’…or a variant….
Its pathogenesis is not fully understood….
Ryo nodded and approached Abel.
“Abel, I’m going to examine your body for a bit.”
“Hm?”
Ryo touched Abel’s shoulder.
Then he closed his eyes.
So he could devote all his attention to ‘examining’ Abel’s body.
Sixty percent of the human body is water.
And Ryo is a water-attribute magician.
Therefore, the inside of a person’s body is Ryo’s exclusive domain.
But again, it wouldn’t be easy to probe the body of a complete stranger, someone who has never been ‘examined’ with magic, but that was not the case with Abel.
Abel’s body had been exposed to Ryo’s magic many times before.
Hence, it’s the body Ryo knew best, only second to his own.
(Are these, foreign substances, cancer cells…?)
Back when he was on earth, he had seen what the cancer cells looked like on TV and in videos.
And most importantly, he also remembered when his grandfather had surgery for colon cancer, and the cancer-infested colon was taken out and shown to him….
(The biggest one is…the one in the stomach? The one in the inner wall has reached the muscles of the stomach wall, which means…it may have metastasized…?)
They can enter lymph vessels and blood vessels within the stomach wall and metastasize to other organs.
It must be carefully examined.
(No! The cancer cells have penetrated the stomach wall and reached the outermost layer of the stomach… peritoneal metastasis… and what are all these things on the peritoneum… spilled cancer cells…?)
Before he knew it, a large drop of sweat was pouring out of Ryo’s forehead.
It was indeed the first time he had explored inside a body so seriously.
(There are some pretty big ones in the lungs and liver…. None in the brain! Thank God for that at least. The primary tumor is in the stomach. Peritoneal and lymphatic metastases…? It also metastasized to the lungs and liver. What appears to be a few small cancer cells have spread quite well. The question now is, what do I do…)
Basically, there are two approaches to treating ‘cancer’.
To remove or not to remove.
Leaving cancer cachexia and other substances that constantly harm the human body in the body without removing them…seems reckless, but it can’t be helped in the case of patients who are not physically strong enough to withstand the surgery.
Or, if the area is technically inaccessible to scalpels…for example, deep in the brain…in such cases, radiation or chemotherapy would be the only way.
On the other hand, in recent years, there have been some new drugs developed on Earth, such as immune checkpoint inhibitors, for which the Nobel Prize was awarded.
However, in terms of immediate efficacy, surgery would be the go to option still?
If he turned out to be in a state where he could withstand surgery, then is resection the only option?
Of course, Ryo had never performed cancer surgery back when he was on Earth.
Neither was he a doctor.
It’s all just amateur knowledge.
At best, he only did some research when his grandfather had cancer….
For such a person to try removing cancer cells was beyond ludicrous.
But….
That’s right, but…this is ‘Phi’.
A world of magic.
And Ryo is a water-attribute magician.
The inside of a person’s body, which is sixty percent water, is his home ground.
But he had some questions.
To begin with, Ryo had been away from Abel for half a year at most.
Abel was very healthy as far as he could tell.
In other words, he became like this in just six months….
Can stomach cancer spread this fast in just six months?
Well, it is also true that the speed of cancer progression and the condition of the body varies considerably from person to person.
Or there may be some other factor….
All things considered, he understood the current situation and what needed to be done.
“Abel, Rihya, I have found the root cause of the illness.”
Ryo opened his eyes and decided to report his findings.
“Ryo?”
Rihya looked at Ryo with a weak but hopeful look in her eyes, as if asking for something.
What could she be asking for?
To save Abel, obviously.
Then he’d better give a proper answer.
“Could you leave Abel’s body in my care?”
Rihya nodded her head without any hesitation.
But Abel’s response on the other hand….
“Ryo…seriously, I am…good…”
He had resigned to his fate.
“No can’t do! I won’t allow it!”
Ryo raged for the first time since he walked into the room.
