From Hogwarts to Strixhaven.

Chapter 561 Heart Transplant Surgery
"Come in, Karak," Ivy invited the Hell Champion Warrior outside the door.

"Ah? Oh! Okay..." Karak looked nervous, but more excited. "This day has finally come... I've seen it in my dreams so many times!"

In the Tourmaline Abyss beneath the vampire lord's palace, Ivy has renovated a prison cell to serve as an operating room. Now, apart from the wall tiles and floor, the cells that were originally used to imprison vampire clones have been completely transformed.

Various magical light sources illuminated the entire space in the operating room, and no shadows obstructed the view. Although this was somewhat superfluous for Ivy, who had dark vision, being well-prepared always prevented mistakes.

In the center of the room was an operating table, with many gleaming knives floating in the air, and some tools that shouldn't be considered surgical instruments mixed in, such as wrenches, pliers, and screwdrivers.

Ivy, after all, was going to take a mechanical artifact out of Karak's chest, so these things would naturally come in handy.

“Relax.” Ivy, who was disinfecting her hands, glanced at Karak, who was fidgeting. “You can sit over there for now. The surgery will begin soon.”

Karak readily complied with the doctor's orders. The moment her bottom touched the wooden stool, she eagerly continued to ask, "Do I need to take my clothes off? You know... after all, I'm about to be disemboweled... or something."

“The process will be quick.” Ivy had already put on sterilized rubber gloves on both hands, which he had created using Transfiguration. “I guarantee you won’t feel any pain, just like you’ve taken a nap.”

“That’s really good…but…do you have any way to keep me sober?” Karak hesitated for a moment before asking.

Seeing the raised eyebrows of confusion on Ivy's face, Karak quickly explained, "When those hellish demons first took out my heart and installed the Purgatory Engine on me, they never asked for my opinion. No matter how much I cried and cursed, they just made me watch everything. My ribs were cut open, my blood vessels were burned... It really wasn't a pleasant memory."

“But I believe that watching that machine leave my chest will be one of my fondest memories… so—it’s okay if it hurts a little, I can really handle it.” Karak grinned.

“That makes sense.” Ivy nodded in understanding. “How about this: I will try my best to use magic to block your perception of pain. You may lose sensation below your neck and feel like those parts are clothes or armor on your body.”

The body structure of the Tyflins is similar to that of humans, since most of them evolved from the human race. Therefore, by temporarily blocking the signal transmission in the central nervous system of the spine, they can use magic to achieve an anesthesia effect.

“Sounds good! Can we begin now?” Karak nodded excitedly several times, then quickly stripped herself naked. As a barbarian, she wasn’t shy about exposing herself in front of Ivy.

While Ivy used magic to anesthetize her, Karak finally noticed two huge jars placed against the wall. The transparent jars were filled with a special frozen nutrient solution that could both maintain the activity of the red dragon's heart and slow down its rejection reaction to magic and other physical substances.

"Wow, that's huge! Even though I've seen it once before, I still have to say, the dragon's heart is enormous! Can it really fit into my chest cavity?" Karak tried to stand up from the stool, but her legs gave way, and she involuntarily fell forward. "Ouch!"

Ivy's magical anesthesia took effect, and the effect was surprisingly good. Karak is now practically an amputated from the neck down.

Karak, with her eyes closed, didn't feel her forehead hit the floor tiles. After a dizzying moment, she was magically placed on the operating table by Ivy.

“This feeling is indeed quite strange…” Karak twisted her neck, turning her face back to the red dragon’s heart by the wall. “Is the dragon’s heart structured the same as ours? What if we got a new heart but it still doesn’t work?”

