Chapter 106: Methanol Poisoning

Shaky voices, the rushed footsteps of nurses, and desperate prayers for Celeste’s guidance erupted from all across the hospital’s emergency department, which had long grown overcrowded. A woman leaned against a dark granite pedestal and vomited. To her side sat a lanky and blind Sacred Hospitaller recruit. He gripped a bed frame, staring through the people crammed around him and breathing down his neck.

Dimitry shoved past them and yelled to be heard over a hundred drunk voices. “Did these patients receive their loading doses?”

“All but those near the western windows!” Lili shouted back from across the chamber. “We’re preparing maintenance doses now!”

Heart pounding against his chest and teeth grinding behind a composed guise, Dimitry’s gaze twitched from patient to patient. Methanol poisoning victims everywhere. Far more than usual. He struggled to differentiate between those who had received treatment and prospective patients who arrived moments ago, desperately searching for a cure.

As they had all night, the hospital doors swung open. A lady wearing a maid’s gown barged inside, dragging along a young boy by the hand. Her identity became clear as she approached. She was Annette—one of Saphiria’s orphanage caretakers.

Oh no.

“What’s wrong?” Dimitry asked, hoping the sinking feeling in his gut proved wrong.

Her trembling hand pushed the boy forward. “Y-Your Holiness, I don’t know what to do. Caterpillar, he… he can’t even walk straight.”

Dimitry swallowed the caustic words of frustration lumping in his throat and grabbed a mug from the windowsill. “Did he have any meat pies from those street vendors?”

“Zera at my side, I thought they served you. If I knew sooner—“

“I need you to know. Did he or didn’t he?”

She nodded.

“How many?”

“Just the one,” Annette said. “I brought it back with me to reward Vine for helping me clean the fireplace, but Caterpillar found the pie first. And then he started stumbling and I tried to give him warm milk but—”

As the chambermaid’s tale degenerated from informative into self-blame, Dimitry’s fingers grabbed a cool jug of ethanol and poured the volatile liquid into the mug. Her story was one he had heard many times. This evening, street vendors roamed Malten, distributing meat pies on behalf of the apostle, they claimed. Civilians and Sacred Hospitaller recruits alike accepted their offering.

No one at the time knew; they laced the pies with grimberries. Not only did grimberries contain methanol, a toxic agent with delayed symptoms that spiraled into crippling disability and lethality within days, but the vendors seemed to have planned for this. They vanished from public sight long before the twelve-hour latent period had elapsed.

The first victim to show methanol poisoning symptoms was a recruit whose vision deteriorated soon after consumption—an aberrant case. After receiving another patient who presented with similar signs despite not having eaten a single grimberry, Dimitry realized what had transpired. He alerted the queen.

Even now, town criers across Malten warned that anyone who had meat pies from a street vendor should visit the hospital regardless of whether they were asymptomatic. And people listened. The cathedral overflowed with patients whose pleas grew more desperate as their conditions worsened.

If Dimitry couldn’t cure them before permanent damage resulted, which might have already happened, they would lose their faith in him, blame him for the actions of his supposed employees. A targeted attack—just like on the Night of Repentance and the day Heze was killed. Someone was trying to hurt his reputation and his soldiers. Was their goal to stall the building of his army? Did they think he was getting too powerful?

Worries for later.

Dimitry stared into the mug of twenty percent ethanol, escaping vapors burning his nostrils. A preteen boy weighed about thirty-five kilograms, and at four milliliters per kilogram—fuck it. Without precise units, Dimitry couldn’t make accurate measurements even if he wanted to.

He poured a little extra. “Drink this.”

Caterpillar took the mug and brought it to his face. After a whiff, he winced and pushed the ethanol back into Dimitry’s hands.

“Drink now,” Annette commanded, “or else Lady Julia will have my head and I will have yours.”

After a moment’s hesitation, the boy took a sip. His eyes slammed shut as he turned away.

“It won’t hurt you,” Dimitry said despite knowing the risk of hypoglycemic seizures and respiratory depression in pediatric intoxication. “You’ll feel better soon.”

Like a feral cat once kicked aside by a passerby, second-guessing every kind act, the boy glared at Dimitry.

Annette smacked the back of Caterpillar’s head. “Drink!”

The boy obeyed.

Though Dimitry took no pleasure in getting kids drunk, ethanol was the only antidote he had for methanol poisoning. Both methanol and ethanol competed for the same digestive enzyme in the body, alcohol dehydrogenase, and by flooding one’s system with ethanol, the rate at which methanol metabolized into formic acid would decrease dozens-fold. Formic acid was how methanol poisoning caused everything from blindness to seizures and death. Preventing its formation would delay symptom progression.

