I, Tomoya Aki, am not a bootlicker

This is not to say how good his medical skills are, but that he is extremely low-key in normal times, and his interactions with others are mostly just casual chats.

……

"I always feel like Dr. Moriyama is a little difficult to get along with..."

It was just the first day and Majima expressed such feelings.

This made Akitomo not know how to respond, because on the day when Moriyama became their supervising doctor, Akitomo was also very busy.

"You and Nishikino have been following Dr. Moriyama today, right?"

"Yes, but in the end he didn't ask us to do anything. Instead, Doctor Sagara and Doctor Sasaki called you over directly."

In the lounge, Majima said helplessly.

He and Nishikino Maki followed Dr. Moriyama throughout the day, while Aki Tomoya had to follow Dr. Sagara to finish his work due to the postoperative care of the patient.

He still had some unfinished business to do with his son, so he didn't go directly to Moriyama.

It's just that in name only, Dr. Moriyama is now their supervising physician.

"It shouldn't be that he didn't ask you to do anything, right? Even if he didn't tell you to do anything, you still have to be busy..."

Aki Tomoya replied casually that he had no idea how they got along with Moriyama that day.

However, his situation is somewhat different from that of Majima and Nishikino. At least he has not yet experienced what it means to be difficult to get along with as Majima mentioned.

"But what's wrong with Dr. Moriyama that he can make you, the central air conditioner, feel uncomfortable?"

Similarly, Tomoya Aki was still quite curious about how Majima managed to follow Dr. Moriyama around for a whole day.

"How about Dr. Moriyama? I feel like you, Aki-kun, should know better than me. After all, you've done surgery with Dr. Moriyama, right?"

Majima asked back.

He had not had much contact with Dr. Moriyama before, but Tomoya Aki had performed surgery with Dr. Moriyama and his team before.

Logically speaking, Tomoya Aki should know Dr. Moriyama better than he does.

"...I don't know much about Dr. Moriyama either."

Tomoya Aki looked at Majima helplessly.

In fact, what he knew about Dr. Moriyama was just what Yoshida Aoba had said before.

He actually didn't have much contact with Dr. Moriyama.

Moreover, during the last surgery, Dr. Sagara was their supervising physician, so Tomoya Aki did not have much contact with Dr. Moriyama.

"I just know that Dr. Moriyama used to work at the Department of Cardiology at Osaka University. I don't know much about other things."

Aki Tomoya said in a low voice.

He only told Majima that Dr. Moriyama had worked at the Department of Cardiology at Osaka University.

"No need to chat anymore. I'm on duty tonight. I'm leaving now. See you tomorrow morning."

"See you tomorrow morning."

Aki Tomoya stood up and walked outside.

Chapter 448 Unnecessary worry?

In the middle of the fourth month after entering Kanto General Hospital, Tomoya Aki received an email from Takagi, who was also undergoing medical training at the Tokyo University affiliated hospital.

He was complaining about how unhappy he was with his current rotation in the ENT department.

A certain attending physician in the department simply refused to listen to the advice of this intern.

Because it was during the break, Aki Tomoya came online to comfort him.

"So, what happened in the university hospital that made you so upset?"

"Maybe they thought my opinion as a trainee doctor was not worth mentioning. I suggested that we do a few more checkups, but they said, 'What do you know? It's just a minor illness. Why should we go through so much trouble?'"

Aki Tomoya is also on line

“…Well, what’s going on?”

"Yesterday a patient with throat pain came to me. Clinical examination showed that the throat wall was inflamed, the laryngeal mucosa was inflamed and swollen, and the left vocal cord was poorly mobile. Fiberoptic laryngoscopy showed acute laryngitis and vocal cord paralysis."

"and then?"

"And that's what happened. I asked if I wanted to do another checkup, and I got scolded."

"If it's just a sore throat, your doctor's diagnosis is correct. He's already checked it out."

