Makura has only wanted to quit obstetrics once before.
Bad time after birth, when the baby that was in the intensive care unit died on the tenth day.
All the staff tried so hard to connect their lives, it didn't come true. There was no power left.
To a child who had passed away too soon, his mother was just vain. Makura was also still young, and her position, which was supposed to comfort her, cried and clung, her hands turned to her back, and she was molested. I thought I was totally disqualified from doctors.
Many times in the future, these things will happen. Thinking about it made me less confident I would go on.
That's when my father took me to the grave. Makura died at a young age, in my mother's grave. At a different time than usual, Makura was surprised.
My father said he was changing flowers and putting his hands together with my mother, whom I don't even remember.
"I still have regrets."
……
"At that time, I was told that if I had the knowledge that technology was like now,"
"... yeah"
"But it's something I can't help. It's not just my mother. Guys, one day I'll be gone. That's not an exception."
"... that"
It's not even on the edge. It was something I didn't even want to think about.
My father has always been a walking presence in front of me. I couldn't even imagine it, such as making it invisible. I'm sure it'll stifle me.
"But that's fine. My mother, too, worked hard to the end. Guys, it's the result of trying to live. So that's fine."
……
As a doctor, it was my back that had stared at many lives and deaths.
Makura no longer remembers, it was her back that survived her mother's death.
◇
Wake up.
The wall of the modem went into my eyes.
My body was cold and stiff.
I was suddenly nauseated when I tried to move. Turn away and punch stomach fluids on the floor.
"Or, ha..."
A bitter thing burned his throat, and tears engulfed him.
As he holds down his peristaltic stomach with his hands, he spits out objects in his body like cramps.
Plumping his mouth, when he finally calmed down, Makura looked up at the blurred ceiling.
"What are you doing..."
Crush to a sense of self-derision.
Stand up to support the wall, struggling with the stinging joints.
I've wasted my time. Even though it's suspicious how long the generator fuel might hold.
After changing the dirty things and doing his homework, Makura entered the room where Lunch was, dragging her heavy body.
However,
(Not here...?
It was deserted inside.
The stretcher is being moved.
Surprised, looking around.
Nowhere.
I don't think so, opening the O.R. door.
A man wearing a green surgical dress, a mask and a hat, and rubber gloves on both hands, was waving this one back from the side of the operating table.
"... father...?
The exposed eye area throws a sharp gaze.
Yusuke.
Makura, after a moment of silence,
"... what are you doing?
…………
There is no answer.
On the operating table lay Ryuji illuminated by a shadowless lamp. He opens his eyes and stares at the universe blurred. The arm was wrapped with a sphygmomanometer and the bare chest was equipped with electrodes of an ECG. Did you read the manual while Makura was asleep, the numbers were displayed properly.
Next to the cart on which the appliance was placed, Yusuke is headed for Ryuji. To the sight, Makura hesitated only for a moment.
"... what"
"You're going to have surgery. Cut your stomach, just take it out. Easy win."
"... are you serious!?
"If you're not willing, stay calm. Don't talk."
At Yusuke's feet, surgical illustrative books for residents were scattered, apparently collected from within the hospital. The page remains open and the light of the rolled light is on. He won't touch anything unclean with his hands during surgery, so he's trying to turn it around with his legs and reference it. Even though it's cold, it's barefoot sandals. It was unscrupulous.
Staples for living organisms, apparatus for fastening incised skin with needles are also prepared. Yusuke, who has no procedure, is trying to imitate surgery to the best of his ability.
In addition, my eyes went to the unfamiliar syringe and bottle.
(Ketamine...... I find it often...... drugs that are easy to handle, but that's all I can't maintain)
It's an anesthetic with low respiratory suppression and strong analgesic properties. It is commonly used in unequipped field hospitals, etc., because it does not lower blood pressure.
However, since it is also a psychotic drug, it is necessary to pay attention to patient trends. It's usually used in conjunction with sedatives.
Lung's blurred appearance was a symptom of the dissociative nature of ketamine. Look, there's a patch on the back of my hand. It's an injection trail.
Without even taking the infusion line, you are going to be anesthetized and operated on with a single dose. Makura was relieved by the matter.
"It's impotent......! Stop now."
