Requested by: No One
Title: Kagayaki Days - Part 6
Summary: Ryutaro joins Kagayaki hospital as one of its new cardiology interns, when he discovers theres more to Dr. Okamoto than it seems...
Notes: I'm so nervous about this one... it's been such a long time since i've written anything so this one is a test of my skills!
Yuri and I sat quietly in the cardiology office, we sat staring at the ground, waiting still, as the clock ticked away precious seconds. Keito had come in a few hours ago, and having strong-armed an OR scheduler into keeping an OR open for the next 24 hours, he left to return home, with instructions for me to contact him if the operation was to continue.
“Ryutaro? Are you sure you want to do this?”
“Yes…. I’m sure.”
“No one will blame you if you refuse…..”
“I think I’d blame myself… I mean, think about it, if you were in his position, wouldn't you do the same? You’d do anything to save your son…… and sometimes, things like losing your wife can cause people to act….. irrationally… you cant hold it against them…you could only imagine what they’re going through..” I had never felt more adult as I spoke those words.
“Doctor! The vitals have stabilized, and the charts look good, they’ve reached the goal!” A nurse came barging in, and I nodded to her.
“Chinen, please call Dr. Okamoto, and then meet me in the OR, we’re going to save that boy’s life.”
Leaving the office, I could feel my words sink in, Keito had told me that I was that boy’s best hope at surviving, he had even told it to the father…. As if all the words that had been said suddenly found their way onto my shoulders, I felt …. An immense pressure. I barely noticed how long I was scrubbing my hands until a nurse noted that I had almost exhausted all the soap. I threw on gloves just in time for Yuri to walk in.
“I called, and Dr. Okamoto said he would be here in five minutes.”
I nodded to him and walked first into the OR. The surgical assistants had already brought Tomio in, and despite his young age, having him lay on the surgical table made him feel all the smaller. I could barely bring myself to cut into him.
“Let’s start the surgery, we will begin with an aortic repair followed by complete removal of any leftover debris following the accident” I heard myself say as I took my place at the table.
“Scalpel” I called, and the nurse handed it to me. For a moment I held it in my hand, I knew I had to do it, but my body wouldn't let me.. I was… paralyzed… for the moment. Then suddenly, I felt a hand wrap around my own, a soft warmth that pushed my hand forward and toward the young boy. Gingerly the hand guided mine to open the incision, stitch and all. Just with the same deliberation it guided me towards the heart, still packaged and bound with what little temporary measures the body would allow. And when I had reached my destination, I looked up to see who was guiding me, and I almost jumped back in shock. A soft pale white figure stood on the opposite side of me, his body almost translucent. IT was the boy in the picture, the one that sat in the shrine in Keito’s house…
“Yuto…” I murmured,
“What doctor?” The nurse asked, and I blinked only to find the space before me empty now.
“N-Nothing” I said quickly, turning my attention back to the matter at hand. Yuri took his place opposite me, standing where my guide had once…. Appeared. He retracted and cleared the surgical area, bringing light to the dark cavity within. Softly I stitched closed the huge hole that threatened to kill this boy, I removed a piece of…. something that had managed to find its way into the body, as well as a small chip of bone that had lodged its way deep in the cavity on the opposite side of the body. Somehow, I couldn't believe that all this was caused by a single accident… but this was the horror of my job…. Regardless of whether I believed it or not. Eventually I set in the reinforcements for the valves in the heart, over time the threads would dissolve, they were designed to dissolve slower than the average stitches, and would hold until the vessel had the time to repair itself. An osteopathic doctor came to look at the boy’s ribs, and after helping him repair some of the damage as well as try to reset some bone.. I was ready to close him up again. I could hardly believe what I’d done, one of the more difficult operations… and it was over… I looked at the clock to see that it had been a good few hours since I started the procedure. It had been almost three in the morning when I started, and now, it was close to ten. My feet nearly buckled as I told the nurses to prepare for closing.
“I-I can do it.” Yuri said quietly, and I nodded to him as I handed him to stitching needle as well as the tweezers,
Taking off my mask, I left the OR, and I took a few steps before I fell against the rail of the hallway, my feet ached with pain that I hadn’t noticed before, and my body felt as if it had been tensed the entire time.
“Ryutaro… you did very well.” I heard, as a white cloaked figure walked past me. Keito had smiled as he gave me a nod.
