Tokyo, 1994, starting with medical training

Chapter 29 Emergency Rescue

On his way to the convenience store, a pale red light flashed before Kiryu Kazusuke's eyes, and a warm current rose from the end of his spine, quickly spreading to his limbs and bones.

[Saionji Mina's world line has been resolved]

[Reward: Improvement in physical fitness - slightly]

He stretched his neck, and his trapezius muscles, which had been stiff and sore from working 24 hours a day, seemed to relax a lot.

I tried making a fist again.

A sense of power?

There seems to be a little bit, but not much.

He didn't have bulging muscles like in the comics, nor did he give the illusion of being able to kill a bull with one punch.

It's more like the feeling of being fully charged after sleeping in for a week.

Is this what you call a "slight" improvement?

That works too.

For a medical resident who constantly teeters on the brink of death from overwork, nothing could be more practical.

Kazusuke Kiryu walked into a Lawson convenience store, grabbed a discounted tonkatsu bento box, quickly finished his dinner at the counter, threw the empty box into the trash can, and hurried toward the hospital.

……

In 1994, Japan's emergency medical system was still in a chaotic and unregulated phase.

Although a three-tiered emergency response system was established as early as 1977, which is divided into initial (mild cases), secondary (severe cases requiring hospitalization) and tertiary (critical cases).

Emergency care is usually provided by the emergency center on weekend nights.

Secondary emergency care is provided by the public or private hospital on duty.

The three emergency treatments were handled by specialized life-saving and emergency centers.

Gunma University Hospital, as a national university hospital, theoretically falls under the category of "tertiary emergency care," primarily receiving critically ill patients transferred from other hospitals or terminally ill patients brought in by ambulances.

Gunma University Hospital is marked with a sign that reads "High-Level Emergency Medical Center," and it is a tertiary emergency medical facility.

But in reality?

Any place with an emergency sign will send all sorts of people in.

Whether it's a drunkard who's broken his head from drinking too much, an auntie who's had a stomachache for two days but doesn't want to wait in line for a doctor's appointment, or even an old man who feels lonely in the middle of the night and wants to talk to someone.

As soon as the ambulance arrives, they're all sent here.

After all, ambulances are free in Japan.

This leads to a huge waste of emergency resources.

In this era before a comprehensive system of "ER-type emergency room specialists" had been established.

Those standing on the front lines of the emergency room are not emergency room doctors who have received special emergency care training.

Instead, they were "direct doctors" like Kazusuke Kiryu, who were sent down from various departments on a rotating basis.

To be precise, it's medical training.

Senior doctors usually sleep in the second-line on-call room and will never show up unless there is a major incident that the trainee doctor cannot handle.

Trainee doctors are like consumables in the emergency room, used to fill this huge medical black hole.

"Dr. Kiryu, the ambulance is on its way. They say it's a head injury, but the patient is conscious."

Head Nurse Takahashi, a senior nurse in her forties, was decisive and efficient. Holding a whiteboard in her hand, she spoke without looking up.

"understood."

Kiryu Kazusuke put on sterile gloves and stood at the door of the treatment room.

The sound of police sirens could be heard in the distance.

This is also the daily routine for emergency room doctors: they are either saving lives or on their way to save lives.

Soon, the cart was pushed in.

A strong smell of alcohol hit me, making me wince.

Lying on the stretcher was a man in his fifties, wearing a wrinkled suit, his face flushed, with a cut on his forehead from which blood was seeping out, staining half of his face red.

"One more...one more drink..."

Even in this state, he was still muttering incoherently.

"I drank too much and fell on the steps in front of the izakaya."

The emergency team members explained helplessly as they handed the patient over.

It's this kind of thing again.

In Japan after the bursting of the bubble economy, there were far too many people who drowned their sorrows in alcohol and ended up in the hospital.

"Hold him down."

Kiryu Kazusuke gave instructions to the male nurse next to him.

"Let me go! I can still drink!"