Yusuke didn't even look back, he threw up in a whisper.
"I don't ask you anymore. I'll do it myself."
"... that's not what amateurs can do! It's probably perforated. You're not safe."
"You're gonna die leaving me alone, aren't you? Grave digging comes after you do what you do."
Yusuke, speaking pale, tried to recruit him, and Makura noticed.
Yusuke's eyebrows and forehead are stunned with sweat.
I saw terrible tension.
Makura realized how it was.
Yusuke doesn't think he can operate successfully.
It's just that cowardly hands won't be good enough to make a child look dead.
Makura stood on the spot, confused.
(I...)
Makura nags.
Feeling the signs of Yusuke walking around carelessly, he eventually raised his face.
"... how did you put your gloves on?
"... nothing. I put it on normal."
"I have a way of wearing this, too. Let's start over with the hand wash. You wouldn't want to kill him with a preliminary infection."
……
Makura went in to prep for surgery, feeling a blurry gaze on her back.
◇
The analgesia was already working, so quickly secure a venous route to connect the infusion. A sedative is administered from the lateral canal to put Lunshi to sleep for a moment.
A urine catheter was placed in the bladder, combined with the rectum, and the body temperature was taken with a probe. Set the pulse oximeter on your index finger and have the oxygen concentration in your blood displayed on the monitor.
The next step is intubation into the trachea.
If we hold down the veins through which the blood flows, and the trachea that takes up oxygen, those two things, we don't care what happens to the rest.
Makura stood by Luji's head and put a mask on his mouth. Lift your mandible with your fingers and secure your airway. If you ventilate thoroughly through your lungs with oxygen, even if you stop breathing with anesthesia, hold it for a while.
Once ventilated,
"Eslux. Please put it to the mark"
In Makura's words, Yusuke puts up a syringe to show. of the muscle relaxant's seal. It is coupled to a tripartite stopcock, halfway through the route of the infusion.
When this one nodded, Yusuke slowly injected the drug to the line drawn with magic.
The drug begins to flow through the infusion tube.
I shouldn't let my amateur assist me, but I don't have enough hands. Procedures and simple operations were taught, and they were always carried out under the supervision of Makura, making them a measure of distress.
The muscle relaxant works in minutes.
Twisted the knob of the vaporizer and mixed the anesthesia with the oxygen of the mask in preparation for intubation.
After a while, Lunch stopped breathing.
Take the mask and open Lunch's mouth with both hands.
Take an L-shaped laryngoscope from the cart, turn on the light, and insert the blade into your mouth. Lifting the laryngeal cranium that had been seen in the back, with his tongue, he saw an airway sandwiched between his left and right vocal cords.
Take the jelly-applied tube with your right hand and send it between your vocal cords. At the end of the insertion while fine-tuning, the guide inside and laryngoscope were removed and temporarily stopped at the mouth with tape.
Check the monitor properly. I took the trouble because I didn't have an assistant, but the oxygen level hasn't dropped yet. Blood pressure is normal.
After connecting the tube out of the mouth to the hose of the artificial respirator, place the stethoscope on the chest.
Makura breathed, making sure both lungs were properly ventilated, not the stomach. Let the teeth bite the byte block and secure it securely with tape to prevent the tube from slipping off.
"And then please"
"Oh."
Change positions with Yusuke. Vital surveillance, such as blood pressure and pulse, is Yusuke's job. During the execution, Makura can't even afford it.
After activating the venous anesthesia syringe pump, re-sanitize it in the operating room hand wash.
Latex rubber gloves should be kept out of contact with the surface.
(... ok)
Get in the mood and go back to the operating table.
Yusuke keeps watching the monitor and Ryuji alternately. Ever since I found out that Makura was really willing to perform the surgery, I've been following instructions, much less words. Inside, I don't know what it feels like.
Anyway, let's finish the surgery safely, Makura thought so.
Stand next to sleeping Ryuji.
First disinfect the surface of the body and apply a covering cloth other than the abdomen.
I took the scalpel from the prepared table and gently hit the pre-defined right lower abdominal point.
…………
After capturing the image, cut open about five centimeters in a breath.
Look at the monitor right away, but blood pressure, pulse rate, not so much change. It's evidence that anesthesia is working. If you are in pain, they will soar.
