Tokyo, 1994, starting with medical training

Chapter 34 Bored

In the First Department of Surgery, Professor Nishimura, nearing seventy, could no longer wield a scalpel.

As for Assistant Professor Mizutani, he is a master at writing papers and also adept at office politics, but if you actually put him on stage to perform this kind of life-threatening emergency surgery, he will definitely find an excuse to pee and run away.

There was also an assistant professor named Takeda who was quite skilled, but he had just gone to Tokyo to attend a surgical society meeting the day before yesterday and was not in Maebashi City.

Therefore, the only person the entire First Surgery Department could boast about was Imagawa Ori.

As for the second foreign language, another assistant professor was heard to have gone to Tokyo for a conference, so Professor Nakamura had to take charge himself.

The work on the operating table continues.

Professor Hiroshi Nakamura truly deserves his reputation as the head of the Second Department of Surgery. His decades of clinical experience have given him an intimate knowledge of the anatomical structures within the abdominal cavity, and his hand movements are astonishingly fast.

"There is a hematoma at the base of the mesentery, but there is no active bleeding, so we don't need to worry about it for now."

"A contusion at the edge of the liver can be treated by applying pressure to stop the bleeding."

"The most important thing right now is to stay alive, not to pursue perfection."

After a series of procedures including exploration, ligation, and flushing, the previously chaotic abdominal cavity quickly became clear under his hands.

When a patient's physiological functions are on the verge of collapse, instead of performing complex and time-consuming definitive surgeries, the simplest and fastest method is used to control fatal bleeding and contamination.

Save lives first, then treat illnesses.

Meanwhile, on the other side, the filling work on Imagawa Ori and Kiryu Kazusuke's side was also nearing completion.

Six large gauze pads were tightly packed into the gaps around the pelvis, and the enormous physical pressure forced the ruptured blood vessels to close.

The bleeding has stopped.

Imagawa glanced at the monitor. The C-clamps had reduced the pelvic volume, the preperitoneal packing provided direct compression, and with the addition of a large amount of fluid resuscitation, the blood pressure was now stable at 95/60, and the heart rate had dropped to 110.

Although they are still in the danger zone, at least they won't die for the time being.

Let's wrap this up.

"Close the abdomen!"

"Only the skin is sutured, leaving the subcutaneous and muscle layers open, which are then clamped closed with towel clamps."

"Place drainage tubes: two in the abdominal cavity and two in the pelvic cavity."

Hiroshi Nakamura made the decision without any hesitation.

Modern patients cannot withstand prolonged suturing, and the abdominal cavity is packed with gauze, creating extremely high pressure. Forcibly suturing the fascia can lead to abdominal compartment syndrome.

A second surgery must be performed 48 to 72 hours later, once the patient's condition has stabilized, to remove the gauze and treat the fracture.

Kazusuke Kiryu quickly handed over the handkerchief clips.

Click, click.

With the sound of metal closing, the abdominal incision was temporarily shut.

With his "Advanced Surgical Incision Suturing Technique," Kazusuke Kiryu moves with lightning speed, using large needles and threads to suture the skin layer by layer.

Although this suturing method leaves an unsightly scar resembling a centipede, its advantages lie in its speed, high tensile strength, and ability to effectively prevent the incision from reopening due to high intra-abdominal pressure.

The abdominal incision was closed in less than five minutes.

"Send him to the ICU."

Imagawa took off her blood-stained surgical gown and threw it into the recycling bin.

She glanced at the clock on the wall; it was exactly five in the morning.

In other words, about an hour and a half had passed from when the patient was brought in until the end of the surgery.

The reason this surgery lasted so long was mainly due to Kiryu Kazusuke.

If he hadn't proposed the C-clamp and preperitoneal packing approach, the patient would now be a corpse, and the surgery could have been shortened to just over half an hour.

Hiroshi Nakamura took off his gloves, his gaze sweeping over everyone present before finally settling on Kazusuke Kiryu.

"What's your name?"

"First Foreign Language Research and Medical Training, Kiryu Kazusuke."

"Um."

Nakamura Hiroshi didn't say much, just nodded, and then turned and left the operating room.

Kiryu Kazusuke, Dr. Inoue, and others followed closely behind, pushing a flatbed cart.

As soon as Kiryu Kazusuke stepped out of the airtight operating room, the scene in the corridor made him squint.

The hospital corridor, which should have been empty in the early morning, was now crowded with people.

In addition to Professor Imagawa Ori and Professor Nakamura Hiroshi, who participated in the surgery, Professor Nishimura from the First Department of Surgery was also present, and even the hospital director was there.

These usually high-ranking figures are now with a middle-aged couple.

The man was probably in his fifties, looked exhausted, and was leaning on a cane. The woman next to him was sobbing softly.

On both sides of the corridor stood seven or eight bodyguards dressed in black suits and wearing headsets, each with a blank expression and their hands crossed in front of them.

This is no ordinary event.