"But why do I get scolded and told that I know nothing and have no experience just because I asked for a few more tests?"

Aki Tomoya probably understood Takagi's feelings. He was probably just unhappy. He just made a trivial suggestion and was then taught a lesson by the experienced master.

This made An Yilun not know how to comfort him.

"Your rotation in a private hospital should be easy, right?"

"so so……"

Akitomo didn't dare to say that he and Majima were now comfortably staying in the cardiac surgery department and there was no possibility of rotating in other departments, otherwise, this guy would definitely explode.

Takagi, who works as a trainee doctor in a university hospital, is definitely not as "free" as them.

"Let's not talk about me and Majima, let's talk about your business. Do you still suspect that the patient has other problems?"

"Not really. I just faded out. You were very upset because you were scolded for making a small suggestion. I went to ask that person by myself. You have high blood pressure. According to your medical history, you had an ascending aorta replacement and aortic arch and descending aorta stent implantation when you were in your hometown in Chiba Prefecture a year ago. As a result, I told that person about this and asked if he wanted to have a follow-up examination. As a result, he said I was making a fuss over nothing. Tsk..."

Now Tomoya Aki completely understood that Takagi's kindness was taken for granted.

At the same time, Tomoya Aki also noticed the medical history of the patient that Takagi mentioned.

"Aortic dissection, surgery required... Throat pain, vocal cord paralysis..."

He murmured something, then gradually frowned. When he wanted to express his doubts and ask Yoshida Aoba for his opinion, he looked up and found that everyone else in the room, including Yoshida Aoba, had fallen asleep.

"Takagi, in addition to laryngeal examinations, such as fiberoptic laryngoscopy, have you done chest and abdominal contrast enhancement and reexamination?"

"So, didn't I say that? No."

"Then your worry may not be unnecessary. Wait for me."

Aki Tomoya turned over and climbed out of bed, then changed his clothes. He remembered that Moriyama was among the people on duty tonight.

He ran into the department quickly, and his appearance puzzled Dr. Moriyama and Majima who was on duty with him.

"It's so late, why are you here in the department instead of taking a rest?"

Moriyama looked at Tomoya Aki in front of him and asked in confusion.

At the same time, Majima on the other side also stole a puzzled look, wondering if Tomoya Aki should be on duty tonight.

"Dr. Moriyama, can I ask you a question?"

"...Well, what's wrong?"

"If the aortic dissection ruptures again one year after surgery, the left recurrent laryngeal nerve will be compressed and the vocal cord paralysis will occur, right?"

Dr. Moriyama was stunned. Although he was puzzled as to why Akitomo would ask him such a question at this time, he subconsciously gave an answer based on his past experience.

"Depending on the extent of the dissection, peripheral arterial pulsations disappear, vocal cord paralysis may occur when the left recurrent laryngeal nerve is compressed, and hemoptysis and hematemesis may occur when the dissection penetrates the trachea and esophagus... Why are you asking these questions? Has any patient had an accident?"

He asked with some concern, wondering if one of their patients had a similar condition.

If this is the case, treatment must be sought as soon as possible.

But at this time, Aki Tomoya gave him a reassuring look.

"He is not a patient of our hospital. I just heard about him from another place. His past medical history includes high blood pressure and aortic dissection. He had surgery a year ago. Now he has a sore throat and was admitted to the hospital's ENT department. However, they only diagnosed him with acute laryngitis and vocal cord paralysis."

"…Vocal cord paralysis, how do they explain it?"

Moriyama frowned when he heard this. Vocal cord paralysis is difficult to explain by inflammation, and it should be analyzed based on the existing medical history data.

And Akitomo also said that he had aortic dissection in his medical history, so even if he had surgery, there is still a possibility of re-rupture.

This is not as simple as missed diagnosis or misdiagnosis, it is a matter of life and death.

