[FIC] Mirage
Title: Mirage
Author: kitsune_hikaru
Category: One-Shot
Pairing: RyoDa
Rating: PG-13
Genre: Professionalism, romance
Disclaimer: I don’t own bla... bla... bla... If I do own anyone, I’ll let you know.
Warning: Un-betaed. And there might be some medical terms I use, but I added a glossary to those who have nothing to do with medical field.
Summary: Nishikido-sensei can never tolerate unprofessionalism. Except this one nurse that broke into his barrier.
A/N: I’d like to clarify that even though I rarely write RyoDa, this pairing is special to me because this pair consist two of my three ultimate ichiban (Ryo, Ueda, Tsuyoshi). Thus I really respect good RyoDa writers because it’s not easy to produce a good RyoDa fic. They are, to me, the best authors among all JE fandoms since they challenge the imagination. I’m not one, so I really hope everyone can point my mistakes and give me some constructive criticisms I’ll definitely appreciate. Don’t worry, I’m open about it~ ^^
A/N2: Written for the RyoDa Thon Challenge at ryoda_love. Prompt #21 - Ryo and Ueda doctor/nurse relationship. Coincidentally it happens to hit my profession, so I thought I might give it a try. Dedicated to all RyoDa lovers.
A/N3 (LOL, so many A/Ns):
go_chan2011 had written a very awesome remix of this fic, adding a necessary amount of emotion in Ueda's view. Do check it out~ XD
“Hello?” Ryo answered his annoyingly ringing cell phone, cradling it between his ear and shoulder as his fingers continued tapping his keyboard. He had like up to 30 progress notes to finish in one hour time and Ryo just couldn’t tolerate procrastination during office hours.
“Hello, I’m sorry for disturbing, Nishikido-sensei. I’m Ueda Tatsuya, nurse from 6B,” the voice at the end of the line sounded firm. “I’m calling regarding one patient we want to refer to you...”
“Do you want to refer a patient or do you want to request for an echocardiogram?” Ryo interrupted before the guy could even finish his sentence.
“I want to refer a patient, sensei,”
“If you want to refer a patient, get your MO to call me. Since when are we receiving referrals from the nurse?” with that answer, Ryo pushed the end button and threw his cell phone aside. His eyes were fixed on the screen again.
It was almost an hour later that Ryo’s cell phone rang again. He took a while glancing at the screen, noticing Jin’s name. He sighed, ignoring the call as he finished his last note. It was Jin’s third call that Ryo finally snapped his phone and answered it.
“What took you so long?” Jin’s voice was literally echoing through Ryo’s office.
“I was busy!” Ryo replied. “My nurses are waiting for my notes.”
“Your nurses are that dumb that they need your notes to work?” Jin’s tone was coated with sarcasm. “Anyway, that aside, Tat-chan said you didn’t accept his referral.”
“Tat-chan?” Ryo frowned a bit. “You mean, the nurse just now? Of course I didn’t. Since when are you using nurses to refer cases, Jin? Are you looking down on me?”
“Tat-chan isn’t just another mere nurse, Ryo. He’s like hundred nurses in one,” Jin sighed.
“Jin, you’re exaggerating,” Ryo said, giving a reproachful look though he was well aware Jin couldn’t see him anyway. “Now be a good boy and just give me the name and ID of this patient you want to refer. I’ll just look over your notes then.”
*****
“I want the ultrasound report,” Ryo casted down a firm look.
“Pardon, sensei?” Ueda looked up, reciprocating with a questioning look.
“I said I want the ultrasound report, and I’m not accepting any excuse,” Ryo repeated, right hand placed on the counter before Ueda. Ueda frowned a bit, before ignoring Ryo and continued typing something in the computer.
“Hey! I said-“
“I heard that, Nishikido-sensei,” Ueda interrupted. “But you didn’t make any sense. That was the radiologist part. What do you expect me to do? Go down and force the radiologist to type out the report? Besides, what good does it make if you get the ultrasound report now or later? You entered the plan already. And you still need to wait for the ERCP date.”
Ryo widened his eyes, almost couldn’t believe his ears that a nurse had just turned down his request. Too disappointed that he lost all words in his brain. And now he wondered why Jin recruited this nurse in his team.
Ueda sighed when he saw how pissed off Ryo looked like. “Really, Nishikido-sensei. I promise I’ll call and tell you about the report the second they key in the notes. I heard you’re working at two hospitals. How about you chill down and take it slow?”
Ryo snorted. “You’re not competent to even say that to me,” and he practically stomping away from the ward.