“Go home….. get some rest.” He said, walking towards the office again, and I could only smile stupidly at myself as I sat there on the ground. As per the usual, I did my best not to listen to Keito, instead finding the empty room that I had taken to keeping one of Yuto’s journals in. It sat just where I had left it, on one of the small tables near a drifting window whose curtains seemed to play with the winds that lifted them. Just as I reached for the book though, a strong gust of wind came through, blowing the pages open and stopping just near the middle of the book.
I looked at the page, it was dated just a few days after where I had stopped reading. I felt… intrigued, and I read on…
Today, I had an 11 year old come into the office. A small boy, cheerful and smiling. I couldn't believe it when the parents told me, that they had gone to a cardiologist when the boy was born, and they had told them that due to a defect in their son’s heart, the boy wouldn’t live to see 22 years. Even in front of him, the parents talked so openly, as if they had already resigned to their son’s fate. I could see him though, as he played behind his parents. While his arms and legs were still moving around the small ball he had brought, his eyes and ears were sternly focused upon our conversation. They had heard of an experimental procedure, one that my research in the area had brought about… it was all… purely experimental now…. But it was promising. Just… untested on humans.
I felt so disappointed as I told them this… that even if my research had merits to cure their son… the hospital would never let me do it….. it was too dangerous for them to have it occur under their roof…..
The mother cried until her there were no more tears left for her to cry… and both her and her husband nodded as they said that they had expected as much, that they hadn’t come with much hope, but had to try something.
Why would such a young boy deserve to die at such a young age…? I want to help him… but if I do, would I lose the ability to help others along the way? Is it my choice to decide not to help him so that I could keep my license to help others?
I looked up from the journal and I felt the ethics of his question floating in my head, What would I have done… if I were in his position… doing the procedure would certainly get my medical practice license suspended… but… if that boy died… could I live with myself that a patient died because I was too afraid to save him?
I read on now…
I talked it over with Keito… and he seemed to have a plan, but he wouldn't tell me… and I don't expect him to until he’s ready. He never liked to worry me, and for that I’m grateful, I don't think my heart will take much more of this… He only tells me, to prepare my research, and every night when we sit down together in my small apartment, he hugs me and tells me that it’ll all work out.
“It’ll all work out…” I repeated into the air, I couldn’t fathom what on earth Keito had planned…. Turning the page I read Yuto’s entry for the next day
The surgery will take place….
Keito told me now, that he has arranged for the boy to be transferred to a subsidiary hospital, a smaller one that his friend serves as the chief of surgery at. The boy will be listed as an unknown patient that will go under the hospital’s small pro bono budget, but the parents will be paying a part of the cost. Instead of the surgery, we will be performing a “Routine appendectomy” During which I will have some complications. The nursing staff have been told of the situation and have agreed to help… tonight when the clock strikes 11, we begin……
It was all over in a flash, I could hardly believe the sheer weight of the room in that OR. Not a single person dared to make one move out of step... if anyone else in that hospital found out what we were doing, it would have been the end of us for sure… and for that boy. It was so alien to do those techniques when they hadn’t been tested, I didn't know how his body would react… it was terrifying, but I had to try to safe his life didn't I?
In the end, I remember him looking at me, and he smiled as he nodded and handed me a piece of chocolate his mother had brought him to make him feel better. Seeing him alive… made it all seem… worth it. Sometimes doctors just do what we can, and hope for the best. We cant think about the ones we’ve lost, or the ones that we could have lost and punish ourselves. We just… try and sometimes, the results can be more rewarding than we ever knew…
I closed Yuto’s journal, it was worth it wasn't it? My situation certainly wasn't anything like his, but doing major surgery on a young patient like that… it was… rewarding… to save a young life, someone who had his whole life ahead of him..
“Ryutaro? What are you doing here?” I looked up to see Yuri looking in at the room.
“Uh… nothing… I just… like to sit here sometimes because its quiet… not to mention Keito… I mean uh… Dr. Okamoto told me to go home…”
“I see….” He nodded as he sat on the bed next to me.
“Ryutaro… do you think…. That boy should know anything his father did?”
“What do you mean..?”
“I mean…. This.” He said, pointing to my bandages
“Oh… I think… parents will do anything to save their kids, and we as doctors should work hard to save them too…. We cant lie to them… but let’s just say…. His father did everything he could to get him saved…” I smiled, feeling a little bit more.. enlightened with myself after having read the entry. Yuto was right though, the next day when my ex-patient handed me “Excusal from class” note I smiled at how innocent his mind worked… and he in turn smiled as he wondered what his class had been doing while he was gone. Seeing him like that was…. more than Yuto could describe, or I could imagine. I had shaped his life with my hands….