“This isn’t even the biggest dragon heart I’ve ever seen,” Ivy said, recalling Smaug of Lonely Hill. “The one I killed had a heart big enough for several people to swim in. As for its structure—”

Ivy stood before the jar containing the heart, pulled out her silver linden wand from her sleeve to use as a pointer, and began explaining to Karak: "Although it's incredibly large, a dragon's heart has a structure similar to that of a mammal. It has four ventricles for exchanging blood, four main arteries and veins that transport blood to various parts of the body, and of course, some other blood vessels. Don't worry, I'll connect them all properly to ensure your life is safe."

“Okay… what’s that?” The sharp-eyed Karak noticed an accessory organ below the dragon’s heart, a feature unlike any other mammal.

“That’s a unique organ called the basal vessels, an organ possessed only by true dragons.” Ivy pointed to the area below the fire dragon’s heart, which looked like another liver. “The outer ring of glands is the center of magical activity within a true dragon’s body; for a red dragon, it’s primarily fire elemental magic. All the blood flowing from the heart passes through here, then is distributed to every corner of the body. It allows a true dragon to breathe dragon breath and also enhances its metabolism, ensuring that the dragon can support its enormous body with its wings. As long as it works within your body, you will receive unimaginable enhancements.”

“I will use magic to shrink them and then place them in your chest. Although the power will be reduced, the actual effect should not be significantly diminished due to the vast difference in size between you and a dragon.” Ivy turned around and put away her wand. “Alright, let’s begin now.”

Ivy clapped her hands, and the intravenous drip, suspended in a glass bottle, was inserted into a vein in Karak's arm. Reaching down, she pushed aside the mass of fat covering the red skin, revealing the access port located below Karak's sternum. Besides her chest, Karak had a similar one on her back; the combustion chamber insulation panel Ivy had made for her last time had been installed through this very spot.

“The access panel is too small. I need to cut open your chest…” Ivy looked at Karak, whose eyes were turned down and whose lips were pursed. “Do you need me to lift your head up a little?”

Although I don't think it's necessary for the patient to watch the entire surgery, Ivy will certainly comply since Kara has made the request.

"Of course... thank you."

As she watched the gleaming knife slice through her skin, Karak instinctively took a breath, but felt nothing else.

Even when the mage's hand floating beside Ivy wiped away the blood with gauze, Karak didn't feel anything real; it was as if it had happened to someone else.

“The Infernal Engine takes up much more space than I imagined.” Ivy sawed through the Hellfire alloy securing Karak’s sternum, opening her left chest like a vent in a coal stove, and carefully examined the internal structure. “It’s more than enough to fit a fire dragon’s heart, and there’s even room for those massive basal vessels. To fit the access panel, the demons cut off a lot of your lungs… and they used Hellfire to stop the bleeding… how brutal.”

Ivy stroked Karak's scarred organs and pursed her lips, but Karak didn't notice anything amiss under the mask. The devil's surgical skills were extremely poor, a typical case of killing without burying the victim. If the warrior who received the Infernal Engine didn't survive, the engine might even be removed and reused.

After all, the demons born from the River Styx are endless, and even their own kind are just consumables to them, so how could they cherish other races that are considered slaves?

“The Purgatory Engine is essentially a blood exchanger, except that your blood is additionally affected by hellfire when it passes through here, which is why it exhibits the characteristics of high temperature and flammability.” Ivy began to dismantle the machine in Karak’s chest that was emitting high temperature and the smell of sulfur. It was clumsy, rough, and black, and it was obvious at a glance that it was a primitive model that had not been optimized much.

"In battle, the flames from the Infernal Engine are indeed quite useful, but in daily life, they often cause trouble." Karak has been fighting in Hell for ten years, but she can count the number of things that have made her happy on one hand. "You know what? Once, I was in a tent and set it on fire. In the end, I had to blame it all on the little devil."

Ivy took a deep breath. He could understand Karak's desire to share, and such private matters were not topics that could be shared with ordinary people. But since they were in surgery, Karak's desire to share did have a kind of beauty that disregarded her own life and death.

"Don't worry, you'll still be able to set things on fire in the future." However, maintaining a good doctor-patient relationship is indeed a very important aspect, Ivy casually added.