"I don't know whether the patient provided the attending physician with his past medical history, or whether the attending physician asked about it, but my colleague at the University of Tokyo affiliated hospital, after learning about this, suggested a reexamination to his supervising physician, but it was rejected."

Akitomo said helplessly that even if there was no history of aortic dissection, vocal cord paralysis was difficult to explain with an inflammation.

Moreover, the problem now is that there is already a history of aortic dissection, but the cause of vocal cord paralysis has not been analyzed, and only symptomatic treatments such as anti-infection, cough suppressants, and expectorants are given.

If there is really a possibility of aortic dissection rupture again after surgery, it would probably cause big problems.

After Takagi told him about the situation, Akitomo thought about these things, and now he ran over to ask Moriyama just to confirm his worries.

"I think it's necessary to remind the Tokyo University affiliated hospital to re-examine the patient for aortic dissection. What do you think, Dr. Moriyama?"

If possible, they should go and remind Aki Tomoya if he wants to come.

But at this time, what he didn't expect was that Moriyama seemed very hesitant.

"The matter at the university hospital..."

Moriyama frowned, his eyes flickered, and he was quite hesitant at this moment. It seemed that he really didn't want to get involved in the problems at the university hospital.

Ever since Aki Tomoya said that the incident originated from the Tokyo University affiliated school, his expression became strange.

Chapter 449 We are doctors, right?

Moriyama hesitated, and his hesitation was not incomprehensible to Akitomo Tomoya.

I don't want to get involved in matters concerning the university hospital. Perhaps the very existence of the university hospital is just a thorn in the side of this man.

A complaint from Takagi, a friend of his class, about the condition of a patient made Akito Tomoyuki feel uneasy.

He had a history of aortic dissection and had surgery in Chiba last year. He was admitted to the hospital yesterday because of throat pain, but only underwent a fiberoptic laryngoscopy examination and was not re-checked to see if the aortic dissection had ruptured again after the surgery.

After the rupture, the cause of vocal cord paralysis is most likely due to compression of the left recurrent laryngeal nerve, which is not a simple inflammation.

"He doesn't want to be this good guy..."

Aki Tomoya thought with some confusion in his heart.

It's not easy to be a good guy, this may be what Moriyama considered.

The university hospital’s affairs are the university hospital’s affairs, and it is not the place for people from private hospitals to interfere.

Not to mention, that is the cardiac surgery department of Kanto General Hospital, which is affiliated with the University of Tokyo. More than half of the people there came from there. As for whether there is a sense of belonging there, it is hard to say. It depends on the person.

The obvious hesitation of Dr. Moriyama in front of him made Aki Tomoya feel a little disappointed.

"We just need to suggest them to do a first-line artery enhancement angiography to find out the situation of aortic dissection."

Aki Tomoya whispered to Moriyama.

"…Why don't you ask your colleague to mention this to the attending physician again?"

"If it can draw their attention, I can remind them, but will they listen to us?"

Akitomo was also very disappointed with Moriyama's words.

He knew what Moriyama was worried about, and there was no way for this good man, Tomoya Aki, to take on the role at this moment.

If possible, he can also give reminders, but the prerequisite is that someone will listen to them.

Aki Tomoya finally asked with a pleading look in his eyes: "Dr. Moriyama, we are doctors, right?"

"…It's not your turn to be on duty tonight. Go back and rest, Amai-kun."

He ultimately decided not to intervene.

Considering that it was a matter of the university hospital, Moriyama, who also graduated from the Tokyo University affiliated school, had no intention of interfering.

Whether he was being cowardly or had some so-called knot in his heart, Aki Tomoya didn't want to comment too much.

If you don't want to, then don't. There's no way for Akitomo to ask this person to do something he doesn't want to do, so let's just leave it at that.

"Excuse me, I'll leave first."

Aki Tomoya turned around and walked out of the department without looking back, his hands clenched into fists and his face expressionless.

Less than half a minute after he walked out of the department, Majima chased him out.

"Ayi, are you okay?"