Hermione was devouring all the books in the library she could find on magical illnesses, but it was all to no avail. So far there was no mention of potion-resistant illness anywhere. She couldn't shake the feeling that this was all too familiar though. She knew something, or at least suspected something, but she couldn't get the thought to fully form. Maybe she was looking in the wrong place? She sighed in Neville's direction.
"Neville, you're useless," she grumbled unhappily. "The boys usually say something asinine and then it sparks something and voila. You don't make me 'voila.'"
"I'm sorry Hermione," he replied sheepishly. Then his face lit up with an amused grin. "Maybe you should try for a 'eureka' instead? I might be eureka material."
She smiled wanly at his attempt to cheer her up. She really did miss the boys.
"Okay," she said, trying to refocus by talking aloud. "So, what do I know about magical illnesses? Maybe my scope is too narrow?"
She paused to consider the problem. "Okay, what do I know about illness in general? In muggle medicine, illnesses are typically caused by either viruses or bacteria. Are magical illnesses caused by the same thing?"
She answered her own question. "No one has ever studied it. So, let's just assume that magical illnesses have the same causes."
She pinched her lips between her fingers in thought. Neville studied her with a lost expression on his face.
"If that's the case, then are we dealing with a virus or a bacteria?"
Neville fidgeted nervously as she studied him. "Ummm, I don't mean to be rude, but what the hell are we talking about?"
She waved a hand at him in a dismissive manner and continued speaking aloud.
"If it is a virus, we use anti-viral medicine. If it is a bacteria, we use antibiotics. Madame Pomfrey has a variety of potions to treat a number of different ailments, just like with the different antibiotics and anti-virals."
Her eyes widened as the implications dawned on her. "Eureka!" she announced, grinning at Neville. "MRSA."
Neville was taken aback by the strangeness of her exclamation.
"Is that some kind of spell?" he inquired.
"MRSA," she repeated. "Methicillin-resistant Staphylococcus aureus."
"I still don't get it," Neville replied with a shake of his head.
"MRSA or Methicillin-resistant Staphylococcus aureus is a muggle bacteria that developed a resistance to traditional antibiotics – the medicine muggles use to treat it. Maybe we are dealing with something similar? A bacteria that has developed a resistance to magical medicine?"
Her eyes were twinkling with excitement as she stood. "I need to discuss this with Madame Pomfrey right away."
"That's probably a good idea, Hermione," Neville replied with a wolfish grin. "I think she needs to give you a once over while you're there - you've been speaking in tongues."
"I had no idea that Muggle medicine was so advanced," Madam Pomfrey exclaimed. "We rely on potions and spells to identify the qualities of an illness and then utilize the appropriate spell or potion to treat it. To think that all this time, these spells may have just been providing us information about tiny little organisms living within us."
After a moment's silence she inquired, "So, how does that help us with the boys?"
Hermione paused to consider things, glad that the witch had understood what she was trying to explain.
"If magical medicine doesn't work, maybe we need to try muggle medicine?" she suggested with a shrug. "Muggle and Wizard physiology can't be that different."
Madam Pomfrey mulled the idea over. Hermione waited with baited breath.
"I will get in touch with St. Mungo's to see if they can send a muggle healer over," she announced.
"Doctor," Hermione corrected.
"Yes, of course. A muggle Doctor."
A portly man in a white coat was staring up at the ceiling of the Great Hall in wonder.
"My mother-in-law was a witch," he explained. "She used to tell the kids stories about her years here at Hogwarts. I never thought I would ever actually get to see it with my own eyes. My wife was born a squib and none of the kids or grandkids inherited the gift either."
Madam Pomfrey cleared her throat loudly, interrupting his musings. "This way, Doctor Maddison."
He smiled apologetically, following her through the Great Hall. Hermione was quick to join them.
"Wonderful. Simply wonderful," he exclaimed, stopping occasionally to marvel at a talking portrait or moving staircase.
"You wouldn't happen to be hiring, would you?" he inquired good-naturedly.
"Not as far as I am aware," the witch responded with a stern expression. Hermione couldn't help but smile at the man. He was someone that most people instantly liked, but Madam Pomfrey seemed immune to his charms.
"So," he continued, changing the subject abruptly. "Tell me about the patients. What are their vitals?"
"Vitals?" Madam Pomfrey questioned, a confused expression on her face.
"You know, their vitals - heart rate, SPO2, blood pressure, temperature?" he explained.
She blinked at him, clearly mystified and glanced in Hermione's direction for assistance.
"Umm," Hermione attempted to explain. "Where you use potions and spells to identify issues with your patients, muggles use machines to extrapolate that data and put it into a meaningful format. He just wants to know what your medical observations are."
Doctor Maddison studied her, clearly impressed by her explanation. In response, she gave him a bashful smile.
Both medical professionals walked on in silence for a while, contemplating the difficulties ahead. Magical medicine and muggle medicine were completely different animals on the surface, but Hermione was certain they could find common ground.
Finally, Madam Pomfrey began to relay her medical observations.
"At first they came in with a high fever and sore throat. Potions have been ineffective at halting the progress of the illness but have provided temporary symptom relief."
