Tokyo Unnatural Forensics

Chapter 309, The End of Medicine (Bonus Chapter for 3k Monthly Tickets Last Month)

"A pound of pear!"

Attorney Guoping, representing the defense, immediately stated: "Your Honor, the subject of Uesugi's testimony has changed; the argument has shifted from medical issues to other matters. I demand an immediate halt to the testimony!"

"Uesugi, is there anything you'd like to say?" the judge asked after a few seconds of contemplation.

“I want to state that the problem is not with the medical assessment, but with the medical procedure.” Uesugi Muneyuki nodded and said frankly, “Just like this report in my hand, it has been altered, and that is my reason for testifying in court.”

“Mr. Uesugi,” the defense attorney asked, “you entered the First Department of Surgery at the Medical and Dental University and interned under Professor Zaizen, right?”

“Yes.” Uesugi Muneyuki nodded.

"During that time, according to our information, you received multiple complaints from patients, and eventually had to be transferred to the forensic department, right?" Attorney Guoping held up the case file in his hand and waved it at Uesugi Muneyuki.

"Yes."

"According to our understanding, it was Professor Zaizen who arranged for you to transfer to the Department of Forensic Medicine. It's a pity that you were admitted to medical school but had to transfer from surgery to the Department of Forensic Medicine. Can I assume that you have some prejudice against Professor Zaizen, which is why you decided to testify in court?"

Attorney Guoping was full of confidence: "As a student who was abandoned, it seems reasonable to oppose the judgment of your former mentor, right? Can I assume that you are using the fact that your autopsy report was modified to attack your former mentor because of some resentment towards Professor Zaizen? But as you said, you have no objection to the results of the medical examination, so you came here purely for personal grudges?"

"A pound of pears!" Attorney Sekiguchi immediately interrupted, "This question has absolutely nothing to do with the proceedings! I request to withdraw it!"

“No, this is a courtroom. Poisonous trees don’t bear good fruit!” Attorney Guoping immediately said, “I’m just stating a fact! Personal grudges cannot affect the trial!”

The presiding judge was silent for a moment, then said, "Uesugi-kun, please answer the defense's questions."

“Okay.” Uesugi Muneyuki nodded and said, “Actually, this question is quite simple. I think Professor Zaizen should know why I received so many complaints and why I was relegated to the forensic department.”

The room fell silent, filled with curiosity.

"Actually, the reason is very simple. I never hide my patients' conditions. In any situation, as long as a patient asks me what disease they have, whether it can be cured, and how much the treatment will cost, I will answer truthfully," Uesugi Muneyuki said simply. "And that is why I am here in court today."

"From a medical perspective, Professor Zaizen's diagnosis was flawless, and from a doctor's perspective, his surgery was perfect. The treatment plan he proposed at the time was undoubtedly the best option. Considering that CT scans cannot accurately identify the patient and the risks of lung biopsy, the deceased had neither the strength nor the time to wait for further test results."

“But…” Uesugi Muneyuki said, “But Professor Zaizen, were there any other treatment options for that situation?”

Professor Zaizen fell silent.

“Let me tell you, yes,” said Uesugi Muneyuki. “Besides surgery, we can also have conservative treatment, chemotherapy, and radiotherapy.”

"Admittedly, conservative treatment can only extend the deceased's life by a year or two at most, but... that's why I'm standing here today," Uesugi Muneyuki said. "Did you truthfully inform the deceased's family about the condition and the different treatment options? When the deceased's family asked questions, did you truthfully answer their questions?"

“The answer is no.” Uesugi Muneyuki held up the diagnosis report in his hand: “Just like this altered diagnosis report, you must have told the deceased’s family that surgery was necessary, right?”

"Before you performed the surgery, Dr. Satomi and your subordinate Dr. Yanagihara and others had already warned you that the deceased's lungs were at risk of becoming cancerous. And when faced with questions from the deceased's family, you must have forced them to have esophageal surgery, right?"

“That’s why I’m standing here today,” Uesugi Muneyuki said. “You didn’t give the deceased’s family the right to know, you didn’t give them the opportunity to consider multiple options, you didn’t even bother to tell them what your assessment of the condition was, you just directly demanded surgery, right?”

"Objection!" Attorney Guoping quickly said, "This is a fallacy of equivocation, assuming something doesn't exist! Your Honor, we have a surgical consent form as proof. Signing the surgical consent form is equivalent to having the right to know!"

“No need.” Professor Zaizen gestured to Attorney Kuniping not to be presumptuous. He coughed twice, looked at his former student with eyes full of fighting spirit, and said, “I will answer this question.”

“Uesugi-kun, you are also a doctor, so you must know that our profession is a highly specialized field. Cancer, although a broad category, can actually present with countless variations depending on the lesions, symptoms, and progression.” “The deceased’s case was very special. This decision was made based on my professional knowledge and abilities, and just as your judgment and the medical assessment indicated, this was the optimal solution. Medicine is a profound field, and this was a precise judgment I made based on all my past experience and a comprehensive consideration of all possibilities.”