*****
“Wait, the urine was concentrated?” Ryo dashed to the bedside as he took a peek at the urine bag. Tilting his head, he frowned when he saw the color was clear, not as dark as he thought it would be.
“I ran two pints of Hartmann,” Ueda explained, as if he knew what Ryo was thinking about. “She was slightly hypovolemia, stage 2. And she’s slightly tachycardic if only you see my chart. Increased diastolic pressure with narrow pulse volume. I wrote down the sodium depletion too. ABG and FBC taken just in case,” Ueda shoved a board to Ryo. “But the CVP this morning was 6 cmH2O so all is good.”
Ryo looked back at Ueda curiously. “Who inserted the CVL?”
“Tat-chan did! Isn’t he good?” Jin suddenly jumped, patting Ryo’s shoulder.
“Wait, you let a nurse insert the CVL?” Ryo swatted Jin’s hand away in sheer admonishment.
“Why not? It looks fine to me,” Jin shrugged.
Ryo grimaced, almost couldn’t believe how laid back Jin was in handling this issue. “Jin, he was a fucking nurse. What if he inserted it the wrong way and entered the artery? It might go through the jugular vein instead. Or maybe damaging the pleural dome?”
“I put the patient in trendelenberg position with US-guided, thank you very much,” Ueda rolled his eyes. He really couldn’t understand what was Ryo’s problem. Ever since Jin referred a patient to Ryo, Ryo had never stopped accusing Ueda over every single thing.
“Don’t accuse me of something like that Ryo,” Jin looked annoyed, stepping a step forward as if trying to defend his nurse. “I told you Tat-chan isn’t just a mere nurse. He’s a registered nurse!”
Ryo blinked, looking up at Jin. “A registered nurse? Where was he previously?”
“ICU,” Jin answered simply stating the fact, leaving Ryo dumbfounded.
*****
Ryo threw a medication chart in front of Ueda who was busy recording patient’s vital signs. Looking up at the doctor in questioningly, Ueda noticed Ryo’s eyes were darker, as if he bottled something he couldn’t tolerate inside him.
“Why didn’t you serve the Sando-K to the patient? Are you planning to slowly kill her?” Ryo’s voice was dangerously low, but it didn’t make Ueda flinched a bit. The nurse flipped over the medication chart instead, revealing the page behind.
“Because she was on thiazide,” Ueda pointed at the prescription written. “Are you planning to make her hyperkalemia instead?”
Ryo frowned a bit, managing to maintain some of his dignity by snapping shut his jaw. “Jin didn’t tell me that.”
{C}
“Maybe he just missed the fact,” Ueda shrugged. “We need second opinions sometimes.” And Ueda ignored Ryo then, almost thinking that Ryo was sulking. But it could have been only his imaginations anyway.
{C}
*****{C}
The month when Ryo was on duty at the hospital at Osaka, leaving his job in Tokyo to his MO, Ueda realized Ryo was a bit more particular in patients compared to Massu. But Massu was broader in inspecting, and he trusted the nurses more. Every now and then Massu got a phone call from Ryo though, asking for a report from Massu and sometimes he asked a few things that would make Massu stumbled and rushed to check the notes.
Ueda wondered if Ryo ever stopped thinking about his patients in both hospitals. When Ryo was at Tokyo, Ueda noticed how Ryo would call back to Osaka just to ask if the inotrop of his patient had been stepped down. And it seems like it didn’t change much when Ryo was in Osaka either. But Ueda enjoyed how Ryo would observe the details, though they would get into some arguments then. In a way, Ueda felt challenged, and more alert with the surroundings. It had been such a long time he didn’t have this rush of adrenaline. It was since he quit being a critical care nurse, as far as he can remember. He almost felt too happy when Ryo returned from Osaka, taking over his patients back. And Ueda had to contain the urge of grinning and bouncing around when he saw Ryo entering his ward to review the patient.
“You’ve overworked again,” Ueda said when Ryo sat down to enter the note. He couldn’t help but to notice the bag under Ryo’s eyes.
“I didn’t. I have enough sleep in Osaka,” Ryo denied, but failed to mask his exhaustion upon answering.
“Liar,” Ueda replied softly. “You were definitely working your ass out at Osaka too. We both knew Osaka had as much patients as we had in Tokyo. And we both knew you never let go of your patients at both hospitals.”
“It doesn’t matter. I’m not a quitter like you,” Ryo glared.
“Quitter?”
“Why else did you quit being a critical care nurse then? You couldn’t stand the pressure?”
