1:00 p.m.
After the lunch break ended, the doctors in the First Surgery Department’s office began to bustle.
Kiryu Kazusuke walked over to the whiteboard on the wall.
It was densely filled with the week’s surgical schedule, with the names of the primary surgeons, assistants, and patients distinguished in black and red marker.
At a university hospital, surgeries were mainly divided into two types.
One was emergency surgery. That was a race against the Grim Reaper; there was no need to talk about rules, and no one cared who came first or later. If they came in, they were operated on.
The other was elective surgery.
Every Thursday morning, after the department meeting, the professor would take the two associate professors and go through all the submitted surgical plans. Those approved were stamped and scheduled; those rejected were sent straight back.
Only after passing review would a patient’s name be qualified to appear on this whiteboard.
This was the bulk of the department’s daily operations, and also where power rent-seeking and human relationships were most concentrated.
The professor’s surgeries were arranged in the prime slot, which was nine in the morning.
The associate professors’ surgeries followed immediately after.
The surgeries of lecturers and specialists were usually arranged in the afternoon, or in those less desirable time slots.
As for specialty trainees like Takigawa Takuhei, they could only pick up the leftover scraps of time, or get their turn as primary surgeon when the professor did not want to do it, the associate professors were too lazy to do it, and the specialists had no time.
There were quite a few surgeries this week.
Although Professor Nishimura rarely went onto the operating table herself, there were many surgeries listed under her name; the actual procedures were all performed by the lecturers or senior specialists below her.
As for Associate Professor Mizutani’s surgeries, most were hip replacements or spinal operations.
Those types of surgeries had expensive instruments and plenty of room for kickbacks.
Kiryu Kazusuke found Imagawa Ori’s name.
In the past, as the model worker of the department, her name had practically occupied one-third of the whiteboard. She was a surgical machine among specialists.
But this week, her surgical volume had been directly cut in half.
Moreover, the remaining surgeries were all relatively routine, medium-sized procedures such as “open reduction of clavicle fracture” and “internal fixation of tibial plateau fracture.”
There were no highly difficult reconstructive surgeries that required standing at the table for a dozen hours.
With a little thought, the reason became clear.
Professor Nishimura had probably used an administrative order to deliberately reduce Imagawa Ori’s clinical workload, so as to free up time for her to write papers.
But it was not a big problem.
According to their previous agreement, within three months, as long as Kiryu Kazusuke wanted to, he could get onto the operating table.
And this afternoon, in Operating Room No. 2, she had a surgery.
[Surgery: Open Reduction and Internal Fixation of Right Tibial Plateau Fracture]
[Primary Surgeon: Imagawa Ori]
[First Assistant: Tanaka Kenji]
Not every surgery required two assistants. For a procedure of this level, one person to help with hemostasis and cutting sutures was enough.
If a second assistant had to be arranged, it would probably be a medical student standing behind them to learn.
Tanaka Kenji was a junior resident who had entered the department one year earlier than Kiryu Kazusuke. Although he was not yet a specialty trainee, he still counted as an old hand in the department.
For a surgery of medium difficulty like this, arranging him as first assistant was both training and in line with the rules.
“Kiryu-kun.”
The sound of high heels came from behind him.
Imagawa Ori, holding a can of coffee she had just bought from the vending machine, stood beside him.
“At three this afternoon, I have a tibial plateau fracture surgery.”
She glanced at the arrangement on the whiteboard. It said the first assistant was Tanaka Kenji.
“If you want to go on as first assistant, I can have Tanaka step down.”
“Will you go tell him, or should I?”
As she spoke, she took a sip of coffee.
As for whether Tanaka Kenji, who would be replaced at the last minute, would feel disappointed or wronged and harbor complaints because of it?
As long as she did not hear it.
Kiryu Kazusuke glanced at Tanaka Kenji, who was not far away with his head lowered.
This senior had been in the department for over a year. Although he had a bit of a big mouth and liked gossip, when Kiryu Kazusuke had first entered the department, he had helped him quite a bit.