The day flew by for me, I spent hours pacing up and down at home, practicing, trying to remember exactly what I did in that procedure, the movements my hands made, I practiced them a hundred times over on the imaginary heart that floated in front of me. Every once in a while though, I’d sit down on my small couch, and stare blankly at the small TV in front of me, I had never really turned it on other than to watch videos of surgeries, but right now… it seemed to be a welcoming sight. I settled my mind down… and sat still now, drawing a small blanket around my shoulders as I hitched my pajama covered knees up to my chest on the couch, and over a small plate of mashed potatoes, chicken, and broccoli, I had a relaxing night watching a show called “Hyakushiki Ou” I must have laughed dozens of times as the boys on the shows played a game and an unfortunate boy naked Sanada kept mixing up the pitches he was supposed to sing in the game.
Somewhere in the dead of the night, I woke up to find my plate empty on the table, the TV still on, and myself laying on the couch, with remote on the floor. There was a knocking on my door and I got up groggily, stumbling to my peephole, where an eagerly knocking Chinen greeted me.
“W-What…. is going on..?” I asked sleepily, as he barged in and threw my jacket at me.
“We have to go! The hospital is in trouble and there’s massive casualties coming in!” He said.
“What…. happened?” I yawned as I was pushed out the door.
“An electrical plant had a major malfunction that resulted in an explosion! The patients with burns have been treated, but there are a lot of patients with heart rhythm abnormalities because of the shock when the coils discharged…. The hospital cant handle them all with just the night staff, Dr. Okamoto said he called you but you didn't answer so he sent me to get you!” Chinen spoke with the speed you often find in cartoons, but seeing as how the information made it to my brain one way or another it didn't matter to me.
“We can change in the office into our scrubs lets go!” He said pulling me out the door and into a waiting taxi that sped off in the direction I’d usually have walked.
Three emergency pacemaker insertions, a minor heart abnormality and a small but still lethal metal and concrete removal surgery later, I stumbled out of the OR to find Keito sitting there with his hands over his head.
“Is he okay?” I asked Miki as she pulled off her surgical gown and threw it into the waste with Keito’s.
“He’s just a little exhausted… he had to work quickly these last hours… but even then… I’m afraid there were still patients that didn't make it onto the table… he always thinks about those… “
“Keito..” I smiled softly, approaching him as he looked up and took a sigh before smiling at me, putting his hand away from his head. I noticed he had his phone pressed against his head but I didn't think to address it now…
“I saw some of your work in the last surgery…. You seemed a bit more springy today eh? I can tell you finally took my advice and took some time for yourself…” He smiled and I nodded to him.
“Ryutaro.. when you can find that balance between pleasure and….. pain… then you can be like that all the time” he smiled sarcastically as he looked around him. I chuckled as he gave me a pat on the back.
“DOCTOR! One of the patients is destabilizing! He’s having a reaction to the antibiotics we gave him after surgery!” One of the nurses called as she ran out, and Keito jumped up, running after her.
I heard a faint click and on the ground lay Keito’s white cell phone. It must have fallen off his lap… I grabbed it and ran after Keito, arriving in time for him to call for me to bring a intubation kit.
“I need to get the tube in, his throat is swelling shut, whatever antiobiotics he’s on, get rid of it and make a note in his chart that he’s allergic to it.” Keito said sternly as I saw him insert the tube slowly. There were some doubtful times… but after a few minutes of hoping and a few injections later… the patient calmed down and the heart monitor beeped steadily. I excused myself first as I walked back to the office and just as I was about to reach it… something took hold of me and made me walk past it to the break room…. No one in the cardiology department used it because we had the office, so it was quiet and empty, a perfect place for me to….
“I shouldn't….” I stopped myself as I shut the door to the break room, leaving the lights off so as to not attract attention. The white cell phone rested in my hands… and I sighed softly as I turned it over and over. No matter how much I protested…. How much I debated…. I couldn’t help myself as I flipped the phone open and looked at the call log.
There, in the first slot of the outgoing calls, was Yuto’s name, followed by a small heart. Quietly I pressed the call button, not sure who I was trying to keep the call a secret from in such a vast room. I heard the message go straight to voicemail and I heard Yuto’s voice for the first time. He was laughing… and his voice was soft… and comforting…
“Hi! This is Dr. Yuto Nakajima, you’ve reached me when I am unavailable to take your call, please leave a message and I will get back to you as soon as possible!”
There was a slight pause and I noticed there wasn't a beep yet, then I heard it…
“Keito! Stop! Ahaha! Stop! I just recorded my message! I love you too but you’ve got to stop… Oh! It’s still recordin-“ The message cut off as a beep came.
