“Suzuki-san’s joint instability was mainly due to occult partial tears in the ligaments caused by long-term strain. That’s very difficult to detect on preoperative imaging.”
“After conventional reduction failed, we determined that the problem did not lie in the bone fragments themselves, but in the soft-tissue structures that maintain joint stability.”
“So we changed our strategy.”
“We no longer tried to force those unstable bone fragments back into place. Instead, we did the opposite.”
“…”
As Imagawa Ori spoke, she unconsciously imitated Kiryu Kazusuke’s movements from that time, extending her fingers and gesturing in the air.
Her explanation was clear and well organized, her logic rigorous.
Although the theory and technique had both come from Kiryu Kazusuke, after her own understanding and retelling, it sounded as though it were a masterpiece born of her own careful deliberation.
Being able to clearly articulate a technique was also an important ability.
Imagawa Ori was very good at that.
She knew how to package a concept, how to describe a complex procedure in a way that made it sound both sophisticated and reasonable.
“Ligament tension reconstruction…”
After listening, Professor Nishimura murmured the phrase several times.
This line of thinking was far too ingenious!
In conventional fracture surgery, doctors focused all their attention on the bones: how to put them back together, how to fix them more firmly.
But this approach had stepped beyond the bones themselves, starting instead from the “soft environment” that maintained joint stability, solving the problem with a method that used a small force to move a great weight.
This was no longer merely a technique. It was an innovation in philosophy!
The more Professor Nishimura thought about it, the more excited she became.
If this theory could be systematized, and paired with Suzuki Shinya’s perfect case, it would absolutely become a paper capable of drawing attention in Japan’s orthopedic community!
She had even already thought of the title.
“A New Strategy for Treating Comminuted Distal Radius Fractures Based on the Principle of Ligament Tension Reconstruction.”
That was very good. Eye-catching enough, and weighty enough.
But she soon calmed down again.
Because there was still one key issue in the surgical record.
Professor Nishimura tapped the printed paper with her finger.
“It says here that the Kirschner wire fixation was performed by Dr. Kiryu Kazusuke. Why?”
“If I remember correctly, this Kiryu Kazusuke is a resident who only arrived this year, isn’t he?”
“You let a resident serve as first assistant in such a complicated operation, and even let him complete the most critical Kirschner wire fixation?”
“What the hell was Takigawa Takuhei doing?”
“Or was this actually done by you, and you only put his name on it to help a junior along?”
In a university hospital, it was not unheard of for senior doctors to look after juniors they favored by altering the names in surgical records, allowing those juniors to accumulate more surgical cases.
But that was for routine operations.
Putting a resident’s name on such a highly difficult procedure?
That was far too absurd.
Imagawa Ori cursed him as an idiot inwardly.
Normally speaking, even if the person who performed a key step really was a resident, to avoid risk, the record would still state that it had been done by the first assistant or the lead surgeon.
After all, if something went wrong during the surgery, a resident was not qualified to bear responsibility.
That fellow Takigawa had probably not used his brain at all when writing the record.
Or perhaps he simply had not dared to claim that perfect Kirschner wire technique as his own, afraid that he would be exposed if the professor questioned him.
“Professor, you’ve misunderstood.”
“Takigawa-kun was feeling unwell at the time. After completing the exposure, his hypoglycemia acted up, and his hands were shaking badly.”
“Considering the surgical risk, I had him step away from the table.”
“But the operation couldn’t stop. I saw that Kiryu-kun’s fundamentals were usually quite solid, and this Kirschner wire fixation plan was also proposed by him.”
“So I let him give it a try.”
“Throughout the entire process, I was beside him overseeing everything. Nothing went wrong.”
Imagawa Ori’s expression did not change as the words came smoothly from her mouth.
After listening, Professor Nishimura adjusted her glasses.
“So that’s how it was.”
“However, since the procedure was completed by a resident, that further demonstrates the feasibility and reproducibility of this ‘ligament tension reconstruction’ theory.”
“If even a resident can complete it under guidance, that means this technique has tremendous value for broader promotion.”
She did not care about the truth.
In First Surgery, she was heaven. Whatever she said was the truth became the truth.
And for top medical journals, reproducibility was an extremely important metric.
If this was merely a personal showcase by a genius doctor like Imagawa Ori, its value would be greatly discounted.
But if it was a standardized procedure, then its significance would be entirely different.
“Imagawa-kun.”
“I want you to organize this case.”
“Not a simple case report. I want a full original article, targeting the Journal of the Japanese Orthopaedic Association.”
“I’ve even thought of the title for you: A New Strategy for Treating Comminuted Distal Radius Fractures Based on the Principle of Ligament Tension Reconstruction.”
“You will be the first author, and I will be the corresponding author.”
“As for Kiryu-kun…”
Professor Nishimura paused, thinking for a few seconds, as if weighing how much importance should be given to a resident.
“List him as the third author. Consider it encouragement for him.”
“I want to see the first draft within one month.”
Her gaze crossed the desk and fell on Imagawa Ori’s face.
“Yes, I understand, Professor.”
Imagawa Ori immediately replied, but inwardly she was groaning in misery.
The full name of the journal Professor Nishimura had mentioned was the Journal of the Japanese Orthopaedic Association.
Although it was a Japanese-language journal and not SCI-indexed, making it little known internationally, within the domestic medical system, it was an absolute authority.
Today was December 25th. That meant that on New Year’s Day, January 1st, she would still be poring over large amounts of literature, drawing surgical diagrams, organizing data, and performing statistical analysis.
But that was not the most important part.
After all, to her, New Year’s was not much different from any ordinary day.
The most fatal thing was—
She understood “how to do it,” and she more or less understood “why,” but to elevate it to a “theoretical level”?
She might as well be killed.
She was a clinician, more skilled with a scalpel than with a pen.
But could she refuse?
No.
Professor Nishimura’s connections in the academic world were extremely deep.
If this paper was truly published, it would be very useful for her future career development, whether for promotion to associate professor or for moving to a higher-paying private hospital.
…
After leaving the professor’s office, Imagawa Ori glanced at the time, then quickly walked back to the First Surgery medical office.
Most of the doctors had already gotten off work. Only a few unlucky doctors and residents on duty were still dealing with miscellaneous tasks.
Kiryu Kazusuke was organizing a patient’s discharge documents.
The old computer he was using had been eliminated from use elsewhere in the medical office. It was slow and laggy; even typing a single character came with a long delay.
But residents had no right to choose.
“Kiryu-kun, come out for a moment.”
Imagawa Ori, in high heels, knocked on the door at the entrance.
Kiryu Kazusuke raised his head. Seeing that it was her, he saved the document and walked out.
The two of them came to the window at the end of the corridor.
It was relatively secluded here, and few people usually came by.
Imagawa Ori did not waste words. She directly slapped the surgical record in her hand onto the windowsill.
“You don’t need to do anything else these next few days.”
“The professor requires that Suzuki Shinya’s surgical record be rewritten first, and then that the intraoperative technique of using Kirschner wires to release stress be written up as an academic paper.”
“Submit the first draft within one month.”
“Consider yourself lucky. The professor left you a third-author byline.”