The emergency department during the New Year period was busy, but most cases were mild—upset stomachs from bad food or people who had drunk too much. Compared with the usual traffic accidents and traumatic injuries, it was somewhat easier.
Besides, there was that rare thing: overtime pay.
In terms of seniority, Kiryu Kazusuke was still a newcomer who had only been on the job for half a year.
At times like this, he was the one meant to be sacrificed.
Rather than complain, he might as well make good use of those two days. A holiday meant everyone else was resting; it also meant the senior doctors were not around.
If a major emergency operation came in at a time like that…
Then it would be his stage alone.
Tanaka Kenji sighed. “Ah, I wanted to go back to my hometown. I heard they’d arranged a marriage meeting for me.”
Kiryu Kazusuke smiled. “Then turn it down. Tell them you’re devoting yourself to the cause of medicine.”
Tanaka Kenji consoled himself as well. “True. It’s not like I have the money to get married anyway.”
The two of them stuffed the things into the trunk of the professor’s Crown sedan.
Then they returned to the department office.
Seeing off the visitors who had come bearing gifts—visitors who could practically be described as coming to pay tribute—did not mean the work was over. On the contrary, it was only the beginning of the daily routine.
Kiryu Kazusuke walked over to his desk.
Several thick German medical books were piled on his chair. Assistant Professor Mizutani had casually tossed them over the day before yesterday, saying they were for him to “study.”
In truth, it was merely because that fat man wanted to clear space on his own desk.
He moved the books aside, took a stethoscope from the drawer, and hung it around his neck.
Today, he had rounds to make.
Or rather, there were rounds every day.
On days that were not Monday, there was no grand round in Nishimura-sensei’s “daimyo procession” style, with everyone mobilized in full force. But that did not mean junior residents could slack off.
On the contrary, the daily small-team rounds were what determined whether one survived the day.
Within the ecosystem of a university hospital, there was a misconception about patient allocation—not only among outsiders, but even among many medical students just entering the field.
In theory, patients came for the hospital’s name, or for the professor’s name.
But there was only one professor, and he could not split himself into multiple bodies. It was impossible for him personally to manage the food, drink, urine, and stool of every patient in every bed.
And so, authority was delegated layer by layer.
For the sake of management, the professor would organize the doctors under him into several “clinical teams,” each responsible for a certain number of beds and patients.
After a patient was admitted, they would be assigned to a certain team either at random or according to the severity of their condition.
This meant that the one treating the patient was not a single person, but a team.
Of course, both nominally and legally, the ultimate person responsible for all inpatients was the department professor.
And within the little pyramid known as the “Imagawa Team”—
Standing at the very top was naturally Imagawa Ori, who held specialist certification, possessed superb technique, and loved money as much as life itself.
The team leader held absolute decision-making power.
Who to operate on, how to operate, and when to operate.
In the middle tier were the specialist trainees.
Although Takigawa Takuhei was his senior, in front of Imagawa Ori, he could only be meek and submissive.
He was mainly responsible for carrying out orders, handling complicated paperwork, and, when Imagawa Ori was in a bad mood or too busy, taking the scolding and serving as a substitute.
At the very bottom, without a doubt, were the junior residents.
Their daily work consisted of changing dressings, drawing blood, running errands, writing endless progress notes, serving as human retractor stands on the operating table, and blocking patients’ complaints on behalf of the senior doctors.
If there was merit, it had to be because the senior doctors had guided them well.
If there was a mistake, it was because the junior resident had not observed carefully enough.
Kiryu Kazusuke washed his hands, picked up his stethoscope and stainless-steel chart folder, and headed toward the wards.
He was responsible for six patients, distributed among different rooms.
What he needed to do now was preliminary rounds. He had to memorize the patients’ temperatures from last night, drainage volumes, urine output, and any bleeding from their wounds.
During formal rounds, the senior doctors would not give you time to flip through the charts.
If they asked, you answered.
If you could not answer, that was dereliction of duty.
