Omake Chapter: The doctor is in.
1640hrs, 10 April 2006, Tokyo, Japan.
"Wherever the art of medicine is loved, there also is love of humanity." Hippocrates.
It had been a long day at Saeko Mizuno's rotation; she had been seeing patients all day and it was about time she could go home and relax…perhaps see her pride and joy, Amy, play in the piano recital this evening, but she had missed so many of those as of late. It was the nature of the job, anyway. That loser of a "husband"…no, he wasn't even deserving of that name, was somewhere off in the middle of the Japanese countryside, painting his life away. Of course, he was ignoring his daughter, just like she was. I guess we're not all that different, after all, she thought to herself as she got ready to see her last appointment of the day.
"Hello Hotaru! How are you doing today?"
The fact of the matter was, she wasn't. Born three weeks early, she had a series of medical problems that made even the most hardened doctor tear up upon looking at her charts. She had a bad heart, with Cardiac Dysrhythmia making her heart beat strangely…sometimes too fast, sometimes too slow. This in turn led to hypotension, in which she could not properly circulate blood sometimes. More ailments followed; Hyperthyroidism, which led to the prevalence of Graves ' disease, also forced her to take more medication for that as well. In addition, she had acute asthma and had been hospitalized several times in her short life for attacks of said aliment. All of these afflictions meant that she was unable to join in the playful activities that many of her peers were able to engage in. And to top it all off, She was allergic to peanuts, cats, grapefruit and gorilla glue, of all things.
It really sucked to be Hotaru Tomoe, then.
"Ms. Tomoe, thanks for bringing her in today. I know that it must be tough on you…but…"
Ms. Tomoe nodded in thanks. "I understand. My husband, Souichi…you know him, right? He's really busy, but he sends his thanks."
Dr. Mizuno bent down to look at the frail child in front of her. She was twelve years old, but looked so small that one could easily mistake her for being four years younger. She wore a black choker with a black turtleneck with a plated blue skirt…it was all so depressing. The chart from the preliminary check from the nurse had said nothing too terribly bad; BP was 70/110. It was somewhat low, but it was certainly an improvement over the last time she was there. Temperature…37.5 degrees Celsius, a little bit high, maybe she had a slight infection somewhere. Heart rate, was normal, again, for someone with her condition.
"Hi Mizuno-sensei!" she said back, trying to gather strength to be cheerful. At least the attitude didn't match the clothing, or her health in general.
"Glad to see you! Let's get up on the exam table, shall we?"
"Okay!" She scrambled up to the table, which had a new sheet of sterile paper for the patient to lie down on, with a small pillow at the end.
Dr. Mizuno did a quick visual inspection of the child. There was no apparent disease or afflictions present; no bruising of her extremities, some minor scratches, her eyes were slightly red from allergies but that wasn't anything unusual.
"Is your head hurting you or anything?"
"No!" was the excited response. Dr. Mizuno continued on with her exam, checking the eyes briefly (that would come later on in the exam), looking for any external rashes or abrasions, then looking for any signs of internal injuries, like bruising. Finding nothing, Dr. Mizuno wrote the fantastical word "Normocephalic" out on her chart…which meant that her head was a-okay.
"Okay, I'm going to look in your ears."
Dr. Mizuno went over to the wall where most of the standard equipment was mounted on the wall; one tool for looking at the ears, an Ophthalmoscope, one examination light for looking in the mouth and eyes, an Otoscope, with disposable covers for the said instrument right near the Otoscope as well. They were black and cone shaped, and several rows of depleted covers indicated that Dr. Mizuno had been very busy today. Other instruments next to the Otoscope and Ophthalmoscope was a blood pressure cuff, and a place for disposing biohazard waste (used needles, bandages, etc).
Dr. Mizuno picked up the Otoscope from the wall mount, and it automatically turned on. She slipped a plastic cover on it and took a peek into Hotaru's left ear. Aside from a significant amount of earwax, the interior was also red.
"Oooh. Are you having some problems with your ear?"
"It kind of hurts there, Mizuno-sensei," she meekly replied. Yet another mark on her chart.
"I'll prescribe some antibiotics." Hotaru looked down at the floor, knowing that it was just another thing that was wrong with her. The chirpiness was gone now, with the barrage of medical tests that she had gone through and the upcoming ones suppressing that energy. It was something that had to be done though.
"Is the pink stuff?"
"Yeah, penicillin."
Hotaru wrinkled her nose at that. "It tastes kind of funny. I don't like it."
"Well, if it makes you feel better, I'll tell the pharmacy to add some flavoring to it."
That made her pay attention. "Really?"
"Of course. It doesn't cost that much extra."
"That would be great! I would like bubblegum!"
Dr. Mizuno shot a look at Ms. Tomoe, who nodded her approval. She wrote down the note next to the prescription so that the pharmacy that the Tomoe family visited would flavor the medicine appropriately.
"Alright, I'm to take a listen to your lungs, okay? Lift up your shirt for me."
Hotaru did as asked, lifting up her shirt and Dr. Mizuno took a listen. Moving her stethoscope around, she listened intently to the lungs. Hotaru shuddered at the cold metal touching her skin, but at this point in her life she was used to it.
"Uh-huh…uh-huh…are you having trouble breathing again?" Dr. Mizuno noticed that every time that she took in a breath, she wheezed slightly.