"In other words, you think that with the deceased's family's experience and understanding, they are neither able to understand nor need to provide the necessary explanation, right?" Uesugi Muneyuki asked.

"Yes, that's what I mean." Professor Zaizen nodded rather arrogantly.

“And that is why I’m standing here,” Uesugi Muneyuki said softly. “If my memory serves me right, I remember Mr. Sasaki Yohei repeatedly emphasizing that he would not accept surgery before he fell into a coma. If my memory serves me right, the deceased’s family also asked before the surgery if there were any other options, and your answer was no, that surgery was necessary to survive.”

Uesugi Muneyuki couldn't possibly be mistaken, because when he performed the autopsy that day, Sasaki Yohei's spirit was filled with hatred and resentment, constantly emphasizing that he didn't want the surgery and had refused it multiple times, and as a result, he died.

"Therefore, you forced the deceased's family to sign this surgical consent form. You took advantage of your position of information asymmetry to deprive the deceased's family of their right to know and their right to choose!"

"This has nothing to do with medical skills, but it has to do with medicine!"

"…………cough cough." Professor Zaizen coughed and fell silent.

"Your Honor, this is what I wanted to say, and the reason I'm here today." After Uesugi Muneyuki finished speaking, he turned to the judge and said, "I'd like to say a few more words about the medical issues."

"Yes." The Tokyo High Court understood Uesugi Muneyuki's meaning.

Professor Zaizen's problem is not his medical skills, which are practically flawless. His real problem lies in depriving people of their right to know and their right to choose!
"Indeed, Professor Zaizen is right. Medicine is a profound discipline. What is the ultimate goal of medicine? Is it to pursue continuous progress in the study of the human body until all things decay but all living beings perish, or is it to pursue the analysis of diseases so that one day all patients and all diseases can be completely cured? This is the eternal question of this ivory tower. On this question, Professor Zaizen, whose medical skills are better than mine, obviously has more right to speak."

"I am a forensic pathologist. The job of a forensic pathologist is to listen to the voice of the dead. No matter how cruel the truth is, no matter how gruesome the corpse is, I must tell the truth and solve the mystery of death. So every autopsy I perform represents the passing of a life."

"So my consistent principle has always been to not hide anything."

"I once witnessed a pancreatic cancer patient who, under the doctor's well-intentioned lie, thought it wasn't a serious illness and underwent chemotherapy. Her condition improved significantly, and she thought she had defeated the disease. However, after repeated relapses and chemotherapy, she realized the seriousness of her condition and eventually died in pain, complaining to the doctor before she died about why he had lied to her."

“I once saw a young woman who, after being told the truth about her condition by the doctor, fully cooperated with the treatment and fought hard against the disease. She underwent surgery and chemotherapy time and time again, and even when her hair was falling out, she was unwilling to give up. After developing drug resistance to domestic drugs, she went to the United States and Italy to buy targeted drugs that had not fully passed the Japanese test. In the end, she spent all of her 1000 million yuan savings that she had saved for her wedding, but the treatment was still ineffective. Before she died, she complained to the doctor why he did not lie to her, causing her to lose both her money and her health, and finally died in pain.”

"The path of medicine often has no definitive answers. It seems that as long as you cure the disease, everything is right, and as long as you don't cure the disease, everything is wrong."

"Personally, I don't like the current habit of families searching for the murderer as soon as a patient dies. I also know very well that we can't cure all diseases or treat all patients. Hospitals don't always have available beds, just like I can't examine every corpse in Tokyo."

"So all I can do is not hide anything."

"A doctor who cannot take responsibility for the patient in front of him is not qualified to be a doctor. In reality, it is possible for the patient to die, and it is also possible for the doctor to misdiagnose. There is a rule in the United States that as long as the medical risks are formally declared and the family is allowed to make their own decisions, the court will not blame the doctor for medical misconduct even if the surgery fails."

"There is a saying that clinical doctors go through two stages. The first stage is the stage of striving to climb towards the ideal, and the second stage is the stage of stopping after reaching the limit and silently doing their best to treat the patients in front of them."

“Professor Zaizen, I admire your medical skills and understand your efforts and ideals in climbing the medical pinnacle. The medical system itself is a very closed system. The series of professional terms that we use are obscure and difficult to understand. Sometimes our judgments are based on temporary considerations in emergency situations.”

"However, this world is not just a white tower leading to the end of medicine. Just as I have examined more than a thousand corpses in the past year, each corpse has a story to tell me, whether happy or unhappy, asking for help or lying. I must tell the truth. I never hide anything. Perhaps this is why I am suitable to be a forensic doctor."

"If you don't really leave this tower and see the outside world, there will always be a day when you harm your patients."

"And I, Uesugi Muneyuki, also intend to resign from my position as a practicing physician in the Department of Forensic Pathology at Tokyo Medical and Dental University Hospital, to prove that my testimony is not based on personal grudges!"

"above!"

(End of this chapter)