Amam left with his mom after she paid me what she thought was fair. It was far too little, and far too much at the same time. I didn’t think she could afford the number of coins she was trying to shove into my hands, and it simply wasn’t what the biomancy operation was worth. I accepted about a quarter of what she wanted to give me, reminding her that it was cheap biomancy, and called it a day. I poked my head out after them to make sure Auri gave him a cookie for being so brave. She gave me a little look as his mom explained, I nodded, and a cookie got handed over to him.

His bright smile made my day.

The crowds were starting to pick up, although I was just one of a hundred wonders. I settled back in to get some good reading done, waiting for my next client.

It didn’t take long for a grizzled… sharkkin? To hobble through my door.

He had a tight leather vest, looking like beaten armor, and a club at his hip.

[Warrior - 240]. Potential trouble.

I stashed the book and assumed my [Fortune Teller] look.

“I predict you are here… for biomancy!” I dramatically proclaimed.

The sharkkin gave me a grunt, pointing to the stump his leg ended on.

“Can you fix this?” He growled at me.

I dropped the act, and leaned over my desk to peer at his bloody stump.

“It depends.” I carefully qualified. “Can you tell me about it?”

A moderate leveled warrior missing a foot from birth? That was bloody?

“Got caught in a line. Biomancers can fix this, right?”

I rolled my eyes. I didn’t even bother hiding it.

“Yes, but why not, you know, a healer?” I asked in disbelief.

He shrugged.

“Hard to find one that can fix limbs and is affordable.”

I rolled my eyes at him, leaning over the table to poke his shoulder. I blasted my normal healing through him.

I wanted to practice biomancy. I also wanted to use the right tool for the right job, and it felt flat-out unethical to use him as biomancy practice when I could just heal him normally.

“You’re fixed. Now pay up and get out of here.”

He looked down.

“Huh. So I am. Thanks.”

He tossed a few coins onto my desk and lumbered out.

I had an education problem. The average person wasn’t quite sure what the difference between a biomancer and a healer was. They should, but they didn’t.

It was sort-of my problem, but it was far easier to poke them and get them out of my tent, than to painstakingly explain the difference between [Biomancer] and [Healer], then explain I was also a healer, then heal them and get them out.

“Biomancy?” An elephantkin bowed as he ducked into my tent, the room suddenly feeling tiny. Dude was huge in every dimension. The edges of the tent caught on his tusks, then slid unnaturally off of them.

I know I’d want a [Stop Getting Stuck On Things!] skill if I had tusks like this dude.

We were in Ankhelt, kingdom of beastkin. It wasn’t too surprising that every other patient of mine was one, although it did have me mentally flipping through my various comparative anatomy courses.

I didn’t even bother checking his level.

“Only if it’s tiny.” I warned him.

He trumpeted amusement. Somehow.

“Healer told me that. Healer told me only way I could beat the sugars is with a biomancer. Otherwise, have to keep going back. Every day, sometimes twice a day.”

Ah. Diabetes. Type 2, if a healer couldn’t fix him. Given what he’d said, and his surprisingly robust knowledge of his own condition, I believed he was correct.

I eyed him.

“Alright, here’s the deal. How much do you know about your disease?” I asked him.

“Too big. Too fat. Organ couldn’t keep up.” He said.

I nodded.

“That’s exactly correct. Similarly, if I fix the organ now, you’ll continue to degrade it. However…” I paused and looked him up and down, running some numbers in my head.

“How much do you weigh?” I asked him.

“Two tons.”

FUCK. I was considering shaving off a few pounds to give his pancreas a fighting chance when I restored it, but two tons? Forget it. Even if his vitality was low, I could barely make a dent.

Ok. First principles. Let’s tackle this top to bottom.

The pancreas. Among other things, it produced insulin, which regulated how much sugar was running around the body.

Diabetes came in two types. Type I, and type II. Both were failures of the pancreas, but the root cause was different. Type I came from a virus or some other external factors causing the pancreas to shut down. Annoying, terrible for people who had it, but easy enough for a healer to fix up.

Type II was worse, from a magical perspective. The pancreas in type II had simply… given up. It couldn’t keep up with how much person there was, which usually was a result of being too damn fat and large. His mention of regular, daily visits with the healer suggested the second type. Healing wasn’t going to fix the back-image the System had of his pancreas, which was ‘I’ve given up trying’. A full modification somewhere was needed.