Karak, however, looked very surprised: "You mean...?"

Karak really doesn't give Ivy any air at all.

After taking another deep breath to calm herself down, Ivy used magic to temporarily seal several of Karak's important blood vessels. She then gently shook the Purgatory Engine that was fixed to her spine, ribs, and collarbone. During their previous conversation, Ivy had already dismantled all the structures that held the Purgatory Engine in place.

“I’ve removed the Infernal Engine. Your blood supply will gradually stop, but magic will still keep you alive.” Ivy decided to shut Karak’s inappropriate mouth. “Take a deep breath. Dizziness is normal. You might pass out for a while.”

"It is a bit..." Karak hadn't finished speaking when she lost consciousness.

-

"The surgery was a success, you're a great young man now."

"What?" Karak jumped up from the hospital bed, first grabbing a handful of the indescribable area below the neck and above the abdomen, then reaching up to the area above the knees and below the abdomen.

Karak breathed a sigh of relief after finding that what should have been there was still there, and what shouldn't have been there was no extra.

“You’re joking, Ivy,” Karak chuckled dryly. “I’m still a girl, aren’t I?”

“Actually, I installed a hidden version for you…” Seeing Karak’s increasingly worse complexion, Ivy stopped her dangerous remarks. “Don’t worry, I didn’t do anything. There are easier ways to change your gender; you don’t need to have a special surgery.”

"That's great." Karak rolled her eyes, pressing her hand to her chest to feel the throbbing inside. "Changing your gender is really that easy?"

“There’s a gender-changing potion that works on almost any humanoid creature.” Ivy was using magic to tidy up the operating room. The heart transplant surgery had indeed been successful, so the spare parts had been carefully preserved. “And its market value in Faerûn is beyond your imagination.”

"Really?" Karak asked, somewhat skeptical.

“Do you know Nocturne? The Tiflin who came back from the Shadow Embrace Monastery with us?” Ivy tossed Karak’s leather straps onto Karak.

"Nocturne? That girl who was Shadowheart's best friend at the Shar Monastery? The one who even cut her bangs?" Karak sat up from the hospital bed and started putting on her clothes.

“Yes.” Ivy nodded. “Nocturne was originally a boy until he took a gender-changing drug. To be honest, I was quite surprised when I found out. After all, I’ve never trusted male best friends.”

“Indeed…it’s quite puzzling.” Karak reached out and touched her breasts. “They’re so tight…have they gotten several sizes bigger?”

“It’s the red dragon’s basal blood vessels that are at work. It’s boosting your metabolism, repairing scars, and ushering in another growth period until your body and organs are in harmony,” Ivy explained, picking up a cup of tea. “The Hell Artisans left many honeycomb structures in your body for heat dissipation, and I removed them all. I originally thought I would need to use some additional healing spells, but once the fire dragon’s heart started working, your body began to recover at a rapid pace. So I think it’s better to let nature take its course.”

"All benefits? No side effects?" Karak jumped off the operating table, bouncing around to stretch her limbs. "Wow! I feel so energetic!"

“Speaking of downsides… your metabolism is several times faster than a normal person’s, so you’ll probably smell worse faster?” Ivy speculated. “True dragons don’t sweat, nor do they cool down by panting like dogs, because they store heat in organs like their throat pouches to power their breath weapons. But you haven’t developed that function yet, so your faster metabolism will probably require you to clean yourself more frequently. Ah, your food expenses might increase several times over. True dragons eat almost anything, and metal dragons will even eat gems and metals. Forget about non-organic matter, but your need for ordinary food will definitely increase.”

With a rumbling stomach like thunder, Karak swallowed hard: "I'm so hungry I could eat a whole cow!"

Ivy made way, and Karak dashed off like a ball of fire. But before Ivy's clothes even fell off, she turned back and gave Ivy a hug.

(End of this chapter)