Yet ethanol therapy wouldn’t be enough. The formic acid that had already formed and slowly continued to form would tear away at tissue and acidify the blood.

By the time Caterpillar emptied the mug, his scrunched face had more folds than a raisin. But his struggles had just begun. The boy would receive regular maintenance doses to keep his blood alcohol levels high.

“Well done.” Dimitry took his mug and pointed to an overcrowded hospital wall. “Wait there.”

The hammered boy hobbled towards a shattered stained glass window boarded with oak planks.

Annette stepped closer, fear in her eyes. “Is he cured?”

Without a good answer to give, Dimitry gave none. “If you have to go back to the orphanage, go. We’ll look after him. Otherwise, you can wait—”

“Mister Dimitry,” Lili’s shout echoed across the hospital’s domed ceiling, “Laureyn lost sight in her left eye!”

Shit!

Dimitry dashed away, and Annette trailed behind him. “Your Holiness, if the mistress learns of my negligence, of how I injured her children and—“

“We’ll discuss this later.”

“Surely, your divine magic…” she trailed off when a tide of patients blocked her advance.

There was nothing Dimitry detested more than a surgeon who operated on his patients and vanished without a word. A doctor’s job was allaying concerns as much as it was treating the illness, yet he could do neither. His patients were ballooning in number, and their health deteriorated swiftly. Only early and aggressive treatment could prevent permanent injury, but Dimitry didn’t have dialysis equipment to hasten the filtering of methanol and toxic metabolites from the blood, nor did he have sodium bicarbonate to neutralize the resulting acidosis.

But Dimitry did have one thing.

As he checked on Laureyn, the doors to the hospital swung open once more. Fortunately, these visitors wore red robes.

At their fore was a woman who lacked her usual bubbly smile. The hospital crowd parted as Malten’s head enchantress Raina barged through, a caged chicken in her arms. “Are we on time?” she asked, huffing for breath.

“I hope so,” Dimitry said. “Come on.”

“Slaughter those who draw their weapons or run. The rest shall be brought to the dungeon.”

“Yes, Your Highness!” the platoon behind Saphiria chanted in unison.

“Formations!” Leandra ordered.

Like the crushing pincers of a motherlode beetle, knights forked off to encircle the dilapidated bakery from the streets and alleys. Crossbowmen climbed the roofs of surrounding buildings, loaded bolts, and aimed at the windows of both floors.

Fingers curling around the cold steel hilt of her longsword, Saphiria stood at the mouth of the formation, raven hair swaying in the frozen wind. At last, she had found the scum that had been defiling her city. From within this squalid shack on Malten’s eastern outskirts, hiding between a bathhouse and a stable, the filth had concocted their schemes.

They wouldn’t escape this time.

As soon as Dimitry had informed Mother that vendors peddling poisonous meals roamed the streets and before the town criers could announce their villainy to the public, Lukas’ men had stalked their movements. Although they returned to their hideout through meandering routes to evade pursuers, the misdirection failed. Now, the vendors inside awaited their demise, soon to squeal like swine at the sound of slaughter. This gang would color the stiff ground red long before the sun rose and vanquished the dark blue of dawn. Never again would they hurt her kingdom or her archbishop.

Prying eyes pierced Saphiria’s spine. Expecting to find stragglers, she glanced back.

A shadow watched her from across a road gutter and behind a distant barn hatch. A small shadow—solitary, like that of an abandoned child. Perhaps a street urchin that would someday grow into a gangster and die by her blade.

Leandra knelt at her feet. “At your command.”

There was much work to do before Saphiria could prove to Dimitry that Malten was a place of beauty. But this was work, too. “Advance.”

The knights closed in on the bakery.

Saphiria fitted the red and gold helmet Father adorned in his adolescence, the size he wore to war too big for her, and marched forward.

A collapsing window shutter broke open, and a woman vaulted over the sill and scrambled towards the forest.

“Kneel or die,” Saphiria commanded.

The woman chose the latter. One bolt pierced her leg, and another struck her shoulder. She collapsed mid-sprint and rolled across flattened dirt.

Saphiria stood over her. “How many inside?”

“Rot, you upstart bi—”

A squire ran up to offer a handkerchief.

Saphiria plucked the cloth from his hand and wiped her longsword, removing any blood that might rust Father’s blade or any that had dribbled down to the sapphire encrusted in the hilt. She returned the handkerchief.

The thumping of steel against wood resounded in the dawn. With one last strike, the knight kicked down the door and drew his falchion, curved as were most blades inspired by the warrior poets of Feyt. He rushed into the bakery with four men in tow.

