Basic Medicine (self-mod)

[Magus Syfer]

Dianara, Third Cycle, Kalendryas, Autumn, Era II, PF XI

Room 109, room 109. Like chanting a mantra called 'Room 109', Magus ran up the stairs leading to the rooms that served as classrooms for the Insitute of Higher Learning. Though the starting time was not specified last brightening, Magus had an inkling he might be late for his lesson. He had awoken up late this morning, and had nearly forgotten about the lesson. That was the excuse, which was none.

Magus rapped sharply on the doorway of Room 109, and waited for his teacher to open up the door. A tall gangly youthful-looking man opened the door, and greeted him. Surely this can't be the teacher. He's ... he's too young. While Magus looked on in disbelief, the young man explained himself.

"Serale. You must be Magus. The teacher of Medicine is currently inside. I'm just about to leave now. Have fun." Odd, perhaps he's a fellow student of the teacher...

Magus watched the back of the man disappear before he pushed open the door, and turned to greet the lone figure in the room. Shock registered on his face. It was a woman. A woman who looked a bare 5 years older than he. Though with women, Magus found it hard to tell their exact age. They have this ageless quality to them, until they hit 40 that is.

Magus bowed his head curtly. "Serale, I am Magus, your new pupil. I believe we are to start classes from this brightening?" He waited for the reply. A game of coyness and bravery.

"Ah, serlae Magus. I have been awaiting you. I'm Miranda. Please be seated. I'll be going through the basic principles of medicine this brightening and in the subsequent lessons. THis will be followed by a short examination at the end of the course, to assess how much you have managed to learn in the time."

Once seated, Magus found himself calm enough to give his new teacher a closer inspection. She was human, just like him. A human female, shorter by a bit. Holding herself with dignity and an air of confidence about her. Lustrous black hair, shoulder-length no less, hung free. Brown eyes with a piercing quality. Luscious lips, thick and red. A woman whose beauty many men would dream of.

[Magus Syfer]

Miranda cleared her throat. "Right, now we start on the basics of Medicine. Medical Practitioners in the empire require special kits with which they use to heal people. During your course at this institute, everything will be provided for you to use and subsequently practice with. However, once you leave the university, you need to buy yourself a medical kit for your personal use. Needless to say, that which you borrow from this university will have to be returned.

Here, take this. This is a list of the necessary equipment, and also a simple list of the new vocabulary you have to become acquainted with for this course." Miranda handed over a parchment. Magus accepted it graciously, and eagerly pored through the lists.

Basic gear:
Field pack
Medical Kit (pouch)
Prod
Blade
Sewing kit
Fabric
Pads (pack of 3)
Bandages (medium or large roll)
Pegs
Water bowl
Pouch
Pill
Stretcher (folding type)
Pick
Parchments (pack of 10)

Closed fracture: crack in the bone that doesn’t cause splintering of the bone. May not be visible.

Compound fracture: break in the bone where the bone has splintered. May be accompanied by a wound where the bone has torn the flesh (Usually visible).

Pulse: the pulsating of veins as the heart pumps blood through them.

Pulse Points: inside of the wrist, either side of the neck, or over the heart itself. Even though there are 11 pulse points, these are the areas one can most easily check for a patients pulse (see pressure/grasp method).

Tourniquet: made of fabric strips varying in length but usually two feet long. Used to stop bleeding from a limb by wrapping a fabric around the limb above the wound then placing a peg into the wrapping. The peg is twisted until the blood flow stops but usually results in the loss of the applied limb if not removed promptly.

Stretcher: any canvass or clothing stretched out using poles on two sides to be used as a platform or transport for patients. The stretcher is carried from two ends by holding the poles. A folding type stretcher can be made or bought and is used as the frame of the field pack.

Magus nodded. He would be able to get all those equipment with relative ease at the markets. As for the list of vocabulary, he had already memorised them. "I've already learned off the list, Mistress Miranda. What do I need to do now?"

Miranda reply shortly. "Just Miranda will do. So, you think you already know them off by heart? Well, I'll have to test you. Place your parchment face down, so you won't be able to cheat. Ok, now, what are the two type of fractures listed that you can have, and what are the main differences?"