Seven-thirty in the morning.
The inpatient ward on the sixth floor was perpetually filled with the mingled smell of cleaning agents and disinfectant.
Room 602.
It was a large six-person ward, occupied by patients whose conditions were relatively stable, or who were waiting for surgery.
Kiryu Kazusuke walked to the bed closest to the door.
The patient was an old woman in her sixties with a left femoral neck fracture.
However, because she had diabetes and hypertension, her preoperative preparation was taking longer. She had already been hospitalized for nearly a week.
“Good morning, ma’am.”
As Kiryu Kazusuke spoke, he lifted the blanket and reached out to feel the pulse of the artery on the dorsum of the old woman’s foot.
Strong and forceful.
He then checked the straps of the skin traction. The tension was moderate, and there were no pressure sores on the skin.
“Doctor, when can I have surgery?”
The old woman looked at him pitifully. Days spent waiting like this were torment.
“We still have to wait for your blood sugar to come down.”
Kiryu Kazusuke glanced at the blood glucose record hanging at the head of the bed.
Fasting blood glucose: 11.2. Still too high.
With numbers like that on the operating table, the risk of wound infection was extremely high. Once an infection set in, the consequences would be disastrous.
He closed the record book and calculated silently.
At the current insulin dosage, it would probably need another two days of adjustment. Hopefully, they could schedule her surgery in the first week after New Year.
He turned and walked toward the next bed.
Room 605.
Here lay a young man who had just undergone a meniscectomy, also performed by Imagawa Ori.
Kiryu Kazusuke looked at the drainage bag. Pale red bloody fluid, approximately fifty milliliters.
“Did you have a fever yesterday?”
“No.”
“Can you lift your leg?”
The young man gritted his teeth and laboriously raised the leg wrapped in thick gauze ten centimeters off the bed.
“Not bad.”
Kiryu Kazusuke nodded and scribbled the data messily onto the chart paper.
This was preliminary rounds.
Twenty minutes later, he had checked all the patients under his care and had their conditions firmly in mind.
…
Eight o’clock in the morning.
The morning meeting of First Surgery officially began.
Although it was the last working day of the year, the atmosphere did not become relaxed because of that. Instead, with the New Year holiday about to arrive, it seemed somewhat tense.
Doctors were people too. They wanted a holiday too. They wanted to lie at home drinking beer and watching the Kohaku Uta Gassen.
Therefore, how to assign emergency on-call standby during the holiday became the topic everyone cared about most.
“Gather up! Morning meeting begins!”
Mizutani Mitsuma’s booming voice rang out in the department office.
He was dressed with particular vigor today, his hair combed until it shone with oil. Clearly, he had prepared for tonight’s “bonenkai.”
Everyone immediately stopped what they were doing and gathered around.
Professor Nishimura did not appear.
This final morning meeting before the holiday was usually presided over by the assistant professor in his place, with a few formal remarks before announcing the holiday arrangements.
Mizutani Mitsuma clasped his hands behind his back and assumed the air of a full professor of the department.
“Gentlemen, you have all worked hard this year.”
“Under Professor Nishimura’s wise leadership, our First Surgery has achieved brilliant results this year.”
“Our surgical volume has increased by fifteen percent compared with last year, and the number of papers published has also risen significantly.”
“In particular, the successful surgery on Councilman Okawara’s son has greatly enhanced our reputation in the Kanto region.”
At this point, he deliberately paused, his gaze sweeping over those below.
“Especially Doctor Imagawa. Her decisive judgment that night embodied the spirit of our First Surgery—the courage to take responsibility.”
“Of course, I often tell her in ordinary times not to be restricted by conventional treatment plans.”
“On the operating table, the patient comes first in all things.”
As he spoke, without the slightest blush or change in heartbeat, he claimed half the credit for himself.
As for whether he had ever said such words?
It was not important.
If he said he had, then he had. If not, then it was Imagawa Ori who had forgotten.