Following, Saphiria stepped over the threshold. Her gaze flickered from an upturned table and rotary quern to a lopsided cabinet. Not a gangster in sight. “Ambush.”

A thug dashed out from under a stove, the bread knife in his hands aimed forward.

A punch to the abdomen from a knight’s gauntleted hand rendered him unmoving.

“I am Saphiria Pesce,” she said, walking ahead, “heiress and successor to Malten’s throne. Resist and your fearful faces will decorate the pikes outside my gatehouses. Throw down your arms, and I may consider keeping your honor intact.”

War cries shrieked, and seven more thugs attacked. Three dashed towards Saphiria.

She brandished her blade, ready to meet her adversaries in combat. A Y-shaped object flashed into view. Words slithered into her mind. “Formic acid… carbon dioxide. Thermal decomposition.”

Dread squeezed Saphiria’s throat. She could not decipher the meaning of her thoughts, but her muscles tightened as if an unspeakable taboo was being broken.

“Your Highness!”

Hearing Leandra’s voice, Saphiria instinctively lifted her hands, and a dagger scraped against her steel wrist guards, sparks flashing across the crisp air. A teal glow leaked from the edges of her greaves, under which the pairing band lay unseen.

A club crashed from above, and Saphiria sidestepped, stabbing the wielder in his heart.

The other two thugs glanced at their squirming comrade, who soon lay still. They dropped their weapons and knelt.

Leandra ran closer. “My liege, are you well? Did your splinted hand fumble?”

Staring at her arm, Saphiria said nothing.

The court sorceress examined her as if she was livestock at a bazaar. “If you returned after all these years just to perish under my watch, I fear I wouldn’t have fared much better. You must be more careful.”

“And where was your support when I needed it?”

“Forgive me.” Leandra lowered her head, the indignation in her wrinkled amethyst eyes betraying her apology. “I feared my spells would ricochet from your reflectia armor.”

Saphiria did not appreciate the sorceress’s reprimanding tone—her true thoughts doubtless harsher were they not amongst others—but other matters concerned them now. “Leandra, upstairs with me. All others secure the bottom floor. Not one is to escape.”

As the knights detained compliant thugs and ‘pacified’ the more violent survivors, the two climbed a collapsing staircase that croaked on the heel of every step. What Saphiria saw atop engraved itself into her memories.

Rats. Street hounds with plagued purple skin, moldy rye berries, wild hogs dead for at least a week, decaying intestines atop mounds of grimberries, some mashed others whole. And another ingredient—far viler than the rest.

Caterpillar ate that? Saphiria bared her teeth, ready to disembowel all her newfound prisoners and add them to the pile.

“Disgusting,” Leandra spat.

At the room’s end, a woman sat in a dark corner, two dark green pellets in one hand and a spell canister in the other. She pointed the cylinder’s end at Saphiria as if to smite her.

“Leandra?”

“I dispelled her cores before we entered, but her attitude remains to be adjusted.” The court sorceress strutted closer. She slowly lifted a long leg and pummeled her boot into the gangster’s shoulder.

The woman winced, but she did not beg for forgiveness. A demeanor hardened by authority. She led this gang.

“Did you not hear? You are in the presence of royalty. Grovel like a dog before I make you whine like one.”

There was no response.

A wicked grin spread across Leandra’s face as she reached into her vol pocket. “How admirable,” she said sweetly, as if addressing a toddler. “I hope you remain stoic as your blood boils beneath your skin and your eyelids peel—”

“Enough!” Saphiria marched forward. “You will tell me why you poisoned my people.”

“For money,” the thug said. “Why else would anyone do this gruesome shit?”

“I refer to your intentions. Why harm the hungry and slander my archbishop?”

“Me? I just do what I’m told.”

“Told by whom?”

“Whoever pays me.”

Leandra shifted her weight onto her heel, and the thug sucked in air through her teeth.

“Your riddles don’t amuse me,” Saphiria said. “A dozen are not capable of such villainy. Where are the rest of you?”

“What’s the point? To someone like you, we’re worth less than the grease on your armor. You’ll kill us even if I tell you everything.”

“After what you’ve done, you shall swiftly learn that death is a kindness. Unless you wish to pray to the very apostle that you slandered for your every breath to be your last, then you shan’t anger me more than you already have. Speak!”

The thug’s palm tightened around the seal engraved within the canister.

Saphiria slammed her boot into the boarded plank wall beside her head. “You waste my time! Leandra, pry her jaw open.”