Magus paused, rummaged through his memory banks, then grinned. "Well, the first fracture is called a closed fracture. I think it's the one that doesn't cause the bone to splinter, so in a way, the name makes sense. The next type of fracture is called the compound fracture, and that's when the bone has splintered, so the problem is compounded by the fact that you have fracture and splintered your bone."

Miranda smiled in satisfaction. "Very well, then. Tell me, what are stretchers and tourniquets used for?"

Magus instantly replied. "Well, stretchers are used for transporting the injured, so they can lie on them and not move around much. I suppose this is due to prevent any further injuries to them caused by too much movement. And the tourniquet is used to prevent bleeding, but because it stops blood from flowing, I guess that's a bad thing if other parts of your body need blood. So you have to take it off shortly after."

[Magus Syfer]

Miranda nodded in satisfaction, as was her habit. This student seemed to be able to grasp the basic principles she had presented to him so far.

"Very well, Magus. Next we move onto the basic procedures a healer provides. This will include applying a splint, using a stretcher, how to carry a patient properly, how to use a pressure dressing effectively, how to check for the patient's pulse, how and when to apply a tourniquet, and also how to use mouth-to-mouth breathing to help them breathe." Miranda brought forth a bag, filled with many medical implements.

"Firstly, a splint. A splint is mainly used to stabilize a closed fracture. To apply a splint, you require a peg, and a wide bandage or some sort of fabric. Like this." Miranda lifted a peg and a bandage from within the bag, and showed it to Magus. "Now, let's say that I have a fracture in the leg. I begin by tying my injured leg to my uninjured one, like so. Then I use to peg to hold the bandage in place, to support the injured leg. The same principles apply if the fracture is in your arm. Now, I want you to try it."

Magus accepted the proffered bandage and peg. After a few confusing and ultimately failed attempts, Magus succeeded in duplicating the splint that Miranda had previously demonstrated. "Did I get it right? It does seem easy once I get the hang of it. So, what next?"

[Magus Syfer]

Miranda wordlessly pulled a stretcher off the desk. Its rough canvass body was framed by a pair of sturdy sticks that served as support. "Now, I'll show you how to use this stretcher. We'll stretch open this stretcher, and on the count of three, gently lift and lower the dummy onto the stretcher. Be careful not to move his body overly much. In a real patient, this could very well aggravate his injuries, something we most certainly do not want. Now, go to his legs, and grab them. Yes, like so." Magus obediently gripped the dummy by the legs, while Miranda went to the dummy's shoulders. "Now on the count of three... one... two... three, and lift." In a co-ordinated manner, the dummy was lifted and gently placed onto the stretcher.

Magus was rewarded a smile by his tutor. "Another job well done. You're proving to be a natural, young man. Now, in certain situations, where you don't have a stretcher handy, you can always substitute a blanket in its place. Simply place the blanket on the ground, the patient on the blanket, like so. Then drag the blanket along." Miranda demonstrated the procedure, and motioned Magus to do the same.


The young healer-to-be meticulously laid out the blanket he was given by Miranda. He spread it evenly onto the ground of the classroom floor, making sure that the edges were straight and not folded onto itself. Then he gently lifted the patient by the shoulders, and with patience and care, shifted the patient onto the blanket. Wrapping the blanket a bit around the patient, Magus proceeded to drag the blanket for a few feet, before halting and looking to Miranda for assessment of his progress. "Good. Now, onto the next task."

[Magus Syfer]

Miranda picked up a pad and a bandage. Bending down to the inert dummy that lay facing up, its discoloured eyes staring at her, she motioned Magus down so he could watch her. "Now, this next technique is called the Pressure dressing. It is primarily used to control bleeding, but also to prevent a large clot forming on the outside, and also to protect the wound from any disease carriers. First, we look for the wound. If there are any clothings obstructing the view of the wound or interfering with it, we must carefully cut away the clothing so we have a clear path to the wound. Don't attempt to clean or touch the wound in anyway.

Next, once we have a clear path to the wound, apply the pad directly onto the wound. Then roll the bandage around the pad and secure it with a tight, but not constrictive knot. Sometimes the wound doesn't stop bleeding, for one reason or the other. In that case, you simply elevate the leg or arm for about 5 to ten minutes, until it stops. But if the bones are fractures, don't attempt to move them at all."