"Additionally, Mr. Potter had taken on some water after an unplanned swim in the river. The ill effects of that misadventure responded readily to the usual potions and his cough subsided within a few hours."
His eyes widened in surprise. "Are you telling me that you successfully treated pneumonia within a few hours?"
"Yes," she replied curtly before continuing.
"After a day or two, all patients began to suffer from headache, nausea, and vomiting. Mr. Weasley and Mr. Malfoy are both showing signs of improvement. However, Mr. Potter, who was the first to fall ill, has continued to worsen. Lately he had been experiencing seizures, lethargy, and an erratic heart beat."
Doctor Maddison's face drained of color.
"How long has Mr. Potter been experiencing these symptoms?" he inquired, voice tight.
"He has been sick for over a week," she replied nervously. "But the more worrisome symptoms developed a little over a day and a half ago."
Doctor Maddison's pace quickened as he fired off additional questions. "Have you noticed any swelling? Yellowing of the skin or eyes? Confusion? Shortness of breath?"
She shook her head no after every question except the last two.
Finally, they reached the infirmary, Hermione hot on their heels. She crossed the quarantine wards without asking for permission. Madam Pomfrey didn't even notice. She was caught up in the Doctor's sudden sense of urgency.
"Which of them is Mr. Potter?" the doctor asked, moving almost instinctively towards the boy.
"Yes, that one." Madam Pomfrey confirmed.
Harry was deep in sleep, face pale and clammy, breathing labored. Doctor Maddison's expression was grim. He placed his stethoscope to his ears, moving it across various locations on the boy's chest.
"That's a stethoscope," Hermione explained for Madame Pomfrey's benefit, needing to distract herself from the worry that was gnawing at her. "It lets the doctor listen to a patient's heart, lungs, and sometimes even intestines."
Scowling, he opened his bag and pulled out a small blood pressure machine. Hermione interrupted him, "Excuse me Doctor, but electronic devices don't work inside Hogwarts."
"Shit," he cursed and began pulling out an old-fashioned blood pressure cuff and thermometer.
Harry shifted slightly and moaned, his eyes fluttering open briefly as the Doctor took his vitals.
"Hey there, Mr. Potter," he said in a soothing tone. "My name's Doctor Maddison. They brought me in to help you get better."
Harry nodded weakly, eyes unfocused.
"Can you do me a favor?" the Doctor asked. "Can you open your mouth wide so that I can get a throat culture?"
Harry drifted off without responding.
"Come on boy, stay with me," he encouraged, prying open Harry's mouth. "There's going to be a little tickle at the back of your throat, okay?"
Doctor Maddison stuck a long swab into Harry's mouth, he gagged on reflex.
"All done," he announced, swirling the swab in a small tube. An eyedropper was used to place some of the solution into a test tray that he had retrieved from his bag.
The tray was set aside so that the doctor could continue to examine his patient. He pulled back the sheets to observe the boy's ankles, then he took a close look at the boy's fingernails. Without the luxury of the use of modern medical devices, he was forced to rely on good old-fashioned doctoring skills – treating by sight, sound, feel, and smell.
After a few minutes, the doctor picked up the test tray and examined it.
"As I suspected," he announced, solemnly. "He's positive for strep. I'm going to set up an IV for him and then check on the other two."
Madame Pomfrey's eyes never left the Doctor as he dragged a coat rack over, stringing up a bag of saline on it before he began to administer antibiotics and fluids intravenously. Hermione felt confused – strep throat was a fairly common muggle illness. She'd had it once as a child and it hadn't been this serious.
She crossed over towards her boyfriend's bed, placing her hand gently on his shoulder to wake him up for his exam. He opened his eyes with a yawn. "Hi, Mione. You sick now too?" he inquired half-asleep, not fully understanding the situation.
She smiled warmly at him. "No silly. We brought a muggle doctor in to cure you."
Ron's eyes narrowed suspiciously. "He's not here to shoot me, is he?"
She laughed causing Malfoy to stir in his sleep. "You mean give you a shot? Maybe. But if you prefer to die..."
Draco sat up in alarm, not liking what he was hearing.
Doctor Maddison strolled over to introduce himself to them both before beginning Ron's exam. It was over quickly.
"Looks like you're starting to get over this by yourself, but to make the process go a lot faster and prevent possible complications, I am going to be prescribing you an antibiotic. You have to take it twice a day for 10 days. Do not skip a dose and do not stop taking it even when you start feeling better."
Ron nodded solemnly.
Malfoy grimaced as the Doctor stood and began to approach.
"You stay away from me, muggle," he hissed in warning, eyes going wide.
"Oh, get over it," Hermione exclaimed in exasperation. "When you're all better, you can go back to your muggle-hating mental illness."
The doctor studied her with a confused expression on his face.
"Think white nationalists," she explained. He nodded knowingly.
"Excuse me," Madam Pomfrey politely interrupted. "Maybe you can direct me on how to perform that exam? It might calm Mr. Malfoy's nerves to have me do it instead."
"I will not be some muggle test-subject," Malfoy growled heatedly. Everyone ignored him.