He switches to an electric female and burns out the fat layer under his skin.
Further tear the lower muscle and peel the silver membrane with scissors. Upon opening to the internal peritoneum, the starter was set and the open part secured. From the small hole, the gut becomes round.
Switch to a long pin set and explore inside.
The appendix was found immediately. Following it, I saw a torn appendix. No adhesion, not so much pus. Peritonitis would be limiting.
This was fortunate because children have thin bowel walls and are prone to severe illness. Maybe because of the antibacterial drugs I was getting in the garrison.
Grab it with a forcep and drag the appendix out to the outside, keeping it from touching the open edge. I felt Yusuke get a little upset about the vid jumping out of my abdomen.
I understood the feeling. Surgery makes a strong appearance of a living human being as an object. Close human surgery is an indication of upset even by professional doctors.
Makura quickly moves her hand, ligating and severing the arteries that lead to the appendix from the tip. Doing it alone without an assistant broke a lot of bones. Even the replacement of the appliance leaves L.A. and takes a lot of time.
all arteries and tied the body of the appendix at the root, when it finally detached the
"Huh..."
The sweat from the carrot caught my eye.
Yusuke, who came next door, plucked his eyelids and forehead with gauze.
Close your eyes and feel that feeling still.
"It was milder than I thought. Thanks for your help."
"... right"
"Is the vital okay?
"Oh."
Yusuke returns to the monitor.
Makura placed the appendix in the tray and sucked away the pus in the peritoneal cavity with a vacuum. Wash the remaining residue with saline.
(Don't you want Drain...)
In severe peritonitis, the tube that leads from the stomach to the outside is left even after surgery to drain the accumulated pus, but that slows the healing. Because it also increases the risk of external infection, it was determined that washing and administering antibiotics would be sufficient.
"Switch off the syringe pump. I'm going to suture you."
Yusuke looks here before the venous anesthesia pump. One of the switches is accompanied by a finger. When Makura nodded, the pump stopped. The injection of anesthesia from the syringe stops.
There was only one more hunch. Even to prevent wound infection, sutures cannot be grated.
When you count gauze and appliances and make sure you haven't dropped anything inside, you switch your hands to a pinset and needle holder and close them with a carefully absorbed yarn, in turn, from the lower peritoneum.
The task of forgetting time continued.
Eventually, when he had finished sewing everything up to his skin, Makura finally looked up.
View the clock.
Surgery is complete.
I took a small breath.
It took a while, but it wouldn't have been long if I'd finished.
It ended well with no trouble.
"Switch to pure oxygen. If you run out of anesthesia, drain it."
When I looked at Yusuke as I said it, I was staring at the monitor with a strange face for some reason.
"Hey... I'm getting a little warmer, is this normal?
"Huh?"
Check the numerical value of the monitor.
36.6°C.
Looking at the record, in 10 minutes, it's up about 0.3°C.
……
Normally, abdominal surgery does not increase your body temperature. Instead, it goes down. To prevent this, there are heating blankets and fluid-warming devices…
Sometimes equipment errors.
"... in the meantime, turn off the heater. Take the drape and cool it."
Take the blanket that was on the extremities and turn off the heating that was moving at your feet. The operating room was ventilated only and the air conditioning was not working, so the room temperature was low.
After a while, Ryuji's body temperature went up even further.
It is over 37°C.
There was a sudden rise in the sense of crisis.
(Sepsis from peritonitis? Or infections from wounds...... And this rate of ascent is too fast)
There was an arrhythmia in the vital.
Oxygen levels are also decreasing.
Makura observes symptoms while increasing ventilation of artificial respiration.
Lunshi never looked painful and stayed asleep, but she was quite sweaty. My neck is slightly tight.
The infusion is replaced with cold saline and diuretics are administered to keep it circulating.
Still, the temperature doesn't drop.
(Did you have any illness? This fever... thyroid?
Take the arterial line and give the blood collected to the blood gas analyzer.
When I started thinking about cooling my body temperature with gastric lavage, the results of the blood gas analysis came out.
low pH. Blood is leaning towards acidity.
Acidosis was awake.
Sweating. Elevated body temperature. Muscle stiffness. Increase in carbonated gases.
