Rememdium
I: Venenum / Venom
Original post: 04/03/13
Her thin, forest green Motorola Minitor pager beeped incessantly. Springing up from her desk she briskly walked towards the door, paperwork forgotten. She opened the door hastily and pulled it to a close. Her heels clicked against the ceramic floor in a rapid tempo as she turned her pager off. She didn't like heels as they didn't allow fast movement but she was required to wear them as part of the dress code. She began clearing her mind of any negative and worrying thoughts. Her champagne pink hair that hung down to small of her back was now being pulled up into a simple bun. Pulling a barrette from her coat pocket she clipped the rebellious strands away from her face. The doctors and nurses steered clear of her path as this was a daily occurrence.
The windows reflected the pink-orange from the setting sun onto the shiny floors. Her face became stoic as she opened the doors the Accident and Emergency department and made her way through the corridor. One of the nurses scurried from behind the desk with a clipboard walking down the hall briefing her. As she reached the room she greeted the parents and brother of the patient before she walked inside. The mother of the patient insisted that they go inside while the nurses disagreed and argued but she was full of understanding because what mother wouldn't want to be next to her child? Unfortunately, she had to explain to the mother that she couldn't enter the room. She washed her hands at the sink before carefully drying them and slipped on latex gloves.
Her patient was currently lying down as he was unable to sit up. His loss of motor and sensory function didn't allow it. She started to pity him until she remembered most people didn't like to be pitied.
"Alright Sato, Kiroki and Nakamura we need to work quickly before the paralysis takes full effect," she rushed towards a table with bottles of strange liquids on it. "First, the toxin has to be expelled from his body by inducing vomiting since he hasn't started." Nakamura, her medical student, had a clipboard in her hand to record everything.
She turned to the patient and inquired, "Can you swallow?" After witnessing his inability to swallow she ordered the nurses to flip him over so that his head hung over the bed. Placing a plastic tray under his head she opened his mouth and poked the back of his mouth with a tongue depressor. She allowed him to spill the contents of his stomach into the tray. She gestured to the respirator machine. As the nurse placed the mask over the patient's mouth and nose she turned the respirator machine on.
Looking at Nakamura with the clipboard she explained, "The respirator maintains cardiovascular function until the toxin is completely removed." Moving back to the table she searched for a particular bottle that was missing. "Kiroki, where is the antimyasthenics*?"
Kiroki replied, "Watanabe-san refused to send any up." Sakura's viridian eyes narrowed at this sentence. Speaking into her pager she said, "Watanabe I need some physostigmine* stat." Looking at Nakamura she explained the need of physostigmine as it restored motor strength. Turning to Nakamura she asked, "Does he have asthma or any breathing problems?" After Nakamura shook her head she patiently waited for the antimyasthenics and sat in one of the few reclining chairs around the room.
She looked at her watch and then at the patient. It had been twenty minutes since the immediate symptoms occurred and he was currently at stage one giving her just about forty minutes to finish the procedure. The Cholinergenic would take about thirty-five minutes to take effect. This procedure was cutting it close. She beeped Watanabe's pager again and a nurse answered it. "Haruno-sama, Watanabe-san just left for lunch." After hearing those words she felt a headache. The nerve of that woman!
Looking at her watch again she dug in her pockets for a set of keys. "Nakamura you have more experience in Tetrodotoxin poisoning so I expect you to page me if the symptoms become stage two, especially if paresthesia occurs. He should experience muscular contractions and hyperventilation. Putting on a stoic demeanor she walked out of the room towards the elevator with a faster tempo than when she was arriving.
Reaching the elevator, she pressed the button and folded her arms as she became impatient with waiting. When her pager beeped again she was ten meters from the room. "Haruno-sama, he is hyperventilating and about to go into a panic attack."
"I'm approaching the room right now. Prepare some alcohol on a cotton ball," she answered. Less than thirty seconds later she entered through the doors and shoved the needle to the hands of one of the closest nurses. Striding to the sink she took her gloves off, washed her hands and replaced the gloves. Walking toward the patient she allowed one of the nurses to apply pressure to his arm before she wiped the intended injection site with an alcohol-soaked cotton ball. She then held the needle up tapped it and then placed the needle into his skin slowly pushing the stopper down. "Kiroki and Uchiha-san, if you could hold down the patient before he goes into a panic attack." After removing the needle she applied pressure to injection site to stop the blood from oozing. She applied alcohol to another cotton ball and wiped the area and placed a small circular bandage on the area.
"It will take about two minutes for the asthenics to take effect. Then a further thirty minutes for the asthenics to take full effect. He will have to stay overnight," she said to Nakamura. Turning to Kiroki she said, "Remind me to dock Watanabe's pay. Better yet remind me to submit her name to Tsunade-shishou. This isn't the first time she pulled a stunt like this." Checking the patient's heart rate, eyes and blood pressure she turned to Nakamura. "Hmm…decreased heart rate, miosis*, narrowed airways and decreased blood pressure due to vasodilation*." She told Nakamura they were normal signs that the physostigmine was working. She sat down at the desk, moved the clipboard and began to write her notes. Looking towards the patient she saw him sleeping peacefully. "He needs food when he wakes up."
Her patient was being discharged at three. An hour after the Tetrodotoxin removal her pager beeped and she had another emergency to tend to. After she finished the removal of a spine from a sea urchin from penetrating a major blood vessel in a young child she visited the room again. Everything was going well and there were no symptoms to show that his body was rejecting the antimyasthenics. She left again after her pager beeped.
With thirty minutes before his projected release, she stopped by the room one last time. She had a brief conversation with the patient's father. "Uchiha-san, we would like the Umibe no shīfūdo restaurant investigated. That's the third Tetrodotoxin poisoning this month and about the fifth for the year. Usually, the chefs leave just a little bit of toxin to tingle the tongue but the dose on that fugu dish was lethal. People who notice the signs late could die in that restaurant."
"Well the restaurant has seemed suspicious lately and we wanted enough evidence to do a full-scale investigation. These incidents will help us with that," he responded.
The mother and father of the patient both thanked her and invited her to dinner which she politely declined. She sent Sato in her place. Her job took up most of her time so she was unable to take part in such lighthearted things that often.
Later that week after the investigation Fugaku Uchiha stopped by her office.
"Apparently someone paid for the overdosed fugu to be delivered to me. Unfortunately, my son ate it instead of me. It seems as though there is someone working behind the scenes to assassinate people. I would like it if your department could keep a lookout for other incidents similar to these," he asked. Sakura complied.
I changed a few things because the inconsistencies were killing me and it wasn't developing realistically. Sorry that it has so much medicine. This kind of stuff is interesting to me and I often find myself researching this instead of what I'm supposed to be doing. I want this story to develop properly unlike my first fanfic. Bear with me a little while.
Tetrodotoxin – protective toxin found in fugu, frogs, and newts; inhibits Sodium channels causing nervous system deterioration in a matter of 20 minutes to 8 hours which left untreated results in death
Antimyasthenics - an agent that counteracts or relieves muscular weakness
Physostigmine – an antimyasthenic that reverses the effect of anticholinergic drugs in this case, Tetrodotoxin which inhibits Sodium channels causing nervous system breakdowns.
Fugu – Japanese puffer fish
Miosis – the contraction of the pupils
Vasodilation – blood vessels dilate allowing more blood to flow through decreasing the pressure that the blood is under, usually caused by medicine
