"Daddy! Mommy!" a little seven-year-old Aoi Arai ran towards her parents after her cigarette-smoking granny took her to the park. "It was so much fun back at the festival!"
"Mother! Please don't smoke in front of Aoi-chan!" Aoi's worried father said before lifting the tiny girl up his broad, manly shoulders.
"Don't call me Mother! Call me Mother-in-Law, Son-in-Law!" said the granny, who made quite the sight by admonishing a man who was many heads taller and larger than her. "And if she doesn't have asthma, it should be all right! It's not like I'm blowing smoke up her butt like a rooster!"
"Come on, Mother-in-Law..." The father could only scratch his head. He was always such a pushover. A gentle giant.
Her mother, who seemed like a younger version of her grandmother by all intents and purposes, presented her with a gift: A funny-looking paper mache doll.
From atop her father's shoulders, Aoi tapped at the toy several times, seeing it wiggle and wobble but never topple down on the palm of her mother's hand. "What's it called, Mommy?"
"It's an okiagari-koboshi (literally meant "getting up little priest")! It's supposed to bring good luck! An abundance of luck for us who live in 'Good Luck Island' (which was also what "Fukushima" literally meant)!"
"Oh, you mean the thing in that lullaby you sing to me every night!" said the seven-year-old girl who tugged on her father's long, puffy hair like horse reins.
"Yep!" And thusly, Aoi's mother began to hum that familiar tune.
Even at that point of her growth and development, the kid remembered the lyrics well, singing the song while her mother hummed.
"Sleep, sleep, sleep, little one! Why does the child continue to cry? Is the milk not enough? Is the rice not enough? Now, when father returns from the Great Lord's palace, candy will be given to you, and also cake, and a taffy too, and a rattle as well, and an okiagari-koboshi that will stand up immediately after being thrown down!"
Youtou Shinnoken
A Rurouni Kenshin/Yuyu Hakusho Crossover Fan Fiction Story by Chester Castañeda
Original Concept by Chad Yang
The end of the three-part Doctor Arai arc.
Disclaimer: Yuyu Hakusho is the rightful property of Yoshihiro Togashi, Shueisha, Fuji TV, and Studio Pierrot. Rurouni Kenshin is the rightful property of Nobuhiro Watsuki, Shueisha, Shonen Jump, Viz, Sony Studios, Fuji TV, Studio Gallup, Studio Deen, and ADV. This disclaimer also covers all the other copyrighted material that are far too many to mention here. Don't sue me please, I'm very poor.
Chapter 46: Fourth Avenue Cafe (Part 4)
About half a decade later after 1993, around 1998, Doctor Aoi Arai would hear on international news about the case of a certain Jack Kevorkian.
The former doctor was a euthanasia activist who advocated terminal patient suicide assisted by physicians, thus making her revisit this nightmare case and moral dilemma she had back in 1993.
He was best known for championing a terminal patient's right to die with the help of a physician, claiming he assisted 130 patients. While the media portrayed him as Doctor Death, many others considered him a hero who famously said, "Dying is not a crime."
Thanks to an episode of the CBS News' 60 Minutes that was broadcast in November 22, 1998, everyone got to know who "Doctor Death" was.
In the program, Kevorkian allowed the airing of a videotape he made back in September 17, 1998, where he depicted the assisted suicide of a Lou Gehrig's Disease sufferer, Thomas Youk, 52 years of age. He got Youk's fully informed consent in what the Youk Family claimed as a "humane" execution.
She'd then learn, as the whole world who followed the news at the time did, that as far back as 1987, Kevorkian had been advertising in Detroit as a "Death Counselor".
In 1990, he did his first public-assisted suicide of an Alzheimer's disease patient by the name of Janet Adkins, 54 years of age. News items then began to spread about him about how 60% of the patients who committed suicide with Kevorkian's help weren't terminally ill.
His medical license was then revoked in 1991 by the State of Michigan, thus he was no longer permitted to work with patients and practice medicine.
It was because of this fact and many more that led to him being charged with second-degree murder and the illegal delivery of a controlled substance in March 26, 1999.
Kevorkian's attitude about euthanasia reminded Doctor Arai of Doctor Hiroshi Suwabe, their resident "psychic" surgeon.
However, instead of assisting a suicide, the Yamada case was more like the Terri Schiavo case, a legal struggle about prolonged life support in the USA that lasted from 1990 to 2005.
Aoi wouldn't know about the case until it gradually gained traction in the mainstream media from 2001 to 2005, though.
Regardless, as far as the Japanese legal system was concerned, there were no official laws on euthanasia's status and the Japanese Supreme Court never had hard-and-fast rules on the matter.
This was so even though Japan was one of the countries with the highest suicide rates in the world (beaten only by Greenland, Lithuania, South Korea, Guyana, Kazakhstan, and Slovenia, but still part of the top ten suicide-prone countries).
Back at the Fourth Avenue Cafe that fateful Saturday night...
"I have the life of a comatose child in my hands, and I don't know what to do with her. Should I end her suffering by pulling her plug or allow her to go on as her loved ones wish? What would you do if you were in my shoes?" was the question Doctor Aoi Arai posed to Sanosuke Sagara and Kenshin Himura.
A heavy, dense air fell upon the three people gathered in the cafe late at night, their barista busing the tables in silence all the while.
Euthanasia. Mercy killing. It was never a pleasant after-dinner topic. Or a pleasant topic period. It was a hot-button topic for sure.
It certainly wasn't something that should be taken lightly, in any case. Her case wasn't at all like the Kevorkian case she'd later learn about, though.
"I've had my share of mercy killings. Unfortunately," said Kenshin in an attempt to break the ice, and Aoi didn't have the heart to question his statement about another past life claim with a snide remark after seeing the look in his eyes.
She instead rationalized that he must've meant mercy-killing livestock back in their farm from wherever in Japan the four came from, whether it was Hokkaido, Nagano, or the Gifu Prefecture.
Hiding her face behind interlocked hands and staring at nothing in particular, Doctor Aoi confessed the following: "Sano, to be honest, you're the stupidest man I've ever met."
"EH? Is that what you wanted to tell me earlier?! Do you want to pick a fight with me now of all times!?" demanded Sanosuke.