I snapped shut the phone instantly, sitting there in misery at what I’d done… this was such an invasion of privacy… quickly I deleted my call from the call log and I put the phone back in my pocket. Just as I left the break room, I saw Keito entering the cardiology office and darted after him. The sooner this phone was out of my possession, the better.
“Ah…. I’d wondered where I’d left that..” He said as he pocketed the phone and sat down at his desk.
I hated myself at that moment, just like I had every time I had snuck around behind Keito’s back, but I couldn't help myself…. Quietly I stared at my small desk, absentmindedly signing off on medical records and placing files around my desk in no particular order.
“Are you okay?” I looked up suddenly to see Chinen staring at me worriedly.
“Uh… er… yeah…” I said, forcing an awkward smile.
Somehow I couldn’t manage to look Keito in the eye, but when I got home that night, he was all that was on my mind. It wasn't so much how angry I was with myself for spying on him, but rather how I would feel… if I were in his position.
He tries to put on a brave face, to say that he’s okay, but inside he’s just so… lonely. A warm cup of citrus spiced tea did nothing to comfort me as I wrapped myself in the warmest, softest blanket I had and sat down on the couch, my new bed for the last few nights.
I awoke in the night not from the sounds of my alarm, but by the sudden shattering of the vase I kept on the coffee table. The ground trembled as my couch slid slightly to the left, to the right. I jumped of the couch and ran on shaky ground underneath the dining room table and braced myself for the worst. I heard a giant slam somewhere in the distance, car alarms, and a giant crash rang out as I saw the chandelier above me crash onto the table. When the earthquake subsided, I slowly crawled out of the small cave I had created. My roof was broken, and the second floor was in shambles. What little ground I had unlittered by pieces of wall or celing, were covered with glass from objects or windows alike.
After calling the insurance company, My couch, the only unscathed part of my home beckoned to me again, but just as I reached it, I heard a small vibration and after digging through the cushions, I found my pager going off with an emergency call. The Hospital.
I got out the door just to freeze as my neighbors stepped out as well.
“Help! Help!” My eyes darted around to see a woman running towards me.
“Ryutaro! Ryutaro! He’s caught! He’s caught!”
My eyes focused in the dark to see my neighbor, Mrs. Ishikawa, she grabbed my hand and pulled me along running quickly through the door and up stairs to her son’s room.
There lay a boy about 16, his breathing ragged as a large beam from the ceiling pinned him down in bed, he had managed to react fast enough to grab the beam on its way down and prevent some of it, but I saw the blood flowing and from the way he was breathing…. Something was definitely wrong.
“H-Hand me my bag.” I said as I pulled what minor things I could off him.
“Masato? Masa can you hear me?” I said as I checked his pulse, weak, but slowly declining. He nodded slowly and grabbed my bag to bring some bandages out.
“Masato, I need you to listen okay? I don't have any strong anesthetics with me, but I can give you something that will help, it will hurt but I need you to try not to move as much as possible okay? I need to get this beam off you and I don't want the wood to cut anything on its way out. So stay as still as possible okay?” I said as I readied a syringe. It was a weak anesthetic, meant only for minor injuries, but this was all I could do.
I injected him around the area, and he seemed to breathe a little easier.
“Okay..I need two people to help me move the beam, they have to have steady hands, and have to be strong.” I said as the neighbors that had gathered in the room by Mrs. Ishikawa’s cries stepped up.
“I need you two to move the beam out along the path it went in, CAREFULLY, so the wood doesn't splinter and injure anything more than it already has. The minute you two get rid of the beam I’ll move in and try to seal the wounds.” I instructed.
“GYAHHHHHHHHHH!” The boy screamed as the wood left his body and blood flowed freely. The broken beam had managed to puncture him, leaving sharp scratches, but those didn't matter.
“Someone get her out of her, she doesn't need to see this.” I said as the women in the neighborhood grabbed the sobbing mother and ushered her out.
“Masato, listen to me, I need to make widen the hole with incisions okay? With this angle I cant see everything okay?’ I said as I sterilized the scalpel with as much alcohol as I had in the bag. I drew a single line with the scalpel, revealing more of his body and I saw blood coming from a severe scratch on his lung, there was a sharp splinter laying close to the still beating, but weakening heart. Any wrong move would shift it and cause it to dig in.
“Masato!” One of the neighborhood men shouted as the boy passed out and I silenced him.
“It’s better he’s unconscious for this part” I said as I reached for tweezers and slowly began the extraction. I managed to remove the splinter and pack the wound. He was definitely far from safe, but he was temporarily stable….. temporarily.
