Medicine as a profession. Vol I. A chemist-fantasy pharmacist’s eyes

• Place of Service in the Organism: All cells of the Body-State (governance of basal metabolism).

• Working Tool (Mechanism): Levothyroxine binds to nuclear T3/T4 receptors in all tissues. Thiamazole blocks the enzyme thyroid peroxidase, completely halting the assembly of new energy hormones.

• Side Effects: Tachycardia, tremors, and insomnia (in case of an overdose of the understudy, Levothyroxine); a drop in white blood cell levels — agranulocytosis (a risk when the saboteur, Thiamazole, is at work).

• Affected Organs (Risks): The cardiovascular system and bone marrow.

• Conditions of Admission (Indications): Hypothyroidism and endemic goiter (for Levothyroxine); thyrotoxicosis and preparation for surgery at the TPP (for Thiamazole).

• Categorical Contraindications: Untreated thyrotoxicosis and acute myocardial infarction (for the understudy); severe blood count disorders (for the saboteur).

• Site Restrictions: Levothyroxine requires strict morning intake on an empty stomach, well before the rest of the body’s transport and digestive logistics are launched.

• Transport and Logistics (Dosage Forms): Tablets for oral administration.

• Delivery Speed: Slow. Levothyroxine requires up to 7—12 days of duty to completely rebuild the country’s heating network. Thiamazole damps down the boilers gradually over several days until the old hormone warehouses run dry.

3. Diplomatic Peacekeepers of Emergencies

When the State is threatened by a sudden external attack or a severe internal crisis, the head of the Security Council, the Hypothalamus, instantly sounds the alarm, hits the red button, and deploys a brutal and ruthless general into the bloodstream — Adrenaline. The general knows no pity and does not believe in compromises. He immediately enforces total martial law across the country.

Adrenaline seizes all radio towers and command posts — receptors — and screams into his megaphone: “Faster! Even faster! Work to the absolute limit!”. By his command, all peaceful rear services are completely shut down and stripped of funding — public utilities (the GI tract) and digestion grind to a halt, and factories close. The entire gold reserve and blood flows are rerouted exclusively to combat units — the muscles. Under the command of the furious general, the heart-motor begins to pound violently, pistons melt, and pressure within the vessel-pipes skyrockets to critical levels.

If this adrenaline-fueled assault drags on and the country enters a state of chronic stress, catastrophe strikes. Transport routes wear out, the pistons of the main motor crack from overload, and the entire system finds itself one step away from a massive heart attack and complete destruction.

To prevent the demise of the State, diplomatic peacekeepers — beta-blockers (Bisoprolol) — arrive urgently at the scalding facility.

Their oral tablet transport delivers them to the emergency site swiftly — within just 1—2 hours of arrival, they take control of the heart’s control panels. Acting as clever competitive antagonists, the peacekeepers do not engage in open combat with General Adrenaline. They act more cunningly: they physically enter the command posts — beta-1-adrenergic receptors in the heart tissues — and block them with their shields. The peacekeepers carefully plug the ears of the receptors, jam them with powerful signal scramblers, and completely block Adrenaline’s furious orders. No matter how much the general screams into his megaphones, the heart no longer hears him. The motor exhales, slows its RPMs, the pistons cool down, and the life rhythm and pressure smoothly return to peaceful, safe metrics. For this unique ability to restore peace, Bisoprolol is officially hired by the Ministry of Transport to tame rebelling vessels.

Professional Risks:

A peacekeeping mission is highly delicate, precision work. If the diplomats overstep and lock down too many control panels, the heart will drop its RPMs below a safe minimum. This will plunge the country into a dangerous slowing of the pulse (bradycardia) and a critical drop in pressure — leaving factories starved of supplies once more, but this time due to a deficit in blood flow.

Furthermore, if inexperienced peacekeepers accidentally block the adjacent panels of another department (Beta-2 receptors), it will cause the immediate closure of ventilation shafts — a severe bronchospasm. Air will stop entering the city, and the State will begin to suffocate. Because of this, Bisoprolol is strictly contraindicated in cases of bronchial asthma and cardiogenic shock.