He had told him where there were free boxed lunches and which head nurse had a bad temper.
He had treated him, his junior, quite well.
For the sake of this surgery, after Tanaka Kenji arrived at the department today, he had been looking at anatomical atlases whenever he had free time.
“No need.”
Kiryu Kazusuke shook his head.
For a surgery without much technical content, there was no need to snatch away the opportunity Tanaka Kenji had waited so hard for.
Imagawa Ori looked at him with some surprise.
She had originally thought Kiryu Kazusuke would seize every opportunity, like a bloodthirsty shark that would recklessly chase after the scent of blood.
Even if it was only surgery on the tibia of the lower leg, it was still rare for a junior resident.
“Are you sure?”
“Since it’s already been arranged, let Senior Tanaka go on.”
“Suit yourself.”
Imagawa Ori shrugged indifferently.
In any case, to her, it made no difference who acted as assistant, as long as they did not cause trouble for her.
With that, she turned and left.
Kiryu Kazusuke remained looking at the whiteboard.
[Surgery: Open Reduction and Internal Fixation of Bimalleolar Ankle Fracture]
[Primary Surgeon: Takigawa Takuhei]
[First Assistant: Kiryu Kazusuke]
A bimalleolar fracture, meaning a fracture of both the medial and lateral malleoli, was what people commonly called a broken ankle.
This was also an entry-level surgery that had been arranged last week.
For a doctor at Imagawa Ori’s level, she could probably do it with her eyes closed.
Although Takigawa Takuhei had been a specialty trainee for several years, because his hands were rather clumsy, he rarely had opportunities to be the primary surgeon.
This time, because the patient was an old patient he had previously been responsible for and specifically asked for him, the professor had agreed.
Having Kiryu Kazusuke serve as first assistant was probably because they had taken notice of the stability he had recently displayed.
In other words, he could cover for him.
……
3:50 p.m., operating room changing area.
Takigawa Takuhei was scrubbing in.
He looked somewhat nervous. The hand holding the brush was exerting so much force that he had scrubbed his skin red.
He was already a fifth-year specialty trainee, but the opportunities he had had to operate independently as primary surgeon could be counted on one hand.
Every time he stepped onto the operating table, it was a major examination for him.
If he did well, perhaps he could leave the professor with a good impression before next year’s specialist examination.
If he messed it up… No, no, no. He could not mess it up again.
“Senior Takigawa, good afternoon.”
Kiryu Kazusuke walked in, picked up a brush, and stood at the sink beside him.
“Oh, Kiryu-kun.”
When Takigawa Takuhei saw him, he visibly breathed a sigh of relief.
“I’ll be counting on you for this surgery.”
“This patient’s lateral malleolus is badly comminuted, and it seems the fracture line is spiral-shaped too.”
“That area at the distal fibula is just skin over bone. If the plate isn’t placed properly, it can easily cause flap necrosis.”
“I’m also a little unsure about restoring the length of the fibula…”
By laying out the difficulties first, if he worked slowly later, or if some small flaw appeared, he would have an excuse.
In addition, this was also a disguised way of asking Kiryu Kazusuke for help.
“Don’t worry, Senior Takigawa.”
“I’ve looked over all the films.”
“Although the fibula is a bit fragmented, the main anatomical landmarks are still there. As long as you handle the lateral malleolus first, the medial malleolus will be very simple.”
“I’ll be beside you retracting. Just go ahead and do it without worry.”
Kiryu Kazusuke’s words both gave his senior sufficient face and put him at ease.
“That’s good.”
Takigawa Takuhei nodded, and his previously tense shoulders also loosened somewhat.
The two of them did not speak again.
In the mirror, as Takigawa Takuhei scrubbed his hands, he was still muttering to himself, probably reciting the surgical steps.
Kiryu Kazusuke did not disturb him.
Toward someone like Takigawa Takuhei, he did not harbor any dislike.
Although he was mediocre, although he was timid, and although he sometimes liked putting on the rotten airs of a senior.
At the very least, he knew his own limitations.