The sterile air of the operating room felt like a cold mountain mist. I, Kuroto Dan, stood over the patient, Rei, a young woman whose life was in grave danger. Her pallid face, etched with pain, reflected the intestinal bleeding she tried to ignore for too long.

The preliminary diagnosis had been alarming - multiple ulcers and 'Rosalia worm' tumors festering within her small intestines and colon. She was a college student studying calculus and accounting. For a whole month, Rei dismissed her bloody stools and gut pains as an abnormally long menstrual period. However, just a few hours ago, she was rushed here by an ambulance - Rei collapsed on the college campus, with thick, metallic-smelling, foamy blood oozing from her mouth. Her boyfriend and her classmates alerted the authorities, and she is on life support - she also has asthma, so she is breathing through a C-PAP oxygen mask with anti-astmatic drugs. Shortly before we wheeled her into the operating room, another doctor took an x-ray of Rei's digestive system - revealing numerous black tumors and ulcers throughout her small and large intestines. The tumors are very likely from the Rosalia worm - Rei rarely eats red meat or processed meats, she has kept a daily meals diary of her healthful (regular) diet. Her favorite foods changed by season. In summer it was hiyashi-chuka noodles and cucumbers/watermelon, but in winter it was oden or nabe hotpot. She usually ate baked toast for breakfast, with vegetables and cheese. It is unknown how she caught a Rosalia parasitic infection, but we know that this patasite is HIGHLY contagious. Since it's August, Rei might've been infected by Rosalia eggs from the water - she and her boyfriend visited a natural spring, which might've been contaminated by Rosalia eggs. The water there was also drinkable and clear, appearing healthy and innocuous, and she reportedly drank some of it.

I adjusted the IVF needles on Rei's arm, securing them into her veins. I administered painkillers into Rei's C-PAP machine, hopeful her surgery shall be painless and successful. 'Alright, Emu,' I said, preparing to cut open Rei's torso as an appendectomy procedure would, with three starting incisions and the needed IVF tubes, 'This girl's life's on the line. Make sure her oxygen levels are OK and her heart rate is OK. Be quick - we can't loaf around. She needs major surgery."

I remembered that Rei had a burst appendix at age twelve in middle school, meaning that Rei had an appendectomy, according to her medical history. She also had reoccuring Clostridium infections as her appendix - the colon's re-populator of beneficial microbiota - was no longer there, and she was also hospitalized throughout her teen years for Clostridium infections and severe colon pains. She also had numerous eczema outbreaks since her appendectomy, one outbreak on her feet. Her gut alternated between constipation.and diarrhea, since her appendectomy at age twelve. At one point, one surgeon wanted to give Rei a colectomy to remove her entire colon, which Rei and her parents refused, due to serious side effects and the colostomy bags required if they were to accept it.

We both knew the risks. This wasn't an appendectomy, which Rei already had many years ago. This was the parasitic equivalent of Tartarus in a charming college girl's guts. The horsemen of the apocalypse - in the forms of carnivorous, human-flesh-eating Rosalia worms and their crazy reproductive abilities. In some cases, they lay giant egg cysts in the heart of a patient, circulating dozens of baby worms throughout a patient's body, sometimes devouring entire corpses to the bones. Similar to octopus eggs, except I like eating octopus eggs with tamari sauce and Sansho pepper. Those damned Rosalia egg cysts remind me of the Chest-Burster cryptids from the movie "Alien"!

Emu handled the initial procedure, a precisive and careful C-section-like precision to access the small intestines. As he worked, I concentrated on preparing the endoscope, the long, flexible tube equipped with a tiny camera, our weapon against the insidious tumors. This endoscope went down the duodendum throughout the entirety of Rei's small intestines, from the duodendum to the ileocecal junction (where the small bowel empties semi-digested contents into the cecum), slowly and gradually. We made sure to burn and apply gel to every ulcer in sight. We made sure to extract each tumor we saw, not missing even one. Rei's vitals were unstable, the rhythmic beep of the monitor a constant reminder of her fragile state.

