Tokyo, 1994, starting with medical training

Chapter 5 There is no savior in the world

The First Department of Surgery is primarily responsible for the diagnosis and treatment of orthopedic-related diseases and is also known as Plastic Surgery.

As a medical trainee, Kiryu Kazusuke's daily work is complicated and tedious.

My main task in the morning was to accompany the senior physician on ward rounds, understand the latest condition of the patients under my care, and carry out the doctor's orders.

For example, changing dressings, ordering tests, and recording all observations and treatments in the medical record.

In the afternoon, unless there are special arrangements, you either stay in the hospital to study, or you may be called to assist in surgery, usually doing some basic work such as retractors and suturing.

Although they are called assistants, they are actually responsible for the physical labor on the operating table.

When Kiryu Kazusuke pushed open the door to the medical office.

Several doctors in white coats were gathered around a table, chatting.

"Kiryu-kun, over here."

A medical resident of about his age peeked out from behind a desk against the wall and waved to him.

His name is Kenji Tanaka. Like Kazusuke Kiryu, he is also a trainee in the First Department of Surgery, but he joined a year earlier and is considered a senior.

"Good morning, Tanaka-senpai."

Kiryu Kazusuke walked over and placed his bag on the empty spot next to him.

"What do you mean 'early'? It's almost noon." Kenji Tanaka pointed to the clock on the wall. "You're really late today. I thought you overslept."

"I spent some time in the medical department," Kiryu Kazusuke casually explained.

"Oh, it's about that matter." Tanaka Kenji immediately understood. He lowered his body and moved closer to Kiryu Kazusuke.

"So, did you tell me everything?"

"Yes, just telling the truth."

"Tsk, that woman really deserved it. I heard the patient's family made a huge scene, and the nursing department is under a lot of pressure. I guess she's finished this time."

Kenji Tanaka patted him on the shoulder.

"Oh, right, there's one more thing."

As he spoke, he seemed to remember something, and pulled a document from the folder on the table and handed it to Kiryu Kazusuke.

"This is a new patient admitted to the emergency room yesterday."

"Distal radius fracture, preliminary assessment indicates open reduction and internal fixation is required."

"Professor Mizutani specifically asked you to come and prepare for the operation. First, complete the admission examination, medical records, and all the other tests."

Kiryu Kazusuke was somewhat surprised: "Me?"

Preoperative preparation may seem simple, but it involves a series of interconnected steps, including taking a medical history, conducting a physical examination, issuing and following up on various laboratory tests, informing patients of surgical risks, and signing consent forms.

Although he had already obtained his medical license, during his medical training period, especially in the first year, his main job was still to follow behind senior physicians and do odd jobs.

There are very few opportunities to independently take charge of a patient's preoperative work.

and……

He not only cheated on Mizutani Mitsuma's lover, but also reported him to the medical department.

In this situation, it would be a blessing if Mizutani didn't cause him any trouble, so why would he voluntarily hand over the patient to him?

Therefore, the most likely scenario is that the other party wants to use this as an excuse to cause trouble.

If he makes a mistake in any aspect, it's not impossible that he will be punished, or even kicked out of the First Surgery Department and sent to Hokkaido to see the snow.

"You're just in charge of preoperative preparation, not the surgeon."

Kenji Tanaka stretched and leaned back in his chair, making a cracking sound as he did so.

Kiryu Kazusuke didn't explain, took the medical record, and returned to his corner.

His desk was the smallest in the entire hospital, right next to the filing cabinet. Every time someone came looking for old medical records, he had to stand up to make room for them.

He pulled out a chair, sat down, and opened the medical record in his hand.

The patient, named Suzuki Shinya, 43 years old, accidentally fell from scaffolding while working at a construction site, resulting in a comminuted fracture of the distal radius of his left arm.

Kazusuke Kiryu pulled out the X-ray film and looked at it under the fluorescent light above his head.

The distal end of the radius, above the wrist joint, is broken into several pieces, with the largest piece curving backward, forming an unsightly deformed angle.

This is why open reduction and internal fixation (ORIF) is the standard surgical procedure.

The skin and muscles are cut open to expose the fracture ends, the broken bones are pieced back together, and then a special metal plate and several screws are used to firmly lock it in place, waiting for the bone to heal itself.

This sounds like carpentry work.

But the complexity of the human body far exceeds that of any type of wood.

The surgical field is crisscrossed with nerves and blood vessels, and the slightest mistake could cause permanent damage.

This surgery was not easy.

……

The ward is on the sixth floor of the inpatient department.

In a standard hospital room with three beds, a middle-aged man was lying on the bed by the window.

His left arm was immobilized in a plaster cast and suspended in front of his chest with bandages; his face appeared somewhat sallow due to pain and anxiety.

A woman, probably his wife, was sitting by the bed, wiping his face with a towel; her eyes were red.

There was also a teenage girl standing next to her, wearing a high school uniform.

Kiryu Kazusuke walked to the bedside, first nodding slightly to the family members before turning his gaze to the patient on the bed.

"Hello, Suzuki-san, I am your attending physician, Kiryu Kazusuke."

"Hello, doctor."

The man on the bed, Suzuki Shinya, struggled to sit up.

"Just lie down, you don't need to move."

Kiryu Kazusuke pressed down on his shoulder, then pulled over a stool and sat down.

He began taking the patient's medical history according to standard procedures.

"Besides your arm, is there anything else that's bothering you?"

"From what height did you fall?"

"Have you ever had any chronic illnesses before? Such as high blood pressure or diabetes?"

Are you allergic to any medications?

Shinya Suzuki answered each question, while his wife quietly added her comments.

After asking a few questions, Kiryu Kazusuke gained a general understanding of the patient's basic condition.

Next comes the physical examination.

Kazusuke Kiryu first examined the sensation and motor function of each finger, confirming that there were no obvious signs of nerve damage.

Then I checked the radial artery pulse at my wrist, and the main blood supply artery was fine.

After the examination, he re-secured the patient's arm.

"Doctor, is the situation serious?"

Mrs. Suzuki, sitting beside the hospital bed, asked with great concern.

A sixteen or seventeen-year-old high school girl standing beside her was also looking at him nervously.

"Judging from the X-ray, it is a comminuted fracture of the distal radius, with the bone broken into several pieces."

"Then... what should we do? Do we need surgery?"

"Yes, surgery is necessary in this situation. Even if it grows back, the bone won't return to its normal position, and it will eventually lose its function."

Kiryu Kazusuke added an explanation.

Although Shinya Suzuki's case has not yet been approved, surgery is inevitable; a comminuted fracture cannot be treated without surgery.

When Mrs. Suzuki heard that surgery was required, her face paled instantly.

"After the surgery, will I be able to recover to my previous state?"

Shinya Suzuki wasn't afraid of surgery, but his only means of survival was his hands. If his hands were ruined, his family, which depended on him, might collapse.

"We will do our best."

Kiryu Kazusuke remained silent for a moment, and in the end, this was the only answer he could give.

The standard surgical procedure, open reduction and internal fixation, is highly invasive and will inevitably result in a certain degree of stiffness and limited mobility after the procedure.

It is very difficult to fully recover to the agility and strength you had before the injury.

"I understand, thank you, doctor."

Shinya Suzuki immediately looked disappointed, but he still nodded.

Afterwards, Kiryu Kazusuke explained some pre-operative precautions, such as the requirement to abstain from food and water.

Then he got up and left the ward.

He has witnessed too many moments of helplessness and has learned how to separate his emotions from his profession.

There has never been a savior in the world.

He didn't believe he had that ability either.

(End of this chapter)