Magus observed the demonstration with keen interest. So far, the lessons were progressing smoothly, to his liking. Taking the proffered bandage and pad from his tutor, Magus bent closer to the dummy, and imagined that there was a wound on its leg. He gently applied the pad onto the imaginary wound, as imaginary blood leaked out uncontrollably and refused to stop, staining the bandage an imaginary dark crimson. Then he proceeded to tie the bandage around the leg, securing the pad as he did so, terminating the bandage ends in a knot. He gently elevated the leg, and then placed it down once he considered the charade over.

[Magus Syfer]

Though Magus was quite comfortable with the idea of using the pressure dressing, he thought to himself, but what is the wound is far too large for the pad, or we don't have enough bandages at hand?

This concern was subsequently articulated to Miranda, who responded readily. "Well, there is another technique called Pressure Grasp. This involves applying pressure with two fingers, not the thumb, to particular points around the body called pressure points. Depending on where the wound is on the body of your patient, you have to apply the pressure grasp onto the pressure point nearest to the wound, and on the pressure point that is between the wound and the heart.

Perhaps I should go over the 11 pressure points briefly with you. Now, they are: at the lower jawbone just below last back tooth, the temple, the side of neck, the top of collar bone, in the inner side of bicep, just below inner side of elbow, on the wrist, in front of pelvis, at the top of quadriceps, at the back of knee, and on the ankle." Miranda slowly went over the location of the pressure points on the dummy, making sure that Magus understood what she was saying. It was a mouthful, to be sure. Magus frowned throughout the whole lesson, trying to memorize all the details, as much as he could. Through the jumble of information, he made a mental image of the human body, and placed imaginary flags over the top of the pressure points. This will have to do, he hoped.

When Miranda requested him to go over the dummy and start applying pressure to all the different pressure points over the whole body, Magus ummed and errred and tentatively pressed on each of the points just like he remembered. At the healer's instigation, Magus repeated his locating of the pressure points, and pressed harder into the dummies inanimate skin. He felt the familiar sensation of everything falling into place, as he realised that he could probably do this in a real case scenario. He allowed himself a private grin.

[Magus Syfer]

Miranda motioned Magus to approach her, and took hold of his hand. Magus gulped, unsure of his teacher's intentions. A coy smile played at her lips, as she regarded him in turn. She winked at him, and Magus blushed.

"Alright, now your next lesson for this brightening will be to learn how to check for pulses. Checking for pulses is important to make sure that your patient's heart is still beating. The principle is quite basic, simply place two fingers at points along the body that you are able to feel the pulse." With Magus' hand still in her grasp, she guided it towards her neck, directing his two fingers onto the lateral side of her neck, where her pulse was beating calmly. Pressing the boy's fingers firmly against her skin, she looked at Magus, and raised an inquiring eyebrow.

At first, Magus was unsure of what it was he was supposed to feel. But after a moment, he could feel the pulse pulsating beneath his fingers. The calm, monotonous beating of blood coursing through her carotid arteries amazed him. It was vibrant and seemed so full of life. "I think I can feel it. It... it certainly pulses alright."

Miranda smiled at the enthusiasm her young charge displayed. "Excellent. Now, there are several sites where you can feel for the pulse. These include around the side of the neck and at the sides of the wrists. Alternatively, you can simply place your ear against the chest of your patient, and listen for the heartbeat. Now, a word of warning. Never feel for the pulse points on both sides of the neck at the same time, or else you risk cutting off the blood supply to your head, and get all dizzy."

Magus nodded. Relieved that Miranda had let go of his hands, he took a deep breath and focussed on his tutor once more. A throbbing headache began to form, gradually entering his consciousness. He shook his head, as if trying to dislodge the ache from his head. It didn't work.

Miranda, busy continuing with the lesson, failed to notice Magus' discomfort. "Now, for the last technique I'll teach you for the brightening. This technique may seem a bit intimate, however in emergencies it can be a true life-saving technique. Pay close attention. When a person's heart is still beating, which you can detect using the pulse check, but he or she isn't breathing, then you must help breathe for them until such time as professional help arrives. Essentially, to properly apply this mouth-to-mouth technique, you must clear all obstructions to the person's airways, by sweeping their mouth clean with your finger. Afterwards, place your mouth directly over theirs, sealing it tightly so no air can escape from any stray holes between contact. Tilt the person's head up a bit, so their chin juts up to the sky, and face towards the person's chest. Then proceed to steadily breathe in through your nose, and exhale into their mouth. Their chest should rise as you breathe into their mouth. Do this at a constant rate of about 20 times a minute, as long as you can. Now, have a go with me."

