The First Surgical Department was mainly responsible for the diagnosis and treatment of bone-related diseases, and was also known as orthopedic surgery.
As a resident physician, Kiryū Kazusuke’s daily work was complicated and filled with trivial tasks.
His main duties in the morning were to follow the senior doctors on ward rounds, learn the latest condition of the patients under his care, and carry out medical orders.
For example, changing dressings, issuing examination requests, and recording all observations and treatments in the medical charts.
In the afternoon, if there were no special arrangements, he would either stay in the doctors’ office to study or be called in as an assistant for surgery, usually doing basic work like holding retractors or suturing skin.
Assistant, in name—but in reality, he was the one responsible for the physical labor at the operating table.
When Kiryū Kazusuke pushed open the door to the doctors’ office,
several doctors in white coats were gathered around a table, chatting together.
“Kiryū-kun, over here.”
A resident about his age poked his head out from behind a desk against the wall and waved at him.
His name was Tanaka Kenji. Like Kiryū Kazusuke, he was also a resident in the First Surgical Department, though he had joined a year earlier, making him his senior.
“Good morning, Tanaka-senpai.”
Kiryū Kazusuke walked over and placed his bag on the empty seat beside him.
“What do you mean, morning? It’s almost noon.” Tanaka Kenji pointed at the wall clock. “You sure came late today. I thought you’d overslept.”
“I was at the Medical Affairs Section for a while,” Kiryū Kazusuke explained casually.
“Oh, for that matter.” Tanaka Kenji immediately understood. He lowered himself and leaned closer to Kiryū Kazusuke.
“How’d it go? Did you tell them everything?”
“Mm. I just told the truth.”
“Tsk. That woman really had it coming. I heard the patient’s family is making a huge fuss, and the Nursing Department’s under a lot of pressure. She’s probably finished this time.”
Tanaka Kenji patted him on the shoulder.
“Oh, right. There’s something else.”
As he spoke, he seemed to remember something and pulled a document from the folder on the desk, handing it to Kiryū Kazusuke.
“This is a new patient admitted through emergency yesterday.”
“Distal radius fracture. Preliminary judgment is that he’ll need open reduction and internal fixation.”
“Professor Mizutani specifically named you to handle the preoperative preparations. Do the admission examinations first—the medical history, all the tests, and so on.”
Kiryū Kazusuke was somewhat surprised. “Me?”
Preoperative preparation might seem simple, but every step was connected, covering medical history taking, physical examination, issuing and following up on various lab tests, explaining surgical risks, obtaining signed consent forms, and so forth.
Although he had already obtained his medical license, during the residency stage—especially in the first year—his main job was still to follow behind senior doctors and do odd jobs.
There were very few opportunities to independently take charge of a patient’s preoperative work.
Moreover…
Not only had he made a fool of Mizutani Mitsumasa’s lover, he had also gone to the Medical Affairs Section to report her.
Under these circumstances, Mizutani not coming after him was already something to be thankful for. Why would he take the initiative to hand a patient over to him?
So the greatest possibility was that the other party wanted to use this as a pretext.
As long as he made even the slightest omission in any part of the process, it would not be impossible for them to discipline him—or even kick him straight out of the First Surgical Department and exile him to Hokkaido to admire the snow.
“He’s only asking you to handle the preoperative preparations. It’s not like he’s asking you to be the lead surgeon.”
Tanaka Kenji stretched lazily and leaned back in his chair, his bones cracking audibly.
Kiryū Kazusuke did not explain. He took the chart and returned to his own corner.
His desk was the smallest in the entire doctors’ office, right next to the filing cabinet. Every time someone came to look for an old medical record, he had to stand up and make room.
He pulled out the chair and sat down, then opened the medical file in his hands.
The patient’s name was Suzuki Shinya, forty-three years old. While working at a construction site, he had accidentally fallen from scaffolding, resulting in a comminuted fracture of the distal radius in his left arm.
Kiryū Kazusuke pulled out the X-ray film and held it up to the fluorescent light overhead.