The drunk man twisted and turned on the bed, waving his arms and legs wildly, and was completely uncooperative.

Kiryu Kazusuke ignored his ramblings and shone a flashlight into his pupils.

He is sensitive to light, and both pupils are equal in size and round. He has no brain herniation.

After checking the movement of the limbs, there was no paralysis, so it was most likely just a superficial injury plus a concussion.

"Go get a head CT scan to rule out intracranial hemorrhage."

Kazusuke Kiryu wrote the order.

Even if he already had a judgment in his mind, this procedure could not be skipped.

If this drunkard really does have a subdural hematoma and he releases him without detecting it, then he can expect to be on the front page of the news the next day.

This is also the first rule of survival in the emergency room: you don't have to be a miracle doctor, but you absolutely cannot miss a diagnosis.

While waiting for the CT results, the nurses didn't let him sit idle.

"Dr. Kiryu, patient number 3 has a stomachache."

"They're here."

Bed number 3 belonged to a young woman in her twenties, curled up on the bed, her face deathly pale.

"Where does it hurt?"

Kazusuke Kiryu pressed on her abdomen.

"Here...lower right abdomen..."

Significant tenderness at McBurney's point and positive rebound tenderness are typical signs of acute appendicitis.

"Get a blood test and an ultrasound."

Kiryu Kazusuke skillfully wrote out the prescription and then called the on-call doctor from the Second Surgery Department.

At this point, the drunkard's CT scan results came back: no skull fractures were found, no abnormal high-density shadows were seen in the brain parenchyma, and it was purely a skin injury.

"Wound cleaning and suturing."

Kazusuke Kiryu picked up the needle-holding forceps.

The drunkard was still groaning, but the male nurse held him down firmly, preventing him from moving.

The wound on his forehead was about three centimeters long, with irregular edges and some grit embedded inside.

Rinse with saline solution, disinfect with hydrogen peroxide, drape with towels, and administer anesthesia.

After the lidocaine was injected, the drunkard finally calmed down a bit.

In the past, Kiryu Kazusuke would have found the task of stitching up the faces of patients reeking of alcohol extremely tedious.

The smell alone makes you want to vomit.

They also had to endure the patients' restlessness, and crooked stitches were a common occurrence.

But today is different.

He held the needle-holding forceps in his hand, and a sense of familiarity and control welled up within him.

Although it's just simple debridement and suturing, no complicated intradermal suturing techniques are needed; the most basic interrupted suturing is sufficient.

but……

It feels amazing.

Insert the needle, thread it through, tie a knot, and cut the thread.

The movements were so fast that even the head nurse, Takahashi, standing nearby was momentarily stunned.

Typically, the skin of such drunkards is loose, and the bleeding makes stitching very difficult.

But Kiryu Kazusuke's hands seemed to have their own consciousness, avoiding blood vessels and precisely aligning with the skin edges.

Less than three minutes.

Five stitches were completed.

The wound was so neat it resembled a red centipede, with each stitch spaced perfectly even.

"It's finished sewing."

Kazusuke Kiryu threw the needle pliers into the curved plate and took off his gloves.

"That's it?"

Head Nurse Takahashi glanced at the wound and looked somewhat surprised.

In the past, Kiryu would take at least ten minutes to sew a scalp and would complain about the patient moving around.

Why are you so efficient today?

And the quality of the stitching...

How come he seems even better than those arrogant medical school graduates?

"Hmm, not difficult at all."

Kiryu Kazusuke replied casually and turned to wash his hands.

There's nothing to brag about in this low-level game.

It's just a matter of practice.

But that smooth, flowing feeling is indeed pleasing to the mind and body.

His skill "Advanced Surgical Incision Suturing" does not actually include this type of non-surgical incision.

Therefore, this is thanks to the "slight improvement in physical fitness" given by Saionji Mina, which includes hand stability and coordination.

but……

If each suture could save seven minutes, he could get an extra hour or two of sleep each night.

This is not just a slight improvement, it's a lifesaver.

(End of this chapter)