If your KH is 19º then your pH should be at least 8.5 not 7.4. It may come directly from the well at pH 7.4 with ~20 ppm CO2 but it should then gradually rise as the CO2 vents with the atmosphere over the next 24 hours.
I realize I forgot to mention that I have added a bit of salt to his tank. There isn't much in there, but I wanted to help with this breathing and I am afraid of taking him out in his weakened state.
I will try to get some video here shortly, hopefully that helps.
The pH of the water out of the well was originally 8.3-8.4 a few years ago, after the water softener was added (sigh) it comes out as 7.4 out of the tap. If it is heavily aerated, it returns to 8.3, which is what is going on out in our koi pond.
I'm really glad you don't think this is columnaris. When the koi come in for winter, their holding tank gets sets up fairly close to the GT tank and I was worried about unintentional cross-contamination although I know the situation isn't solved yet.