Ueda narrowed his eyes, feeling his heart clenching at the remark. But he decided to stay quiet then. By that time, Ueda wasn’t in the mood to argue. Moving away to the patients’ beds as he carefully prepare for further dressing, Ryo stole a glance at the nurse.
*****
“What?” Ryo answered his phone sleepily, rolling himself over on his comfy bed.
“Okay, don’t get pissed off,” Ueda started his speech. “I’m not referring a patient, but Jin just wanted me to ask you about this pyloric stenosis patient in our ward, that we plan to do a gastrojejunostomy bypass. Apparently he had an ASD, so Jin wanted to know if we need to refer her to you first.”
Ryo propped himself on his elbow, holding his cell phone to his ear for a few seconds before a smile forming on his lips.
“Hey, hime,” he finally spoke. “Tell me more about this patient. I’ll review the patient this coming morning.”
There was a long silence at the end of the line before Ryo decided to break away, “I’m implying that I don’t mind getting a referral from you, donkey face! Now get down to business, you’re the only nurse I’ll be accepting referrals from in my whole life, okay!”
*****
“Hello, 6B ward, staff nurse Ueda Tatsuya here, what can I help you?” Ueda answered as he picked the hospital phone that has been ringing a few times.
“Hey, Ueda, it’s me,” Ryo replied. “Would you do me a favor? There is this one patient at my ward 5E that needs an operation. Review the ECG for me, check if the patient optimized and report back to me.”
Ueda raised his brows, slightly glancing at the receiver. “Where are you?”
“At home, of course! That’s why I asked your help or I would’ve done that myself!” Ryo retorted.
“I thought Masuda-sensei is on call?”
“Well...” Ryo hesitated. “I just want you to double check. You know... You’re pretty reliable at this.”
There was a long silence between the line and Ryo become a bit restless. “Please,” he added. And he heard Ueda sighed.
“You should seriously rest when you’re at home, you know. You’re even checking on patients during your breaks.”
“I’m living up to my reputations-“
“What is it that you chase after, Nishikido-sensei?” Ueda asked, not bothering to listen to Ryo’s explanation. “The fame? Working back and forth from Osaka to Tokyo, paranoid over almost everything. You don’t even trust your co-workers. It was as if you lost your reasons of becoming a doctor.”
Ryo was taken aback by the sudden outburst. Slightly feeling anger raising inside him, but he closed his eyes, slumping onto his white leather sofa as he let out a heavy depressed sigh.
“Like you’re chasing over something you don’t even know,” Ueda continued. “Something that you won’t satisfied no matter how hard you try. Like a mirage. It disappears once you thought you almost reach it.”
“What does a nurse like you understand?”
“I totally understand that, Nishikido-sensei! I understand that more than anyone else! I used to chase over that mirage too.”
And heavy silence filled between them once again. Ryo bit his lips. He almost couldn’t believe he got preached by a nurse. And to his most surprise, he actually pondered over it.
“I’ll go and see that patient. I’ll call you back,” was Ueda’s last words before he hung up. And Ryo was left in his own thought.
*****
Ryo grumbled, scratching his head when he reviewed his patients in his ward. Massu and Shige were biting their lips, probably almost too scared to even voice an opinion here. Ryo’s scrunching face was clearly the sign that he was going to explode anytime from now. And neither of them would want to risk playing with fire.
“Nurse!” Ryo finally exploded. “I said, daily povidone dressing! When the hell did you change this dressing?”
“I’m sorry, Nishikido-sensei,” a female nurse trotted her way towards the doctors. “No one passed over to us that it needed daily dressing.”
“Yeah, like a gauze dressing can stand for three days,” Ryo rolled his eyes sarcastically. “Do you really need a pass over for something like that? Where’s your common sense? What if he got infected? What’s the white cell count?”
“White cell count?” the nurse blinked. “You didn’t order that one, sensei.”
Ryo pulled up an eyebrow. “Well, then. Did he have any episodes of fever?”
This time, the nurse almost fidgeted. “I’ll check that later, sensei.”
Ryo scoffed. “No, no, never mind. You may sit down enjoying your day in my ward, don’t bother for that,” he snatched his file as he walked out of the ward. Shige and Massu exchanged glances, sighing heavily as they lazily dragged their weight, continuing their uncompleted round. Ryo’s temper killed their morning, really. But well, the patients are at stake. In some ways, that was explainable.
*****
“Seriously, Jin. Can I have your nurse?” Ryo slurs, slouching on the sofa in Jin’s office.
Jin blinked. “My nurse?”
“In some ways, I think that hime was definitely the best nurse of all,” Ryo admitted, though barely audible to Jin’s ears. Jin burst in laughter regardless.
