Dear Dr. Nagde,            

I am writing to you as a concerned mother, hoping to find you willing to cooperate with me on the issue of my son Marlon´s health.

Marlon was born with a heart defect called LQTS. You being a doctor, I am sure you are familiar with the condition; still, allow me to briefly describe the illness and its symptoms (you will find a more detailed medical letter by Marlon´s doctor enclosed[1]) to prepare you for what you will have to deal with.

LQTS involves an abnormal repolarization of the heart; it often triggers irregular heartbeat and may lead to shortness of breath and fainting spells. If untreated, it can have even more dire, if not to say fatal, consequences.
My son has learned to live with the condition; he takes his medication and avoids physical exertion. Still, he needs constant medical care and regular checkups (at least once a week), both of which I have been assured he will receive at Hogwarts. In fact, this has been my and my husband´s condition for letting him go in the first place. I trust you will take good care of him and let us know immediately if his state of health gets any worse, in which case we will pull him out of school and take him back home with us.

Thank you so much for your understanding and for taking special care of Marlon.

Katarina Kaminski[/i]


The late afternoon sun was casting its dusty light on the grounds as Marlon walked across them towards the healer´s hut. He had been told that it was on the edge of the Forbidden Forest, which made him a little anxious. Shouldn´t the school nurse be inside the school, where she was closest to her potential patients? What if someone got severely injured - they´d lose valuable time if they had to go fetch her and bring her back to the castle, no? What if Marlon´s heart decided to give up completely one day… he´d be dead before word even reached her.

His mother´s letter was in the bag slung across his shoulder; he hadn´t read it, but he didn´t need to, he knew what was in there. Dr. Barrett´s letter too, with Marlon´s medical record and the medication he had been prescribed and all the other medical information. The doctor, of course, had been led to believe that he was writing the report for a colleague, another cardiologist… Marlon wondered whether the healer would be able to do anything at all with the information. Maybe she only dealt with herbs and potions and stuff. Luckily, he didn´t need her for his pills and such, as he had taken a supply with him that would get him through till Christmas. But he did need her to check up on him and monitor his illness, see if anything changed… if she was just a hedge witch, however, she wouldn´t be much use. Somehow Marlon couldn´t imagine that there was anything resembling the hi-tech medical equipment he was used to in a place called the Hospital Hut. What he found there would, in effect, lead to the rather weighty decision of whether to stay or not. If there was no adequate treatment in Hogwarts, he couldn´t possibly risk his life and stay at the school. And despite his initial enthusiasm at getting to learn magic and the big adventure of leaving home and living his own life, Marlon found that the enthusiasm had considerably faded as homesickness and the foreign environment and the annoyance of constantly being surrounded by people took the shine out of this new and initially exciting experience. If he had to go home now, he wasn´t sure he´d completely regret it…

He climbed the stairs up to the landing, then raised his hand and knocked at the door of the Hospital Hut, knuckles rasping tentatively across the sun-warmed wood.

1.	or just read http://en.wikipedia.org/wiki/Long_QT_syndrome

The backdoor and windows all stood wide open, allowing a gentle breeze drifting off the lake to snake through the house.  The cabin had grown musty from lack of use over the two months of summer holidays.  The fresh breeze helped usher any remaining stale shadows out from the dark corners.  It had, thus far, been a rather quiet day and foot traffic to the cabin had been minimal. Unlike most schools Tulojow was aware of, Hogwarts had the unique ability to have more students injure themselves during the school week while classes were in session than on weekends when the students were left to their own devices. 

From the kitchen window, Tulojow had watched the young man approach the cabin's front door.  Music issued from the record player[1] standing in the corner of the cabin's main room, offering some background noise as Tulojow finished washing dishes and saw to other end-of-week chores. 

The young man neither appeared to be in pain or having difficulty walking so Tulojow finished drying the glass in her hand before crossing to the front door for the young man.  "Good afternoon, my dear," Tulojow greeted.  A quick glance over the young man revealed her initial observations were true; if the lad was injured, the injuries were well hidden. 

"Can I get you anything to drink?"  Tulojow offered, gesturing for the young man to follow her into the kitchen.  "Tea, cocoa, lemonade?"  The older woman took a seat at the warm, weathered kitchen table.  "How can I help you?"

1.

music

This did not look like a hospital at all.

Marlon´s expectations had already been low, what with the Hospital Hut, but the place he had just entered did not have anything qualifying it for a medical station of any kind. For living quarters, the place was really nice, cozy-looking, with the light-hearted music lending it an extra feel-good air, but for a hospital this was just plain wrong.