But the most critical and unbendable rule of their contract is that peacekeepers are categorically forbidden from an abrupt, sudden withdrawal from the facility. If one simply stops taking the tablets, a fierce “rebound syndrome” will erupt across the country. The insulted General Adrenaline, seeing that the scramblers are gone, will storm the control panels and strike the defenseless heart with redoubled, punitive fury, inevitably leading to a catastrophe.

Specialist Profile

• Name of the Pharmacological Group: Beta-blockers.

• Place of Service in the Organism: The cardiovascular system (the main transport routes and the motor of the country).

• Working Tool (Mechanism): Beta-1-adrenergic receptors in heart tissues. The specialist acts as a competitive antagonist, physically shielding the receptor from adrenaline’s commands.

• Side Effects: Excessive slowing of the pulse (bradycardia), a critical drop in blood pressure, and dangerous bronchospasms.

• Affected Organs (Risks): The heart and lungs (the bronchial tree).

• Conditions of Admission (Indications): Arterial hypertension, ischemic heart disease, chronic heart failure, and severe rhythm disorders (tachycardia).

• Categorical Contraindications: Acute heart failure, cardiogenic shock, pronounced bradycardia, and bronchial asthma.

• Main Contract Restriction: An abrupt withdrawal of peacekeepers from the facility is categorically prohibited — a severe “rebound syndrome” will occur, risking a vascular catastrophe.

• Transport and Logistics (Dosage Forms): Tablets for oral intake.

• Delivery Speed: High. The peacekeepers take full control of the heart’s control panels within 1—2 hours of arriving at the facility.

4. Invited Foreign Consultants of the Department of Demography

The Department of Demography is fully responsible for the uninterrupted continuation of the lineage, social well-being, and external presentation of our Body-State. During peaceful years, its own proven staff labors here tirelessly. Estrogens work as ambitious ministers of female elegance — they strictly oversee the construction of solid bone reinforcements, maintain the ideal smoothness and velvet texture of the skin, and shield the primary vessel-roads from premature wear. At the exact same time, Gestagens operate as a quiet yet incredibly effective Committee for Maternal Protection and Stability Maintenance.

However, time is relentless, and when a natural, nature-mandated age crisis (menopause) hits the Department, the production of native ministerial staff rapidly winds down. Officials leave their posts, and offices empty. Without their firm control, the State begins to smoothly but irreversibly wither: bone-walls thin out and crack, skin loses its former luster, and spontaneous fires break out on once-safe vessel-roads in the form of hot flashes and vascular storms.

To restore the departments’ former crisp structure, strengthen the load-bearing configurations of buildings, and prevent the country from prematurely turning into ruins, the government decides to enlist external aid — hormone replacement therapy (HRT). These are elite invited foreign consultants. They arrive in the city to temporarily occupy the vacant ministerial chairs. The consultant-hormones penetrate the dormant departments, bind to specific intracellular receptors, and begin confidently issuing orders, mimicking the work of the previous leadership. Life inside the Department buzzes once more, and vascular riots subside.

Professional Risks:

The introduction of foreign managers requires textbook precision and caution. If these consultants overstay their welcome in their chairs or begin excessively stimulating the factories that produce blood clotting factors in the liver, deadly gridlocks — thromboses — will instantly form on the main transport routes.

Furthermore, their prolonged presence can provoke a covert mutiny of cells within the tissues of the mammary glands or uterus, which is capable of escalating into hormone-dependent tumors. For this reason, the contract with foreigners requires a regular and stringent audit: the specialists need constant monitoring by the security service (mammography and ultrasound), and at the slightest suspicion of a cellular riot, their mission is immediately terminated.

Specialist Profile

• Name of the Pharmacological Group: Estrogens, progestogens, their analogs, and combinations.

• Place of Service in the Organism: The reproductive system, bone tissue, and vascular highways.

• Working Tool (Mechanism): Specific intracellular estrogen and progesterone receptors in target tissues.

• Side Effects: Painful engorgement of the mammary glands, migraine-like headaches, and an increased risk of blood clot formation on vessel-roads.

