Tokyo, 1994, starting with medical training

Chapter 71 Nakamori Pharmaceutical

"Maintain traction, don't let up."

Imagawa Ori frowned and increased the pressure on her hands.

Joint instability caused by ligament rupture cannot be resolved by manual therapy alone.

But she must maintain this unstable repositioning as long as possible before the plaster hardens.

This requires a great deal of finger strength.

Kiryu Kazusuke looked at Imagawa Ori's knuckles, which were turning white from exerting so much force.

I slightly adjusted the angle of the traction to put the wrist in a slight dorsiflexion position.

This angle allows the tension of the surrounding unruptured ligaments and joint capsule to act like a net, holding the lunate bone in place and preventing it from slipping back to the palmar side.

This is what "Fundamentals of Joint Dislocation Reduction" brings us.

Unlike the "Perfect" skill, which allows you to walk a tightrope on a cliff.

He simply used the most basic principle of "ligament restoration" when performing traction, and he also knew how to cooperate with the surgeon's pressure to create a stable base.

Imagawa Ori immediately sensed the change in her subordinates.

The force that had been trying to slip away suddenly disappeared, and the lunate bone was firmly wedged in the lunate fossa of the radius.

She glanced at Kiryu Kazusuke with some surprise.

"Get a cast."

But Imagawa Ori didn't waste any words. She freed one hand and gestured to the nurse next to her to hand over a bandage.

With the two working together, the plaster cast was quickly applied.

To maintain the reduction, the wrist joint was fixed in a position of slight dorsiflexion and ulnar deviation.

Mrs. Ando looked at her right hand, which was wrapped in a thick plaster cast.

Although it looks bulky, the excruciating pain and the awkward feeling as if something inside the joints was out of place have indeed been reduced quite a bit.

Imagawa Ori asked with satisfaction, "How does it feel?"

"It feels...much better." Mrs. Ando tried moving her shoulder. "It doesn't hurt as much as before."

"That's good."

Imagawa Ori nodded and turned to give instructions to the nurse.

"Redirect to the radiology department for a repeat X-ray."

"This time we need to take comparative X-rays of both wrist joints, and also take a stress X-ray of the clenched fist position."

……

An MRI scan is needed to confirm the repositioning, but afterwards only an X-ray is required.

After all, an MRI costs tens of thousands of yen and the experience isn't great. If Mrs. Ando makes a fuss, it would be a loss.

In the radiology department's reading room.

The freshly developed X-ray film still smelled of acidic developer, and Imagawa Ori inserted it into the light box.

Okay, the repositioning is excellent.

The surrounding ligaments are still ruptured, but this is the limit for palliative care.

On the lateral radiograph, thanks to the traction control of Kazusuke Kiryu, the support of the plaster cast and the tension of the soft tissue combined to restore the lunate bone to its anatomical repositioning point.

The Girulla three arcs regained their continuity.

The capitate, lunate, and radius bones are all in a straight line.

However, this does not mean that Mrs. Ando can escape being stabbed.

If a bone is broken, it can heal itself by itself as long as it is aligned.

But her problem is her ligaments.

In a cavity filled with synovial fluid, coupled with the retraction of the torn ends, a ligament cannot heal on its own.

Once the cast is removed, without the external force to restrain it, and without ligaments, the crescent bone will slip off again like a wild horse.

This will cause the entire wrist joint to collapse.

It's like when the main beam (ligament) of a house breaks, you temporarily prop it up with a wooden pipe (plaster) to prevent the roof from collapsing.

Once all the materials are ready after the New Year, we'll still have to remove the roof and reconnect the main beam.

Otherwise, if the wooden sticks are removed, the roof will still collapse as it was going to.

"As expected of Dr. Imagawa."

Takikawa Takuhei, who was standing to the side, sincerely praised him.

The technique used to reposition the bone was so precise that no one could find fault with it.

"Dr. Imagawa is really amazing."

