Parallel World Pharmacy

Volume 3 - Ch 14

Translator: yompyamper

By the second day, Palles lung hemorrhage had settled down.

Palle was able to breathe without the need for oxygen inhalation, partly due to Falmas dedicated care and the possible effect of the magic wand. Apparently, it seems that the prepared blood transfusion is not needed.

Still, getting up caused made him out of breath because of the anemia, and just taking a bath back to keep clean was a lot for Palle.

While attending Palle, Falma did not close the pharmacy, leaving Ellen and a first-class pharmacist in charge. Different world pharmacy keeps prescription records of their medicines, so the same medicine was given to patients with the same condition as before.

New illnesses or emergencies that day were redirected to the house of De Medicis.

Given the risk of carry-over of infection, patient medical treatment was done in an isolated room.

Melody processed the metal one day after the order and delivered the cylinder. Although the pressure gauge was not installed, there was no problem because it was possible to calculate the absolute pressure in the cylinder and to calculate the flow rate by eye with Falmas material generation power.

The valve has also been made as specified. Once Falma filled it up with liquid oxygen, it functioned well as an oxygen cylinder.

Now Palle can use his own oxygen mask when he has a hard time, and he doesnt have to be stuck with Falma.

The number of visits to Palles room was also limited.

Once a day, only for family members. Although the sanitation sanctuary cleans the entire mansion, the sterility is also broken because of servants coming in and out of the mansion. So, basically, Palle was asked to not come out of his room. It is a strict management system where even the opening and closing of windows is also limited.

Palle was convinced by Falmas rational explanation of why he had to do so.

Blanche and her mother came to visit by taking turns. They were completely covered in protection such as masks and protective clothing. Palle pretended to have a minor condition in front of his mother and sister, who responded by saying strong, or by joking.

After closing the pharmacy, Ellen came to check up on Palles medical condition.

Palle, how are you doing?

Ellen came with a large bouquet of fresh flowers and a large patisserie cake she ordered.

Since Ellen was on a horse, she changed all her clothes, disinfected her hands, changed her shoes, before coming to this place to prevent infection.

Oh, its going well. Its a bad thing Im splitting up the pharmacy by borrowing Falma. Im telling you to go back to the pharmacy, really

Palle tried to convince Falma many times, Im fine, you should go to work, but Falma stubbornly refused to leave Palles side. Because if there is a sudden change in his condition, even rushing over would be too late.

No, its fine. I would like Falma to be with Palle. He needs to be here. Is it difficult to treat?

Ellen imagines Palles suffering from leukemia treatment. Palle being connected to the drip must be painful.

Well, its not as bad as I thought.

Palle said in vain.

Really!? Falma didnt say so though.

Its no big deal, not at all.

If thats the case Its really fine.

Ellen truly believed Palles words of strength. Ellen falls in the category who are convinced by his lie. But she still didnt see Palles inner mind because his performance was too clever.

Oh, I must recover quickly and settle down with you. Ill do my best, ha ha ha!

If you have the strength to laugh like that, its fine

Ellen relieved his heart.

Well, do your best. Lets settle down once you get well

As Ellen shuts the door, Palle slumps onto the bed. Talking for a long time was exhausting.

Falma, who had been treating patients in a separate room, entered the hospital room just after Ellen had finished disinfecting.

My brother, breathing is tough. I heard laughter a few minutes ago. If you raise your voice like that, you will be out of breath

Dont say that, let me tell you about strength

It was too loud, Ellen was worried.

As men of the De Medicis family, it cant be helped to make a racket in front of a girl

Falma felt that he saw his way of life, the awareness and pride as the eldest son of a large aristocracy.

On the morning of the 7th day of treatment, Palle was pouring simmering soup down his throat. What was served to Palle was a stripped-down menu of raw food, spices, oils and fats, and dairy products, in order to reduce the burden on infections and digestive tract.

Dont worry about your diet while on anti-cancer drugs, were paying attention

Palle was lonely during the prolonged treatment. His drinks were not fresh juices, they were raw waters, hot water or product water.

His leg strength was also weakening because he lives in bed.

Its easy to get infected and Ive never been too cautious

Falma also takes the same diet as Palle in the same room. Thats because of the concern for Palle.

Speaking of which, with the decrease of white blood cells caused by the anticancer drug, Palles infection was avoided.

Once in Falmas sanctuary, the risk of bacterial infection is extremely reduced.

I dont want you to eat the same meals as me. Eat properly, meat and fish. Just give up

Palle smiles wryly as if he does not care about being in such a place.

Because you will be tired, it is best to sleep well during the daytime

Im not tired. My fathers potion works, how are you

Brunos nutritive drink was so effective that I thought it might contain drugs. Palle who heard that obviously makes a strange face.

Translator: yompyamper

Editor: Sam

Fathers medicine is really effective, isnt it? My original goal was to become a pharmacist just like him, whose medicine is said to be the most effective on the continent. However, now thats changed.

Having said that, Palle continued to quietly eat his bland meal.

What caused your goal to change? Falma asked, pretending not to know the answer.

Nothing, Palle mumbled in reply. It was just a slip of the tongue.