“You still have a lot of work to do, Abel! You want to leave Noah fatherless? Or leave Rihya by herself? Or perhaps abandon the people…who hail you as their king? Of course you don’t really want that. I, for one, won’t allow it! ”
“But…”
“Abel. There’s no denying that it is a difficult situation. What I am going to do may as well be unconventional and have never been tried before. So I can’t give any assurances. If so, why not think about it this way. ‘Since I’m going to die anyway, I’ll leave it to you, Ryo’.”
“What…distasteful persuasion…”
Abel chuckled, as he said in a weak voice.
Then, he closed his eyes.
After a good twenty seconds, he opened his eyes, looked firmly at Ryo, and said.
“Okay. Ryo…if you’d please.”
“Sure. Leave it to me.”
The room next to the room where Abel was laying.
Ryo was explaining the situation to Rihya.
“To put it simply, there are some pretty bad stuff nestled inside Abel’s body that <Cure> doesn’t work on. I will cut them out and expel them from his body. I know where they are and how many there are. I’ve also thought of a way to go about it. But before I go ahead with the operation on Abel, there is something I would like to try. Oh, and what about the anesthesia I ordered…?”
“Yes, it just arrived.”
Saying that, Rihya handed the bottle to Ryo.
A general anesthetic.
He had thought it was fairly common, since it was available at the inn where he stayed when he operated on Sharfi, the ex-cultist…but it appeared that some were kept in the royal castle too….
“Great. This will come in handy during Abel’s surgery. But before that, there’s a technique I’d like to try…on my body.”
“Eh…”
“It’s okay. I’m just going to try it out a little. I’m going to drill a hole in my belly…in my stomach. After trying out the technique, I’d like to ask you to cast Heal on my body. It’s to confirm if it’ll close up the hole.”
“A hole inside of your belly…?”
Rihya tilted her head.
Can’t blame her.
There is no such thing as surgery…at least not in the Kingdom.
Meaning, they wouldn’t know what goes on inside the body…or so he thought….
“You’re talking about the ‘stomach’, the place where food is digested, correct?”
Rihya knew.
“Did you learn that at the Temple?”
“Nope. From dissecting monsters…”
“I see.”
Certainly, as a former adventurer, she had experience in dissecting monsters… Ryo himself doesn’t dissect monsters very often, except for when extracting magic stones, which explains why he was oblivious to the fact.
Although, he had dissected quite a lot of boars and rabbits in the Rondo Forest…he only ate the meaty parts.
Entrails aren’t really his thing.
The water jet, which is Ryo’s specialty, will be used to remove the cancer cells.
In Japan, the development of the water jet for medical use was already in progress in the 1980s.
So, it’s not a unique technique by any means.
“<Scan>”
Ryo gave a name to the magic that probes the inside of a body.
Only because it seemed more convenient….
After <scanning> his own body several times.
“Great. Here we go.”
Using the water in his body like a water jet, he pierced his stomach.
“Uggha!”
He felt intense pain.
Naturally…since he wasn’t under anesthesia.
It was the severe version of the ‘stomach ache’ that middle managers experience every day.
“Now please, Rihya.”
Ryo, who was out of breath, said, and Rihya put her hand on Ryo’s stomach and chanted.
“Mother Goddess, I leave it to your great healing hands, <Heal>.”
“<Scan>”
At the same time Rihya casted <Heal>, Ryo applied <Scan> to himself.
It was to check in real time the improvements caused by Heal.
Then, he found that the hole in his stomach was gradually closing up.
“Good, looks like Heal will do the work just fine. I prepared some potions I always carry with me just in case, but I don’t think I’ll be needing them.”
Ryo nodded broadly as he said this.
“Ryo?”
“Yes, we can now proceed with Abel’s surgery.”
Ryo announced solemnly in front of Abel who had completely passed out from the general anesthesia.
“We will now perform a partial resection of the stomach, lungs, liver, peritoneum, and lymph nodes.”
No one said anything.
Rihya was concentrating so as not to miss the word “Heal” that would eventually come from Ryo, and Abel, who usually nitpicks his words, was completely under.
Ryo, a little dejected, touched Abel and began the operation.