Now, if I simply gave him a new pancreas, restored it to life and gave it motivation again, things would be great for a few weeks, months, or even a couple of years. But the sheer size of the dude in front of me suggested that, in time, it would fail again.

Restoring his pancreas and taking off the few pounds I could wouldn’t work either. It’d be like throwing a cup of water into a house fire.

He wasn’t quite at a healthy weight either.

“Can I use a skill to look at you?” I asked, trying to be polite.

“If you can fix me, please.” He agreed.

[Elvenoid Visualization] popped up, and I zoomed in on his pancreas. A tiny, shriveled little thing, confirming my suspicions.

Right.

I had a plan.

“Ok, I’d like to tackle this in two, arguably three ways. I would like to get your permission before starting.”

“You have it!” He enthusiastically agreed.

I gave him my best Look.

“You need to know exactly what I’m doing and changing about you. Otherwise you don’t have informed consent.”

He frowned, and leaned forward.

“You’re the expert. Alright, tell me.”

“Step one is fixing your pancreas. I’m going to give you a new one.”

“That’ll fix my problem?”

“Not completely, no. Just temporarily. Let me finish.” I gave him a second Look. He got the message.

“Step two is like step one. I’m giving you a few redundant pancreases. The hope is by sharing the load, they’ll…” I trailed off and cursed.

“Nope, sorry, nevermind, that won’t work.” I grimaced. “Each one will attempt to work like it’s the only pancreas, not knowing about the rest, and the first time you eat something sugary, they’ll flood your body with insulin, causing hypoglycemia and probably killing you. No, I’ll have to supersize your first pancreas.”

The elephantkin was looking nervous.

“Are… you sure you’ve done this before?”

I snorted at him.

“Cheap biomancy, at a student clinic. What do you think?”

He made a motion to get up, then slumped down.

“I’m screwed either way.” He muttered.

“Good! Glad we’re on the same page! Now, after one extra-large pancreas, I’m going to fiddle with your stomach nerves. The goal is to mess with your satiety cues, so you’ll eat less and lose weight, letting your new organ work. Losing weight will also be good for you. It’s imperfect, there are better solutions, but you’re just too damn big for the other solutions, especially after I’ve fixed up your pancreas.”

I paused, my mind catching up with my mouth.

Pancreas. Average weight on a human - 91 grams.

Elephantkin. Average scaling up factor per organ of 20x.

About 1,800 grams. For a regular sized pancreas.

I wanted to double it in size. Then add in a nice safety margin.

Weirdly, my mana was my main bottleneck, not my power or control.

“If your vitality is over… 130… you’re going to need to get me some arcanite to work with.” I told the elephantkin with a wince. I had the arcanite ball full of mana, but that was partly an emergency reserve, and more importantly, didn’t contain a fraction of the amount of mana I’d likely need.

Some kids had a vitality over 130, promptly after unlocking their System. It was rare, but it wasn’t impossible. The previous kid had been tiny, and had a vitality of four, so I hadn’t needed to even run the calculation.

There was a damn good reason that biomancers primarily worked on young kids, or people who’d just unlocked, and even then, made the smallest changes possible. I was fairly sure the [Biomancer] that had visited Iona when she was a kid simply tweaked her testosterone production.

“How much arcanite?” The man rumbled.

“What’s your vitality?” I asked him.

He hesitated, not wanting to give away that sensitive information.

Just a moment though.

“7,523.”

I closed my eyes, and he must’ve seen my face.

“I’m sorry.” I whispered to him, slouching in my chair.

He rumbled disappointment.

“Can you do the thing with the stomach?” He asked.

I wiped away some tears. Not being able to help someone who’d come to me for healing was more devastating than I’d expected.

I knew I couldn’t fix everything with healing. But with biomancy, somehow, I’d allowed myself to think it was different now. That I could do it all.

“Yeah. Let me see.”

I traced the nerves around his stomach, working out between a mix of theory and practical ‘see what’s in front of my eyes’ which nerves where, and what signal, were responsible for satiety. Ok, technically not satiety, but fullness.

Feeling full was only one part in the staggeringly complex equation that dictated satiety, which in turn helped dictate eating habits and amount. There was more to it than that. How often did people eat for pleasure? For fun? Because they had a problem?

This was only going to give Mr. Elephantkin a small leg up on his weight problem.

It was better than nothing.

