Chapter 130 - Lecture
Luci stayed back in their temporary residence with Akida while Riaku and Syryn left to attend the lecture.
When they reached the amphitheatre, Riaku led the alchemist to two seats in the front row. Almost all of the seats had already been filled in when the duo arrived. The avians respectfully allowed them to pass through and made no trouble for the non-avian attending the lecture. Syryn though was the recipient of many curious stares since his presence was unexpected. His youth and ethereal good looks, coupled with his being accompanied by their prince attracted every eye in the amphitheatre.
"They're all staring at me. Is it a rarity for a non-avian to attend this lecture?"
"We dont usually allow non Nuans inside Helios so, yes, you're a rarity. It also helps that you're very attractive."
"You think I'm attractive?" Syryn asked Riaku.
"Now you're just fishing for compliments."
The amphitheatre quieted down at the entrance of Elder Toka. He was of advanced age and had a head of greying hair. His well-groomed snowy beard reached the level of his chest. Even the clothing he wore was dignified and understated.
Behind Elder Toka was a young man who looked as young as Syryn. The young man's features were elegant and noble. Cold eyes made him look unfriendly, and on his brows was a seriousness that added maturity to his bearing. The young man wore simple clothing, unlike the heavily coloured choices that the other avians made.
"Who is that?" Syryn asked Riaku.
"Thats Utsui, Elder Toka's grandson. He's considered a young medical genius and has been working with his grandfather for the last few months. Utsui is already a full-fledged healer and working towards earning a master crest."
"Is he like his grandfather?"
"No, he's a good kid but far too serious for his age."
Elder Toka stood at the marble podium and looked around the audience till his eyes rested on Riaku and Syryn. The old man's gaze slid past the alchemist like his presence was of no consequence.
As for Utsui, the young man briefly glanced at Syryn and Riaku while heading to his spot just a few seats away from theirs.
"Good evening, young healers and students, you who are future seeds of Nua's glorious medical heritage."
And without wasting any time, the elder jumped straight to the introduction of his topic.
"Why is intestinal obstruction a medical emergency? Can someone tell me?" He asked the audience.
"The patient can go into shock," A young avian female answered when the elder pointed to her.
"Alright, and how does one go into shock?"
Several hands went up in the air and Elder Toka picked a random student. This time, it was a middle-aged man.
"It can cause a lack of blood supply and thus necrotise the affected segment of the bowel. This can further lead to a perforation in the bowel and cause peritonitis, and then sepsis which spreads and kills the patient."
"Correct. What are the causes of intestinal blockage? This is also an easy one."
"Hernias," one of them answered.
"Malignant masses."
"Inflammatory conditions in the bowel."
"Blunt force trauma which causes a haematoma."
"Volvulus and intussusception."
"Paralytic Ileus caused by surgeries or opium consumption! And mesenteric ischaemia."
"All valid answers," the elder smiled at the audience. "But you've missed the most obvious and common answer. Utsui, can you tell us what it is?"
Syryn heard the clear and low voice that answered. "Adhesions in the tissues caused by previous surgeries."
Elder Toka nodded and looked around at the audience. "I know you're all eager to come up with the most complicated conditions but that's not how you begin the diagnosis of a patient. You always start with the most obvious differentials. Now, let's get onto the meat of this lecture. We'll begin with a discussion on the symptoms of intestinal obstruction. The patient presents with the following symptoms-"
Syryn liked the Elder's way of engaging with the audience. So far he wasn't learning anything new but it was fun for him to sit there and experience something he hadn't in his first life.
---
When the lecture ended after an hour, elder Toka gave the students some time to ask their questions about the topic of the lecture. And that's when Syryn raised his arm.
Among all the hands that were raised in the air, Syryn's arm was the most obvious because he waved it back and forth like a stalk of cattail plant dancing in a breeze.
"It seems we have a very eager foreigner in our lecture," the elder said to the audience. His smiling gaze rested on Syryn with an amiability that would have fooled most people. Not Syryn. He could see the thread of disdain in the old man's smile.
Syryn put his hand down knowing he had the man's attention. The other students in the amphitheatre did the same realizing that the non-avian had snatched away their chance.
"Who are you and how did you get the permission to sit in my lecture?" The old man asked, face set in serious lines now.
"I'm the healer that Prince Riaku hired, the one you refuse to allow to see the dowager queen." Syryn hoped he hadn't just said something that would get the prince into trouble. From the lack of reaction on Riaku's face, it seemed he hadn't blabbered a secret.
Elder Toka chuckled. "A healer still green behind the ears, how old are you, foreign healer?"
"My age has nothing to do with how much better I am than every healer present in this lecture," Syryn replied without any pride in it.
The amphitheatre was completely silent as the old man looked down at Syryn with the weight of reproach that an elder would express towards an arrogant youngster.
"Your highness, this is the reason I keep insisting on how inferior foreign healers are. This utter lack of propriety and humility has enlightened me as to the kind of healers the outside world churns out. He looks even younger than Utsui. What kind of joke is this?"
Riaku glanced at Syryn and sat quietly. His nonchalance mirrored Syryn's.
