Chapter 12: Laryngeal Swelling? Can Divine Arts Help?

Chapter 12: Laryngeal Swelling? Can Divine Arts Help?

Tracheal intubation—if Garrett hadn’t done it ten thousand times in his past life, then at least eight thousand.

In modern hospitals, there were really only three departments that did intubations frequently: Anesthesiology, Otolaryngology (ENT), and the ever-versatile, jack-of-all-trades Emergency Medicine.

For scheduled surgeries, it was routine—an anesthesiologist could handle the intubation, or ENT could help out. ENT, after all, specialized in throats (it was in the name), and their grasp of the anatomy was top-notch. Intubations were second nature to them. As long as the surgery was planned and evaluated in advance, everything went smoothly.

But the emergency department didn’t have that luxury.

If a patient was already suffocating, that tube had to go in—immediately. What were you going to do, call for a consult and wait for someone from Anesthesia or ENT to come down? Whether they took the stairs or the elevator, in those few minutes, the patient could be dead!

So, we poor, overworked ER doctors had no choice. When push came to shove, we just rolled up our sleeves and did it ourselves...

Garrett had intubated via the mouth, the nose; with tracheotomies and without; using standard tubes, reinforced tubes with steel wire, tubes with built-in suction—he’d done them all.

All except this one.

A. Chicken. Bone.

The ends cut off, slightly smoothed. Porous trabecular bone still clinging to the inside. Sterilization? Highly questionable.

If he had any other choice, Garrett would never use this thing in place of a tracheal tube. But with nothing else at hand… well, a chicken bone was better than nothing, he supposed.

And while he worked, he had to multitask—explaining to the curious cleric at the same time:

“Once the cricothyroid membrane is opened—what’s the cricothyroid membrane? It’s this spot I cut. You can’t just slice anywhere on the neck; this is the safest place to make the incision…”

“After the cut, you need to insert a tube quickly, or else the cricoid cartilage could collapse or get damaged and lead to airway obstruction. What’s the cricoid cartilage? Why does it get damaged? What’s airway obstruction? I don’t have time to explain right now…”

“In kids, the airway is really narrow, so you can’t push the tube in too far. If you miss and go into the esophagus instead, you’re in big trouble…”

And on and on and on…

If this were a student of his, asking these kinds of basic questions during an emergency, he’d have thrown them out of the OR to reflect on their life choices—What the hell were you doing during lectures!?

But this was a cleric from another world. He couldn’t have known any of this. And besides, Garrett didn’t have the luxury to ignore him right now, so he forced himself to answer with half a mind while focusing the rest on the task.

No shadowless surgical lights. No overhead fluorescents. Just flickering candlelight and torches—and not even someone holding a reflective mirror to help, either. Even Edison used a mirror when he helped his mom, right?

...Well, though that part of the story might’ve been made up.

“Oh, so then—”

“Don’t talk! I’m starting!”

The cleric jumped, lips snapping shut.

Garrett lowered his head. In the swaying, dim light, he carefully aligned the chicken bone with the incision in the cricothyroid membrane. Steady hands. He pushed in.

There was a slight resistance—then a familiar “give” at his fingertips. That sensation told him the makeshift intubation—the chicken bone—had broken through the opening and was now inside the laryngeal cavity.

A faint, whistle-like sound of air moving through the bone met Garrett’s ears.

It worked!

Now the next step was… uh, securing it.

Oh crap! Oh no!

He didn’t have tape!

Nothing to hold the chicken bone in place—nothing to secure it to the child’s neck to keep it from moving!

What the hell could he grab to MacGyver this thing together…?!

On his first day in another world, during his second emergency surgery, Garrett once again found himself on the verge of tears.

As it turns out, when it comes to saving lives, a doctor's imagination and creativity truly are limitless.

He stared for less than a second at the child’s throat—where a chicken bone now protruded—before making up his mind. Without hesitation, he grabbed the boy’s hand and shoved it into the farmer’s:

“Uncle Edmund! Hold him tight!”

He spoke with sharp urgency, grabbing the farmer’s other hand and pressing it down firmly onto the child’s shoulder:

“Don’t let him move! Not even a little! Especially the neck—this tube I stuck in, it must not move! Not even slightly!”

The bearded farmer nodded vigorously. He called over several other men, and together they pinned the boy down carefully but firmly. The cleric, who’d been holding his breath this whole time, finally exhaled in relief and asked anxiously:

“So it’s done now?”

“Far from it.”

Garrett gave a bitter smile.

He pointed to the boy’s throat and motioned for the cleric to take a look:

“See? His larynx is still swollen. He still can’t breathe properly. He’s not out of danger until the swelling goes down.”

“Is that so?”

The cleric bent down, squinting hard, even trying to coax the child into opening his mouth. But the lighting in the hall was too dim, and after a long struggle, he gave up and snapped his fingers:

Pop!

A soft white glow floated upward, gently drifting toward the boy’s mouth.

“Hey!”

Garrett’s eyes widened. Alarmed, he snapped:

“Don’t cast anything yet! You can’t just treat him like this!”

“But—it’s just a light spell…”

The cleric flinched at the scolding, looking a little hurt. The knight beside him gripped his sword and glared at Garrett with barely concealed hostility.

Garrett didn’t notice—or didn’t care. He leaned close to the cleric, pointing insistently:

“Look inside his throat... the very back. It’s all swollen, isn’t it? You can’t even see the black opening that’s supposed to be there. The swelling goes deep. Air can’t pass through. He nearly suffocated just now.”

“You’re a cleric of the Spring Goddess, right? You can control water—can you, I don’t know, drain the swelling?”

“What’s ‘drain the swelling’?”

“Make the swollen parts release the fluid. Stop them from blocking the airway.”

“Oh…”

The cleric froze. He frowned deeply, thinking hard, then shook his head:

“There’s a high-level divine art like that—but it’s an attack spell. It drains all water from the body. Way beyond my level. But to just target one tiny swollen area like this… I don’t know. I’ll pray—see if I can receive divine guidance.”

And with that, he knelt down.

He didn’t even care that his silk robe was being stained by the dusty ground. Knees to dirt, hands clasped at his chest, he began praying—long, rhythmic chants in an ancient tongue.

Minutes passed.

Finally, he raised his head and sighed in defeat:

“No good. The goddess didn’t respond… What about you? Do you have a way?”

Once again, all eyes turned to Garrett—full of hope.

Garrett stood in silence.

‘I was hoping I could skip the steps and jump straight to the solution with divine magic… but no. It still won’t work?’

‘The limitations of divine arts are just too great. If the answer is already known, you can use it. But if there’s no ready-made spell… there’s not even a starting point.’

‘Well then… once again, it’s up to me.’

Modern medicine will have to take it from here.