“So, the almighty Nishikido Ryo finally decided to take a nurse into his professional team?” Jin teased, only to earn him a glare from Ryo. Jin patted Ryo’s shoulder, ignoring the warning look descended from the Osakan’s eyes. “I hope I can give Tat-chan to you, but I can’t.”
“You can’t?” Ryo repeated in confusion.
“He quit.”
“He quit?” Ryo sat up abruptly, eyes ogling in surprise. “Why?”
“There was a need of nurse in a hospital at Kanagawa. So he accepted the offer,” Jin said, leaning back as he sipped his wine.
“He was called back to a district hospital?”
Jin shrugged. “Tat-chan is the type to enjoy his work. And he enjoyed taking care of patients no matter where it was. It’s not a surprising thing about him. It was also the reason why he left the critical care unit.”
Ryo stared deeply into Jin’s eyes, as if he was searching the truth in Jin’s words. Jin instinctively shifted a bit, defiantly withdrawing from Ryo’s piercing gaze.
*****
“Tatsuya-nii, thank you for your care!” the 10-year-old child waved before trotting away towards his parents. Ueda smiled, waving back as he stood to return in the hospital.
“You really love kids, huh?” Nakamaru chuckled as he saw Ueda grinning all the way in.
“Don’t blame me. They are cute,” Ueda replied, whistling and swirling on his chair.
“I can’t believe you are actually a registered nurse. You can almost rival a doctor. We don’t need the transferred doctor with you here then,” Nakamaru praised.
Ueda chuckled slightly. “There are still some things I cannot do, so no, we still need the transferred doctor. And since I’m quite worried, that transferred doctor needs to be here as soon as possible before we receive any difficult cases.”
“He’ll be here today, you don’t have to worry,” Nakamaru said consolingly. He was definitely relieved with Ueda helping him there. “I’m going to assist some physiotherapy upstairs, will be right back before lunch, okay. Bye!” Nakamaru waved as he left the office.
Ueda reciprocated the smile as he turned to rearrange some files. Just as he was about to start, he craned back his neck, watching the naked blue sky that day, with only the faintest wisps of white, like breathy caricatures sponged across its bare expanse. It was a beautiful day indeed. He almost thought it might be the brightest day in his life.
“Enjoying your leisure?”
Ueda spun, a bit surprised at the sudden greeting. It didn’t take him too long to recognize the tanned guy with raven hair, leaning against the door, grinning towards him.
“What are you doing here?” was his first question.
Ryo shrugged. “I was transferred here.”
It took Ueda a few seconds to process the information before he replied, “You were supposed to be the transferred doctor? But... Why? You love your department.”
Ryo picked himself up, walking towards the window to join Ueda watching the nice wide blue sky. It was heart-warming indeed. “I was thinking that you might probably be right,” Ryo paused, looking at Ueda’s confused look. “It’s time for me to chase over something concrete rather than chasing over uncertain mirage.”
Ueda stared back at the doctor, not quite getting where Ryo was leading to. But when Ryo leaned in and capture his lips in a light, soft kiss, Ueda was stunned. And it was at that moment Ueda thought he might get what Ryo tried to say, and maybe words were no longer matter between them. It was just a warm kiss, lasted for a few seconds as Ryo broke the kiss and stared down to the copper-haired guy.
“I enjoyed our teamwork,” Ryo whispered, feathering his words across Ueda’s cheek, as Ueda lowered his lashes. “You taught me the excitement in this field of work again. I kinda wanted to continue working with you.”
Ueda’s lips curved into a smile. “It’s amusing how the great Nishikido-sensei is proposing a nurse to work with him.”
“It’s Ryo,” Ryo interrupted.
“Yeah, sure, Nishikido-sensei,” Ueda chuckled.
“My, my, it looks like I’m going to be a bit busy making my stubborn boyfriend to behave.”
Ueda rolled his eyes. “You are so full of yourself, Nishikido.” But when Ryo reached out and cupped Ueda’s head, drawing them for another kiss, Ueda knew it seemed they were done talking. Deep inside, he secretly wished Nakamaru won’t be back for lunch. He definitely wouldn’t mind being left alone this time.
~The End~
Glossary:
MO: Medical Officer
Echocardiogram: A kind of ultrasound procedure performed to review the layers and valves of the heart, usually done and reviewed by Cardiothoracic specialists. Yerp, I’m implying that Ryo is a cardiothoracist here~ ;)
ERCP: A procedure where a camera was inserted through your throat down to your stomach, mainly used to observe the bile duct and liver.