"You really are a dummy, aren't you?" She conked his head and laughed, knowing full-well that it wouldn't even faze Mister Hollow Block Smasher in the least with his brute strength and endurance.
She dabbed a napkin over her eyes after laughing so hard.
"I was really happy to have met you back in that cemetery. You and Yahiko-kun. And Botan-chan. And Ken-san."
Sano and Kenshin both trailed off with respective murmurs of "Doc..." and "Aoi-dono..."
"I'm sorry I can't express myself any better than this, but... those days we've had together were the happiest and saddest I've ever experienced. Bittersweet days."
She smiled, remembering Yahiko's attempts at appearing old even though he was just a teenager by reading up on information about stuff that happened before he (or anyone currently alive) was born, the karaoke night she had with Kenshin, the jealous and passive-aggressive confrontation she had with Botan, and the time when she thought that Sanosuke was about to abduct her.
Okay, so she must've been out of her gourd to think those were precious moments, but somehow they were. As far as she was concerned, they were indeed valuable.
She bit her lip. "It almost makes me want to believe that we've met before, in another life. In another time. Or we'll meet again somehow, in the future. Again and again. Forever."
She then told them about what she found out about euthanasia's legal implications in Japan.
She read up on the subject and consulted with a lawyer acquaintance of hers in her spare time, around the same time she stopped going to the Fourth Avenue Cafe and meeting up with the "Kenshingumi".
At present, only one local case of euthanasia helped define the euthanasia policy of Japan, which happened in Nagoya in 1962. Another incident that would also disambiguate euthanasia laws wouldn't happen until two years later at Tokai University in 1995.
The Nagoya case of 1962 was a case of Shokyokuteki Anrakushi (Passive Euthanasia). It involved pulling the plug, like the feeding tube of a patient, or stopping therapy.
As for the Tokai University case of 1995 (that happened two years later, so back in 1993, Arai only had the Nagoya case as reference), it dealt with Sekkyokuteki Anrakushi (Active Euthanasia), which meant it involved the use of lethal injection or actual assisted suicide.
It came about with a legal precedent about 33 years later after the Nagoya Case.
Both cases ended up with the doctors found guilty of violating laws and conditions when they took the lives of their patients. Furthermore, the precedents set by them weren't necessarily binding.
Regardless, in the Yamada case, euthanasia wouldn't fly and was, in fact, somewhat illegal, according to the lawyer she talked to.
Euthanasia was allowable in Japan if the patient was in the final stages of his or her disease and if he or she expressed consent of dying.
In 1993, they could only be euthanized legally by stopping their IV drip, blood transfusion, artificial respiration, dialysis, chemotherapy, or medical treatment for their condition.
It was up in the air whether or not the Yamada grandchild's condition was incurable, but she definitely wasn't in the final stages of it.
The kid hadn't expressed (couldn't, really) consent to stop treatment, either. Family testimony was out of the question thanks to how adamant her grandparents were of her treatment.
"That's why I wanted to get your head checked for concussions, remember?" she told Sano after relaying the results of her research.
"Hey! Is that another side comment on my intelligence?" he demanded.
"Well, yes, you are an idiot, but I meant you could've ended up in a bad place too, like the kid I'm taking care of, after Ken-san knocked you out. You should be more careful of your body," said Arai. "Head injuries are serious business."
Head injuries could cause brain bleeding and swelling. The fluid from the swelling brain could push it up against he skull and down the brain stem, which could damage the part of the brain that was responsible for awareness and arousal (the RAS or Reticular Activating System).
The Yamadas had two options. Wait for the girl to recover from her brain swelling, which was straining their financial resources already, or they could do risky brain surgery that had a small percentage of success and could lead to her death.
That was Doctor Hiroshi Suwabe's loophole over the family's refusal to do Passive Euthanasia, wherein they pull the plug on the patient in a final act of mercy. Her coup de grace.
"Look, long story short, she has a slim chance of survival by taking an operation offered by someone in the surgery department, but the risks are too great and the old couple funding the operation are adamant to not go through with it," Aoi summarized.
Not that she could blame them. Everyone, from their own family to the insurance company to the hospital having concerns about who'll keep on funding the granddaughter's life support were pulling at them at every direction.
If the two found out the things Suwabe had been telling Aoi, they'd even be doubly wary of letting that "quack" get his hands on their precious little girl.
Because of such remarks at the ER, there were also rumors of Hiroshi serving as the Angel of Death for many an under-the-table assisted suicide. No one had come forth with evidence of this, but there were plenty of suspicion regarding the subject.
Arai wouldn't be surprised if the old couple already heard about the Angel of Death moniker of Doctor Suwabe.
"So what's the problem?" Sanosuke asked. "It's out of your hands and you don't want to do anything illegal. Even if you don't believe in the gods, a god, or the afterlife, why do you care so...?"
"I CARE BECAUSE I WANT TO CARE, DAMMIT!" She didn't mean to raise her voice that loud, her sudden jerking movement making her cup of coffee tremble like a frightened child about to get punished by strict parents.
Sano bowed his head. "I see." When Aoi attempted to apologize, he waved her off. "No, no. It's my bad. Usually, when I fight, I leave it up to fate who lives and who dies, like how a duel should be fought. Leave it to a doctor to have the complete opposite point of view."
"...I want to do something about it. I know I could say something to change their minds, if I only tried harder. But I'm not sure if I should. I'm not sure if I should just bear with it, because it's their decision," said Aoi. "Am I making any sense?"
"Yes. You want to intervene, but something's stopping you from doing so," Himura ventured, sipping his own cup of coffee. "Usually, you have to kill the spider to save the fly. But..."
"...What if you want to save both?" Arai finished Kenshin's sentence. "What if you wanted the best-case scenario possible to happen?"
"You really are just like Kenshin, aren't you?" said Sano. "What did the Christians call it? It's almost like you have a... Messiah Complex. You want to save everyone, even at the cost of self-sacrifice."
"But usually people can't have their cake and eat it too," responded the rust-haired, effeminate man with a cross-shaped scar on his cheek. "Or rather, they can't eat the same cake twice."
"I wanted a third option, but even the third option is as horrible as the first and second ones," she added. "A cultish leap of faith."