Kenji Tanaka also brought his face close to the lightbox, his eyes filled with admiration.

Is this the strength of a specialized medical institution?

however……

Imagawa Ori didn't say anything, she just stared at the see-through film on the lightbox.

She knew in her heart that the ability to achieve this level of repositioning was not entirely due to her own efforts.

Kiryu Kasuke.

He adjusted the angle of traction and used an extremely subtle technique, utilizing the tension of the joint capsule to hold the bone that was trying to slip.

If the person in charge of towing at that time had been Takikawa Takuhei...

That means there's a high probability that only 70% of the time can be restored. The remaining 30% will depend on whether Mrs. Ando is blessed by heaven.

"I'm gone."

"Tanaka, go tell Mrs. Ando that the repositioning was successful."

"Takikawa, prescribe her the best painkillers so she can have a good New Year."

"Kiryu, you can go back to the clinic now."

Imagawa Ori snapped off the film reader light, unplugged the film, and didn't want to see Takigawa Takuhei and Tanaka Kenji's stupid expressions anymore.

Kazusuke Kiryu followed behind, his hands in his pockets.

After leaving the radiology department, the group dispersed.

The corridor was bustling with people, all of them patients and their families who came to see a doctor before the holiday.

When Kiryu Kazusuke reached the corridor leading to the pharmacy department, he stopped.

At the corner of the connecting corridor, a middle-aged man in a dark gray suit was standing against the wall, holding several exquisite paper bags printed with the "Nakamori Pharmaceutical" logo.

He is a pharmaceutical representative.

In that era, their power had not yet been limited by the stricter regulations that followed.

They could enter and leave the professor's office as if it were their own backyard.

Gift-giving, entertaining guests, arranging golf games, and even helping doctors pick up their children, wash cars, and move.

They'd do anything to get doctors to write more of their company's drug names on prescriptions; even pillow sales were commonplace.

The middle-aged man seemed to sense that someone was watching him and looked up.

When Kiryu Kazusuke saw the name tag on his chest that read "Training Doctor," his smile became somewhat stiff.

He nodded perfunctorily, then lowered his head and continued pretending to sort through the gift boxes.

Kiryu Kazusuke didn't seem to care much about this.

Trainee doctors do not have prescription rights, or rather, their prescription rights are limited.

In the eyes of pharmaceutical representatives, medical trainees are like barren land with no development value; they can neither generate sales nor determine the procurement list.

In comparison, specialists, lecturers, and professors are the real prey in their eyes.

Kazusuke Kiryu glanced at the gift boxes.

Judging from the quality of the packaging, there are several boxes of beautifully packaged high-end pastries inside, with a few shopping cards from a department store or an envelope underneath.

Although the bubble has burst, the healthcare industry remains incredibly lucrative.

Drug prices are inflated, and kickbacks are rampant.

This is the medical field in 1994.

The exchange of benefits is laid bare, and as long as the media doesn't catch them in the act, everyone will tacitly abide by this rule.

As he passed the pharmaceutical representatives, Kiryu Kazusuke slowed his pace slightly.

After getting closer, I took another look at the gift bag.

Zhongsen Pharmaceutical?

It seems to be a second-tier pharmaceutical company that mainly produces antibiotics and painkillers. Recently, it appears to have launched a new nonsteroidal anti-inflammatory drug and is promoting it with great effort.

But that's not the point.

Kiryu Kazusuke remembered the woman who had tried to pick at Imagawa Ori, Nakamori Sachiko.

He can afford to drive a Maybach, wear millions of dollars worth of jewelry, and even spend over ten million yen to open a champagne tower.

This level of spending power, if it were the president of a large pharmaceutical company in Gunma Prefecture... or the president's wife?

That makes sense.

If I could just get the world lines back together from her, I could squeeze out a few hundred thousand yen.

Kiryu Kazusuke made up his mind that he had to find an opportunity to bump into her.

(End of this chapter)