I explained what I was doing, and he seemed to understand, although he sounded as disappointed as I felt.

There was a chance on a small adult I could’ve fixed their pancreas, especially if I just needed to spruce it up, instead of also enlarge it. My patient was simply too large and too high leveled, and had lost out as a result.

I debated doing a partial fix on his pancreas, and doing everything I could to restore it to its old healthy operation, but no.

Down that path lay flat-out murdering my patient, when the operation inevitably stalled out mid-change. There was no telling what a partly healthy, partly ‘naturally diseased’, and partly ‘dear gods what is going on here’ pancreas would do. It wasn’t worth the risk.

Nerves were small and relatively easy to play with, although he might be getting conflicting signals. I wasn’t screwing with all the nerves, just 80% of them, such that 80% of his nerves endings in his stomach would always report being full, and the remaining 20% would report some degree of ‘hungry’ to ‘full’.

The brain was one big mystery, one that we hadn’t cracked, and it was possible that it would rewire itself to only pay attention to the remaining ‘operational’ nerves, and entirely ignore the modified ones.

[*ding!* [Smooth as a Baby’s Bottom] leveled up! 11 -> 14]

[*ding!* [Permanence] leveled up! 2 -> 3]

Biomancy was hard.

Some biomancy was easy.

Colorblindness when the issue was a lack of cones in the eyes. Gave my patient a splitting headache afterwards, and I was forced to run him back to the School proper as an emergency. The [Healers] descended on us, fiercely interrogating me as to what I’d done, but after extensive, exhaustive analysis, I’d done everything perfectly.

His head was just struggling with the information overload. He’d gone an entire lifetime missing the colors, and his brain wasn’t coping well with the new inputs.

A good lesson.

I was regranted permission to continue working on my biomancy.

Changing someone’s hair to a ‘natural’ ginger was simple, and saved them a lifetime of hair-changing appointments.

Extra eyelids.

Stopping hair growth.

Starting hair growth.

[*ding!* [Smooth as a Baby’s Bottom] leveled up! 14 -> 19]

[*ding!* [Permanence] leveled up! 3 -> 7]

Tattoos.

I hadn’t previously put together that I could use biomancy to make permanent tattoos, but I had more than a few guards politely make the request, each one bringing a small heap of Arcanite with them. It was something of a thing here, and the guards knew both the mana requirements, and that ordinary healers could easily destroy normal tattoos on accident.

There were a number of workarounds - permanent paint being a semi-popular one, a very expensive [Tattoo Artist] with something of a monopoly on the truly permanent tattoos in the city - but getting young biomancers to do the work was just well-known in this particular circle.

Cheaper to boot.

Some biomancy was hard, when not flat-out impossible.

Changing a dullahan’s metal composite. What a dullahan was made out of had major cultural implications, and a pair had traveled from the Han empire just to get a chance at finding a biomancer to help them out.

They’d brought fully formed suits of pure adamantium armor that they’d wanted to ‘replace’ their old armored skin with, and when I’d explained the problem - metal armor and skin weighed a ton - they’d drawn swords and almost immediately shaved their old armor off, practically down to nothing.

It was like a human peeling their own skin off with a potato peeler, one strip of flesh at a time, and I watched, utterly horrified and fascinated.

It did make the operation possible, since their innate vitality didn’t apply to the new armor, not until I’d attached it. They stoically put on the ‘new’ armor, and I ‘latched’ it to them, then made the changes permanent.

[*ding!* [Smooth as a Baby’s Bottom] leveled up! 19 -> 30]

The large jump was concerning, and I’d never taken the Magical Metallurgy class. It wouldn’t surprise me if not everything was entirely correct, and I told them so.

I was [Oath]-bound to.

They stretched and jumped and generally made a huge ruckus, and declared that they were happy with the results. It made me uneasy, and I suggested they get a follow up with a specialized biomancer.

They gave me sixteen diamond coins for my work, and I was getting a really, really bad feeling about the whole thing. A single diamond coin was worth the same as a ruby coin, and each one was worth 10,000 arcanite coins, the smallest coin. Way more than enough to pay for a normal biomancer… so why did they come to me? An out of the way nobody?

Strange. I wonder if they were trying to also buy my silence or something? Not that I needed it, I was already sworn not to reveal confidential patient information, which this qualified for.

The downside of that was I could only complain to Iona at the end of the day in vague terms about what had gone on.