"I may be arrogant but I'm not a pompous old fool who disregards a healer chosen by the prince, at least not without first gauging their level of expertise. You took one look at my age and decided I was no good. I could say the same for your dearest grandson." Syryn's violet eyes languorously looked Utsui up and down like he was appraising an object. "He's a very handsome gentleman but what about his skills? How much practical experience does he have? Can he make a patient feel comfortable despite looking gloomy enough to chase away all the weak-hearted patients? Does he know that his grandfather's lecture did not mention a type of intestinal blockage that's uncommon but still important enough to be included?"
That final question drew a sharp glance from Utsui who was writing down something on a parchment.
"Elder has not missed anything," Utsui replied with a frown. "Every single type of blockage has been included in the lecture."
"The foreign healer speaks nonsense," Elder Toka informed his grandson. "Do not lower yourself to engage with him in the capacity of a healer."
"But aren't you curious?" Syryn directed his words to Utsui. The smile in his eyes compelled the young man to reply.
"If you have nothing meaningful to contribute then you will have wasted all of our time." It was a yes. Elder Toka was very fond of his grandson. If Utsui wanted to hear the explanations of the foreign healer, he would allow it.
"It'll be worth your time," he smiled coyly at the young man. Syryn was out to needle Elder Toka who looked unhappy with the way his grandson was being eyed by the foreigner. "Have you ever seen a case of intestinal blockage caused by a gallstone?"
Utsui's brows drew together with displeasure. "The gall bladder duct is so small that all the larger stones get impacted in the tract itself while the smaller ones get defecated after pushing through the tract. It is impossible for such a blockage to happen."
Elder Toka chuckled and the crowd of students began laughing and jeering at Syryn.
"It's alright students, let's learn about this new type of blockage from the foreign healer. Why don't you get up here and teach us then?" The old man said, expecting Syryn to cower and retreat.
The alchemist shrugged and made his way to the podium under the surprised gazes of all the people in the amphitheatre. They had no idea he was such a gutsy fellow. Everyone was expecting the alchemist to make a fool out of himself. What did he know that elder Toka didn't already know?
In a confident and measured voice, Syryn began to speak. "I thank elder Toka for giving me this opportunity to enlighten Nua's healers. I can only hope that my explanation will help your understanding to improve."
Syryn then pointed to the large anatomical diagram that was painted on a white paper screen. It was an exquisitely detailed piece of art that even the alchemist admired.
"Can anyone of you tell me what a fistula is? Utsui, you answer."
"An abnormal passageway in the body."
"So you aren't just a good looking face after all," Syryn said to the glowering man. "Anyway, a gallbladder-duodenal fistula is an uncommon bilioenteric fistula between the gallbladder and the duodenum. It usually occurs following a chronic case of cholecystitis upon which the gallbladder adheres to the adjacent duodenum, and a stone penetrates through the wall-"
When Syryn slipped into his lecture mode, his disdain for the elder was forgotten. The alchemist confidently walked about the stage like he had already been there a hundred times lecturing his students with clarity and crispness. If there had been any doubt about his knowledge of anatomy or medicine, it was washed away as he continued to speak and uncover his broad understanding of medicine.
Syryn's explanation was logical and it made sense. All the people gathered in that place were finally beginning to realise that it was possible. There was another type of blockage they hadn't heard of.
The atmosphere in the amphitheatre changed to one of complete silence and seriousness. Quills began to scratch on the surface of parchments as all the students began taking notes. Even Utsui was doing the same. As soon as Syryn had begun explaining the condition, the young man's gaze had become intense and he was listening with the same focus as he would during his grandfather's lessons.
"Patients with a biliary-enteric fistula are often seen with non-specific signs and symptoms that mimic those of chronic cholecystitis-"
Syryn hadn't intended for it to happen but his lecture had stretched to half an hour. His sights grazed the elder who was sat next to Utsui. Elder Toka was deep in thought and did not interrupt Syryn's lecture. When he wound up the lesson, the alchemist looked around at the hundred or so people and asked.
"Any questions?"
Almost every hand in the crowd went up including Utsui's.
"So many hands," Syryn perused the crowd with lazy eyes. A small sadistic smile lit up his face and he told the crowd of people, "It's too bad that I'm just a foreign healer who knows nothing. Save your questions for the esteemed elder Toka who knows more than I do."
The alchemist then added one final insult for the angered elderly man.
"And for those of you who are interested in the knowledge that a foreign healer might have to share, I'll be treating a patient of Nua who your glorious healers could not cure. If you have the connections, find me at that patient's house at nine in the morning and I will answer whatever questions you have. In addition, you'll have the opportunity to witness me at work. Come if you're capable."
Syryn then left the stage with an easy confidence that swayed all the hearts of the people in the amphitheatre, including the elder's.
"Utsui, what do you intend to do?" Elder Toka asked in a low voice.
"I don't know who he is but he has my respect, grandfather. I will do my utmost to find out which house is hosting his presence as a healer." Utsui had never met anyone younger than himself who not only knew more but was also qualified to be made a master healer, at least based on what little he had gleaned from the teen's knowledge. His gaze followed the exit of Syryn and Riaku. Whoever he was, Utsui was determined to find him again.