"I've called you all here so late because I entrust my son's life to you."

The middle-aged man bowed slightly to the dean and the two professors.

"Please rest assured, Representative Okawara, we will definitely utilize the best resources."

Unlike the junior doctors, the hospital director did not show any fear. He simply nodded slightly, maintaining the composure and dignity of the head of a national university hospital.

His tone was calm, neither humble nor arrogant.

Okawara?

Kiryu Kazusuke quickly searched his mind for the surname.

Genta Okawara is a member of the House of Representatives elected from Gunma Prefecture and a powerful figure within the ruling party.

At the same time, he serves as the chairperson of the Standing Committee on Health and Welfare, responsible for coordinating the review and oversight of medical, welfare, and health policies within the prefecture.

No wonder.

No wonder she could summon two surgical professors; no wonder Imagawa Orihime could run faster than a rabbit.

This isn't about saving lives; it's about saving the future, saving the budget, and saving the hospital's funding for next year.

"The surgery was successful, and your son's vital signs have stabilized."

Professor Hiroshi Nakamura stepped forward, speaking in a calm tone.

Seeing this, Imagawa Ori looked somewhat disappointed.

If it were her, she would definitely embellish the story of the dangerous surgery to highlight her own contribution.

"Thank you for your hard work, Professor Nakamura. The Okawara family will never forget this kindness."

Genta Okawahara's tense face finally relaxed a little, and he took the initiative to reach out and shake Professor Hiroshi Nakamura's hand.

……

After settling the patient in the ICU and handing over all the medical orders, it was already 5:30 a.m.

Although his life was saved, the next 48 hours were still a life-or-death situation. Infection, multiple organ failure, coagulation disorders—any one of these complications could take the patient's life at any time.

But this is no longer under the jurisdiction of surgeons.

Kiryu Kazusuke leaned against the wall, feeling a wave of exhaustion wash over him; the side effect of the adrenaline rush subsiding was extreme drowsiness.

Even if his physical abilities are slightly improved, he is still human after all.

"Give."

Something cold was pressed against his face.

Kiryu Kazusuke turned his head and saw Imagawa Ori standing next to him, holding a can of slightly sweetened coffee that she had just bought from a vending machine.

"Thanks."

Without any hesitation, he took it, pulled the tab, tilted his head back, and took a big gulp.

The cold liquid slid down the esophagus, giving one a refreshing feeling.

Imagawa Oriya leaned against the wall, looking at the closed doors of the ICU in the distance: "The favors of the Okawara family are very valuable."

She said something completely out of the blue.

Kazusuke Kiryu smiled and said, "It's all thanks to Dr. Imagawa and Professor Nakamura."

Imagawa Ori shook her head: "But it was you who suggested the C-clamps and preperitoneal packing. If it weren't for you, that guy probably would have died on the stage before I arrived."

She paused for a moment before adding, "Well done."

This was the first time she had ever praised someone so directly.

In her eyes, there are only two kinds of people: useful people and useless people.

Previously, Kiryu Kazusuke belonged to the latter category, but now he has clearly been promoted to the former, and is the "very useful" type at that.

"Just lucky."

Kiryu Kazusuke shook the empty can in his hand and gave a casual, perfunctory reply.

He didn't want to explain why he knew these advanced first aid techniques; explaining would be a cover-up, and a cover-up would be just telling a story.

But Imagawa Ori did not press the matter further.

Just like people who buy kitchen knives don't care about the manufacturing process; they just want to take it home and make it work.

The two remained silent for a while.

The only sound in the air was the hum of the vending machine compressor.

Kiryu Kazusuke looked at Imagawa Ori's profile. The morning light shone through the window at the end of the corridor onto her face, giving her cool features a soft golden edge.

He suddenly remembered something.

A world line branched off regarding the scenario where "This Saturday is her birthday, you bought a cake and wished her a happy birthday."

Today is Thursday.

"Dr. Imagawa."

"Um?"

"Excuse me, when is your birthday?"

Why are you asking this?

Upon hearing this question, Imagawa Ori turned her head, narrowed her eyes slightly, and looked at Kiryu Kazusuke.

In her understanding, when a man asks about her birthday, there are usually only two purposes.

First, they harbored improper thoughts.

Secondly, they want to use this as an excuse to give gifts, curry favor, and build relationships.

But either way, it's troublesome.

Kiryu remained unfazed; he had anticipated this reaction from the other party.

"It's nothing."

"I've been studying astrology lately, and it seems like Virgo and Scorpio doctors are having particularly good financial luck today. I want to see how accurate it is."

That's all.

"..."

This is an excuse that couldn't be worse.

But in this era where everyone is superstitious about zodiac signs and blood types, it's barely acceptable.

Imagawa looked at him suspiciously for a few seconds.

Finally, she gave a cold snort.

"boring."

"November 24th."

"I'm going home to sleep."

After saying that, she accurately threw the empty can into the trash can a few meters away, then turned and left.