Falma let it slide. I understand. Then Ill pretend I didnt hear anything.

But it wont always be this way! Ill learn the Medicine Gods knowledge myself and overtake you! Haha-cough-hahaha!

As Farmas elder brother, Palle played the part and never complained to him. Even though Falma was pained at Palles condition, his mood was improved by Palles bright and energetic personality.

Brother, youre still coughing, so stop it. Besides, if youre feeling better then I want to resume ATRA treatment. The symptoms of pulmonary hemorrhaging have disappeared.

Without ATRA treatment, the number of leukemic cells will begin to grow again. The leukemia could also cause further internal hemorrhaging, independent of ATRAs side effects. Furthermore, Falma was apprehensive of the possibility of cerebral hemorrhage, so he was looking for an opportunity to resume treatment as soon as possible.

Wont things just turn out the same way?

Palle gulped. He was just laughing and smiling, but now he was cautious.

The risk is always present, so next time well start from 75% of the original dosage.

Palle remembered the pain from the hemorrhage and thought about how he had wanted to die.

He made up his mind. I know I need to do this. Lets just get it done.

Still, was there any treatment more terrifying than this one? In his heart, Palle realized just how horrible of a disease cancer was.

Similarly, to Falma cancer is like the king of diseases, because whether a patient can or cannot be cured can only be left to the imagination.

Palle felt that he couldnt thank Falma enough. Not much is known about cancer in Nova Root, yet Falma was able to diagnose it. Furthermore, in order to treat Palle, he synthesized numerous drugs and even harnessed the power of the Medicine God.

So, my cells are attacking each other

Thats why its a tough disease to treat. If they werent your bodys cells, your immune system would attack it. However, because they are your own cells, your immune system wont attack, Falma confirms.

Actually, I should have used chemotherapy from the start. That was my mistake. Next time Ill apply ATRA and chemotherapy together.

Chemotherapy places a heavy burden on the patients health, so Falma decided to delay it by one day after administering ATRA in order to observe the effects of ATRA by itself. This turned out to be the wrong choice.

Moreover, theres an alternative treatment called ATRA monotherapy which may be effective depending on the situation. However, its effectiveness is difficult to judge.

For Falma, his lack of clinical experience in his past life as a pharmacist was very troublesome.

Falma tells Palle to be prepared for side effects, because they may be unpleasant. Palle wore a serious expression on his face.

Use whatever method you think will work best. Im tough, so dont worry about me.

Then Ill get started. If you feel nauseous, tell me so I can give you medication for it. You may also get a fever, stomatitis, or be severely fatigued. Are you ready?

Yes!

Falma made clear the difference between a pharmacist talking with a pharmacist, and a pharmacist talking with a patient. In the end, its up to the patient to decide how much treatment they want.

Palle wants to recover from this disease so that he could inform the Medical Association about this case, as well as Falmas accurate treatment for it.

On the 6th day, Palle resumed taking ATRA. He also began taking Idarubicin through IV.

ED: IV medicines are delivered through a needle inserted into a vein. Youve probably seen them in the form of those drip bags in hospitals. Idarubicin (4-demethoxydaunorubicin) is an IV-delivered drug that treats leukemia.

Palle watched attentively while Falma filled an IV bottle with Idarubicin and inserted the IV into his body.

This is the first time anyones used an IV bottle or injection. Its completely groundbreaking. I wonder what other purposes this can be used for.

As expected, Falma thought. Palle praises this like its a godly revelation, not something that humans can think of.

Although, Falma says, I do have some experience with IV drips. Only with animals.

Hmm I just heard something terrible. When did you practice with animals?

Only when Brother is not around.

It was during Falmas past life as a pharmacist, but Falma thought it was best to not tell Palle.

The human body and an animals body are mostly the same, so its probably fine.

I see. but the anti-cancer drugs are toxic and have a disgusting color. They also turn the urine red

Palle had no choice but to watch as the rust-colored liquid dripped into his body.

It seems like the IV drip is a different place than last time. Is this intentional? Palle asked. He was observing Falma closely and noting even the smallest differences.

Its better to not use the same blood vessel, as the anti-cancer drugs will start to damage them.

You said it was cytotoxic? So, the blood vessels will be damaged upon touching the anti-cancer drugs? I see

Translator: yompamper

Editor: Sam

Six hours after Palle resumed treatment, he was struck by intense nausea. At first Palle could still crack jokes, but after vomiting several times the gastric acid irritated his esophagus. The repeated vomiting also drained his stamina.

Brother, lets switch the anti-nausea medication. Try this one.

Nausea significantly impacts a patients quality of life. However, Falma cant identify which medication will be effective for Palle thorough medical examinations. As such, he can only change the medication and try again.

Okay, Ill try it.

Palle drinks the anti-nausea medication but immediately vomits it out, so Falma mixes it into the IV bottle. In some cases, nausea can be a symptom of anxiety which cant be treated with medication, but Palles nausea soon goes away.

ED: While medication such as antidepressants and beta-blockers are prescribed for anxiety, they cant cure it.