Hartmann: It’s a type of fluid that used to replace mild blood loss or to correct low blood pressure. Was put in a bottle of 500ml called ‘pint’.
Hypovolemia: A situation where you lost your blood volume either because you peed too much or maybe you’re bleeding too much.
Tachycardic: A situation when your pulse is too fast.
Diastolic: One of the measurement of blood pressure. It’s kinda hard to explain precisely, but well, it shows part of the pressure of your heart.
ABG: Acid Blood Gas and Lactate, one of the blood investigation to measure oxygen saturation.
FBC: Full Blood Count, one of the typical blood investigation. White cell count are included, which indicates if the patient got infected or not.
CVP: Central Venous Pressure. A concise method to measure blood volume.
CVL: Central Venous Line. The type of line that we insert through the arm, neck or leg straight into the heart. Usually inserted through the arm. This procedure needs a high knowledge of blood vessel positions because it might misplace and went to the brain instead which can cause death. Or it can accidentally hit and collapse the lungs which make the patient can’t breathe. For more accuracy, US-guide (ultrasound) is highly recommended. Beginners who are learning this technique would definitely need strict supervision.
Trendelenberg: A position where we lie someone with his head lower than his legs.
Registered nurse: Nurses that was specially trained and certified to take care of critically ill patients. They are usually working at places like ICU, NICU, emergency department etc. Their skills are very good and they are definitely a big help to the doctors. They are actually even better than some doctors. These type of nurses are definitely not someone you should take for granted.
Sando-K: A supplement potassium tablet used to slowly correct the low potassium inside our body.
Thiazide: A diuretic drug that makes us pee more. That’s the layman word. Hehe... But it’s prone to make the potassium low. If it was combined with Slow-K, it would reverse the effect and increase potassium highly.
Hyperkalemia: the situation where the potassium in blood are raised. Please note that low or high concentration of potassium in blood can kill someone. *gasps* OMG I’m teaching how to kill people!! XD
Inotrop: A drug that prevent the muscles to contract.
Povidone: An iodine solution used to clean wounds. IDK, I think most of you knew this already.
Pyloric stenosis: A disease where the stomach obstructed due to scarring. Usually genetic if they are children. If it happen in elderly, it usually caused by chronic gastritis. No meds can be used, except operations.
Gastrojejunostomy bypass: A type of operation when you cut the small bowel and attach it to the stomach. It’s more like we’re making a new way to overcome a permanent obstruction.
ASD: Atrial Septal Defect. A genetic heart disease where the heart had a hole between the upper chambers. Usually only found out when the patient reached adult age because it usually didn’t show any signs when they were young.
ECG: I think you knew this already. Electrocardiogram, the drawings of grass on a paper with small boxes. You know... Hehehe...
Gauze: A light, open-meshed fabric of muslin we used to cover a wound.
Author: kitsune_hikaru
Category: One-Shot
Pairing: RyoDa
Rating: PG-13
Genre: Professionalism, romance
Disclaimer: I don’t own bla... bla... bla... If I do own anyone, I’ll let you know.
Warning: Un-betaed. And there might be some medical terms I use, but I added a glossary to those who have nothing to do with medical field.
Summary: Nishikido-sensei can never tolerate unprofessionalism. Except this one nurse that broke into his barrier.
A/N: I’d like to clarify that even though I rarely write RyoDa, this pairing is special to me because this pair consist two of my three ultimate ichiban (Ryo, Ueda, Tsuyoshi). Thus I really respect good RyoDa writers because it’s not easy to produce a good RyoDa fic. They are, to me, the best authors among all JE fandoms since they challenge the imagination. I’m not one, so I really hope everyone can point my mistakes and give me some constructive criticisms I’ll definitely appreciate. Don’t worry, I’m open about it~ ^^
A/N2: Written for the RyoDa Thon Challenge at ryoda_love. Prompt #21 - Ryo and Ueda doctor/nurse relationship. Coincidentally it happens to hit my profession, so I thought I might give it a try. Dedicated to all RyoDa lovers.
A/N3 (LOL, so many A/Ns):
go_chan2011 had written a very awesome remix of this fic, adding a necessary amount of emotion in Ueda's view. Do check it out~ XD
“Hello?” Ryo answered his annoyingly ringing cell phone, cradling it between his ear and shoulder as his fingers continued tapping his keyboard. He had like up to 30 progress notes to finish in one hour time and Ryo just couldn’t tolerate procrastination during office hours.
“Hello, I’m sorry for disturbing, Nishikido-sensei. I’m Ueda Tatsuya, nurse from 6B,” the voice at the end of the line sounded firm. “I’m calling regarding one patient we want to refer to you...”