Watching her graceful departure, Kiryu Kazusuke could only feel envy.

The surgeon can simply walk away and go back to catch up on his beauty sleep, but the resident physician has to go back to work.

After returning to the medical center.

Kiryu Kazusuke took out a stack of medical records and a black ballpoint pen from the drawer.

Although electronic medical record systems have been piloted in some top hospitals, paper medical records are still the mainstream in places like Gunma University Hospital.

Before the morning meeting begins, all the surgical records, medical records, and transfer records for the emergency surgery that just happened must be handwritten.

Furthermore, it must be written using German terminology mixed with English terminology.

This is a ridiculous tradition in the Japanese medical community.

Older professors favored German, while the new generation favored English, resulting in medical records becoming this incongruous hybrid.

Preoperative diagnosis: Pelvic fracture (Tile C type), hemorrhagic shock

[Surgery Name: Pelvic Packing + C-clamp Fixation]

Kazusuke Kiryu's writing is fluid and dynamic.

This kind of mechanical work offers no enjoyment whatsoever; it's purely a drain on your life.

But he had to write down every single detail.

After all, this is the son of Representative Okawara, and this medical record will definitely be under the scrutiny of countless eyes in the future. Any slight mistake could lead to a medical dispute.

By the time I finished writing the last line, it was already broad daylight.

It's 7:30 in the morning.

The number of people in the clinic gradually increased.

Kenji Tanaka walked in carrying a briefcase and came straight over: "Good morning, Kiryu-kun. I heard you had a big job last night?"

News always travels faster than a virus.

Kiryu Kazusuke closed the neatly organized medical record folder and rubbed his aching wrists: "The son of Congressman Ōkawara fell from a high-rise building."

Kenji Tanaka gasped: "Dr. Imagawa is the surgeon?"

"And Professor Nakamura from Beijing Foreign Studies University."

"Wow, what a star-studded lineup."

Kenji Tanaka smacked his lips enviously.

Being able to appear in this level of VIP surgery, even if it's just as a hook-up, is a significant achievement on one's resume.

Kiryu Kazusuke pointed to the thick stack of papers on the table: "Don't be envious. If you want to write these twenty pages of medical records, I can let you have them."

Kenji Tanaka immediately shrank back: "Then forget it."

……

It's exactly eight o'clock.

The sound of leather shoes tapping on the floor echoed through the corridor of the First Surgical Department, dense and rhythmic, like an army marching.

The professors' return visits, also known as the "queue of famous professors," have begun.

Logically speaking, today isn't Monday, so Professor Nishimura shouldn't be bothered to leave his office.

With her firm control over the First Surgery Department, she didn't need to make frequent trips to the backyard.

But today, a patient, the son of a congressman, came to the hospital.

Then it's worth making an exception this time.

Professor Nishimura walked at the front, his hands behind his back.

Assistant Professor Mizutani followed closely behind, leaning slightly forward to maintain a half-body distance, holding a small notebook in his hand, ready to record the professor's instructions at any time.

Following them are lecturers, specialists, medical trainees, and finally, medical trainees like Kazusuke Kiryu.

A group of more than twenty people, in a grand procession, occupied the entire corridor.

Seeing this, the other patients, nurses, and family members all stood close to the wall, bowed in respect, and dared not utter a sound.

Everyone rushed to the ICU.

Although Okawara's son was under the jurisdiction of the emergency department, it was still a surgical operation, so the professor had to personally oversee it.

The automatic door to the ICU opens.

Representative Genta Okawara was sitting on the sofa in the rest area with his eyes closed, when he saw Professor Nishimura enter and immediately stood up.

"Professor Nishimura."

"Mr. Okawara, I'm sorry to have kept you waiting."

The two shook hands and exchanged pleasantries.

The patient was still unconscious, the ventilator was running regularly, and the waveform on the monitor, though weak, was relatively stable.

"How is the situation?"

Professor Nishimura asked, his hands behind his back.

Before Kiryu Kazusuke could speak, Assistant Professor Mizutani stepped forward first.

"Professor, the patient's vital signs are currently stable."

"Last night's surgery was very timely. Currently, the abdominal pressure is within the monitoring range, the drainage tube is unobstructed, and urine output is recovering."

He spoke with such conviction, as if he himself had stood on the operating table the night before.

However, in reality, he didn't even appear as a ghost.

But his ability to naturally transform other people's achievements into the achievements of "our First Surgery Department" is what makes him so skilled.

"The C-clamps were used well; that's a highlight."

Professor Nishimura nodded in satisfaction.

"Yes, the situation was urgent, and we had to make a quick decision."

Assistant Professor Mizutani adjusted his glasses and smiled modestly.

Kiryu Kazusuke stood on the outermost edge of the crowd, watching this scene with a blank expression.

This is the workplace.

Those who do the work are the medical trainees, those who work hard are the specialists, those who receive credit are the assistant professors, and those who enjoy the glory are the professors.

(End of this chapter)