“With pleasure.“

“What use is a tongue for she who doesn’t talk? Stay ready to burn the stump so she does not bleed too much.“

Watching the longsword draw near, the glint from its edge reflecting in her eye, the thug peddled back against the wall. “Wait, I don’t know. All we did was make the pies and hand them out. The supplies were brought to us.”

“Who brought them to you?” Saphiria asked.

“Wulf was that shithead’s name—their boss.”

“Another gang?”

She nodded.

“You will lead me to their hideout. Now.”

“I can’t. Aside from skirmishes by the river, it was the first time we talked to them since we got to this cursed city. The only reason we didn’t tear their heads off was because our client paid for our cooperation.”

Saphiria’s eyes narrowed. Her ceaseless hunt for the slag of society proved they weren’t fools, fleeing long before capture, and now she knew why. They were allied. No, worse. They were commanded. “Who is this client?”

“Never saw him before. He sends a messenger whenever he needs us, and even the messenger wears furs. Doubt he’d talk to me unless I was born suckling on a gilded tit, ‘cause rumors say he’s some kinda lord.”

“A lord?” Leandra muttered. “Impossible.”

Like molten iron flooding a cast, boiling fury poured into Saphiria’s face, swelling red with rage. One of Mother’s vassals? Defiling the very land they defended for generations? Though she strove to win their favor, attending those wasteful banquets and listening to every opportunistic marriage proposal, they continued to spit on the city her ancestors had built! Now Saphiria knew why gangsters and mercenary sorceresses had assaulted her archbishop on the Night of Repentance. She had to prune the virulent branches of Malten’s aristocracy before the poison uprooted her home.

Fingers strangling the hilt of her sword, Saphiria pivoted, and her cape whipped behind her. “Leandra, the knights are to keep the survivors alive. For now. Even vermin have a use.”

Just as modified preservia had heated bacterial DNA to cure the plague, Dimitry hoped the spell would work similarly for methanol poisoning. His plan was two-pronged: while orally administered ethanol inhibited alcohol dehydrogenase, slowing the enzyme’s conversion of methanol into deadly formic acid, preservia would decompose the formic acid deposits that had already accumulated within the body.

His idea should work. Most molecules made up of carbon, oxygen, and hydrogen broke down into carbon dioxide and water with the addition of heat, and formic acid would be no different. Or so Dimitry figured, based on his hazy recollections of the organic chemistry lectures he attended over a decade ago. How he wished to remember the precise reaction mechanisms. Though casting medicinal magic with uncertain effects gave him pause, the hesitation didn’t last. People were dying. He prayed to Zera, Jesus, and the entire Greek Pantheon for a thermodynamically favorable outcome.

Patients shouting around him, their panicked voices a raucous blur as the symptoms of methanol poisoning worsened, Dimitry palmed the upper cores on Raina’s back and envisioned the addition of heat to the chemical bonds in formic acid, splitting the toxic chemical into carbon dioxide and water. “Preservia.”

He waited. And waited.

No matter how long Dimitry stood there, glancing over Raina’s shoulder, most of the lustrous green vol pellets remained atop her hand, and no glow weaved around the gown her palm hovered over. Rushed by the plight of his patients, he tried different spell modifications, such as preservia producing molecular hydrogen or risking the combustion of formic acid with oxygen gas, but neither variation worked.

“Sweetie,” Raina whispered, abandoning formal speech after endless failures, “I haven’t exactly been pious these past few years, so maybe Zera will like another enchantress better?”

“You’re fine,” Dimitry said, bouncing a foot against the speckled dark granite floor. He was missing something. Perhaps the issue lay in the fundamentals.

Preservia was a spell that prevented the decay of flesh. Dimitry had often used a modified version to denature the DNA of corrosive bacteria—an obvious route through which the spell could enact its effect—so targeting formic acid didn’t seem like a reach. But what if preservia didn’t consider isolated chemicals a decaying factor? Did they have to be part of an organism? How lacking was his understanding of modified spells?

“Everything’s going blurry!” a woman shrieked from across the hospital.

A nurse rushed to her side, but the only medicine she could provide was comfort.

Wiping the cold sweat from his palm against his trousers, Dimitry abandoned preservia. He needed an alternative. He thought he had one. “Let’s try again.”

Raina nodded.

Dimitry envisioned the cleaving of formic acid with thermal energy once more, but this time, he chanted a spell specializing in heat production. “Incendia.”

The thin cotton of the gown remained a bland gray. Raina’s shoulders slumped, her optimism gone without a trace. She glanced back at another woman in a red robe. “Alya, come try—“

“Wait,” Dimitry interrupted the head enchantress before she could call over one of her two subordinates.