“<Scan>”
He carefully <Scanned> from the top of his head to the tips of his toes.
There was no need to rush at all, so he did so carefully and repeatedly.
“Good.”
Ryo nodded his head and brought his right hand to Abel’s abdomen.
There was no real need to put his hand on it at all, but he couldn’t help being conscious of the target area.
The cancer cells had invaded from the inner wall of the stomach to the outside of the stomach, completely penetrating the stomach wall.
The primary tumor… had scattered quite widely from the stomach….
The reasonably large ones in the lungs and liver also need to be removed.
The other scattered cancer cells throughout the body were not large, but were quite numerous.
Ryo’s procedure was to remove these scattered cancer cells first.
This would be impossible if it were on Earth…because they were too spread out and too numerous…and some of them were too small….
But that’s where water-attribute magic comes into play.
Ryo, who can manipulate water on a molecular level, can find even tiny cancer cells on a nano level.
Since the scattered cancer cells were not large, their invasion into each tissue wasn’t too serious.
The water in the body was used like a water jet to strip away the cancer cells.
The cancer-infiltrated areas were excised … it would recover later with Rihya’s Heal…the blood vessels and lymph vessels were covered with a film of ice to prevent blood from flowing out into the body….
The same thing was done on the lungs and liver.
Since the primary tumor was in the stomach, the cancers in the lungs and liver also originate from the stomach cancer cells.
Hence, on Earth, the treatment for stomach cancer would also treat these lung and liver cancers….
However, this is ‘Phi’…and Ryo is a water-attribute magician.
There’s also a former saint named Rihya on standby for recovery, so he could boldly excise them!
As he gathered those stripped and excised cancer cells near the stomach, he further excised whatever cancer cells he could detect.
On Earth, there is a way to kill tumors so small that they are unrecognizable through cryosurgical therapy.
Originally used to treat tumors outside the body, such as skin tumors, it is sometimes used as an option for surgical removal of tumors inside the body.
But Ryo doesn’t even need that….
Since he is a water-attribute magician who can manipulate water on a molecular level.
All hail water-attribute magicians!
After more than an hour, all the cancer cells, except for those in the stomach, were finally stripped away.
As expected, Ryo was beginning to feel slightly fatigued.
Such precise control consumed a great deal of concentration and magic power.
But he wasn’t done!
It was the most important part.
That’s right.
Resection of the primary tumor, the stomach cancer.
He performed another <Scan> to pinpoint the exact location of the invasion.
The difference in elasticity from healthy areas, which cannot be seen with the naked eyes, was decisive.
“Here goes nothing.”
Ryo muttered quietly and slashed at it in one go.
He cut from the inner wall of the stomach to the serosa, the outermost layer.
The primary tumor was then placed ‘inside’ the stomach.
The stomach was then ‘filled’ with cancer cells from the lungs, liver, and other cancer cells collected earlier, while controlling gastric juices and blood flow, leaving the gaping hole intact.
Now, all the cancer cells in the body were in the stomach.
“Rihya, cast Heal on the entire body.”
“Got it. Mother Goddess, I leave it to your great healing hands, <Heal>.”
At Ryo’s signal, Rihya performed Heal on Abel’s entire body.
Not once, but twice… and then a third time to wrap up….
Ryo confirmed that the Heal had repaired the lungs, liver, and infiltrated areas that had been removed, along with the hole in the stomach, with <Scan>.
“Expelling now.”
Water was produced in the stomach, and the water captured all the cancer cells and carried them gradually up through the stomach and into the esophagus, like reflux esophagitis.
Finally, the cancer cells were removed from Abel’s open mouth into a bag of water.
“<Ice Coffin>.”
The removed cancer cells were entrapped in ice….
Finally it was all over.
Ryo took a couple of deep breaths.
Then he announced.
“Rihya, the surgery was a success.”
“Ohh…”
Hearing Ryo’s words, Rihya broke down in tears.
Ryo looked at Rihya and Abel, who was sleeping peacefully, and muttered to himself.
“Magic is truly amazing. Long live the world of fantasy!”
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