Tokyo, 1994, starting with medical training

Chapter 13 A More Perfect Approach

Backstage at the nightclub "Kagura Club".

Imagawa Ori drove everyone out. Due to her superior status in the shop, no one dared to be angry or speak out, so they obediently complied.

After the door closed.

With a cold expression, Imagawa Orizo asked in a deep voice, "Do you still remember the Physician's Oath?"

The so-called Physician's Oath is the Japanese version of the Hippocratic Oath.

Although, unlike at Western University across the ocean, medical students here don't have a white coat ceremony or a collective oath before officially starting their clinical studies.

However, during ethics training at medical school or hospital, students will also learn the physician's oath.

"Since we wear white, we should know the weight of this responsibility."

"Human life is of utmost importance. When you see even one person, you should do your utmost and not be negligent."

"Pain, confusion, and weakness are all human nature. Doctors should view them with a normal mindset and not damage their dignity."

"Practicing medicine requires adhering to rules and acting with conscience, without showing favoritism or acting arbitrarily."

"Even small mistakes can lead to great disasters, so we should always examine ourselves and be vigilant."

"The path of medicine is endless, and learning has no end. Those who are capable today must still be diligent tomorrow and must not be complacent."

"This work is not something one person can do alone; we should advance together with like-minded people and walk alongside all living beings."

"We hereby, in the name of physicians, solemnly swear this oath: to never forget our words today, and never abandon the weight of our white coats."

Kiryu Kazusuke didn't know why the other person would suddenly ask this, but he still dutifully recited it.

After listening, Imagawa Ori nodded and gently parted her lips.

"Kiryu-kun, if I remember correctly, you've hardly ever been in the operating room, have you?"

"Since you still remember the Physician's Oath, how dare you request to perform temporary Kirschner wire fixation on Mr. Suzuki after only six months of training at the medical center?"

"What do you take the vows you made for granted?!"

As she spoke, Imagawa Ori's phoenix eyes narrowed slightly.

She might even try to turn down a surgery before taking it on if the patient couldn't provide the "gift money" they wanted.

But if she takes on the patient.

So, on the operating table, she is Dr. Imagawa, who strives for the perfect surgery.

Any factor that could affect the outcome of the surgery, whether it be her own emotions or the skill level of her assistant, must be eliminated.

It's important to understand that a poorly performed surgery would not only ruin her reputation, but the subsequent rehabilitation, management of complications, and even medical malpractice would also take up her time that she would otherwise spend earning money.

From the most pragmatic perspective, performing each surgery perfectly is the most profitable choice.

Yes, she does love money; she can even take off her white coat and immediately put on a suit to please those lonely women here.

But she absolutely cannot tolerate anyone treating surgery as a joke.

Even though the heating in the backstage area was on full blast, Kiryu Kazusuke could still feel that the air around him had gotten several degrees colder.

Looking at Imagawa Ori's serious expression, he was somewhat surprised.

The person he is now is a completely different person from the "Imagawa Nao" who was just now maneuvering between him and Nakamori Sachiko in the booth.

It's quite a contrast.

However, her reaction is understandable.

After all, Imagawa Ori was unaware that he possessed the truly perfect Kirschner wire fixation technique.

"Kiryu-kun, do you think you can do whatever you want just because you have something on me?"

Then she took another step forward.

The distance between the two shortened to the point where they could almost feel each other's breath.

Kiryu Kazusuke is 1.8 meters tall, while Imagawa Ori is only about 1.6 meters tall. Even though she is wearing heeled leather shoes, she still has to look up to meet his gaze.

This gesture softened her originally aggressive demeanor somewhat.

Looking down from Kiryu Kazusuke's perspective.

Her shoulder-length hair, cut extremely neatly for playing male roles, fully revealed her small and delicate facial features.

"Dr. Imagawa."

Kiryu Kazusuke didn't defend himself; instead, he closed his eyes.

The X-ray images of Suzuki Shinya's fracture, as well as the 3D reconstruction images of the CT scan he received this afternoon, clearly appeared in his mind, like a 3D model that could be rotated and scaled at will.

"Suzuki's fracture is type C3 according to the AO classification, with comminuted articular surfaces and a dorsal bone fragment tilted at more than 25 degrees."

"The biggest problems are the collapse of the lunate articular surface and the avulsion fracture of the ulnar styloid process."

"In conventional Kirschner wire fixation, the wire is usually inserted through the radial styloid process to pry and temporarily fix the bone."

"However, Suzuki's radial styloid process has a hidden fracture line, and inserting a needle from there is very risky and could cause the bone fragments to break further."

At this point, Kiryu Kazusuke opened his eyes.

"So? What are you trying to say?"

Imagawa Orihime frowned slightly, and her expression underwent a subtle change.

As Kiryu Kazusuke said, the problem is indeed that even a typical medical school graduate might not be able to handle this situation well.

"Therefore, my idea is to use two 1.2 mm Kirschner wires, which are inserted percutaneously from the dorsal side, to fix the main bone blocks of the lunate and scaphoid articular surfaces, and restore the articular surfaces to a roughly flat state."

"This step is to establish a stable operating platform."

"Then, make a small incision on the palmar side of the wrist joint to expose the pronator quadratus muscle."

"While protecting the median nerve, use the third Kirschner wire as a lever to lift the collapsed joint surface from the palmar side."

"The two Kirschner wires that were inserted earlier served as support to prevent the bone fragments from collapsing again after repositioning."

"Once the articular surface is completely flat, a fourth needle is inserted percutaneously from the ulnar side and transversely through the distal radius to complete the final temporary fixation."

"In this way, the entire radiocarpal joint structure is stabilized, allowing for the placement of the plate and the insertion of the screws with ease."

As he spoke, Kiryu Kazusuke stretched out his hand and gestured in the air to indicate the location of the needle insertion point.

He spoke slowly but clearly and logically, giving the impression that he had performed this surgery countless times.

Imagawa Ori fell into thought.

As a genius who obtained her specialist medical qualification at the young age of thirty, she has absolute confidence in her skills.

After seeing Shinya Suzuki's film, she also conceived a preliminary surgical plan.

They even shared the same idea as Kiryu Kazusuke, using a Kirschner wire to pry and reposition the device from the palmar side.

However, they ultimately abandoned the project due to the difficulty of the procedure and the risk of nerve damage.

Kiryu and Kazuki used two needles on the back side to provide support beforehand, avoiding the risk of the structure collapsing again after repositioning.

This reduces the difficulty of the entire operation by one level.

Is this idea something that a medical student could come up with?

Even Imagawa Ori had to admit that this surgical plan was far more meticulous and perfect than anything she had considered.

She looked at Kiryu Kazusuke again.

Unfortunately, nothing seemed amiss on his face.

It seems that his request to be the first assistant was not out of arrogance, but rather because he was truly prepared.

The anger in Imagawa Ori's heart had unknowingly subsided by more than half.

Her expression softened slightly.

"The approach is alright."

"But surgery isn't just theory; can your hands keep up with your brain?"

Before Kiryu Kazusuke could answer, Imagawa Ori had already turned and walked towards the door.

"Let's go, Nakamori-san is still waiting for us."

"You contributed to the construction of that champagne tower, didn't you? Perfect, you can finish it."

"If not a single drop of wine is spilled during this process, and the tower of glasses doesn't wobble at all, then I'll consider making you my first assistant."

"Just pray the waiter hasn't finished setting it up yet."

"Luck is also a part of ability."

(End of this chapter)