• Affected Organs (Risks): Deep veins of the lower extremities (risk of thromboembolism), the liver, and mammary gland tissues.

• Conditions of Admission (Indications): Severe manifestations of menopausal syndrome (hot flashes, sweating) and the prevention of postmenopausal bone depletion (osteoporosis).

• Categorical Contraindications: A history of hormone-dependent tumors or suspicion thereof, acute venous or arterial thrombosis, and severe destructive liver lesions.

• Site Restrictions: A strict, rigorous annual audit is required (mammography, oncocytology) to detect and suppress any internal cell mutiny in time.

• Transport and Logistics (Dosage Forms): Tablets, transdermal gels, and patches. They are administered orally or topically (the latter allows them to arrive at the facility by bypassing the liver customs).

• Delivery Speed: Average. The support program unfolds smoothly; systemic effects and the stabilization of the city are locked in after several weeks of a scheduled course.

5. Inspectors of Structural Supervision and Building Soundness

The primary duty of this strict architectural and building inspection is to ensure that the load-bearing structures of the Body-State (the bones of our skeleton) remain monolithic, strong, and easily endure any everyday stresses and blows of fate. Within the bone department, a massive reconstruction takes place continuously, day and night, where two opposing crews labor without pause. The first — osteoblasts — are the creators, neat construction workers erecting new, solid layers of bone tissue. The second — osteoclasts — are brutal demolition-destruction workers whose task is to recycle old, spent, and worn-out building material in a timely manner. Normally, an ideal balance reigns between them.

However, during severe systemic crises (for example, the age-related leaching of calcium), the demolition crew suddenly loses its mind. The osteoclasts begin smashing load-bearing walls, columns, and building beams with frantic, fanatical speed, absolutely refusing to wait for the construction workers to pour fresh concrete. The state’s skeleton turns into a fragile, porous sieve, ready to collapse from the slightest nudge. The Bisphosphonates’ instructions command them to immediately infiltrate the ruined construction site and heavily crack down on the maddened destroyers.

Using their unique chemical phosphate “anchors,” the drug molecules literally sink their teeth into the mineral structure of bone beams and fall silent, setting up a hidden ambush. When an unsuspecting osteoclast attempts to “bite off” another chunk of bone wall, it swallows the lurking inspector along with it. Once inside the destroyer, the Bisphosphonate acts instantly: it blocks a key enzyme, completely decimates the internal cellular skeleton of the osteoclast, and forcefully dispatches it to the scrap heap, triggering a program of cellular suicide (apoptosis). The demolition of buildings halts completely, and construction workers finally gain the opportunity to calmly restore the destroyed walls.

Professional Risks:

These architectural inspectors are chemically incredibly aggressive, corrosive, and toxic during direct transportation. If, due to haste or carelessness, they accidentally get stuck in the main transport tunnel — the esophagus — en route to the construction site, they will literally begin burning and eroding the mucous membrane, leading to severe erosive esophagitis and deep ulcers.

This is precisely why a strict, unviolable working protocol exists for Bisphosphonates: they are delivered to the city exclusively in the morning, strictly on an empty stomach, washed down with a huge glass of pure water. But most importantly — after this, the specialist is obliged to stand or sit strictly upright for at least half an hour!. It is categorically forbidden to lie down, in order to eliminate the risk of the corrosive chemical washing back into the esophagus. Furthermore, during long-term service, inspectors may overdo it and make bones too dense yet brittle, which in rare cases threatens tissue death in the jaw area (osteonecrosis).

Specialist Profile

• Name of the Pharmacological Group: Bisphosphonates.

• Place of Service in the Organism: The musculoskeletal system, bone tissue (the entire load-bearing skeleton of the state).

• Working Tool (Mechanism): The molecular target is a specific enzyme inside the cells of destruction (osteoclasts). The delivery channel is the hydroxyapatite crystals of the bone, where the drug integrates itself using phosphate “anchors”.

• Side Effects: Severe erosive irritation of the esophagus and stomach, GI discomfort; with many years of continuous work — the risk of developing osteonecrosis of the jaw.

