Tokyo, 1994, starting with medical training

Chapter 30 Death's Invitation

Kiryu Kazusuke had just washed his hands and hadn't even had a sip of water yet.

"Doctor, the ambulance is here again."

"What is it this time?"

"It was a car accident. They said he crashed his motorcycle into a utility pole and suffered an open fracture of his left lower leg."

Kazusuke Kiryu was greatly encouraged.

Orthopedic work.

As long as it's not one of those intractable and difficult-to-diagnose internal medicine ailments, he now prefers the straightforward injuries of surgery.

When the cart came in, the scene was somewhat bloody.

The young man was wearing a biker gang's special attack uniform, and his pants had been cut open.

The middle of his left tibia was broken, and the white bone fragments pierced through the skin and were exposed, bleeding profusely.

"Give me a dose of Demerol! It hurts like hell!"

The young man screamed in agony.

In Japan at that time, even for ordinary fractures that did not require surgery, Demerol was used extremely commonly in the emergency room and during reduction.

It wasn't until the latter half of the 90s that the Ministry of Health, Labour and Welfare and the Society of Anesthesiology began to gradually restrict the use of Demerol.

"Don't shout yet, save your energy."

Kiryu Kazusuke stepped forward to check and found that the dorsalis pedis artery pulse was still present and the nerve sensation was also present.

Fortunately, no major blood vessels or nerves were damaged; it was just a simple fracture.

Although it looks scary, in the eyes of orthopedic doctors, it is simpler and more straightforward than the appendicitis case they just discussed.

"X-ray, prepare plaster cast, notify the operating room."

This is an emergency surgery that must be performed, including debridement, repositioning, and external or internal fixation.

According to emergency procedures, this type of surgery is usually performed by a senior physician, with a resident physician assisting.

Kazusuke Kiryu picked up the phone and dialed the number for the First Surgical Department's on-call room.

"I'm Kiryu from the emergency room. I've admitted a patient with an open tibial fracture..."

"Yes, surgery is needed..."

"Okay, got it."

After hanging up the phone, the senior doctor told him to perform debridement and temporary fixation first, and then schedule the formal surgery early the next morning.

This is the norm for night shift emergency room work.

Unless it's a life-threatening hemorrhage or internal organ rupture, surgery that can be delayed until daytime will never be performed by waking someone up in the middle of the night.

Especially with this kind of fracture, as long as the blood supply is not a problem, it won't kill you even if you wait a few hours.

Kazusuke Kiryu returned to the treatment room.

"First, clean the wound."

The wound was rinsed with plenty of saline solution to remove dirt and foreign objects, then covered with sterile gauze and temporarily immobilized with a long leg cast.

The young man was still calling out, "Doctor, can you set the bone first?"

"We can't do it now, the professor will arrange surgery for you tomorrow morning," Kiryu Kazusuke said casually while getting his cast applied.

His movements were extremely fast.

The plaster cast was soaked in water, wrung out, and then wrapped around the calf in circles.

Apply even pressure, with appropriate tightness.

This is also a basic skill.

If the bandage is applied too tightly, it can compress the limb and lead to ischemic necrosis (compartment syndrome).

If it's too loose, it won't provide any stability.

"Alright, let's take him to a ward."

After finishing in a few minutes, Kiryu Kazusuke patted the plaster that wasn't completely dry yet.

The next few hours were just endless repetition.

A feverish child cries incessantly; medication and physical cooling methods are used. A college student with food poisoning vomits and has diarrhea; an IV drip is given. A housewife who cut her hand while chopping vegetables receives a bandage and a tetanus shot…

There was no dramatic rescue operation, nor any miraculous resurrection.

This is what an emergency room looks like.

Assembly line operation.

People are categorized; those who can be treated are treated, those who cannot are transferred, those who need to be hospitalized are hospitalized, and those who need to go home are sent home.

Kazusuke Kiryu was like a tireless machine, shuttling between the beds.

If it were before, he would have been so tired by now that his back ached and he just wanted to find a corner to take a nap.

But today...

Very strange.

Even though I had been working for four or five hours straight and my feet were hot, I was still full of energy.

Clear thinking and quick reflexes.

I didn't even experience the low blood sugar and palpitations that usually occur in the middle of the night.

He glanced at the clock on the wall.

Three o'clock in the morning.

The emergency room was finally a little quieter.

Head Nurse Takahashi sat at the nurses' station, organizing medical records while rubbing her shoulders.

"Dr. Kiryu, aren't you tired?"

She glanced at Kiryu Kazusuke, who was still flipping through a medical magazine, as if she had seen a ghost.

The number of patients tonight is actually quite high; in fact, it's practically overflowing.

If it were any other resident physician, they would have been slumped over their desks by now, but this guy looks even more energetic than when he first started working.

"fine."

Kazusuke Kiryu turned a page in his book.

However, he was only managing to keep going by "slightly improving physical fitness".

Now he finally understands.

This reward, while not turning him into a superman, greatly enhanced his "endurance" and "recovery speed".

For doctors, this is incredibly useful.

Head Nurse Takahashi couldn't bear to watch any longer and said, "Dr. Kiryu, why don't you go to the break room and take a nap? I'll call you if I need anything."

Although medical training supplies are consumables, if these supplies are used too much and ruined, it will ultimately be the nurses who suffer the trouble.

"Okay, thank you, head nurse."

Kiryu Kazusuke didn't act coy. Although he didn't feel tired, there was no need for him to act too abnormally.

If you can slack off, you should.

He closed the magazine and went into the duty room.

There were two bunk beds inside, and an internal medicine resident was already lying there, snoring loudly.

Kiryu Kazusuke climbed onto the empty upper bunk and lay down fully clothed.

Close your eyes.

But the image of smashing the alarm with a metal folding chair in apartment 301 kept flashing through my mind.

Smashing things can be really stress-relieving...

This also applies to him.

If another drunk jerk who assaults a doctor comes to the ER next time, could he also...?

Never mind, that's illegal.

Kiryu Kazusuke turned over, and a few seconds later, his breathing became steady and long.

However, he felt that he had only closed his eyes for a short time when he was woken up by a violent shaking of his shoulders.

"Dr. Kiryu! Wake up!"

"Critically ill! Red alert! We're on our way!"

Head Nurse Takahashi's signature loud voice, accompanied by rapid banging on the door, pierced right through the door panel.

Kiryu Kazusuke suddenly opened his eyes.

Red alert!

This means that a critically ill patient has been brought in, and if immediate rescue is performed, there is a high chance of survival, so every second counts.

Therefore, there was absolutely no room for Kiryu and Kazuya to stay in bed.

He immediately jumped out of bed, grabbed the stethoscope hanging on the back of the chair, and rushed out of the duty room while hanging it around his neck.

At that moment, the emergency room door was suddenly kicked open.

"Get out of the way! Get out of the way now!"

Emergency responders rushed in pushing a stretcher. On the stretcher lay a man in his thirties, covered in blood, his clothes torn to shreds.

"Falling from a great height, fourth floor!"

"Blood pressure 60/40, heart rate 140, respiratory rate 35, confused!"

"Left thoracic collapse, pelvic instability, abdominal distension, and open fractures of both lower limbs!"

The emergency responders loudly reported the vital signs and injuries.

Severe multiple injuries are defined as serious injuries to two or more parts of the body, with at least one of them being life-threatening.

This is an invitation from Death.

"Push her into the recovery room!"

Kiryu Kazusuke, ignoring unnecessary words, pressed one hand on the wounded man's carotid artery and ran alongside the speeding flatbed cart, directing the direction as he went.

At that moment, there was simply no time to consult with superiors.

(End of this chapter)