No, this went against everything Marlon knew about hospitals. And he knew a lot about them. They were cool places with hard surfaces and cold lighting, impersonal and aseptic and, well, clinical. It wasn´t that Marlon liked any of these things. But that wasn´t important. The fact remained that all these things were what made a hospital, and all these things were absent here – thus, he had a hard time believing this place was any good when it came to treating sick people.

Then again, maybe this wasn´t the hospital part, just the living quarters, and the examination rooms were somewhere further inside, or in the basement. The thought came to him as he followed the healer into the kitchen after politely wishing her a good day and nodding at her offer of a drink.

“Uh, lemonade please. Thank you.”

Wrapping his fingers around the glass she handed him, he lifted it to his lips and took a sip. It was good, not too cold and not too sweet, just as it should be. Marlon was almost starting to feel comfortable here… he liked the cabin (although it definitely did not look like a hospital, or perhaps because of it), he liked the wooden interior and he was beginning to like the healer, a timeless-looking woman who surely wasn´t young anymore, but whose age Marlon found hard to pin down. She exuded an air of serenity that was quite comforting; but she definitely didn´t look like a doctor.

That reminded him. He pulled his bag onto his lap and extracted the two letters by his mother and doctor respectively, and handed them to the healer.

“My mother asked me to give you these. It´s because of my condition… she wants to make sure I´ll be fine, I guess.”
 

Tulojow took a long, casual sip from her own glass of lemonade before setting it down to take the two letters from the young man.  She read the letter from Katarina first, growing quiet as she gave the information careful consideration. 

She understood the mother's concern entirely and without need for further elaboration.  For muggle parents to send their eleven-year-old off, not only to school, but to the depths of a whole different society they had not way of really comprehending was daunting, to say the least.  Despite whatever reassurances and explanations the school officials might offer, in the end, it required a certain leap of faith for the parents.  Tulojow had always wondered what her own parents might have thought; but, they'd both passed on by the time she'd been admitted to her own school back in the US.  Add into that having a condition such as Marlon's, and Tulojow could sympathize with the parents completely. 

She could picture the scene in her head.  The school officials arriving, largely unannounced, to explain about their son's magical abilities.  And, Katarina and her husband trying to explain to the wizards about their son's condition and needs - all of which would have probably sounded like rubbish to the school representatives.  They'd probably insisted they had a healer that could handle anything - but it would have been a generic response.  The same they would have given to a parent with a child with peanut allergies.  Or eczema.  Or any number of muggle conditions they knew nothing about.  The blank, lost looks on their faces wouldn't have been reassuring to the parents. 

For all she knew, the young man sitting across from her probably had the same reservations. 

But - there was a pressing matter that needed to be addressed before moving on to any more details.  In fact, once the information registered, Tulojow didn't bother to take the time to read the doctor's letter.  "Do you have an implanted defibrillator?" Tulojow asked, certain the school officials wouldn't have known to ask.  Luckily, the devices usually lay dormant until they detected a dangerous change in heart rhythm so one would only become an issue if the young man had an episode.  But ... if he did ... it would react to the ambient magic around Hogwarts the same way any other battery- or electrical-powered muggle device would. 

It would be bad. 

The school officials had been jovial enough, assuring Katarina and Tadeusz that their son would be in good hands at Hogwarts, that every measure would be taken to ensure his health and safety.

Marlon´s parents hadn´t been entirely convinced, however; much more than the school officials´ promise it had been the sympathetic, reassuring personality of Madam Hooch that had gained their trust. They would let their son go with her, if she considered it necessary. She had something about her that told them that their boy was in safe hands.

This healer was a little like Hooch, he thought. The Flying Instructor might be quirkier, with mischief twinkling in her eyes, and somehow Marlon suspected that when challenged, the old woman could swear like a sailor… while the healer seemed more contained, calm and self-sufficient. Just like with Hooch, he felt a certain degree of safeness when he was around her.

“No, I don´t have an implanted defibrillator. I think the doctors did not consider me… strong enough for the surgery. I´ve heard them tell my parents that they would do it only if it was unavoidable; but for now, they think I´ll be fine if I just regularly take my medicine.”

He extracted a longish box from his bag, with seven compartments. In each compartment were the pills he had to take during one day. Setting down the box before Tulojow, he pulled out a list and slid the paper over the table towards her.

“This is the list of pills I´m taking. It´s a copy, you can keep it. Dr. Barrett thinks you should know. Not that Dr. Barrett knows who you are… he thinks you´re just a regular doctor.”

He recalled the word they used: muggle. It felt strange on his tongue when he tried it out.

“A muggle doctor. He doesn´t know you´re a… healer. Is that right, healer? What exactly does that mean? I mean, do you have, uh, a medical degree of some sort?”