You should also change your clothes

Palle changes into looser, more comfortable, clothing.

Phew now I feel better. Its dizzying how things are going from one thing to the other. Also, why was I feeling nauseous just now?

The anti-cancer drugs affect the part of the brain responsible for controlling vomiting. You might not want to vomit, but you just do.

Theres a complex reaction happening inside my body. If I could just stop the nausea, I can help you formulate.

Palle tries to formulate more anti-nausea medication in his hand, but Falma stops him.

Since my combination of medication is already effective, please allow me to make more instead.

Oh

Palle was frustrated at how, in front of Falma, he could only be the patient.

Ill leave it up to my brother if I get sick, then.

You flatter me

Falma didnt count on it, but Palle had become more mature.

On the twelfth day, the number of leukemia cells was steadily decreasing. It was great news, but something else happened which caused Palle to lose his spirit. Due to the anti-cancer medication, his long silver hair began to fall out.

Every time Palle combed his hair with his hands, more fell out. Soon, his pillow was covered with hair.

My hair wont stop falling out, right?

With a strange feeling inside, Palle silently began to throw the fallen hair into the garbage can. Watching him, Falma asked.

Are you okay with this?

Its what I expected.

Falma nods.

Alright.

Palle didnt complain at all.

Will it all fall out? If thats the case, I want to get rid of it all straight away.

It might not all fall out I dont know. I think itll be sparse, though. Thats because cells that divide quickly, like hair follicles, are vulnerable to the anti-cancer drugs, which causes them to stop dividing. Itll be better to shave all the hair off all at once.

TN/ED: Anti-cancer medication works by damaging fast-dividing cells, either during a specific phase in their lifecycle or indiscriminately. Hair follicles divide every 23-72 hours, and so are also affected.

Will I be bald for life?

Being only 18 years old, Palle hasnt been able to fully enjoy life yet. Being bald for the rest of his life would be a cruel fate.

Still, Palle was prepared for this kind of life.

No, just be patient. Itll grow back once you stop taking the anti-cancer drugs.

I see. I cant help but not want anyone seeing me during treatment

Blanche was listening from behind the door as Palle spoke those timid words, and soon after

Kyah!!

Lottes scream echoed throughout the mansion.

Lady Blanche, what did you do!?

While Falma was running over to look, Blanche bound her long blonde hair together and cut it off with a knife.

Why did you do such a thing your beautiful hair!

Lotte took the knife out of Blanches hands and hugs her so she cant do it again.

Blanche what are you doing!

Falma couldnt find the words to ask Blanche, who held a handful of her own hair, what she was doing. For the children of nobles, long beautiful hair is an asset. To cut it without the permission of her mother, Beatrice, is just asking for trouble.

Here, I want you to make a wig for my big brother with this. Even though big brothers hair is silver and mine is blonde, I still want you to do it.

With a firm look, Blanche held out her own hair.

Cant you use this?

Due to the anti-cancer medication, Palles hair began to and will keep falling out. In response to this, hell shave the remainder of his hair off. Blanche thought that if Palle wears a wig, then hell be able to go outside or meet with others.

I would have preferred you ask me before cutting your hair.

Knives are dangerous, and it would have been unbearable for Falma if Blanche got hurt.

But, right now big older brother and small older brother are both trying their best

Blanche was thinking about what she could do to help.

Oh, Im sure Palle will be happy. Lets make a beautiful wig afterwards.

Aii

Falma patted Blanches head. Meanwhile, the hair that was cut off was sent to the wigmaker, who was confident that such high-quality hair could be made into a beautiful blonde wig.

Under the circumstances, neither Beatrice nor Bruno scolded Blanche for her selfish actions.

And then the 18th day of treatment began.

Bear with me, older brother

Falma drew and examined Palles blood, then shouted out in excitement. Bruno and Falma entered Palles room together. It seemed like there was a faint smile on their lips.

Good news

Bruno also spoke.

Good news?

Due to the side effects of anemia as well as his fatigue, Palle was exhausted. Additionally, because his hair had been cut very short, he seemed dispirited.

Since the beginning of treatment 16 days ago, older brothers leukemic cells have decreased by two orders of magnitude and now account for 3% of cells in the bloodstream.

what does that mean? Theres still more?

Its fine, Falma says as he shakes his head. The leukemic cells in the bloodstream wont immediately disappear. Nevertheless, by combining ATRA and anti-cancer medication the amount can be reduced below 5% which falls within a certain guideline. That is to say

Complete hematological remission. Im happy.

Congratulations, big older brother

As Falma finished talking, Blanche entered the room with a large box in her hands.

What are you holding?

Palle looks at the box and at Blanche.

Well-, This-. I brought a present because big older brother worked hard.

Can I open it?

Yes

This is

Blanches gift to Palle was a wig, which he accepted with a complex expression. He regretted how short Blanches hair had become but understood why she chose to cut it. Palle expressed his gratitude to everyone and said, Thank you all.

On the 18th day of treatment the remission induction therapy succeeded.

With the help of Falma and his family, Palle had overcome the first obstacle.

Palle, who had escaped the brink of death, began to take the first steps towards rejoining society.