"That won't be necessary," Doctor Maddison assured them with a shake of his head. "I don't need to examine him to see that he is on the mend. He just needs to follow the same instructions as Mr. Weasley."
He turned to Madam Pomfrey, handing the healer a bottle labeled Amoxicillin with a set of written instructions. "I will leave their care in your capable hands," he informed. "They should be good to return to classes after 48 hours."
He glanced in Harry's direction, expression turning grim once more.
"Now back to my first patient," he announced with a sigh.
Hermione grew suspicious. She wracked her brain, trying to come up with everything she knew about strep throat and its possible complications if left untreated. Honestly, she didn't know very much on the subject.
"Is he going to be all right?" she asked, voice cracking slightly.
Both boys studied her face apprehensively. They had been sleeping during Harry's exam, but it was no secret that he was not doing well.
"I can't say," the doctor responded thoughtfully. That was not the answer that she wanted to hear from him. She gazed at him imploringly.
"I need to run additional tests, but I don't think I can do that here," he explained, shrugging helplessly.
Hermione pursed her lips, studying the man thoughtfully. There had to be something that they could do.
"Tell me what you need, and I will see if there is magical method of doing it," Hermione suggested.
He sighed and considered his words carefully, acutely aware that all eyes were on him.
"One of the potential complications of untreated strep throat is rheumatic fever. It usually sets in after one to five weeks and causes arthritis and heart valve damage."
He paused to let them take in the full effects of his words.
"With just a stethoscope, I have confirmed that there is something going on with his heart, but without the right equipment I am unable to fully evaluate the extent of the damage. At this point in time, I can't rule out congestive heart failure as a possible outcome."
Hermione had to find a chair to sit down in. It was a lot to process. Ron appeared scared and confused, his eyes darting about as if he didn't know where he should be looking.
"So, what I need," the man continued. "is the imaging equipment necessary to take a good look at his heart. Do you have something comparable?"
She let out a noisy breath and composed herself, standing up to pace back and forth, wracking her brain for a solution. She needed to focus.
"I think I might know of something," Hermione announced, glancing between Doctor Maddison and Madam Pomfrey. "The Mirror of Revealing. It allows a person to peer through objects that are not warded. It should allow you to see what you need. If we don't have one, they are relatively easy to make with a few simple charms. The staff here should be able to throw one together."
Madam Pomfrey had been following the conversation closely, her brow drawn tight as she attempted to keep up with the Muggle medical terms.
"Excuse me," she interrupted again. "Are you saying that Harry's heart has been damaged in some way by this illness?"
They both nodded solemnly.
She smiled brightly at them. "It shouldn't be a problem then. The healers at St. Mungo's can repair the damage to his heart as soon as his illness has passed."
"I am such an idiot," Hermione exclaimed, flushing in embarrassment. "Of course, you can repair heart damage! I mean, I've never heard of a wizard dying from a heart attack."
"I don't think it will be that easy," Doctor Maddison stated, shaking his head with a regretful expression. "He has to survive this illness first."
Hermione's heart sank at his words.
"So, what do we need to do to cure him?" Madam Pomfrey inquired, not letting herself get discouraged. "Does he require this amoxicillin as well?"
"Well – yes," the man stammered, taken aback by her determined expression. "That is one of the drugs that I put in his IV."
"You mean that thing?" she asked pointing at the bag on the coat rack. He nodded.
"What else do we need to do?"
Doctor Maddison shifted nervously.
"Plenty of rest and fluids. Make sure he isn't putting any undue strain on his heart – not that he will be capable of doing that," he added.
He sighed in exasperation, eyeing the woman with a stern expression. "But we're getting ahead of ourselves here, he still might die. I have no way of knowing how serious the damage is."
Ron let out a frightened squeak. Even Malfoy turned ashen at the harsh statement.
Hermione jumped into action-mode, forcing herself to stay focused on what could be done. "Well, where's that damned mirror?" she demanded. "Let's stop speculating and get some answers."
Madam Pomfrey smiled appreciatively. "I'll go get one right away."
She came back a few seconds later and handed the mirror to the muggle Doctor.
He took it apprehensively. "Now, I'm no cardiologist..." he started.
"He means a doctor who specializes in medicine related to the heart," Hermione explained for Madam Pomfrey's sake.
"...so, I don't know how much use I'll be. I would feel a lot better sending him off to a specialist."
"Doctor, quit stalling," Hermione admonished.
He blanched at the sharpness in her tone. "Okay, show me how this thing works."
Madam Pomfrey led him to Harry's side. They chatted at great length, pointing out aspects of Harry's heart and functions. Neither of them seemed tense, so the news must be good. Hermione felt relieved.
He smiled back at the nervous teens.
"The damage isn't as bad as I feared. His heart is still struggling to pump blood efficiently, but he shouldn't be in any immediate risk of dying. We should keep an eye on him and let the meds do their job. If he were in a normal hospital, he would be a prime candidate for a heart transplant."
Hermione visibly paled at his statement and the contradictory information she was receiving – the damage wasn't that bad and he needed a heart transplant.
"Doc, if you keep doing this to me," she squeaked. "Then I'm going to be the one needing a heart transplant."