"Is it that bad?" asked, perhaps even challenged, Kenshin. "Is it that bad for her to undergo that surgery?"
Doctor Aoi took a deep, long breath and finished what was left of her coffee in one gulp.
"Back when I was young, my grandmother contracted lung cancer. It was a hard and long battle for her and our family. We were never that rich in the first place, and we got all sorts of loans to keep her alive. As long as possible, with her iron lung and respirator."
She could taste the bitterness of her hollow laugh. "We were naive. Foolish. We left Granny untreated for so long, believing in psychic surgery, superstitions, and 'snake oil' medicine that couldn't even provide a placebo effect that we ended up paying for an even bigger hospital bill after she lost a lung."
"So even back then, you wanted to save both the spider and the fly," Sano remarked, but backed off and raised his hands up when Aoi stared at him. She must've been quite the sight. "No offense, Doc."
"No, you're right. We wanted to have our cake and eat it too. We wanted a happy ending so bad when it came to Grandma, we paid for it."
Her mouth turned into a small line underneath her nose as she bit her lower lip.
"It's a terrible thought, but to this day I wondered if we should've just let her pass on, since she was already old. Since she was 'supposed' to die, just to escape our eventual debt."
Of course, Suwabe would've said something different. He would've said her grandmother would've been better off without suffering the rigors of the final stages of lung cancer, since even back when the elderly woman was alive, there was already a legal precedent for euthanasia in Japan.
"Our huge debt forced both my parents to work hard to support me and get me to college. Even then, they put their trust on a higher power. On 'Kami-sama'. Or the myriad of kami. Their faith never wavered even as mine did. It was all about gaman (forbearance) and all that."
But then bad became worse. And worse became worst. The worst-case scenario happened.
One day, Missus Arai had a stroke from the stress of working as an attendant at one of the busiest onsen in Fukushima. She blamed it on evil spirits and a curse from their grandmother's enemies, of course.
This was back when a college-aged Aoi was attending her first year in Fukushima Medical University, at the beckoning of her parents, reassuring her that they'd find a way to fund her somehow.
She meant to take a course in Liberal Arts for Modern Society in Fukushima University back in high school, but when her grandmother died and their finances were significantly depleted, she became more practical with her life choices.
In turn, she shopped for scholarships and funding to assist in the payment of her tuition fees, but she could only get partial payment scholarships because of her grade point average.
Their finances already strained, the remainder of the Arai Family savings went to the mother's hospitalization (much to Missus Arai's chagrin).
Aoi's aunt from Tokyo was the one who covered her mom's bills because what her father made monthly from farming and taking care of livestock wasn't nearly enough to deal with their mounting medical expenses since they were still in debt and couldn't make a bank loan because of that fact.
The young Arai almost quit college to pursue a vocational job to support the debt-ridden family herself. Meanwhile, letters from her aunt told her to cut her losses and keep herself from being dragged into the mire her parents were in.
The worst-case scenario then finally happened when Aoi's mother, after loads of treatment as well as pent-up guilt for ending up sick and becoming a burden to her family, suffered a second stroke and was left comatose, just like Aoi's grandmother.
Aoi's father scrambled for as much money as he could muster to save his wife's life, up to the point of getting short-term payday loans to help her through.
This only worsened their situation, especially when the unpaid debt from before became even bigger, ballooning from carryover unpaid payday loan debts.
Her aunt then sent Aoi a letter stating in not so many words that she might not be able to send any more money to fund Aoi's mother's hospitalization because she had her own family to take care of back in Tokyo.
Remembering the (figurative) hell they went through exactly because they couldn't let go of a dying senior citizen with lung cancer, Aoi... a legal adult and next of kin... gave the go ahead to pull the plug on her mother, right behind her father's back, before their family suffered any further.
She did what they should've done back when her grandmother was sick. Accept loss, grief, and death as part of life and bear with the pain rather than fight fruitlessly against the inevitable.
She did what she thought was right. All the same, despair soon followed. She and her devastated father got into a huge fight about her okaying the euthanasia of her mother.
She could still remember the despair in his voice all those years ago, a husk of the big, strong man she loved and admired.
"I had the money! We could've made it! She could've survived! How could you do this, my own daughter?" he wailed, clumps of checks and paper bills crumpling in his balled-up hands.
Things then got heated. Things were said. They called each other names. Painful half-truths. She called him a failure. He called her a murderer and slapped her hard enough to knock her down in his lividness.
They didn't talk since, not even during her mother's funeral. She talked to her aunt about living with her family in Tokyo, got a scholarship, and finished the rest of her medical studies in Tokyo University.
It was also then that she had to break up with her boyfriend at the time, the strain of her stressful life too much for their relationship to handle; that, and they agreed a long-distance relationship wouldn't work out.
Her father later sent her letters and checks for her Tokyo schooling, but she threw them all away and shut him out of her life, never forgiving him for being called her mother's murderer.
She insisted on getting on-the-job training and working part-time jobs to supplement her needs and pay her aunt rent. She was also working hard to get a medical degree in case her family's debtors decided to go after her or her aunt in Tokyo for payment.
She eventually softened her stance when the letters stopped coming, planning to reunite with her father and help pay off their debt as a full-fledged doctor.
However, just before she graduated, she learned that her father had passed away. By committing suicide.
She drowned in guilt all over again when she heard the news. She'd later learn that her aunt had been saving all the letters and checks she'd thrown all the while, putting it up in a trust fund in her name.
Every last letter Aoi read from her father was a letter begging for forgiveness. Apologizing for being weak and being taken by the heat of the moment from losing his beloved wife because she had her mercy-killed.
Not one letter blamed her for the incident. He told her he was proud of her for being stronger and smarter than he ever was with her life.
All those years he'd been working hard and paying back the debts they'd accrued since her grandmother's and mother's hospitalization, hoping against hope that she, his daughter, would find it in her heart to forgive him and contact him.
She never did. Until it was too late.
When he died, it was also all for her sake as well. In order for her and the rest of the Arai Family to be freed by the shackles of bank debt and rolled-over payday loans, he took out a life insurance plan and checked their statutes and limitations for payouts in case of suicide.