“Do you want to refer a patient or do you want to request for an echocardiogram?” Ryo interrupted before the guy could even finish his sentence.
“I want to refer a patient, sensei,”
“If you want to refer a patient, get your MO to call me. Since when are we receiving referrals from the nurse?” with that answer, Ryo pushed the end button and threw his cell phone aside. His eyes were fixed on the screen again.
It was almost an hour later that Ryo’s cell phone rang again. He took a while glancing at the screen, noticing Jin’s name. He sighed, ignoring the call as he finished his last note. It was Jin’s third call that Ryo finally snapped his phone and answered it.
“What took you so long?” Jin’s voice was literally echoing through Ryo’s office.
“I was busy!” Ryo replied. “My nurses are waiting for my notes.”
“Your nurses are that dumb that they need your notes to work?” Jin’s tone was coated with sarcasm. “Anyway, that aside, Tat-chan said you didn’t accept his referral.”
“Tat-chan?” Ryo frowned a bit. “You mean, the nurse just now? Of course I didn’t. Since when are you using nurses to refer cases, Jin? Are you looking down on me?”
“Tat-chan isn’t just another mere nurse, Ryo. He’s like hundred nurses in one,” Jin sighed.
“Jin, you’re exaggerating,” Ryo said, giving a reproachful look though he was well aware Jin couldn’t see him anyway. “Now be a good boy and just give me the name and ID of this patient you want to refer. I’ll just look over your notes then.”
*****
“I want the ultrasound report,” Ryo casted down a firm look.
“Pardon, sensei?” Ueda looked up, reciprocating with a questioning look.
“I said I want the ultrasound report, and I’m not accepting any excuse,” Ryo repeated, right hand placed on the counter before Ueda. Ueda frowned a bit, before ignoring Ryo and continued typing something in the computer.
“Hey! I said-“
“I heard that, Nishikido-sensei,” Ueda interrupted. “But you didn’t make any sense. That was the radiologist part. What do you expect me to do? Go down and force the radiologist to type out the report? Besides, what good does it make if you get the ultrasound report now or later? You entered the plan already. And you still need to wait for the ERCP date.”
Ryo widened his eyes, almost couldn’t believe his ears that a nurse had just turned down his request. Too disappointed that he lost all words in his brain. And now he wondered why Jin recruited this nurse in his team.
Ueda sighed when he saw how pissed off Ryo looked like. “Really, Nishikido-sensei. I promise I’ll call and tell you about the report the second they key in the notes. I heard you’re working at two hospitals. How about you chill down and take it slow?”
Ryo snorted. “You’re not competent to even say that to me,” and he practically stomping away from the ward.
*****
“Wait, the urine was concentrated?” Ryo dashed to the bedside as he took a peek at the urine bag. Tilting his head, he frowned when he saw the color was clear, not as dark as he thought it would be.
“I ran two pints of Hartmann,” Ueda explained, as if he knew what Ryo was thinking about. “She was slightly hypovolemia, stage 2. And she’s slightly tachycardic if only you see my chart. Increased diastolic pressure with narrow pulse volume. I wrote down the sodium depletion too. ABG and FBC taken just in case,” Ueda shoved a board to Ryo. “But the CVP this morning was 6 cmH2O so all is good.”
Ryo looked back at Ueda curiously. “Who inserted the CVL?”
“Tat-chan did! Isn’t he good?” Jin suddenly jumped, patting Ryo’s shoulder.
“Wait, you let a nurse insert the CVL?” Ryo swatted Jin’s hand away in sheer admonishment.
“Why not? It looks fine to me,” Jin shrugged.
Ryo grimaced, almost couldn’t believe how laid back Jin was in handling this issue. “Jin, he was a fucking nurse. What if he inserted it the wrong way and entered the artery? It might go through the jugular vein instead. Or maybe damaging the pleural dome?”
“I put the patient in trendelenberg position with US-guided, thank you very much,” Ueda rolled his eyes. He really couldn’t understand what was Ryo’s problem. Ever since Jin referred a patient to Ryo, Ryo had never stopped accusing Ueda over every single thing.
“Don’t accuse me of something like that Ryo,” Jin looked annoyed, stepping a step forward as if trying to defend his nurse. “I told you Tat-chan isn’t just a mere nurse. He’s a registered nurse!”
Ryo blinked, looking up at Jin. “A registered nurse? Where was he previously?”
“ICU,” Jin answered simply stating the fact, leaving Ryo dumbfounded.
