Tokyo, 1994, starting with medical training

Chapter 40 Third Author

"Suzuki's joint instability is mainly due to long-term overuse that has led to hidden tears in some ligaments, which are difficult to detect on preoperative imaging."

"After attempts at conventional reduction failed, we determined that the problem was not with the bone itself, but with the soft tissue structures that maintain joint stability."

"So, we changed our strategy."

"Instead of forcibly repositioning those unstable bone fragments, we did the opposite."

"..."

As Imagawa Ori spoke, she unconsciously imitated Kiryu Kazusuke's actions, gesturing with her fingers in the air.

She spoke clearly and logically.

Although the theory and practice originated from Kazusuke Kiryu, her own understanding and retelling made it sound like her own well-thought-out masterpiece.

Being able to clearly express technical concepts is also an important skill.

Imagawa Ori is very good at this.

She knows how to package a concept and how to use it to describe a complex operation in a way that sounds both sophisticated and reasonable.

"Ligament tension reconstruction..."

Professor Nishimura listened and muttered to himself several times.

This idea is brilliant!

In a routine fracture surgery, the doctor's attention is focused on the bone itself, how to put it back together, and how to fix it more securely.

However, this approach goes beyond the bones themselves, focusing on the "soft environment" that maintains joint stability, thus solving the problem with minimal effort.

This is no longer just a technology; it's a revolution in concepts!

Professor Nishimura became more and more excited as he thought about it.

If this theory could be systematized and combined with the perfect case of Shinya Suzuki, it would definitely be a paper that would attract the attention of the Japanese orthopedic community!

She had even come up with a title.

A new strategy for treating comminuted fractures of the distal radius based on the principle of ligament tension reconstruction.

This is good; it's eye-catching and substantial enough.

But she quickly calmed down.

Because there is another crucial issue in this surgical record.

Professor Nishimura tapped his finger on the printed paper.

"It says here that the Kirschner wire fixation procedure was performed by Dr. Kiryu Kazusuke. Why?"

"If I'm not mistaken, isn't this Kiryu Kazusuke a medical trainee who just started this year?"

"You appointed a resident physician as the first assistant in such a complex surgery, and even had him perform the crucial Kirschner wire fixation?"

"What does Takikawa Takuhei do for a living?"

"Or is it that you actually did this, just to promote a younger generation, and only put his name on it?"

In university hospitals, it's not uncommon for senior doctors to change the names on surgical records to give their favorite junior colleagues more surgical experience.

But that was a routine surgery.

This kind of highly complex operation—is it appropriate to give a nominal position to a medical trainee?

This is simply outrageous.

Imagawa Ori cursed him as an idiot in her heart.

Normally, even if the person performing the key steps is indeed a resident physician, in order to avoid risks, the record will be written as the first assistant or the chief surgeon himself.

After all, if something goes wrong during the surgery, the resident physician is not qualified to take responsibility.

Takikawa probably didn't even think when he was writing down his notes.

Or perhaps he simply didn't dare claim the perfect Kirschner wire technique as his own, fearing he'd be exposed if the professor questioned him.

"Professor, you've misunderstood."

"Takikawa was feeling unwell at the time. After finishing the exhibition work, he suffered from low blood sugar and his hands were shaking badly."

"Considering the risks of the surgery, I removed him from the operating table."

"But the surgery cannot be stopped. I think Kiryu-kun's basic skills are quite solid. This Kirschner wire fixation plan was also proposed by him."

"So I let him give it a try."

"I was there to oversee the whole process, and nothing went wrong."

Imagawa Ori remained unfazed and began to speak fluently.

After listening, Professor Nishimura adjusted his glasses.

"So that's how it is."

"However, since the procedure was performed by a resident physician, it further demonstrates the feasibility and replicability of this 'ligament tension reconstruction' theory."

"The fact that even resident doctors can complete the training under guidance shows that this technology has great potential for widespread application."

She doesn't care about the truth.

In the First Surgery Department, she was like a god; whatever she said was the truth.

For top-tier medical journals, reproducibility is a very important metric.

If this is just a personal showcase for a genius doctor like Imagawa Ori, then its value is greatly diminished.

But if it's a standardized process, then the meaning is completely different.

"Imagawa-kun."

"I need you to compile this case file."

"It's not just a simple case report; I want a complete treatise, with the goal of being published in the 'Jizhenghui Journal'."

"I've already thought of a topic for you: a new strategy for treating comminuted fractures of the distal radius based on the principle of ligament tension reconstruction."

"You are the first author, and I am the corresponding author."

"As for Kiryu-kun..."

Professor Nishimura paused, thought for a few seconds, and seemed to be weighing the importance he should place on a medical trainee.

"Let's list him as the third author, as a way of encouraging him."

"I need to see the first draft within a month."

Her gaze passed over the desk and landed on Imagawa Ori's face.

"Yes, I understand, Professor."

Imagawa Ori immediately responded, but inwardly she was filled with dread.

The full name of the journal the professor mentioned, "Journal of the Japanese Society of Plastic and Reconstructive Surgery," is "Journal of the Japanese Society of Plastic and Reconstructive Surgery."

Although it is a Japanese journal and not an SCI journal, so it is unknown internationally, it is an absolute authority in the domestic medical system.

Today is December 25th, which means that on New Year's Day, January 1st, she was also reviewing a large amount of literature, drawing surgical diagrams, organizing data, and conducting statistical analysis.

But that's not the most important thing.

For her, the New Year was not much different from any other day.

The most terrible thing is--

She knows "how to do it" and roughly understands "why," but how can she elevate it to a "theoretical level"?

That would be better than killing her.

She is a clinician, more skilled with a scalpel than a pen.

But can she refuse?

No.

Professor Nishimura has an extremely deep network of connections in academia.

If this paper is actually published, it will be very useful for her future career development, whether it's getting promoted to assistant professor or switching to a private hospital with a higher salary.

……

After leaving the professor's office, Imagawa Ori glanced at the time and quickly walked back to the First Surgical Department.

Most of the doctors had already gone home, with only a few unlucky on-call doctors and trainees still dealing with miscellaneous tasks.

Kazusuke Kiryu is organizing the patient's discharge records.

The old computer he was using was a discarded one from the hospital; it was slow and laggy, and it would take half a day to type a single word.

However, resident physicians do not have the right to choose.

"Kiryu-kun, come out here for a second."

Imagawa Ori, wearing high heels, knocked on the door.

Kiryu Kazusuke looked up, saw it was her, saved the document, and walked out.

The two arrived at the window at the end of the corridor.

This place is quite secluded, and few people usually come here.

Without saying a word, Imagawa Ori slapped the surgical record in her hand onto the windowsill.

"You don't need to do anything else these next few days."

"The professor requested that Suzuki Shinya's surgical record be rewritten first, and then the procedure of using Kirschner wires to release stress during the operation be written into an academic paper."

"Submit the first draft of the paper within one month."

"Consider yourself lucky; the professor gave you a third-author listing."

(End of this chapter)