Miranda sensuously clasped a hand around Magus', and dragged him down to the floor with her, as she gracelessly flopped down. Guiding his hands to first check her pulse, then pulling his head down towards hers, Miranda went limp, pretending to be unconscious. Sweat began to form on Magus' brows. The intimate contact frightened him somewhat. Steeling his resolve, Magus enveloped the feminine lips of Miranda, and tilted her chin up. Turning his hand to look at her chest, he suddenly blushed. He was looking straight down her chest, from the top. Realising that Miranda was still waiting for him to perform his task, he hastened to breathe in and out. In his rush, he breathed in too fast and shallow, causing Miranda to sputter and sit up. "That - was alright for a first attempt. Try to breathe in and out more slowly, and calmly." She understood his nervousness, having taught many a student the same course before.

Magus did as he was instructed and once again covered his tutor's face with his mouth. Now, he poured all his concentration into breathing in and out, in and out calmly. Miranda placed a gentle hand on Magus' shoulder, indicating to him that he could stop. Magus stood up, and bent down to help lift Miranda upright. "Very well done. Now, I just have a few more things to teach you, then we're done. Come back next brightening. It's already getting too dark here."

[Magus Syfer]

Ioannolia, Third Cycle, Kalendryas, Autumn, Era II, PF XI

Magus rapped on the doorway, waiting politely for an answer. He could hear animated whispers behind the doorway, and decided it would be unwise to intrude upon his tutor when she could still be unprepared to see him. Presently, the door opened, and the same young man Magus saw last brightening came out. Magus nodded to him, then proceeded through the open door. Miranda sat calmly, as if she had been waiting for Magus this whole time. Her hair appeared slightly dishevelled, and she was trying to surreptitiously comb it with her hands without alerting Magus to the fact. She failed.

"Serale, Miranda. I hope I didn't come too early, and disturbed you."

Miranda sighed, before schooling her face in an unreadable mask. "No, not at all. I was about to go and see if you came. So, this brightening, we might be able to finish all the theory part of your course. Now, first technique you'll learn today is how to apply a tourniquet.

Now, the use of a tourniquet is quite dangerous as it severely restricts blood flow, so it's often used only as a last resort to stop blood loss in severe accidents. Come over here to the dummy. Now, imagine there is a large gaping wound on the dummies hand. Watch as I wrap the fabric around the arm between the wound, and its heart. Don't wrap it directly around the wound itself. Now, using a peg, place it under the wrapping, and twist it until the flow stops and the wound stops bleeding. Right, now use a second fabric to secure the peg to the limb, like so. And that's it."

Magus grinned at the simplicity of the task. It seemed similar to the pressure grasp last brightening, only more effective with the use of fabric and peg. He took the fabrics and peg from his teacher, who had just unwound it from the dummy's hand. Imagining a wound on the dummy's hand, he wrapped his fabric around the arm just above the wound, firmly pulling the ends to make sure that it wasn't loose. Then he took the peg from Miranda's proffered hand, and pegged the ends of the fabric. He proceeded to twist the peg, until it could twist no further. Satisfied that this would result in the halting of blood flow in a real person, Magus used the other fabric, and secured the peg as Miranda has done.

[Magus Syfer]

"Now, the next thing you need to learn are the four life-saving steps, that all stewards, indeed everyone in the medical profession, should be aware of. These steps are very important for patients with life-threatening conditions, should you come across them in your travels or trade." Judging Magus suitably cautioned on the dangers to his patients should he forget these steps, Miranda proceeded to list them out to him, before she would elaborate upon them.

"The first step is to restore their breathing. If your patient is not breathing, check for their pulses and use your mouth-to-mouth technique to help breathe for them for the time being, until more professional help arrives, or perhaps, Gods willing, they start breathing for themselves.

The second step is to stop their bleeding. Using the Pressure grasp or pressure dressing techniques on the patient, stop their blood loss. Assess them if they are strong enough to walk. If you think they need help getting to the nearest clinic or hospital, use the stretcher or carry them yourself.