"Yes, my chest has been tight."
"Have you been taking the steroids that we prescribed?"
"Yes, my mom always reminds me to take them before I go off to school each day."
"Very good." Dr. Mizuno made a note on her chart about that. They would probably have to up the dosage on her medication. Again.
Just to be sure, Dr. Mizuno brought out a funny looking device that would assess Hotaru's breathing. "Breathe into the peak flow meter here," she instructed. Hotaru took the device from Dr. Mizuno's hand and breathed into it as hard as she could. The results…could have been better. The marker that went up and down with the exhaled breath was below the green, much to everyone's disappointment. Dr. Mizuno made her do it a couple more times, just to be sure, but the result was the same.
"Thanks Hotaru," she said to the now depressed girl on the exam bed. "You're doing just fine." That at least brought some spirit back into her, and she smiled. "I'm going to listen to your heart."
Again, Hotaru complied.
Thump thump…thump thump…
"Heart sounds good. You've been taking meds for that as well, correct?"
"Like you told me too!"
"Very good." At least something was going right today; she scribbled down that despite her heart condition, she sounded good.
"Have you been exercising lightly?"
"Mmm-hmm. The gym teachers have been very nice about it."
That was very good to hear. In the face of everything, this little girl could persevere and continue on with life despite the circumstances was unbelievable, and inspiring at the same time. Despite the ear infection and asthma, she was looking much better, mainly due to the fact that Dr. Mizuno had been really good with her.
Dr. Mizuno continued on with the routine exam; the abdomen was okay, the extremities had some cuts and scratches, but that was from the normal wear and tear from a girl her age. The neurologic exam came up clear as well, with all signs pointed to a sharp and alert girl.
Finally, it was over. Dr. Mizuno finished up her charts and went over the prognosis with the two of them.
"…and you should probably get those vaccines I recommended earlier, we can't be sure in her weakened state what will happen. Some people might be able to walk off the effects of Whooping cough, but we can't take any chances. Other than that, I'll get the prescriptions in and they should be ready at your pharmacy later next week. Got it?"
Hotaru nodded excitedly. "Got it!"
"Ms. Tomoe, please make sure that your daughter takes her medications as usual, although you seem to be on top of that particular issue."
Ms. Tomoe nodded. Her eyes flickered to Dr. Mizuno, then to her daughter, then back to Dr. Mizuno.
"Hotaru, would you mind waiting outside for a second? I need to speak with Dr. Mizuno."
That surprised Dr. Mizuno for a second, but it must be important.
"Yes mom." Hotaru exited the exam room and plopped down into a seat in the waiting room, reading a magazine about some new school up north for disabled children.
There was silence for a second, but then Ms. Tomoe started speaking. "You know, my husband is working on some sort of procedure…I'm not quite sure what it is, but he says it might help ease the suffering of my daughter."
That got Dr. Mizuno's attention. She didn't know much about Dr. Tomoe, but from what she did know, he was a brilliant and gifted man. "Really? What is it?"
"I don't know. He's so secretive about those things, you know?"
"Where does your husband work again?" Dr. Mizuno asked Ms. Tomoe.
She smiled, embarrassed. "He works for the Nakanishi Group. Some biological labs, but he won't say much more than that."
"The Nakanishi Group, huh? They've been slowly making their way into the medical industry as of late," Dr. Mizuno said.
"What do you think of them?"
"To be honest, I don't know. They've been doing a lot of good for Japan, especially helping out the flagging economy…but…" Dr. Mizuno hesitated at that, trying to hide her concern.
"But?" Ms. Tomoe pressed on anyway.
"They're demanding of so much. They're looking at this hospital as of late for purchase, and I don't want the needs of the patients to go unmet in the name of profit. They just keep getting larger and larger, like a malignant tumor that eventually kills the patient."
"A tumor…? That's an interesting way of putting it."
"I'm sorry if I spoke out of line. All I know is that I don't want my daughter to grow up having a miserable life under some mega-corp, you know? Even if it does help her life…what's the point?"
"Well, that's very noble of you, Mizuno-sensei." Ms. Tomoe collected her purse and went outside to the waiting room, where Hotaru was waiting.
"Bye Mizuno-sensei!" Hotaru said, smiling brilliantly and waving to Dr. Mizuno.
"Bye, sweetie!"
They left, leaving Dr. Mizuno standing in the doorway, watching the brave little girl walk off, hand in hand with her mother. It was a very emotional sight, and she wished that with her own daughter…
Shit, what time was it? She looked at her watch, and realized that it was almost time for Amy's recital to begin at the middle school. She had been doing quite well at adjusting to the new rigors of middle school, and she hoped that she could keep it up to become a doctor like her.
"Hey, Kawasaki! Can you cover for me! I gotta go see my daughter!"
"Sure!" Dr. Kawasaki said. He was right out of medical school, and starting his internship at the hospital.
Figures, he thought. The interns get stuck with everything. Oh well, at least it was an honor to work with Dr. Mizuno, despite never seeing her most of the time, because she was so busy.
I wonder if I'll meet her daughter at some point. I don't even know what she looks like. Huh.
With that, Dr. Kawasaki went back to doing his work, finishing up some paperwork and continuing on with his shift.