“I don’t think I can—“

“If anyone can, it’s you. Just give me a moment to think.” Dimitry took a deep breath. Wintry air smelling of patients’ vomit rushed into his nostrils. The sickly sweet odor hit the back of his nose, and an idea came to mind. “Raina, one more try.”

“Right…”

He pressed his palms below her exposed shoulders, skin warm and soft. Dimitry’s mistake was two-fold. Just as illumina had to produce light, incendia had to produce heat. He, however, tried to use the spell to fuel an endothermic reaction—a process that consumed heat. The opposite of incendia’s effect. His modification and choice of spell were both wrong.

But there was a solution, he thought.

Dimitry envisioned the Y-shaped molecule and its carboxyl group once more, but rather than formic acid accepting thermal energy from magic, magic would pump heat into formic acid from its aqueous environment, cleaving chemical bonds to produce water and carbon dioxide while lowering the surrounding temperature. “Freezia.”

Like an ice sheet atop a dark, deepening ocean, a navy glow spread across the gown and grew thicker.

Raina gasped, and two other enchantresses tiptoed closer as if to avoid disrupting a sacred art. The patients who could still see fell silent. Noticing a subtle shift from disaster to hope, the visually impaired quieted, too.

Dimitry held his breath as the last of the vol vanished from Raina’s palm. He pried his eyes away from the enchantment. “Where’s the chicken?”

Lili ran closer, a cage cradled in her arms. “Here, Mister Dimitry!”

He rested the fowl’s enclosure atop the enchanted gown. Though the chicken inside clucked wildly, she did not seem to be in pain. Proof enough of the magic’s safety given the circumstances.

Dimitry grabbed the gown, which was no colder than the instrument table it lay on, and rushed through the packed hospital. Countless gazes watched the enchantment clutched in his hands, their gazes hesitant yet pleading, but the first to receive treatment would be a lanky man with busted glasses, whose expedited symptoms allowed Dimitry to warn the queen early and prevent a citywide catastrophe.

After five minutes in the enchantment’s embrace, Jost’s vision didn’t improve. Nor did it worsen. The halted progression of symptoms and a slowed heartbeat hinted at the successful decomposition of formic acid.

An actual miracle.

Hoping Jost would recover with time, Dimitry channeled three more gowns and had the nurses circulate them amongst the patients, most severe cases first. Aside from someone who claimed her navy blue enchantment flashed green, probably a visual defect resulting from optic nerve damage, the magic worked without issue.

Initially.

Less than half an hour later, patients began complaining of dizziness, breathlessness, and intensifying headaches despite recovering visual faculties. Never having heard of symptoms worsening and improving at the same time, Dimitry assumed the mixed outcomes resulted from ethanol consumption while recovering from metabolic acidosis.

A nurse beckoned him. “Your Holiness!”

Dimitry rushed to the bedside of a middle-aged woman who, like several others, heaved for air. But she had two rare symptoms that made his hair stand on end—ghastly pale skin and lips redder than the ripest cherry, both signs of high carboxyhemoglobin levels.

Carbon monoxide poisoning.

So that was why his patients had difficulty breathing! But how did they go from methanol poisoning to carbon monoxide poisoning? Did freezia switch from decomposition to the combustion of formic acid? Why was the shift delayed? Dimitry’s scientific understanding must have withered more than he had hoped.

Dimitry pointed at a porter. “Take her outside! She needs air—”

“It’s hurting him!” a shriek cut him off. Nervously bouncing on her heel, Annette hovered over Caterpillar, who pressed a hand to his chest while his gown flickered between purple and gold and green and every color in between.

Quiet except for a chicken’s anxious clucking, all eyes focused on the unstable enchantment.

“Ah!” another patient groaned.

“Get rid of them!” Dimitry made the call. “Throw them here!”

Four gowns flopped onto the emergency room floor. Their enchantments overflowed with color, glowing brighter and whiter.

“Everyone, out!”

None budged despite Dimitry’s command, backing up against the walls instead.

The dark granite floor beneath the gowns disintegrated and coalesced while frozen fragments formed and vanished in the air above. Space bent as if seen through a funhouse mirror. Crackling and fizzing sounds teetered between delayed and hasty.

Unwilling to see what perversion of physics would happen next, Dimitry looked at Raina. “Kill it!”

Her response was delayed. She held out a hand. “Dis… dispelia!”

Entrenched in a crater in the floor, the granite-infused gown fragments lost their blinding glow. Two hundred wide-eyed stares drifted towards Dimitry.