Chapter 2

Nao's results that were requested from the Tajima National Health Institute ASAP were delivered to Toshio's hand the following day just before noon. The rain from the night before had lifted. Again, the sunlight poured in, downright annoyingly.

Bringing in the results and the coffee, Ritsuko looked over the waiting room that had become piled with books in such a short time and sighed. Answering Ritsuko's question as to whether the room could be cleaned with a retort to do as she pleased, Toshio looked over the results. He laid them side by side with the simple examination results performed at the hospital yesterday.

It was the same as Megumi's case. All types of blood cells were decreased, as were her hemoglobin and hematocrit levels. Clear signs of anemia. More specifically normocytic normochromic anemia. However, serum bilirubin and LDH levels were normal. With all other values normal, there appeared to be no irregular functioning of the liver or kidney. The results of the Coombs tests were negative. While it was negative, there was no abnormal hemolysis. The same as Megumi. It didn't look like there was anything that could be it besides anemia.

(Is it really simple anemia, or is it...)

Last night, he put the peripheral blood smears and the bone marrow sample under a microscope. The blood smear showed an increased reticulocyte count, as well as nucleated red blood cells. Hyperplasia was occurring in the bone marrow but while Toshio was no hematology specialist he found nothing amiss in its form. There was nothing that could be thought of as abnormal other than the blood production levels. Rather, it'd be better to think of it as a release of young red blood cells due to an expenditure of a large quantity of red blood cells.

(If that's the case)

Was it lost to internal bleeding, or was it quickly destroyed by hemolysis?

(It isn't internal bleeding...)

Neither through palpations nor x-rays were there particular signs of internal bleeding. It didn't look like there was really any swelling of any internal organs either.

(But, I can't think of it as hemolysis either.)

The Coombs tests came back negative. It wasn't autoimmune hemolysis, and looking at the images of the blood smear, it wasn't hemolysis stemming from irregular cell shapes either. With serum bilirubin and LDH levels normal, it really couldn't be thought of as hemolysis.

No matter how many times he thought about it, the more he thought on it , the more each possibility was thoroughly denied. What shouldn't have been happening was happening. Something was strange.

Deep in thought as Toshio was, for a while he didn't realize that Ritsuko who was sorting the mountains of books had asked him something.

"---Doctor, are you listening?"

"Nn? Aa?"

Ritsuko's expression faintly clouded. "Is she that bad, Nao-san?"

"Nah. That's not what it is. I just get the feeling the results have a kinda mismatch with common sense. ---So what about what, now?"

Ritsuko forced a smile. "It wasn't important. I just said it seems that the mountains are crumbling in here and there, aren't they?"

"Heeh?"

"Before, Sagawa-san from Naka-Sotoba had come, for treatment. At the Sagawa Ojii-chan's place, which is built facing the western mountain cliff, that cliff gave out and mud came pouring into the house, he said. He was lamenting how hard it was to clean up."

"Damn---it'd have been just as well if the mud swallowed the whole house and was done with it."

"Ojii-chan was saying the same himself. The main room was a field of mud but it should have just finished the job, he said. After all, if the whole thing collapses in, it might turn into a crisis."

"You said it."

"The northern mountains might be giving too. I heard noises last night you know. As if exposes were being used, 'boom', like."

"....The northern mountain?"

Yes, Ritsuko nodded. Ritsuko's house was in Kami-Sotoba. Near the base of the northern mountain.

"I think it was the northern mountain. Going by the noises, I wonder if it wasn't a major landslide? But, as the northern mountain is the temple's territory, there wouldn't be anybody there, would there."

That's true, Toshio murmured. Would it be good to let Seishin know? As he thought that, Ritsuko piled up the last book on top of the low table. "I've inserted blank memo sheets into the pages they were open to so you can find where you were again, so don't worry."

Thanks, Toshio said with a forced smile, then calling out to Ritsuko as she made to step out. "Sorry again, Ricchan. Could you call the construction firm and ask about Nao-san's condition for me? It's fine if it's the family rather than her. Anyway, ask how she is, let them know that if she needs a re-examination, even this evening is fine, so be sure to come."

Ritsuko's brows furrowed. "Is it that serious....?"

"It's not for sure it's that bad, I told you that right? The results seem to defy reason in a weird way. I thought we should try re-analyzing her one more time."

Is that so, Ritsuko said, sounding unsatisfied with the explanation. He called out once again to stop Ritsuko who was leaving, holding the tray.

"That's right, Ricchan. One more thing. After the break, before the front desk opens could you call everyone together?"

"Yes?"

"I was thinking we'd add some appointments into the schedule. Not for all the patients, by any means. Just the patients I specify are fine."

"Uhm.... starting tomorrow, is it?"

Toshio nodded. He'd give more precise details when everyone was gathered, so he dismissed, but Ritsuko's expression was somewhat unsettled.

She must be suspicious, Toshio thought. But that's fine, he said to himself. The hospital staff was on the front lines. Sooner or later, they'd notice the unusual circumstances, and furthermore, since they couldn't help but be on the front lines facing the threat, he couldn't leave it hushed up forever.

"What do you think this is about?" Ritsuko asked Yasuyo. Yasuyo looked to Kiyomi, exchanging glances, then gravely nodding.

".....I knew it. I thought something was strange."

That's right, Kiyomi said with a sigh. "I got the feeling he's being clearly protective over the young wife of the Yasumoris, too."

What do you mean? Satoko and Yuki both tilted their heads. Yasuyo resolutely folded her arms.

"What I mean is, aren't there too many dead around? Yuki-chan, you two might not have noticed but, since this August, it's been unusual."

"Has it?"

"It wouldn't be impossible to think that. After all, the patients never came in, all that comes in are notices of their death. And on top of that, early in the mornings. Before we've even come in to work."

Kiyomi nodded. "In Kami-Sotoba, somebody under forty died, didn't they? And then the three in Yamairi."

Aa, Yuki and Satoko nodded.

"And after that, in Shimo-Sotoba, a high school student. From there, Giichi-san, and the mother of the first death."

Eh, Yuki's eyes were wide. "Seven people? Since August began?"

"That's just it. I was sure it was something suspicious. Death does tend to come in mysterious patterns but, no matter how you think about it, these are too many in a row."

"Do you think something's happening?"

Listening to the two of them, Ritsuko nodded as if thoroughly understanding what the older nurses were saying.

"I wonder if it isn't an epidemic. At least, the Junior Doctor may be suspecting it. Patients may be coming in with that from here on, and those patients he would want to give preferential examinations."

"Then, Nao-san is also...."

"The way he's so vigilant on her, he may suspect it."

Yuki and Satoko exchanged worried looks.

"Uhm... I wonder if we'll be all right?"

"Who knows? But, if it's dangerous, the Junior Doctor would tell us wouldn't he? That he isn't saying anything may mean he has no positive proof yet, but for the time being the hospital's all right, isn't it? That person is, even if only in matters like this, a precise and proper doctor."

Kiyomi breathed another sigh. "Either way, it'd be better to use disinfectant and be sure to wear gloves at all times. We have to at least be aware of that much."

Yasuyo nodded. "There's a disease we don't know anything about going around after all. ....It'll be good if it's not too unusual of one, but."