One name came to mind, and Makura remembered the war.
(... malignant hyperthermia...)
Extremely rare symptoms caused by vaporisation anesthetics or certain muscle relaxants. Genes are used as factors, occurring in a proportion of one in 10,000 people, but boys have a particularly high incidence.
If you don't do anything about it, your body temperature keeps rising and your muscle tissues collapse, causing kidney failure and dying.
Fatal.
But there are special effects.
(Dantrolene sodium!)
"Wipe your body with alcohol! Whatever, keep your body as cool as you can! I'll get the pills!
It's not the kind of medicine available on the O.R. shelves. Fly out of the O.R. and head to the drug vault.
Turn on the lights, start the receptionist terminal and try to search, but the management system was down.
I'll go into the vault and check the shelves from scratch.
Dantrolene goes into muscle relaxants as a classification, but it is an expensive drug and is not often used except for malignant hyperthermia. As a result, many hospitals pick it up from others in an emergency, without putting stock away.
Existence in this father's hospital was a bet.
(Please... please...)
I just checked half the vault and found a vial with orange powder.
Check the label.
(There it is!
Hold the bottle with both hands and jump to the operating room.
"I'll prepare it now! Flush the route with water for injections!
"Say it more plainly!
Even Yusuke's voice, which leans over the Ryuji, dwells in a rush of color.
Makura breathed,
"When this is used in conjunction with other medicines, it reacts and precipitates in the route. To avoid that, push the contents of the route you have now into your body with water for injections!
"Okay!
Put sterile water for injection into the vial and dissolve the powder. Suck the solution up into the syringe, change places with Yusuke, and inject it into the route from the tripartite stopcock. The finger holding the syringe was trembling.
After a while and time, change came.
The temperature increase stopped.
I'm going to lose my mind, but it's not over yet. We need to calm down the rampaged vitals.
Look at the gap and secure another venous route, slowly returning symptoms while also administering medicines to reduce tachycardia.
It wasn't until two hours later that all the coping was finally over.
◇
After the surgery, Ryuji entered the recovery room.
Through the glass, connected to various monitors, sleeping.
Makura sat by the wall, blurring in a different direction.
"What are you looking at?
A voice was called out to the lid.
Yusuke.
He holds two cups in his hands and looks down at this one.
"... no. Anything."
Answer quietly and receive a cup of coffee.
At the edge of my vision, there was that black shadow. Put me in the shadow, I'm staring at you.
I didn't feel much fear because I ran out of sperm and roots after the surgery. More than that, there was only sorrow.
Close your eyes and slowly open your eyelids as you feel that indelible fragrance of coffee.
The shadow was gone.
Strangely, my grief grew stronger.
Make coffee while Yusuke climbs to the next wall.
"This time it helped. Thanksgiving. You owe me."
"... I'm still worried."
"That's okay. Nothing. Do what you gotta do. Ah."
For a while, silence flowed.
Yusuke basically said that Makura was blurring with the coffee in his hand.
"You, why don't you quit the committee? Whatever you think, you're worn out. You need to do that for someone else?
Makura smiled faintly.
"It's not convincing if you say so. You were desperate to help people's children."
…………
Yusuke frowns and makes a difficult face.
I took a sip of coffee, put it away for a while, then I said.
"That's not true.... If he really matters, you don't think he should cut himself a belly. Probably kill him. Just candle... If it's around the middle of the moon, I think I'm begging you to cry. Throw away your pride. I'm not going to sit down with you to help Lunch."
…………
"He just had a blame. Do what you can and you'll have an excuse."
"... what is the burden?
"You haven't heard from the late moon?
"I heard about that at the supermarket...... But you weren't originally obliged to protect them, were you? It's force majeure to be attacked, and you need to feel so down..."
Yusuke laughed with her nose.
"Didn't I tell you? Well, yeah. I was holding it instead of eating. Deep moon."
Makura grabbed the cup.
Stare at the wavering ripples.
I told him to squeeze it out.
"... for God's sake..."
"It's annoying to just eat."
Makura bites her lips off.
The shock was.
It's an unacceptable fact.
I should have remembered my contempt.
At the same time, however, it also brings back the sights of earlier times. He was desperately uplifting himself in an attempt to help a child whose life was in danger.