The suicide clause stated that no death benefit would be paid if the insured committed suicide within two years of taking out a policy. Indeed, three years after religiously paying for the premium while at the same time keeping the size of the debt in check, he committed suicide by drinking insecticide meant for his crops.
All the paperwork had been completed and their farm had been sold off in his passing, which helped pay off any and all debts they had. This also left quite a chunk of life insurance payout money that was also in Aoi Arai's name.
It was blood money she donated to a suicide charity in honor of her father. The money he sent her when he was alive, she actually kept for the same reason; to honor "Daddy".
The three sat there in silence. Sanosuke and Kenshin, quite frankly, didn't know what to say.
Aoi broke the ice, getting back to the original topic at hand. "On one hand, I don't want that old couple to get estranged from the rest of the Yamadas and end up using all their retirement money on a girl that might never wake up, with her one foot already in the grave."
She choked back a sob and dabbed a handkerchief over her moist eyes.
"On the other hand, I don't want them to have blood in their hands, signing off the death warrant of their grandchild like I did with my mother. And my father. They're stuck between a rock and a hard place, just like I was many times in my life."
The tears began to flow.
"I wish I'd never said I didn't want Granny to die! I wish I'd never okayed the euthanasia of Mommy! I wish I didn't call Daddy a failure! I did everything I thought was right, but in the end... why did it still all go wrong?! Was I wrong all that time after all? Tell me, Ken-san! Sano!"
Kenshin was the first one who responded. "I have no magic words to say about that, Aoi-dono. You've been through a lot. I can only offer my condolences."
After she calmed down and wiped out most of the tears from her bloodshot eyes, she nodded without looking at the samurai wannabe. "I see. That's fair. Pardon me for making it look like I'm asking for advice. Those were rhetorical questions. I just wanted to vent."
"Was that why you were at the cemetery that one Sunday evening?" asked Sanosuke. "You wanted to vent?"
She answered, "I just felt like wandering there. I heard the parents of my patient was buried there, so I came looking for their family grave to pay my respects. I really shouldn't have done it at night and with a flashlight, though."
"...On second thought," interjected Kenshin after a minute of silence, "I have to ask: What do you really want to do, Aoi-dono?"
"I don't know. That's why I'm asking you what you would've done in my shoes."
"No, what I meant was... what do you want to happen?"
"I want to save that little girl, of course. The problem is I don't know how. I don't know which choice is the right choice anymore. Leave her in life support until her funds last or somehow convince her grandparents to go through an operation with the slimmest chances for survival."
"It's your Catch-22, isn't it? Damned if you do, damned if you don't?" Kenshin said.
She smiled in spite of herself, blinking back the tears in her misty eyes. "Yeah, something like that."
In the middle of Kenshin and Sanosuke imbibing Aoi with inspiring words of encouragement and wisdom on yet another life-or-death situation that was in her hands, her Pocket Bell pager rung her up, requesting her to go back to the hospital ASAP despite it being a weekend.
She felt a sinking feeling in her stomach as, yet again, right before her very eyes, bad became worse and worse became worst.
The comatose Yamada granddaughter contracted pneumonia, and Aoi was needed there for some much needed emergency care. Naturally, this put an even huger strain on the budget of the elderly couple funding their granddaughter's hospital stay, and with it came more calls for them to finally pull the plug.
What should Arai do? Should she do something and not just let the ones funding for the girl's hospitalization do what they wanted? What was the right thing to do? Wait for a miracle? Give up and implore them to cut their losses?
Thankfully, it was bacterial rather than viral pneumonia, which meant that only two days later, on a Monday, the granddaughter's body stabilized with the right medication.
It was expensive medication, though. Particularly strong antibiotics.
Her chills, cough, and sputum with blood subsided in short order, but it gave the old couple enough of a scare to ask, "What were you saying about an operation? Surgery, was it?"
Unlike her with her mother who suffered a stroke twice and went comatose as a result, the grandmother and grandfather still had hope that their little girl would somehow recover. The same way her father did, actually. Once upon a time.
She closed her eyes, remembering what Kenshin told her.
"I don't have all the answers, nor do I pretend that I do. However, with this little girl you want to save, all I can say is don't go into extremes. Take a chance. Have faith. But don't rely only on faith to get you through. Do something about your situation too. If I were in your shoes, that's what I would've done. You can't save everyone, but that doesn't mean you shouldn't try."
She opened her eyes then started explaining the brain surgery... craniotomy or craniectomy, either of the two (she wasn't sure; it wasn't her specialization anyway)... that might ease the swelling in their grandchild's brain and get her to wake up.
Maybe. She proceeded to explain the potential complications and the percentages of survivors undergoing this surgical procedure as well as checking with their insurers if they have coverage for the operation.
At the back of her mind as she talked, she heard Sanosuke's last words before they parted ways as well.
"Do what your gut tells you is right, Doc. I mean, you went through a whole lot of shit, so I don't blame you for second-guessing your intuition. I know that feeling myself. But in the end, it all boils down to doing whatever you believe is right even at the risk of being completely wrong. For what it's worth, I think most of your decisions were right, despite what had happened. Despite all your regrets afterwards."
Lesson learned. The road to hell was paved with good intentions. But that didn't mean the intentions were wrong; it instead meant the ends didn't justify the means.
If she wanted to do the right thing, she should be prepared for failure and the mercilessness of circumstances beyond her control to rear their ugly heads. Regardless, she could only do what she thought was right.
That was all she could do. Everything that happened from then on was all on her, for good or for ill.
She gave the elderly Yamadas time to think things through while their granddaughter recovered from her bought of pneumonia. The very next day, they gave their consent to go through with the operation, aware of how little of their money was left.
This was their last ditch effort to save her. All or nothing.
She then remembered her mother back in a festival when she was seven years old telling her that she should be like the toy she gave him, a paper mache doll called the "getting up little priest" or the "okiagari-koboshi".
"No matter how many times you push the okiagari-koboshi down, it always gets right up. Like bamboo during the storm. It's not like a wall or a rock that stands steadfast until something strong pushes them down, making it hard for them to get back up."
The naive seven-year-old asked while on top of her father's shoulders, "So when I get knocked down, I should go down immediately then get up when the meanie who knocked me down is gone?"