At the distal end of the radius, above the wrist joint, the bone had broken into several pieces. The largest fragment was tilted toward the dorsal side, forming an ugly deforming angle.
This was precisely the standard indication for open reduction and internal fixation, ORIF.
They would cut through the skin and muscle, expose the fracture ends, piece the shattered bone back together, then use a specially made metal plate and several screws to lock it firmly in place, waiting for the bone to heal on its own.
It sounded like carpentry.
But the complexity of the human body far surpassed any piece of timber.
Within the surgical field, nerves and blood vessels crisscrossed. The slightest carelessness could cause permanent damage.
The difficulty of this surgery was by no means low.
……
The ward was on the sixth floor of the inpatient department.
In a standard three-person room, a middle-aged man lay on the bed by the window.
His left arm was fixed in a plaster splint and suspended in front of his chest with bandages. Because of pain and unease, his complexion looked somewhat sallow.
A woman sat beside the bed—probably his wife—holding a towel and wiping his face for him, her eyes red.
Beside her stood a teenage girl in a high school uniform.
Kiryū Kazusuke walked up to the bedside, first nodding slightly to the family members before turning his gaze to the patient on the bed.
“Hello, Suzuki-san. I’m the doctor in charge of you, Kiryū Kazusuke.”
“Hello, doctor.”
The man on the bed, Suzuki Shinya, struggled to sit up.
“Just lie down. No need to move.”
Kiryū Kazusuke pressed down on his shoulder, then pulled over a stool and sat down.
He began taking the medical history according to standard procedure.
“Other than your arm, do you feel uncomfortable anywhere else?”
“How high did you fall from?”
“Have you had any chronic illnesses before? Such as hypertension, diabetes, and the like.”
“Are you allergic to any medications?”
Suzuki Shinya answered each question in turn, while his wife softly added details from the side.
After the questioning, Kiryū Kazusuke had a general understanding of the patient’s basic condition.
Next was the physical examination.
Kiryū Kazusuke first checked the sensation and motor function of each finger, confirming that there were no obvious signs of nerve damage.
Then he felt the radial artery pulse at the wrist. There was no problem with the main artery supplying blood.
After finishing the examination, he fixed the patient’s arm in place again.
“Doctor, is it very serious?”
Mrs. Suzuki, sitting beside the hospital bed, asked with deep concern.
Beside her, the sixteen- or seventeen-year-old high school girl also looked at him nervously.
“Judging from the X-ray, it’s a comminuted fracture of the distal radius. The bone has broken into several pieces.”
“Then… then what should we do? Does he need surgery?”
“Yes. In this situation, surgery is necessary. Even if it heals on its own, the bone won’t grow back into its normal position, and it will lose function later.”
Kiryū Kazusuke added one more sentence of explanation.
Although Suzuki Shinya’s case had not yet been discussed in conference, surgery was inevitable. A comminuted fracture was not something that could be handled without operating.
When she heard that surgery was needed, Mrs. Suzuki’s face instantly turned several shades paler.
“After the surgery, will I be able to recover to how I was before?”
Suzuki Shinya was not afraid of surgery. It was just that these hands were what he relied on to make a living. If his hand was ruined, then the family that depended on him might collapse as well.
“We will do our utmost.”
Kiryū Kazusuke was silent for a moment. In the end, this was the only answer he could give.
The standard procedure, open reduction and internal fixation, involved significant surgical trauma. After surgery, a certain degree of stiffness and limited mobility was inevitable.
To fully recover the flexibility and strength from before the injury would be extremely difficult.
“I understand. Thank you, doctor.”
Suzuki Shinya immediately showed a disappointed expression, but he still nodded.
Afterward, Kiryū Kazusuke explained a few preoperative precautions, such as the requirement to fast from food and water when the time came.
Then he got up and left the ward.
He had seen too many moments when there was nothing that could be done, and he had also learned how to separate his emotions from his profession.
There had never been a savior in this world.
Nor did he believe he had that ability.