*****
Ryo threw a medication chart in front of Ueda who was busy recording patient’s vital signs. Looking up at the doctor in questioningly, Ueda noticed Ryo’s eyes were darker, as if he bottled something he couldn’t tolerate inside him.
“Why didn’t you serve the Sando-K to the patient? Are you planning to slowly kill her?” Ryo’s voice was dangerously low, but it didn’t make Ueda flinched a bit. The nurse flipped over the medication chart instead, revealing the page behind.
“Because she was on thiazide,” Ueda pointed at the prescription written. “Are you planning to make her hyperkalemia instead?”
Ryo frowned a bit, managing to maintain some of his dignity by snapping shut his jaw. “Jin didn’t tell me that.”
{C}
“Maybe he just missed the fact,” Ueda shrugged. “We need second opinions sometimes.” And Ueda ignored Ryo then, almost thinking that Ryo was sulking. But it could have been only his imaginations anyway.
{C}
*****{C}
The month when Ryo was on duty at the hospital at Osaka, leaving his job in Tokyo to his MO, Ueda realized Ryo was a bit more particular in patients compared to Massu. But Massu was broader in inspecting, and he trusted the nurses more. Every now and then Massu got a phone call from Ryo though, asking for a report from Massu and sometimes he asked a few things that would make Massu stumbled and rushed to check the notes.
Ueda wondered if Ryo ever stopped thinking about his patients in both hospitals. When Ryo was at Tokyo, Ueda noticed how Ryo would call back to Osaka just to ask if the inotrop of his patient had been stepped down. And it seems like it didn’t change much when Ryo was in Osaka either. But Ueda enjoyed how Ryo would observe the details, though they would get into some arguments then. In a way, Ueda felt challenged, and more alert with the surroundings. It had been such a long time he didn’t have this rush of adrenaline. It was since he quit being a critical care nurse, as far as he can remember. He almost felt too happy when Ryo returned from Osaka, taking over his patients back. And Ueda had to contain the urge of grinning and bouncing around when he saw Ryo entering his ward to review the patient.
“You’ve overworked again,” Ueda said when Ryo sat down to enter the note. He couldn’t help but to notice the bag under Ryo’s eyes.
“I didn’t. I have enough sleep in Osaka,” Ryo denied, but failed to mask his exhaustion upon answering.
“Liar,” Ueda replied softly. “You were definitely working your ass out at Osaka too. We both knew Osaka had as much patients as we had in Tokyo. And we both knew you never let go of your patients at both hospitals.”
“It doesn’t matter. I’m not a quitter like you,” Ryo glared.
“Quitter?”
“Why else did you quit being a critical care nurse then? You couldn’t stand the pressure?”
Ueda narrowed his eyes, feeling his heart clenching at the remark. But he decided to stay quiet then. By that time, Ueda wasn’t in the mood to argue. Moving away to the patients’ beds as he carefully prepare for further dressing, Ryo stole a glance at the nurse.
*****
“What?” Ryo answered his phone sleepily, rolling himself over on his comfy bed.
“Okay, don’t get pissed off,” Ueda started his speech. “I’m not referring a patient, but Jin just wanted me to ask you about this pyloric stenosis patient in our ward, that we plan to do a gastrojejunostomy bypass. Apparently he had an ASD, so Jin wanted to know if we need to refer her to you first.”
Ryo propped himself on his elbow, holding his cell phone to his ear for a few seconds before a smile forming on his lips.
“Hey, hime,” he finally spoke. “Tell me more about this patient. I’ll review the patient this coming morning.”
There was a long silence at the end of the line before Ryo decided to break away, “I’m implying that I don’t mind getting a referral from you, donkey face! Now get down to business, you’re the only nurse I’ll be accepting referrals from in my whole life, okay!”
*****
“Hello, 6B ward, staff nurse Ueda Tatsuya here, what can I help you?” Ueda answered as he picked the hospital phone that has been ringing a few times.
“Hey, Ueda, it’s me,” Ryo replied. “Would you do me a favor? There is this one patient at my ward 5E that needs an operation. Review the ECG for me, check if the patient optimized and report back to me.”
Ueda raised his brows, slightly glancing at the receiver. “Where are you?”
“At home, of course! That’s why I asked your help or I would’ve done that myself!” Ryo retorted.
“I thought Masuda-sensei is on call?”
“Well...” Ryo hesitated. “I just want you to double check. You know... You’re pretty reliable at this.”
There was a long silence between the line and Ryo become a bit restless. “Please,” he added. And he heard Ueda sighed.
“You should seriously rest when you’re at home, you know. You’re even checking on patients during your breaks.”