Her mother then laughed. A big, boisterous, unfeminine laugh that she never heard from any other mother she ever knew in Fukushima or Tokyo. "Don't be a smart aleck, you li'l brat! That's playing possum, not being an okiagari-koboshi! Ah, whatever. You'll understand when you grow up! Right, Daddy?"
Her father then gave her sides a little tickle while nodding at her mother his assent. "Yep."
And so she did. At least, she hoped she did.
So be it. She decided to be like the okiagari-koboshi for this operation, come what may.
This was also Aoi's first leap of faith since she erred on the side of caution with her mother's comatose state after her second stroke.
If there really was a loving god or gods, then it was time for him, her, or them to make their presence felt.
Because Hiroshi Suwabe was only a junior surgeon, the actual surgery was done by the Head Surgeon, but with Doctor Hiroshi serving as his Assistant Surgeon.
As luck would have it, after getting her cranium CAT scanned and going through with the surgery, the insurance company actually okayed coverage for the operation (as opposed to the less modest proposal of keeping the child on life support for an indefinite number of years).
Prior to the surgical operation, Arai asked Suwabe what was the difference between a craniotomy and a craniectomy. Apparently, both involved taking a bone flap or piece of skull from the head in order to allow the brain surgeon to reach the brain or, in the little Yamada girl's case, ease interior pressure due to a swelling brain with a low blood supply.
The difference was that a craniotomy involved returning the bone flap while a craniectomy didn't. Craniectomies happen whenever the brain was given more time to get its swelling down.
At any rate, the Yamada granddaughter needed a craniotomy in order to ease brain swelling and (potentially) revive her. A bit of brain and skull reconstruction might also be called for. The main idea here was to reduce the pressure in the skull.
The brain swell and the resulting intracranial pressure (or pressure in her skull) was what cut off the blood supply to her brain, leading to her unconsciousness and unresponsiveness.
A bit of brain herniation or the brain shifting position as well as hematomas also likely aggravated the condition of the patient.
The bone flap (or perhaps a metal plate in case it couldn't fit back) was replaced into the opening in quicker succession since the brain edema should subside faster, if everything went well.
The entire operation took about a full six hours, including the shaving of the girl's head.
Then, two hours later after the surgery, her brain swelling went down and her eyes fluttered open.
She'd finally regained consciousness after all these years.
The miracle actually happened. Aoi knew. She was there, along with the praying grandparents, when she found out.
"Let's feel each other's love with love. Not to lose the touch of love. I will say this no matter how many times, I am sure. You do love me! Don't hesitate. SAY YES! Don't hesitate..."
To the surprise of both the Head Surgeon and Suwabe, the little girl sung the song "Say Yes" by Chage and Aska when she regained consciousness, although some of the lyrics were mumbled or outright wrong, misheard by her young ears.
Her ecstatic grandparents were crying outside the operating room, hearing the young child's voice for the first time in years, crying out her name and thanking the gods for this wondrous blessing.
However, after the song ended, she promptly lay on her bed again and closed her eyes for one final time, never to wake up again after she suffered from cardiac arrest on the operating table, her tiny body unable to take the strain of the operation.
Mere words couldn't describe the howls of despair from the old couple who fought so long and hard to keep their baby girl alive, only to see her expire at the last moment, when she finally woke up.
So close, yet so far.
Doctor Arai herself sung the lullaby her mother sang to her when she was little. Her tribute for the comatose girl who woke up one last time to sing a song to her grandparents.
"Sleep, sleep, sleep, little one. Why does the child continue to cry? Is the milk not enough? Is the rice not enough?"
She held onto the grandmother, gently cradling her and patting her back while the elderly woman shuddered in sobs.
"Now, when father returns from the Great Lord's palace, candy will be given to you, and also cake, and a taffy too, and a rattle as well, and an okiagari-koboshi..."
Sure enough, for good luck, she brought an okiagari-koboshi with her during the operation. The only remnant of her happy childhood.
"That will stand up immediately after being thrown down."
Aoi would later realize that at the time of its release, in 1991, "Say Yes" was played everywhere on the radio. It might've actually been the song the Yamada granddaughter last heard before the car crash that took away her consciousness and left her comatose.
If there were gods out there, they were very cruel. Bordering on sadistic.
The wake and funeral for the little Yamada girl was held soon after.
It happened again. Aoi made the best, most logical decision she could possibly make under the circumstances, and she ultimately faced the consequences of her own good intentions.
Yet again, regret filled her afterwards, making her wonder if they shouldn't have done the operation. Or what if they let the girl recover naturally, without a major operation on her brain?
Even then, hindsight wasn't 20/20. She wasn't sure what would've happened.
Then again, as a doctor, she was going to make a lot of these decisions regardless, so if she was going to get desensitized to all this, she might as well do so early on.
After all, she promised her mother that she'd stand up every time she was pushed down. No matter how many times she went down, she'd rise again. Just like the okiagari-koboshi.
The typical Japanese funeral (known as sogi or soshiki) went about this way: There was a wake immediately after the death, the cremation of the deceased, and the burial within a family grave as well as a periodic memorial service.
Many superstitious ceremonies were observed as soon as the young girl died, including the moistening of her lips or matsugo no mizu (water of the last moment), the placing of a small table decorated with a candle, incense, and flowers next to her bed, and the avoidance of tomobiki (pulling your friends along with you).
The tomobiki was a superstition based on the old Chinese six-day lunar cycle, wherein the second day of the six days was considered a terrible day for funerals but perfect for weddings.
To hold a funeral during that day would mean to curse friends and family of the deceased to death as well.
Worthless gestures; superstitious "lip service", in a sense, like preventing yourself from sticking chopsticks upright on a bowl of rice. Or avoiding black cats.
When the Japanese wake or tsuya (passing the night) for the girl was arranged, her grandparents remained inconsolable, so it was mostly their children and grandchildren that dealt with the whole event.
The Yamadas decided to bury the girl along with her parents in the Aoyama Cemetery. The same place Aoi met Sanosuke and Yahiko.
Aoi, Suwabe, the Head Surgeon, and a couple of nurses that attended to the needs of the young Yamada girl were invited to the wake. Doctor Arai, in turn, invited Himura, Kamiya, Sagara, and Myojin over.