Marlon hesitated; he didn´t mean to sound insulting, asking her about her qualifications as if he did not believe she was on a par with a real doctor… but then, he found it hard to believe that she was. Surely brewing herbal teas and knowing how to apply a bandage was pretty useful, but not the elevated medical science he needed to keep him alive. At least she knew about defibrillators; that reassured him a bit, if not entirely.

Tulojow nodded, taking special care to avoid projecting the degree of relief she felt on the inside.  Until the lad had declared himself defibrillator-free, her mind had already started trying to determine the best route to get the muggleborn away from the magical effects of Hogwarts without the travel, itself, changing his heart rhythm.  But, bouts of panic in the Healer rarely instilled confidence in the patient and with only the slightest sigh, Tulojow smiled at the lad. 

"If talk ever does turn towards the idea of one," Tulojow offered in explanation.  "It would be best to allow me to collaborate with your doctor.  There's so much magic around places like this that the magical energy interferes with batteries and electrical impulses.  We'd have to work out some modification to make sure it could work safely and effectively both in the presence and absence of magic." 

That could be a bit of a logistical, technical nightmare - one that would require the help of someone with more engineering abilities than herself.  She was convinced it was doable - but she was certain it wouldn't be as simple as charming a muggle record player to work within a magical school. 

Tulojow turned her attention to the list of medications.  "I've got professional connections with several muggle pharmacists.  I'll make sure we always have a back up supply of them here.  Just in case they catch Peeves' attention.  They shouldn't; if he gives you grief, just let a prefect, staff member or myself know.  But, just to be on the safe side." 

Tulojow took no offense at the young man's questions, finding them perfectly reasonable and legitimate for a young man in his circumstances.  "Yes.  In the wizarding world, we have nurses and we have Healers - Healers are our equivalent to doctors.  I did return to school for post secondary education back in the US.  Knowledge of muggle diseases and treatments is fairly limited amongst Healers - but I am muggle born.  And, my grandmother was a tribal healer.  I did a lot of field healing and triage work during my years as an Auror and, during that time, spent a fair bit of time collaborating with physicians with Doctors Without Borders." 

Marlon wasn´t entirely sure what a Peeves was; he just nodded, pretending to know what the healer was talking about. If he were to inquire about every little thing he did not understand at this place, he would have no time left for anything else.

At any rate, it seemed to be something,  or rather someone, who could be handled by the prefects, probably a notorious school bully. Marlon made a mental note to avoid anyone named Peeves. It shouldn´t be hard. He had years of training in ducking trouble.

Hearing that healer Nagde had professional connections with normal – muggle – pharmacists was a true relief. So the two worlds weren´t quite as far apart as it sometimes seemed. Even more of a relief was her explanation that a healer was the equivalent of a doctor, as well as the list of experiences she could rely on. Some of Marlon´s tenseness vanished. In fact, he felt a flutter of excitement as a new thought entered his mind…

Leaning in, elbows propped up on the table, he fixed the healer with an intense stare, a look of hopeful anticipation on his pale face.

“Can you make it go away completely? With magic, I mean?”

Could it go away completely with magic?  Tulojow knew the young man was looking for a simple 'yes.'  Tulojow remembered, as a young muggleborn embarking on her first year of magical education, how magic seemed so limitless.  Back then, it seemed magic could do anything - accomplish anything.  It was only with time and experience that Tulojow really began to understand the limits of that power. 

"Potentially," Tulojow offered, certain her vague answer wasn't what Marlon was looking for.  "As you've probably noticed, we tend to keep ourselves separate from the mundane world.  Due to the Statute of Secrecy, there's been a very limited amount of collaboration between Muggle Medicine and Magical Healing.  By necessity, some Healers have developed magical treatments for Muggle diagnoses - I'll have to do a little research to see if Long QT syndrome is amongst them." 

Magic tended to influence the way the human body responded to health complications.  Witches and wizards aged differently; conditions that were devastating to muggles were minor complications to wizards and diseases that disabled wizards were unheard of in the muggle world.  Some diseases did cross over and, quite often, the same set of symptoms in the magical and mundane worlds were given two separate diagnoses - both based on the symptoms their separate technologies were able to detect. 

"We almost never see LQTS-like heart symptoms in witches and wizards which suggests there probably is some effective treatment."  Or, the stress of living in a magical world was too much for those witches and wizards with defective hearts and most of them died in infancy.  "If there is a treatment or cure, it may take some digging to find it.  And, it probably will require starting over with tests to find the magical equivalent.  Which, I should get a magical baseline, anyway.  How are you doing navigating the castle, with all the stairs?  Any shortness of breath getting from History up to your Astronomy class?"