Before surgery, when I performed hand and arm disinfection, I noticed Yusuke's arm was scratched. It was an injection mark.
I immediately guessed. Makura also used the same squad of humans and each other as a practice bench when she was a student to practice injections. Yusuke was on his own. An amateur, before the bump production surgery, alone.
The girl at the time that she held it, she didn't have any evil feelings for Yusuke, she even showed her bareback.
Various emotions nodded against Yusuke, not even knowing where to take it, Makura was confused.
It was strange to go out of my way to say for myself what I should hide. He also looked like he was speaking in an outrageous way.
(... he's a freak...)
If it was Makura before, he might have rounded out his disgust and disputed Yusuke.
But in this extreme state, I have already become fully aware of my weakness and filth.
Yusuke doesn't say anything, but Makura was a physician while privately diverting limited medicines. I'm not in a position to say anything about people.
Yusuke goes on to say things like that about Makura's Goto.
"So well... that's a matter of borrowing. I had more duty to protect the three of you than to hold him. I broke it, so this is how I'm running around. I like it. I volunteer. It's not like you. Not at all. I don't know if it's stupid to root until this happens, but thanks to you, I can't say anything."
Are you praising me, or are you making me?
He wants to say that he is different from Makura, a physician of good will.
"... hah..."
Sigh loudly.
"What the fuck?
"Are you having fun getting me in trouble?
"Huh?"
He may have been inspired by Yusuke, who makes his inner self look unobtrusive.
I wondered what Yusuke would think of what I was going to talk about.
After hesitating for a while, Makura opened her mouth.
"Um... can you listen to me"
"What? Don't hesitate."
Yusuke is not interested in making coffee.
Makura slowly let that sight, which was sinking to the bottom of her heart, climb to her mouth as she stared at the floor.
"... before, at the University Hospital... I killed the baby. My mother attacked me and I stayed..."
Yusuke is silent, listening.
Makura continued her words.
"I was selfless obsessed...... In the dark, it looked very nasty. But I don't know if that was a zombie... I could have lived, an irresistible baby... with this hand... Very soft, not very responsive... but the moment of breaking, I knew very well..."
The end of the story was trembling.
That feeling still remains clear.
"... well.... That's tough."
"... is... yes..."
Take a sip of what's creeping up in the back of your throat.
"... you're always looking at me. That kid... I couldn't sleep at night. I need to fill my head...... So I wanted to be forgiven and I've been... holding on to a lot of things..."
…………
Yusuke is stopping the cup from moving in his hand and hovering the universe.
After a while,
"Are you still watching this?
"... I was there earlier. There...... I wasn't as scared as I was before."
"So you were forgiven, weren't you? I don't know. If you leave me alone, you'll disappear."
Makura erupted into that blurry way of saying it. He doesn't seem to comfort people at all.
Wet your tears,
"I hope so."
"Yeah well...... to be honest, you look hallucinating all over the yak and dont pull. You better not say anything but me."
Mm, Makura frowns unintentionally.
Then he dropped his shoulder,
"... right. I'm going to stop relying on drugs."
"I like that. What a waste of beauty."
The movement stops.
Nagging, after a while,
"... what are you talking about..."
My neck was dyed red.
It was unintentional.
"... I'm having trouble being reacted to like that"
"... then why do you say..."
I can't get my face up.
Yusuke said so as to change the awkward air.
"Uh... yeah. You haven't heard about the plan to move to the mountain outdoor center yet, have you?
"... Yes. What is it?
Raise your lit face as you hold down your hot neck with your hands.
Then Yusuke talked about the possibility of zombies coming out on the streets in the spring, and the plan to make a big trip to the mountains in preparation for it.
"Now you, too, may not be able to get out of the committee, but if you move to the mountains, the environment will change, and then you should just focus on doctors and quit? Just make it at the clinic and pull it off. Some old men can count on you."
……
Makura imagined his life in the mountains.
Just a little bit, I felt like I saw hope.
"Right...... Might as well."
"Well, I'm sorry I can't. So much so."
With the intention of fighting back earlier, I joked and tried to say, do you want to live with me, mumbled.
It was going to taste more serious than I thought, and my neck stained red again.