Nearly all of them came except Botan, who said she had business to attend to, but promised to be there in the kokubetsu-shiki (funeral proper). Both her and Yahiko were already briefed by Sano and Kenshin on what had happened and whose funeral they were attending.
For the event, all the men wore black suits, black ties, and white shirts. Meanwhile, the women wore black kimonos or dresses. The guests also carried juzu (a set or prayer beads) as well as condolence money enclosed within black-and-silver envelopes.
A fight actually broke out during the wake. One of the sons of the old couple, probably the eldest, grabbed hold of Doctor Suwabe and lifted him up by his collar.
"You... YOU! How dare you go into this wake! I've heard about you from the other nurses, how you kept on pressuring everyone in the ER to simply euthanize my niece! You MONSTER! You probably botched up the surgery in order to kill her and get her out of your hospital's hair!"
Doctor Arai was about to interject that this wasn't the case when, out of all people, the grandfather of the deceased was the one to separate his son from the middle-aged surgeon.
"That's enough. We're here to pay respects, not start a fight."
"Why are you protecting him, Father?!"
The grandmother then spoke, addressing the comatose girl's uncle. "We invited Suwabe-sensei over. We know he'd been advocating for passive euthanasia all this time."
"Then why...?" demanded the son, who had his arms pinned by his elderly father.
"He helped wake her up. We were able to hear her voice for one last time, and the Head Surgeon said he couldn't have done it without Doctor Suwabe. He didn't botch the operation. Let him pay his respects."
And so the tense, volatile moment was defused. Then again, Doctor Suwabe left soon afterwards, whispering to Arai, "I know when to take a hint. Please extend to them my condolences, would you? Thanks."
She along with Kenshin, Sano, and Yahiko were seated somewhere in the middle while the immediate relatives were seated closest to the front.
They observed all the related ceremonies for the funeral, from offering incense three times to the incest urn in front of the girl who passed away to the Buddhist priest completing the sutra, which signaled the end of the wake.
She left along with the Kenshingumi while the girl's grandparents and several of the closest relatives held a vigil with the deceased overnight inside the same room, but not before saying the following parting words.
"I don't believe in the afterlife, but it's times like this that I wish it exists," she said to the old Yamada couple with a low-key bow before excusing herself.
Outside the funeral parlor, Kenshin grabbed hold of Aoi's shoulder and squeezed it tight, speaking for the first time with words that weren't greetings or hellos.
"How do you feel?"
"Terrible. I think I made the right decision, but I can't say that out loud while attending the funeral of a patient that I was supposed to protect. Cognitive dissonance."
Kenshin sighed deeply. "I know the feeling. You're asking yourself, 'Did I do the right thing?' 'What was I supposed to do?' 'Would it have been better if I did this or that, or if I didn't do anything at all?'"
"Yes. All that and more."
"You did nothing wrong," said Yahiko from behind Kenshin and Aoi, then Sanosuke chimed in, "The brat took the words out of my mouth, Doc."
She turned at the pair and smiled. "I wish I could believe you."
The funeral proper was held immediately after, on the next day, and this time around, it was the boys of the Kenshingumi who had to opt out, with Botan (or Kaoru, depending on her mood) standing in for them.
The only problem, of course, was that even on that day, Botan ran late. 'Maybe she was busy dyeing her hair back to its original color so that she won't stand out like a sore thumb during the funeral,' theorized Aoi. 'I never did ask her what her job was. Is cosplaying at Akihabara a job...?'
However, once again, Doctor Suwabe made a scene, this time at the reception area. You'd think he'd learn from the wake yesterday! He said he'd be in his best behavior this time around, but yet again, he apparently lied.
Or rather, the doctor who was normally suave to the point of being a bit of a creeper or a stock villain appeared agitated the moment he saw the guest list.
"Please calm down, sir!" the receptionist said.
"I am calm! Now tell me, who is this Kamiya person in your guest list?!" Suwabe demanded.
The attendant scratched his head. "W-ell, sir..."
"Suwabe-kun!" said Doctor Arai, pulling him aside as she bowed and apologized to the receptionist. "Behave yourself! Kamiya is my guest! I had her listed on there because she's running late."
"H-Her...?" he asked, his mouth agape.
"Yes, her. Kamiya Kaoru. Or Botan. Her... um, nickname. She's a friend of mine that I recently met."
The doctor then deflated like a balloon, taking out a handkerchief from his pants pocket and wiping the bullets of sweat that formed on his forehead.
"Oh, thank goodness. I thought... well, that name referred to someone else for a moment there. Hehehe." The surgeon scratched the back of his head.
Doctor Arai shook her head. It was rare to see the euthanasia activist ever being fazed by anything. "Who did you think it referred to? Your ex? A loan shark? A disgruntled customer from your psychic surgery scams?"
He laughed out loud at that last suggestion. "Er... something like that." He adjusted his collar and tie. "Let's just say he's someone I used to know. From another life."
She just stood there as her colleague walked away, his hands in his pockets, to pay his respects to the girl whose life he almost helped save.
What the hell was that all about? 'Goddamn that Suwabe. He's always making all sorts of trouble.'
The same ceremonies that were done in the wake were also done in the funeral, with incense being offered to the deceased while the priest chanted in sutras.
The girl then received a new Buddhist name... the kaimyo (precept name)... which was written in kanji. As the superstition went, this prevented the dead from returning if their name was called, because they now have a new name.
The kanji for the kaimyo were usually so old, obsolete, and esoteric that so few people (aside from the Chinese) could read them. Also, the bigger the donation to the temple, the more complicated you could make the name for the deceased.
Again, the "supernatural" had a way of making profitable business, like those herbal medications and psychic surgery services availed of by Aoi's grandmother and mother.
'What's keeping Botan so long to get here?' Doctor Arai wondered as she looked at her watch to check the time. 'The funeral is about to end, and the cremation is about to...'
She stopped in mid-thought after hearing a familiar song being hummed at an alleyway away from where the funeral was taking place.
She remembered that song well. It was "Say Yes" by Chage and Aska. Hearing the song served as a pinprick to her heart.
Aoi turned, only to find a little girl in a bright sundress blink at her. Blinked back tears, to be exact.
