Tokyo, 1994, starting with medical training

Chapter 65 The Small Pyramid

Although the emergency room is busy during the Lunar New Year, most cases are mild, such as food poisoning or excessive drinking, which are less serious than usual car accident injuries.

Moreover, there is a rare opportunity to receive overtime pay.

In terms of seniority, Kazusuke Kiryu is still a newcomer who has only been with the company for half a year.

In times like these, they are meant to be sacrificed.

Instead of complaining, it's better to make good use of those two days. A holiday means everyone is resting, and it also means that senior doctors are not around.

If a major emergency surgery is needed at this time...

That was his stage all to himself.

Kenji Tanaka sighed, "Sigh, I was thinking of going back to my hometown to visit. I heard they've arranged a blind date for me."

Kazusuke Kiryu smiled and said, "Then let's decline. Just say you're going to dedicate yourself to the medical profession."

Kenji Tanaka consoled himself with the thought, "Yeah, I don't have the money to get married anyway."

The two men stuffed the items into the trunk of the professor's Crown sedan.

They returned to the medical center.

Seeing off the visitors who came to offer gifts—who could even be called "tribute envoys"—did not mean the end of the work; rather, it was just the beginning of the daily routine.

Kazusuke Kiryu walked to his desk.

Several thick German medical books were piled on the chair. Assistant Professor Mizutani had casually tossed them over the day before yesterday, saying that he should "study them."

Actually, it was just that the fat guy wanted to free up his desktop space.

He moved the book aside, took out a stethoscope from the drawer, and hung it around his neck.

I need to go back for my appointment today.

Or rather, you have to go back for a check-up every day.

On non-Monday days, there is no grand "daimyo procession" style follow-up visit like Professor Nishimura's, but that doesn't mean that trainees can slack off.

Conversely, routine group follow-up visits are the key to determining life or death on a given day.

There's a misconception about patient allocation within the university hospital ecosystem, even among many new medical students.

In theory, patients come because of the hospital's reputation or the professor's name.

But there is only one professor, and he cannot be in two places at once to personally take care of every patient's eating, drinking, and toileting needs.

As a result, power was delegated layer by layer.

For ease of management, professors would organize their doctors into several "treatment teams," with each team responsible for a certain number of beds and patients.

After being admitted to the hospital, patients are randomly assigned to a group or according to their condition.

This means that the treatment of patients is not done by one person, but by a team.

Of course, both nominally and legally, the ultimate person in charge of all hospitalized patients is the professor at the medical bureau.

And within the "Imagawa Group," this small pyramid...

At the very top of the pyramid is Imagawa Ori, who possesses specialized medical qualifications, is highly skilled, and loves money more than anything.

The team leader has absolute decision-making power.

Who will be operated on, how will it be performed, and when will it be performed?

Located in the middle level are those specializing in medicine.

Although Takigawa Takuhei was a senior, he could only be subservient to Imagawa Ori.

Her main responsibilities include carrying out orders, handling complex paperwork, and taking the blame and being scolded when Imagawa is in a bad mood or too busy.

At the very bottom level, without a doubt, is medical training.

My daily work consists of changing dressings, drawing blood, running errands, writing endless medical records, acting as a human support for retractors on the operating table, and shielding senior doctors from patients' complaints.

If there is any credit, it must be due to the effective guidance of superiors.

If there was a mistake, it was that the resident physician's observation was not thorough enough.

Kiryu Kazusuke washed his hands, picked up his stethoscope and stainless steel medical record folder, and headed towards the ward.

He was in charge of six patients, who were located in different rooms.

His current task is to conduct a pre-visit check-up, where he needs to remember the patient's temperature, drainage volume, urine output, and wound bleeding from the previous night.

When you have a formal follow-up appointment, your senior doctor won't give you time to look through your medical records.

If you ask a question, you must answer it.

If you can't answer, you're neglecting your duty.

7:30 a.m.

The sixth-floor inpatient ward corridor is perpetually filled with the mixed smell of cleaning agents and disinfectants.

Room 602.

This is a large ward with six beds, where patients whose conditions are relatively stable or who are waiting for surgery are admitted.

Kazusuke Kiryu walked to the bed closest to the door.

The patient was an elderly woman in her sixties who had a fracture of the left femoral neck.

However, because I have diabetes and high blood pressure, the pre-operative preparation time is relatively long, and I have been staying in the hospital for almost a week.

Good morning, sir.

As Kiryu Kazusuke spoke, he lifted the blanket and reached out to feel the pulse of the old lady's foot.

Powerful and robust.

He then checked the skin traction straps; they were just the right tightness, and there were no pressure sores on the skin.

"Doctor, when can I have the surgery?"

The old woman looked at him pitifully; these days of waiting were too agonizing.

"We still have to wait for the blood sugar to come down."

Kazusuke Kiryu glanced at the blood glucose record chart hanging above his bed.

My fasting blood sugar was 11.2 mmol/L, which is still too high.

Having these indicators on the operating table carries an extremely high risk of surgical site infection, which could have catastrophic consequences.

He closed the notebook and pondered for a moment.

Based on the current insulin dosage, it will probably need to be adjusted for another two days. Hopefully, the surgery can be scheduled in the first week after the New Year.

He turned and walked toward the next bed.

Room 605.

A young man who recently underwent meniscectomy lives here; he was also the surgeon operated on by Imagawa Ori.

Kazusuke Kiryu looked at the drainage bag; it contained about 50 milliliters of pale red, bloody liquid.

Did you have a fever yesterday?

"no."

"Can you lift your leg?"

The young man gritted his teeth and laboriously lifted the leg, which was wrapped in thick gauze, ten centimeters off the bed.

"good."

Kiryu Kazusuke nodded and hastily jotted down the data on the medical record paper.

This is called a pre-visit appointment.

Twenty minutes later, he had reviewed all the patients under his care and had a grasp of their situations.

……

It was exactly eight o'clock in the morning.

The morning meeting of the First Surgical Department officially began.

Although it was the last working day of the year, the atmosphere did not become more relaxed; on the contrary, it was somewhat tense due to the upcoming New Year holiday.

Doctors are human too; they also want to take a vacation and want to stay home, lie down, drink beer, and watch the Red and White Song Festival.

Therefore, how to allocate emergency call standby during the holiday period has become a topic of great concern for everyone.

"Gather together! Morning meeting begins!"

Mizutani Hikaru's loud voice rang out in the clinic.

He was dressed exceptionally smartly today, with his hair slicked back and shiny, clearly preparing for the year-end party tonight.

Everyone immediately stopped what they were doing and gathered around.

Professor Nishimura did not appear.

This last morning meeting before the holiday is usually chaired by an assistant professor who makes some polite remarks and then announces the start of the holiday.

Mizutani Mitsuma put his hands behind his back, striking a pose like a senior professor at a medical school.

"Gentlemen, you've worked hard this year."

"Under the wise leadership of Professor Nishimura, our First Surgery Department has achieved brilliant results this year."

"The number of surgeries increased by 15% compared to last year, and the number of published papers also increased significantly."

"In particular, the successful surgery on the son of Congressman Ōkawara has greatly enhanced our reputation in the Kanto region."

He paused deliberately at this point, glancing down at the ground.

"In particular, Dr. Imagawa's decisive decision that night demonstrated the sense of responsibility that our First Surgery Department has forged."

"Of course, I often tell her not to stick to conventional treatment plans."

"On the operating table, the patient is the most important person."

As he spoke, he shamelessly claimed half the credit.

As for whether he actually said such a thing?

unimportant.

If he says yes, then yes; if he says no, then Imagawa Ori has forgotten.

(End of this chapter)