Title: Kotaro's Fight to Live
TW: Surgery, mild swearing, parasites and blood. Rated T/Teens and up.
The sterile smell of antiseptic filled the air as Emu Hojo fired up the surgical lights in the operating room of the Neo Zeal Hospital. The brilliance of the bulbs illuminated the anxiety etched on the faces of the medical team, but Emu stood firm.
Beside him in scrubs was Kuroto Dan, a brilliant but enigmatic surgeon whose ambition often teetered on the edge of obsession. Kuroto's demeanor was cold and calculating, his eyes sharp as he reviewed the charts for their young patient, Kotaro, a mere eleven years old. Kotaro was a middle school boy from Okayama, Japan - a prefecture known for its white-pink peaches, the lefend of Momotaro, and traditional Japanese arts. Kotaro loved science, P.E., and mathematics.
Tragically, Kotaro collapsed during P.E. while moaning in pain, blood pouring from his mouth amid convulsions. A week prior, Kotaro had persistent coughing and wheezing in school, but his parents and pediatrician believed Kotaro had a mere sore throat. Kotaro was tested negative for strep throat and viruses, so he wasn't given any antibiotics - just stronger anti-astmatic medication. Moreover, Kotaro had a moderate asthma diagnosis since he was in kindergarten, and he was never without his inhaler in his randosel backpack. But when Kotaro collasped on the school's P.E. campus, everyone knew his life was in grave peril... A swift X-ray diagnosis revealed the malignant tumors growing inside his lungs, threatening to take not just his life but also his future. Kuroto and Emu knew the X-ray wouldn't rule out the need for an upper endoscopy - an endoscope to carefully film what's wrong in Kotaro's lungs.
"Ready?" Kuroto asked, donning a surgical mask to avoid spreading germs. "We gotta save this helpless boy's life!"
Emu nodded, his resolve unwavering. "Yes, Kuroto. Kotaro's lungs are as inflamed as a California wildfire..."
As they scrubbed in, the atmosphere in the operating room morphed into a chaotic blend of urgency and tension. Nurses prepped the instruments while anesthesiologists monitored Kotaro's vitals. Kotaro's arms were covered in IV needles and secured by medical tape - the IV needles and IV fluids kept Kotaro's blood, oxygen, and nutrient levels stable during the procedure. Emu glanced over at the young patient, sound asleep, a peaceful expression resting on his face that belied the battle raging within his respiratory system, as if moderate asthma wasn't enough.
"Kotaro has had many asthma attacks alongside acute atopic dermatitis (eczema), but he's never had an extreme respiratory episode like that before!," Emu said, his voice slightly shaken. "This is the first time he's coughed up blood. His tonsils are somewhat inflamed as well, but no pus is being discharged from them."
"Kotaro was tested negative for all kinds of viruses and harmful bacteria, so it's probably a parasitic respiratory infection," Kuroto replied, his voice unyielding. "The endoscope will help us see what's going on." Carefully, Kuroto and Emu guided the endoscope down Kotaro's windpipe, slithering down into the boy's lungs as gently as possible. They began with the left lung.
"Not good," Emu spoke, viewing the endoscopy screen. "Kotaro's left lung is heavily inflamed and red."
"Emu!" Kuroto spoke, pointing at the screen's footage. "Do you see it? The lung tissue and bronchi have lots of white dots on them. They're probably filled with pus, so be careful..."
Emu redirected Kuroto's attention to a large tumor. "Kuroto, we'll deal with the tiny dots soon. First, we must extract that large carcinoma near the bronchial network."
"Rodger," Kuroto replied. He got out his scalpel and tumor extraction devices, sterilized and dried off by an assistant, ready for usage. He was ready to extract the large carcinoma from the bronchial network.
But as they began the excision, something unexpected happened. The moment Kuroto's extraction tool cut through the cancerous tissue, tiny, wriggling parasites oozed out from the tumor. They glistened sickeningly, squirming away from the light as if sensing the threat of their existence.
"What… what the hell are these little monsters?!" Emu gasped, panic hitting him like ice. Despite this, his voice volume remained low.
"Parasitic worms, most likely of the Rosalia genus," Kuroto observed, his expression a mix of fascination and disgust. "They must have been feeding off the tumors' pus and sputum, feasting on a mixture of platelets, T Cells and trace nutrients for their survival. Kotaro's IV needs an anti-parasitic serum NOW!"
"Rodger!" A female assistant saluted, carefully administering anti-parasitic medication into Kotaro's IV. "Does he need a local deworming agent alongside the antibiotic ointment?"
"Yes," Emu replied. "Rosalia worms are extremely opportunistic and spread everywhere. If we can't locally exterminate them, they'll multiply and spread to every organ in his body."
With practiced determination, Kuroto pulled out a syringe filled with a potent deworming agent. The room buzzed with tension as the seconds ticked away, and Emu could hardly breathe.
"Blend the treatment with the tumor removal," Kuroto instructed, his voice steady. "We must ensure no trace remains."
As Kuroto injected the solution, the worms writhed helplessly, their bodies contorting before finally perishing. Their carcasses were "vaccuumed" out by a suction tube, and antibiotic ointment was applied to each area to prevent infection. The same scenario was repeated with each pus-filled tumor, in both of Kotaro's lungs.
"I've never seen anything like this," Emu whispered, anticipating a whirlwind of emotions that surged within him. "How does this happen to an asthmatic young boy - out of the blue?"
Kuroto met his gaze, and for a moment, the facade of his composed demeanor cracked, revealing a hint of sorrow. "Rosalia worms are extremely contagious. Remember that butterflies' wings can transmit Rosalia eggs? Kotaro's parents informed me that Kotaro loves chasing butterflies and catching butterflies with a butterfly net. Sometimes, he talks about butterflies and insects with his classmates at lunch. He probably inhaled the eggs from a butterfly's wings."
Emu's heart sank. "How can Kotaro be made aware that butterfly wings can transmit Rosalia eggs? If we tell him the truth, he'll be scarred for life..."
"Time will tell, Emu," Kuroto replied.
Suddenly, the monitor attached to Kotaro beeped loudly, snapping them back into focus. The boy's heart rate began to fluctuate dangerously.
"Kotaro's heart rate is unstable!" Emu spoke. "Kuroto, we must stabilize it!"
"Rodger!" Kuroto stated, directing Emu with iron clarity, "Prepare the cauterizer." They used the cauterizer to reduce and stop bleeding inside of Kotaro's lungs, stabilizing the boy's heart rate and preventing potentially-deadly sepsis. The tumor extractions continued during that time.
With renewed determination, they forged ahead, finally removing the last piece of the tumor and sealing up the incisions. As they finished, the once-thundering monitor began to stabilize. Emu's heart soared with a mixture of relief and trepidation.
"Is he going to be okay?" Emu pondered as he watched Kotaro slowly being stowed away into the recovery area.
Kuroto sighed heavily, wiping the sweat from his brow. "The tumors are removed, and the parasites have been eradicated. But we must witness the aftermath of Kotaro's respiratory surgery..."
Emu replied, "Will the dewormer save Kotaro from extra-respiratory parasitic infections?"
"We don't know," Kuroto replied, "as Rosalia worms can lay dormant and suddenly strike at any moment, anywhere in the body. We do know that Kotaro will need ongoing respiratory care. The dermatologists will help him with his seasonal eczema flareups and atopic dermatitis. He will need nutritional therapy and respiratory herbal medicine alongside his asthma medication regimen..."
To be continued…