"Good job Emu! Be careful extracting that tumor," I spoke. "That tumor is right next to the ileocecal junction..."

The journey through the colon was a rather unsettling one. The camera image on the monitor revealed a landscape of decay, marred by ulcers and the monstrous Rosalia cysts. The tumors were like black, pulsating blobs, teeming with incubating Rosalia worm larvae waiting to hatch. We didn't leave behind a single section, but operated on each one - slowly and carefully. Beginning from the cecum and all throughout the entirety of Rei's colon.

'Kuroto, I've located a very large cyst in Rei's sigmoid colon," Emu announced, his voice tight with tension. 'Prepare the suction tube and antibiotic ointment. It needs to be removed quickly.'

I nodded. I carefully enclosed the tumor's edges with my extraction tool, slowly extracting this big cyst. I guided the endoscope further, cautiously maneuvering the delicate suction tube towards the tumor.

Then came hell. The tumor, under the slightest pressure, ruptured, spewing a black, noxious slime that erupted from Rei's body. It was a sickening sight and I almost vomited into the nearby trash can, but I remained calm. The suction tube was deployed, quickly suctioning the toxic slime from the sigmoid colon, followed by a quick application of antibiotic ointment.

Before Emu could even react, I saw Rei's ileocecal junction bulging, and I shifted my focus from the colon to the small intestines. I looked at the monitor, feeling a bit nauseous. The camera showed a writhing, pale creature – a tapeworm, its segmented body anchored to the small intestine's colonic opening!

'Emu,' I said, my voice a low whisper, 'We have a new problem. Tapeworms of a different species..."

With a grim determination, Emu began extracting the parasites one by one, using tweezers to pull out each wriggling worm detectable. We placed each worm into a Biohazard Disposal box. The tapeworms were all throughout Rei's ileum, but none could be detected in her upper digestive system. As we continued extracting the remaining tumors, I couldn't shake the feeling that something was amiss. Nonetheless, we sewed her gut shut, applying antibiotic gel to her closed incisions.

'How are the vital signs?' I asked, my gaze glued to the monitor. "Is Rei alright? Her gut was full of worms!"

Emu glanced at the screen, his face a mask of concern. 'Her heart rate is spiking. Her blood pressure is dropping. Her oxygen is decreasing and she's gasping for air. Her vitals are in the red!"

Suddenly, Rei let out a deafening scream, her body violently convulsing. She banged her head on the table, unleashing a high-pitched encephalitic screech at the top of her lungs. Her heart rate spiked, making the monitor beep quickly and loudly.

"Rei, stop it!" Emu yelled, rying to hold Rei down as she nearly headbutted Emu several times. "Why are you suddenly so violent?" Rei was so afflicted by this sudden seizure and rage, she couldn't speak clearly. Just mumbled, meaningless babbling. Her legs uncontrollably went into kicking motion, with me holding her jumpy legs down.

'Oh shit... Emu, notify the emergency room NOW!" I spoke loudly. "This girl's having a seizure and she's banging her head! Those worms probably got into her brain!" No wonder she can't control her behavior!"

Hell broke loose, as a team of staff held down the seizing girl, applying full-body restraint shackles to her limbs and head. Rei screamed in pain from encephalitis. She was injected with sedatives through the buttocks.

I watched as they strapped her down face-up from her previous face-down position, her eyes squinting with terror, her screams a chilling echo in the cold, sterile air.

We were slightly victorious, but at what cost? The surgery was successful, but the victory rang hollow. As the gurney was wheeled out of our operating room, I felt a deep sense of dread. "Is Rei going to need more surgery?" I asked. "Is she going to pass away from the Rosalia worms? Total organ failure?"

It wasn't over. This was just the beginning.

[model: toolbaz_v3]