Was she a lost daughter of one of the Yamadas' acquaintances? Was she even a guest? She wasn't following the dress protocol. Or perhaps she was one of the relatives of the deceased? A cousin, maybe?
"Hey there, little one. Are you lost? Don't worry, I'm here to help."
The girl could only look at Aoi sullenly before saying, "I'm not supposed to talk to strangers."
"Er... What a good girl you are! If you're doubting me, then maybe we can find a Mister Policeman to help you out, right? That's what your parents told you, didn't they?" Aoi amended.
Aoi smiled and brushed a lock of her hair behind her ear. This child was probably the same age the Yamada granddaughter was before her accident happened.
The girl smiled in kind. "Yep! Please do... Obaasan (Auntie)!"
That also gave Arai a pinprick in her heart, but for a different reason altogether. "I-I'm not that old, kid. How about calling me Oneesan (Big Sister) instead?"
The little girl looked at the big girl funny. "But you look too old to be an Oneesan."
'Cheeky little brat, isn't she?' Aoi thought with a strained grin while rubbing the girl's head with one hand, which made the latter yelp, "Owie! That hurts, Obaasan! I mean, Oneechan! Please forgive me...!"
Harrumphing, Doctor Arai grabbed hold of the young girl's hand and asked, "Where are you parents? Did they come with you to this funeral or did you get lost here? If we can find them, we won't have to go to the police."
The kid stared blankly at Arai, looked away, and nodded.
The funeral hall was silent and solemn. Everyone took their turns bowing and greeting each other as well as placing incense at the incense urn of coffin of the deceased, a smiling picture of hers placed in a picture frame, while at the same time, the guests performed the same ritual at another location behind the family members' seats.
Because Aoi was a guest, she went and offered incense from behind the family members' seats while accompanying the lost girl, who did the same.
None of the Yamadas recognized the child Arai was with, though, so the doctor assumed that the girl wasn't a cousin or the daughter or niece of any of aunts and uncles of the deceased.
The kid soaked in everything she saw, staring at each and every one of the family, friends, relatives, and acquaintances of the Yamadas like a tiny, observant owl, her eyes as wide as plates.
Arai murmured, "Have you seen them yet? Your parents, I mean."
The girl merely shook her head, humming that familiar little ditty all the while to herself. Then she let go of the doctor and ran towards the non-guest part of the hall, right next to the casket where the deceased lay.
Aoi shouted out after her, "Hey, you!" forgetting that she hadn't asked the little girl for her name, and realizing she was in a funeral and had interrupted the drone of the presiding priest, which made her apologize profusely at everyone around her.
This was going to be a long day, wasn't it?
The girl peered at the coffin and the picture before it, which made Aoi stop. Look. And compare. She realized something. Something unbelievable.
No. No, it couldn't be. That was... stupid and illogical. The doctor pushed the thought away, deeming it nonsense.
The child then ended up in front of the Yamada grandparents just as Arai caught up with her. 'Dammit,' the critical care doctor thought.
By impulse, the kid hugged both the grandpa and the grandma before her. The doctor couldn't bow and apologize enough at the two after what had happened, but thankfully the grandparents didn't mind.
The only way things could get any worse if the kid started humming that love song that served as her comatose counterpart's elegy.
"Oh dear me, is she yours...?" asked the grandmother, whose eyes strained at the little girl. Misty eyes, in fact.
"NO!" Aoi yelped, then amended, stammering, "N-No. I just, you know, found her. I mean, she's someone else's. A lost child...!"
The grandparents chuckled, and the grandmother said, "I was just kidding. You're much too young to have a child this old, Doctor Arai."
Arai sighed and relief, then pouted when the little girl tugged at her dress and said, "You look way too happy after hearing that, Oneechan."
The grandfather laughed heartily, adjusting his glasses. "Now, now, Sweetheart. That's a rude thing to say about the good doc..."
His smile became crooked when he got a good look at the girl's face. He then continued. "Be a good girl and stop teasing her, okay?"
The girl grinned with both rows of her teeth showing. "I won't. I like Doctor Arai, Ojiichan (Grandpa)!"
He patted the little girl's head and turned away, his wife grabbing his arm and holding her head against his shoulder.
Arai bowed again and had the little girl with her bow long with her by putting her hand of her head and pushing her down. "I'm really, really...!"
"Doctor, what if..." the grandfather said, looking up to the sky, his back turned on the two, "she was awake all that time and not just sleeping?"
Doctor Arai pondered his question.
There had been cases wherein what was diagnosed as comatose and completely unresponsive or even in a vegetative state was in fact suffering from locked-in syndrome, where the mind was conscious but unable to communicate because the body was shut down.
It was only after the comatose person woke up and revealed he heard everything that everyone said to him that doctors could know that he was conscious all the while, when they thought he was unconscious.
For many, this was a fate worse than death. Being aware but unable to do anything about what was happening around them. Like someone watching a show of their life and not able to change the channel.
Helpless. Alone. Slowly being driven to insanity.
"I couldn't say, but we were fairly sure she's comatose and unconscious all this time, so it's better not to think about it," said the doctor.
"If she was, then I do hope she'd find it in her heart to forgive us for making her suffer for so long."
Doctor Arai opened her mouth to speak, but no words came out of it. What could she possibly say to that?
The little girl, of all people, told the grandparents, "Don't be sorry. She can't be mad. Because whenever she woke up, you were there. She never felt lonely."
Doctor Aoi went down on one knee and covered the child's mouth too late. Out of the mouth of babes indeed!
The senior citizens turned towards them together, their eyes a cascade of tears.
Aoi sniffled. Dammit, now even she was getting misty eyed. "She's right. You tried so hard for her sake. If she was awake at the time, there was no way she'd ever hate you. No granddaughter would think that. No daughter would think that."
An image of Aoi's father, the man whom she regretted not having said sorry to all those years ago, flashed before her mind's eye.
The grandmother cried onto the grandfather's shoulder while he could only take off his glasses and wipe his own tears, nodding at the doctor. "I suppose you're right. Thank you. Thank you for everything, Doctor Arai."
Doctor Arai and the little girl she had with her went to the parking lot to look for the latter's parents when they heard someone say, "AHA! There you are, you sneaky li'l brat!"