• Affected Organs (Risks): The mucous membrane of the esophagus, the stomach, and the bone tissue of the jaw.

• Conditions of Admission (Indications): Systemic depletion of bone tissue (postmenopausal and senile osteoporosis), Page’s disease, and metastatic bone lesions.

• Categorical Contraindications: Severe organic damage or narrowing of the esophagus (achalasia, strictures), peptic ulcer disease in the acute phase, acute renal failure, and critically low blood calcium levels (hypocalcemia).

• Strict Restrictions: Tablets are taken only on an empty stomach, with a glass of pure water, after which it is forbidden to assume a horizontal position for 30—60 minutes! Do not lie down!.

• Dosage Forms and Routes: Film-coated tablets; solutions for intravenous infusions (IV drips). Routes — oral or parenteral.

• Delivery Speed: Via the oral route, absorption at the GI customs is negligibly small (only 1—3%), but the drop team settles immovably in the skeleton for months and years. With intravenous administration, the drop team arrives instantly and protects the bone buildings for an entire year ahead after a single operation.

6. Elite Group of Chief Structural Engineers

While all other external specialists work with already existing living ministers, officials, and labor crews on the ground, Gene Therapy represents the highest technological elite — the scientist-demigods. They do not lower themselves to writing instructions for petty clerks. They descend into the most sacred place in the city — the secret state archive, where the original blueprints, matrices, and the sacred constitution of the country — the cell nucleus and DNA molecules — are kept under seven seals.

It happens that within this master blueprint, right from the birth of the state, a fatal, tragic typo was made — an inherited genetic disease (for example, SMA or hemophilia). Due to a single incorrect letter in the drafting scheme, the organism’s factories produce defective, non-viable parts throughout its life, or fail to manufacture a vital protein altogether. The country slowly fades away.

Gene therapy is delivered to the archive via a special, hyper-technological, shielded bio-transport — viral vectors (these are viruses from which the combat payload-poison has been removed, leaving only an empty capsule-shell). The engineers penetrate the very heart of the archive, locate the defective page of the blueprint, carefully excise the flaw, and paste in an ideal, artificially created, corrected blueprint. Having received the correct scheme, the factory-cell breathes a sigh of relief and begins manufacturing proper, healthy structures just as if the terrible breakdown had never existed. This is the pinnacle and triumph of modern medical science.

Professional Risks:

The appearance of such a powerful and profound external engineering bureau in the state always frightens and infuriates the regular internal Army — the immune system. Soldiers at checkpoints may mistake the delivery engineers for dangerous aggressors and attempt to storm their bio-transport. This provokes a massive, violent immune response and a temporary, severe failure at the main filtration plant — the liver chemical complex, which bears the brunt of the strike.

Furthermore, if the organism already possesses massive, ready-made antibodies against the specific vector-virus from past encounters, the army will destroy the elite engineers right on the doorstep, ruining the operation. But if the special operation succeeds, the blueprints of the constitution are corrected once and for all remaining life.

Specialist Profile

• Name of the Pharmacological Group: Gene therapy products (based on viral or non-viral vectors).

• Place of Service in the Organism: The cell nucleus, DNA, and RNA molecules (the main classified state archive).

• Working Tool (Mechanism): Functional genes within the DNA structure, viral delivery vectors (for example, adeno-associated virus type 9).

• Side Effects: An acute systemic immune response (cytokine storm), a temporary toxic disruption of the liver chemical plant accompanied by a sharp spike in liver enzymes.

• Affected Organs (Risks): The liver (as the primary filter and center for the initial reception of foreign biological objects) and the immune system.

• Conditions of Admission (Indications): Severe, previously incurable congenital genetic flaws (spinal muscular atrophy, hemophilia, certain types of congenital blindness).

• Categorical Contraindications: The presence of pre-existing massive protective antibodies against the specific delivery vector within the organism, and acute infectious fires in the body at the time of the operation.

• Main Limitation: Most often, this is a unique, one-time, and ultra-expensive special operation — corrections to the DNA constitution are made once and last a lifetime.

