Chapter 6

It was on September 20th that Sotoba resident Katou Yoshihide came to the hospital, supported by his wife Sumie. An emergency case, Towada called. Toshio who was in the middle of examinations turned his eyes towards Yasuyo. Knowing his intent, Yasuyo stepped out into the waiting room where the old man, supported by his wife at one side and Mutou at the other, had at last been settled into a chair.

"Are you all right?" Yasuyo lowered herself to look into the old man's face. He looked faintly at Yasuyo and gave a nod, but it was a vague one, his color poor, shoulders heaving as he breathed. His breath was shallow and weak. When she tookh is hand, she could tell he was in a cold sweat. His pulse was also fast. 

Ritsuko and Satoko turned around as Yasuyo came hurrying. "A stretcher. I'll let the doctor know, so carry him to the treatment room. Be sure to take his pulse and blood pressure. It might be best to prepare an artery catheter."

Yes, they responded, briskly heading off as Yasuyo returned to the examination room. Toshio asked how it was, looking up to her.

"He has been carried to the treatment room," she said, looking Toshio in the eye. It seemed that conveyed her meaning. Toshio excused himself from the patient and went towards the treatment room.

"What's his condition?"

"Tachycardia and tachypnea.  There are some signs of cyanosis and his pupils are constricted."

Toshio nodded and entered the treatment room. "What's happened?"

When Toshio asked, Sumie wrung her sinewy hands together. "Two, maybe three days ago, he had caught a cold and was bedridden. He said himself that if he slept he would get better but today he's still like this---Junior Doctor, it couldn't be pneumonia, could it?"

"I can't say anything yet." 

Satoko presented him with a memo. There were many strokes of his pulse, his blood pressure extremely low. 

"Artery catheter."

Yes, Ritsuko said presenting the catheter. Katou's wrist was already in place. Toshio nodded while speaking to Sumie. 

"What's been his temperature?"

"Around 38 degrees." 

"Cough of headache?"

"There has been no cough. And he didn't especially mention a... We really thought it was a cold. He had said so himself. That's why I had him take a decoction.  My mother-in-law used to use that medicine whenever she had a cold, and no matter how bad it was it would be cured. And yet, he didn't even get a little better at all and..."

"Gas analysis," said Toshio, handing off the centrifuge tube and turning back to Sumio. "....What are you even thinking?"

Sumie looked at him blankly, eyes opened. 

"Cyanosis is occurring. Why didn't you call an ambulance while you were bringing him over here? And on top of that you're telling me you thought it was probably a cold? When'd you become a doctor? Why the hell is an amateur just giving her own diagnosis and administering her own medicines!"

Doctor, Ritsuko said in a small voice. Toshio promptly glowered at Ritsuko, then immediately realized he'd lost himself. 

"....No, I am so sorry."

Sumio was visibly dismayed. 

"I'm sorry. Anyway, we will call an ambulance. Until then we will perform what minimal treatment we can, therefore."

"Uhm, is the old man that unwell?"

"I can't say without test results but it is certain he is having respiratory failure."

Probably ARDS, Toshio added in his thoughts. It was that. And the patient was in the latter half of it---it was already switching phases to MOF. Having Ritsuko prepare compressed oxygen, he gave instructions for a chest XP. For the time being he gave Sumie the standard questions. 

Before he could get all of the results the ambulance arrived, and Yoshihide was taken to the national hospital. 

"Sensei," Yasuyo began in a low voice watching the ambulance drive off. "It may be that, mightn't it?"

"....Probably, yeah."