The third step is to protect their wound until further help can be given by more experienced professionals. If they suffer from broken bones, back or neck, apply a splint and carry or stretcher them to the nearest hospital. Be very careful when moving them, and try to limit their movement at all costs. We don't want to aggravate their injuries. If you cannot safely move them, then wait for expert help.

Now, the last step is to treat them for shock. Give them plenty of fluids, especially clean water, to replenish their volume of blood lost."

[Magus Syfer]

A sudden loud crash could be heard coming from outside the doorway, followed shortly by sharp words of cursing and yelping. Alarmed, Miranda moved towards the doorway, to open and see what the commotion was about. Magus fumbled after her, equally as curious. The door swung cautiously swung open, and the two peeked outside the classroom.

A young girl, perhaps around Magus' age, was sitting on the floor, her face contorted in pain, while clutching her left arm with her right. A large pot plant, previously sitting happily on a nearby pedestal, was now dissembled into smithereens around the girl, scattering dirt around her. A forlorn looking plant lay forgotten at her feet. Around her, shocked onlookers only gawked in fright and looked to each other, uncertainty apparent in their eyes. Miranda moved to break up the crowd gathering about the girl, who was bravely trying not to yelp in pain even as she gasped intermittently and tried her best to limit the movement of her left arm. "Right, can't you daft people see the girl's in pain? Now be off with you, she needs her space to breathe. Go back to your rooms, now!" The last sentence came out as an angry roar. When she assumed her Healer mood, she brook no defiance at her orders.

She turned back to Magus, all the while looking sharply at the extent of the damage wrought upon the girl's broken arm. "I'll need to get my equipment from the infirmary. In the time being, I want you to stay here and take good care of her. Treat her for her broken arm, and I'll come back and finish off the job. And make sure those nosy people stay away from her." With a last harrumph in the direction of the gawkers, she strode off.

Seeing Miranda gone, Magus breathed a sigh of relief. The sudden change in personality and her abrupt forcefulness stunned and frightened Magus to no little degree. He bent down over the young woman, and attempted to comfort her. "It's alright. Help will be here shortly. Now, what's your name? Eliza? Serale Eliza, my name is Magus. Now, don't be frightened. Can I have a look at your arm please? Yes, that's right, slow and easy does it." Carefully, Magus hopped over to the other side of the girl to inspect the arm close up.

It didn't seem like the skin was broken at all, though a good part of her arm had already puffed up and glowed angry red. There didn't seem to be any signs of external bleeding anywhere, though Magus wasn't sure if the fractured arm was bleeding internally. It was fortunately the more benign of the two types of fractures, the closed fracture. Magus breathed a small sigh of relief. Perhaps I should go and apply a splint for her, so she can be ready to move out by the time Miranda returns. Leaning to the woman again, Magus whispered. "Now, Eliza, I have to go and get some bandages first. I'll be back shortly. Just stay put and don't try to move, you hear? I'll be back quick." All Eliza could do was bite her lips even harder, trying to bear the pain.

He ducked back into the room, and rummaged through the pile of material left over from his lessons with Miranda. He picked up several pieces of fabrics, and a couple of pegs, and hastily returned to the girl's side. By that time, a small crowd of curious onlookers had begun to gather around her. Waving his hands in an angry shooing motion, he made quick work of dispersing the crowd. Gently, he wrapped the fabric around the arm, and stabilised it with the pegs, making a makeshift sling. All this time, tiny whimpers of pain would sometime escape the woman's lips.

"Sorry, I know it hurts a bit. But you'll just have to bear with me. Now that I've made you a splint, we'll wait for Miranda to return together."

Before long, Miranda had returned, still retaining her cross expression, but carrying a medical kit. Mumbling something about having trouble finding her materials, she expertly assessed the extent of the damage. "Hmm.. the fabrics are a bit too loose, but apart from that, it wasn't too badly made, all things considered. And thank you for your help in taking care of little Eliza. She's always breaking things; but I didn't think she'd break her arm this time."

Relieved that Eliza was under expert supervision, Magus gave his tutor thanks, and bid them both farewell.

[Dragon]

OOC: Approved. Not an expert on medicine but it seemed good to me