• Specialist Transport: Specialized bio-transport (viral vector-container).

Main Idea of the Chapter

State governance clearly teaches us that the fragile balance in the organism relies on the strictest subordination of decrees and the uninterrupted supply of resources to the regions. Any large-scale crisis — be it the inflation of the glucose-currency, an ice age at the TPP, adrenaline terror by security forces, or a fatal typo in the original DNA constitution — requires its own profile, narrow specialist. One who is capable of returning the system to a peaceful order without destroying the operations of neighboring departments.

Chapter 4. Communications and Telecommunications Service

The human Body-State is a massive, hyper-technological metropolis that is literally entangled in trillions of kilometers of the thinnest “fiber-optic cables” — nerve fibers. For this colossal structure to operate as a single, coordinated mechanism, management commands, reports from the outskirts, and alarm signals must be transmitted between departments at the speed of light. The internal information flow inside us never quietens down for even a single second.

However, our living “internet” has one crucial design feature. Nerve wires do not stretch in a continuous line from the brain to the fingertips — they consist of billions of individual segments. At the junctions of nerve cells — in tiny customs zones called synapses — the high-speed electrical signal inevitably gets stuck. It physically cannot jump across the abyss separating the cells.

And this is precisely where neurotransmitters step onto the scene — the couriers, cryptographers, and signalmen of our Communications Service. As soon as an electrical impulse runs to the edge of the cable, it transforms into a physical “packet of documents.” The sending cell releases the couriers into the synaptic cleft; they swim across it and deliver the secret cipher to the security checkpoint of the next cell.

But what happens if the Communications Service couriers are deathly tired, the state mail gets lost without a trace at sorting stations, and the main cables are severed by stress and illness? The country instantly descends into total informational chaos. The specialists we will meet in this chapter are elite signalmen, programmers, and stern system administrators whose sole task is to fix our body’s internal internet, returning stable communications to the regions.

1. Logistics Controllers of the Department for Combating Systemic Pessimism

When the Body-State is dragged into a prolonged, exhausting economic crisis, the Communications Service is the first to take the hit. De-energized departments stop dispatching the main couriers of joy, tranquility, and motivation — the serotonin messengers — to various authorities. Information feeds empty out. Cut off from good news, Central Administration (the Brain) panics and begins broadcasting just one oppressive update to all regions around the clock: “Everything is bad. There are no gold and foreign exchange reserves. Zero prospects. Development programs are frozen; the factories might as well be closed.” We call this severe state of siege clinical depression.

In normal life, once the serotonin couriers have delivered a positive message to the next cell, regulations state they must return to their original base via a special pump-shuttle (a transporter protein) to go on a well-deserved “forced vacation.” But under crisis conditions, this return happens far too quickly: the couriers barely have time to stick their noses into the synaptic cleft before the base sucks them back in, depriving the city of communications.

At this moment, a strict inspector arrives at the facility — an Antidepressant from the SSRI group. His job description is simple: stop the panic on the communication lines. The SSRI specialist makes his way to the sorting center and tightly blocks the exits and return shuttles for the serotonin couriers, clogging the pump with his presence. The base is closed; there is no way back!

The couriers find themselves locked on the working line — in the synaptic cleft. Deprived of the opportunity to escape for a break, they are forced to remain in the square and knock on the receptor doors again and again, continuously transmitting positive signals. Gradually, the city’s information channels are saturated with long-awaited good news. The Brain sees that stable communication has finally been established, and systemic pessimism begins to retreat, returning the State to a peaceful life.

2. Psychological Suppression Officers of Emergency Situations

Sometimes, it is not just a strike that erupts within the Ministry of Communications and the city’s central substations, but a frantic, destructive panic. The neurons at the main control panels go mad, starting to scream chaotically, wildly, and far too loudly, overloading all channels with false, emergency anxiety. The internal internet explodes with millions of panic messages. The entire country freezes in paralyzing horror, wasting colossal, precious energy on empty, irrational fear and the convulsive expectation of a catastrophe. This nightmare lives in the city under the names of acute panic attacks, psychomotor agitation, or status epilepticus.