“I need someone to get a paramedic, tell him I have a priority one triage and tell him to bring a stretcher.” I said.
“Ryutaro! W-We need help!” Another neighborhood man called. Looking around, I told the men to make sure the ambulance sends them to the right hospital and I ran out side, listening to the man tell me about Mr. Kodaka, who had his entire house almost collapse on him. When we reached the house I saw a familiar figure standing there,..
“Th-There you are! We have to go…. I’ve already treated Mr. Kodaka, he has a minor rib fracture… fortunately, but he’s not in any danger.
I jumped into Yuri’s car and he explained the hospital had called in all available hands. Even though we were heart surgeons, today, we’d be general surgeons…We got to the hospital in time to see a massive influx of flashing lights as stretcher upon stretcher came in with patients from at least the last 20 miles over.
“W-Whats going on with all these people?!’ I shouted as I entered the ER and the nurses came to throw surgical triage gowns over me.
“The earthquake knocked out two of the nearby hospitals, all patients are routing to us! We’re the only medical emergency center that's big enough to handle…… anything!” One of the surgical directors shouted as he called up for immediate booking of all ORs.
“We wont be able to handle them for long if we don't hurry up, so get going!” Keito shouted from behind me, as he pushed two stretchers back out to the paramedics, only to be replaced immediately by two more. He looked at the briefly before he was rushed off to his next patient, with a nurse urgently holding a cell phone to his ear.
Everywhere I looked, there was so much destruction, pieces of concrete, wood and metal pierced patients. The ghostly figures of doctors, woken from their night sleep and draped in soft green and yellow gowns flew from stretcher to stretcher, performing minor fixes, ushering their patients into line at the entrance to the operating room bay.
“Take all priority 1 cases to the east wing! Everything there is least affected! Bring tables to enlarge surgical rooms if you have to! All nurses, be sure that there are NO cross-contaminations between patients! Surgeons, you have permission from the board and all chiefs of staff to use ANY operating rooms you find!” Keito shouted as he hung up his call.
And just like that, the ER scattered, with surgeons rushing two stretchers at a time to the nearest OR they knew.
“Ryutaro!” Keito shouted as I looked at him, my hands still deep in a man’s chest cavity, the eighth of the night.
He motioned for me to come as soon as possible. I finished quickly, leaving the closing to one of the surgical assistants. Rushing over, I found myself face to face with Masato.
“Take him to the third floor operating room, in the north tower. There’s an OR there that no one should have gotten to yet. GO NOW.” He said, pushing Masato’s stretcher. The 16 year old’s body had gotten so pale already, the packaging I had put into him had stifled some of the blood flow, but not all of it.
I ran off to the elevator, getting to the third floor and to the north tower. I followed the signs known only to doctors and I found myself standing in front of the room as the nurses came out to take the patient, and I explained to them the surgery we were going to perform….
I had never scrubbed so fast in my life…. My hands flew between water and soap and then into gloves. The bloody gauze left his body and I was faced with a massive crimson mess. A silk thread found its way in between my instruments, threading itself across open wounds. My hands jumped between the needle and the scalpel, enlarging cuts, sealing others. Somewhere in the chaos I became aware the OR was perfectly still. I couldn't focus on the people around me, but I felt their eyes upon me. The nurses stood in shock, watching as my hands curved along the paths of invisible strings. The heart beat in time slowly conducting the symphony that was my hands. I extracted the stray splinters, sealed what bleeding I could find and quickly repaired a quickly deteriorating heart with methods that came by instinct. The moment that heart monitor stopped blaring its warning my hands froze, realizing he had stabilized my awareness flooded me again and I nearly collapsed as the sweat or tears…. I’m not sure anymore blurred my vision I thought I saw a figure standing over me…. but when I blinked it was gone.
“I-I’ll close doctor.” One of the surgical assistants said, snapping me completely out of my trance. I nodded to him as I left the OR, looking at the clock to see that only an hour had gone by, it was…. impossible. How quickly had I moved? My hands tingled as I walked down to the emergency room bay and received my next patient. Casting aside everything else I quickly patched up a small scratch, he was fortunate….
The aftershock tremors were getting worse, with the doctors working around them, pausing everything to wait as the quakes lessened. They were getting stronger in force now… the day wasn't over yet…. It hadn’t even begun.
“Dr. Morimoto! Male, 23, Sever puncture wound to the arm, with glass embedded in his left leg, possible concus…”
The nurse’s voice faded away as my nightmare of patients began again….