Finally. It was about time Aoi found the parent or sibling or relative of this lost girl.
"Eh? KAORU!?"
"Eh? MEGUMI...?"
"It's not Megumi, it's Aoi!"
"W-Well, it's not Kaoru either, it's Botan! So there!"
To Aoi's surprise, the person that was looking for the girl she found humming and crying alone in some blind alleyway was none other than the kimono-wearing, bright-blue-haired Botan.
Also, to the doctor's chagrin, the ponytail-wearing girl still had loud, Akiba-grade (or Shibuya-grade) sky blue hair that clashed so much against her black with grey-trim kimono, it seemingly shone like a neon sign in the dimness of the parking lot.
And here Arai thought Botan was late because she actually had enough consideration to dye her hair a normal color before attending a funeral. Alas, she still ended up looking like a Shibuya girl with Visual Kei or Hair Metal neon-colored hair.
"Where were you? You were running so late, I expected you to not come!" asked Aoi, who then noticed the little girl hiding behind her. "What...?"
Botan knelt down and extended her hand at the girl. "You've had your fun, right? It's time to go."
The girl shook her head. "No. There's one more thing I have to do. Please?"
Doctor Arai stared back and forth at Botan and the girl before putting two and two together. "Hey, waaaait... Is she your kid from Kenshin?"
Botan choked on her spit. "WHAT IN THE SEVEN HELLS ARE YOU TALKING ABOUT?! NO, I'M NOT HER MOTHER! I DON'T LOOK THAT OLD, DO I?"
"Jeez, okay, okay. Fine. She's not your daughter. Bite my head off, will ya?" said Aoi with a sigh. Whether it was in relief or something else, she couldn't tell.
After Botan composed herself, she said, "I'm babysitting her. I'll be delivering her to her parents tonight."
"Ow! Ow! OWIE!" said the little girl while Doctor Arai twisted one of her ears.
"Oooh. So you're saying that she didn't come here with her parents and that she came here with you, huh? Faaascinating."
The child apologized, "I'm sorry for lying! Please forgive me, Oba... Neechan! OW!"
After Aoi let go, Botan told the girl, "You mustn't lie. Your parents are going to get upset with you if they find out you've been naughty. You have quite the journey ahead of you, after all."
Aoi raised an eyebrow even as she felt the little girl's hands tighten their grip on her dress. "'Journey'?"
"She's leaving Japan for some... foreign country where her parents are," explained Botan before turning towards the kid. "Let's get this over with, shall we?"
The doctor then asked, "Still, bringing a kid along to a funeral? Can't you just visit an amusement park or something?"
The blue-haired girl patted the child's head. "It was all her idea."
"Are you friends or classmates with the Yamada girl or something?" asked Arai.
"Yeah. Kind of. They share similar circumstances," answered Botan for the kid before asking her, "Have you said your goodbyes?"
The little girl answered, "I want to do one last thing. I promise I'll go after it's done, Obaasan!"
The leering Botan pinched the girl's chubby cheeks. "My, my! What a precocious kid you are! What was that again?"
"...Oneechan," corrected the girl with a pout while rubbing her cheeks. "You're just like her."
"What's she talking about?" Botan asked Aoi.
"Beats me," answered Arai with a bite of her lower lip while the child covered her mouth to giggle at the both of them.
And so the three females attended the final moments of the Yamada funeral ceremony, which involved placing flowers in the casket around the deceased's wigged head and shoulders prior to it being sealed and carried to an elaborately ornamental hearse headed straight to the crematorium.
Many days later, her ashen remains was buried in the family grave at Aoyama Cemetery, right next to her mother and father's respective plots.
After that was over, the girl tugged at the doctor's sleeve. "I'm ready to go now."
Arai nodded. "Okay."
The two turned towards the grandparents and bowed while Botan, the newcomer guest, followed suit. "Goodbye, Mister and Missus Yamada."
"Goodbye, Doctor Arai. Goodbye, Miss...?"
"Botan. Botan will do. I offer my condolences for your loss, Sir. Madam."
The kid then said, "Goodbye, Grandpa! Goodbye, Grandma! I hope we see each other again someday!"
The elderly couple waved back and said, "Goodbye! Be a good girl now, y'hear?"
As the trio left and prior to Aoi heading in another direction, back to Sanno Hospital to complete the rest of her shift, she heard the kid hum a new tune that wasn't "Say Yes". It sounded more like a lullaby this time.
Before clocking out, the doctor realized that it was the same tune to the okiagari-koboshi lullaby that her mother used to sing to her.
She then felt goose bumps form all over her body as a spine-tingling chill traveled across her back.
The day immediately after the funeral, a Thursday, at the Sanno Hospital...
"You did a brave thing, Doctor Arai," said Doctor Suwabe. "You did something none of the other doctors assigned to the Yamada case had the guts to do. You should be proud of yourself."
"Don't take this the wrong way, Suwabe-kun, but I don't want to hear that from you," said the no-nonsense Doctor Arai, still recovering from the strange events that transpired yesterday.
She looked at her doctor's orders for the day and groaned.
Of course. Of course she'd be assigned to another comatose patient after going through the emotional rollercoaster that was the Yamada case.
"So this time, it's... Yukimura." Comatose for roughly two months. Unusual case. No brain damage. Abnormal temperature changes. Otherwise healthy.
Just Aoi's luck to be assigned a potential "zebra" case.
Incidentally, a zebra in medical slang meant an unusual medical condition with the same symptoms of a more commonplace one.
It originated from Doctor Theodore Woodward's instructions to medical interns: "When you hear hoof beats, think of horses not zebras."
To Be Continued...
Kind of immature of me, but the name of Megumi Takani's reincarnation and even Doctor Minoru Kamiya's alter ego moniker came about through Japanese names that sounded a lot like Filipino terms. Multilingual puns, if you will.
Arai sounds like Aray (Ouch) in Tagalog, while Suwabe is a reference to the Philippine corruption of the English/Old French word Suave (as in "Mister Suwabe" or "Mister Suave"). I think it's the same word... spelling and all... in Spanish too, but I'm not sure.
Arrivederci,
Abdiel