“I’m living up to my reputations-“
“What is it that you chase after, Nishikido-sensei?” Ueda asked, not bothering to listen to Ryo’s explanation. “The fame? Working back and forth from Osaka to Tokyo, paranoid over almost everything. You don’t even trust your co-workers. It was as if you lost your reasons of becoming a doctor.”
Ryo was taken aback by the sudden outburst. Slightly feeling anger raising inside him, but he closed his eyes, slumping onto his white leather sofa as he let out a heavy depressed sigh.
“Like you’re chasing over something you don’t even know,” Ueda continued. “Something that you won’t satisfied no matter how hard you try. Like a mirage. It disappears once you thought you almost reach it.”
“What does a nurse like you understand?”
“I totally understand that, Nishikido-sensei! I understand that more than anyone else! I used to chase over that mirage too.”
And heavy silence filled between them once again. Ryo bit his lips. He almost couldn’t believe he got preached by a nurse. And to his most surprise, he actually pondered over it.
“I’ll go and see that patient. I’ll call you back,” was Ueda’s last words before he hung up. And Ryo was left in his own thought.
*****
Ryo grumbled, scratching his head when he reviewed his patients in his ward. Massu and Shige were biting their lips, probably almost too scared to even voice an opinion here. Ryo’s scrunching face was clearly the sign that he was going to explode anytime from now. And neither of them would want to risk playing with fire.
“Nurse!” Ryo finally exploded. “I said, daily povidone dressing! When the hell did you change this dressing?”
“I’m sorry, Nishikido-sensei,” a female nurse trotted her way towards the doctors. “No one passed over to us that it needed daily dressing.”
“Yeah, like a gauze dressing can stand for three days,” Ryo rolled his eyes sarcastically. “Do you really need a pass over for something like that? Where’s your common sense? What if he got infected? What’s the white cell count?”
“White cell count?” the nurse blinked. “You didn’t order that one, sensei.”
Ryo pulled up an eyebrow. “Well, then. Did he have any episodes of fever?”
This time, the nurse almost fidgeted. “I’ll check that later, sensei.”
Ryo scoffed. “No, no, never mind. You may sit down enjoying your day in my ward, don’t bother for that,” he snatched his file as he walked out of the ward. Shige and Massu exchanged glances, sighing heavily as they lazily dragged their weight, continuing their uncompleted round. Ryo’s temper killed their morning, really. But well, the patients are at stake. In some ways, that was explainable.
*****
“Seriously, Jin. Can I have your nurse?” Ryo slurs, slouching on the sofa in Jin’s office.
Jin blinked. “My nurse?”
“In some ways, I think that hime was definitely the best nurse of all,” Ryo admitted, though barely audible to Jin’s ears. Jin burst in laughter regardless.
“So, the almighty Nishikido Ryo finally decided to take a nurse into his professional team?” Jin teased, only to earn him a glare from Ryo. Jin patted Ryo’s shoulder, ignoring the warning look descended from the Osakan’s eyes. “I hope I can give Tat-chan to you, but I can’t.”
“You can’t?” Ryo repeated in confusion.
“He quit.”
“He quit?” Ryo sat up abruptly, eyes ogling in surprise. “Why?”
“There was a need of nurse in a hospital at Kanagawa. So he accepted the offer,” Jin said, leaning back as he sipped his wine.
“He was called back to a district hospital?”
Jin shrugged. “Tat-chan is the type to enjoy his work. And he enjoyed taking care of patients no matter where it was. It’s not a surprising thing about him. It was also the reason why he left the critical care unit.”
Ryo stared deeply into Jin’s eyes, as if he was searching the truth in Jin’s words. Jin instinctively shifted a bit, defiantly withdrawing from Ryo’s piercing gaze.
*****
“Tatsuya-nii, thank you for your care!” the 10-year-old child waved before trotting away towards his parents. Ueda smiled, waving back as he stood to return in the hospital.
“You really love kids, huh?” Nakamaru chuckled as he saw Ueda grinning all the way in.
“Don’t blame me. They are cute,” Ueda replied, whistling and swirling on his chair.
“I can’t believe you are actually a registered nurse. You can almost rival a doctor. We don’t need the transferred doctor with you here then,” Nakamaru praised.
Ueda chuckled slightly. “There are still some things I cannot do, so no, we still need the transferred doctor. And since I’m quite worried, that transferred doctor needs to be here as soon as possible before we receive any difficult cases.”
“He’ll be here today, you don’t have to worry,” Nakamaru said consolingly. He was definitely relieved with Ueda helping him there. “I’m going to assist some physiotherapy upstairs, will be right back before lunch, okay. Bye!” Nakamaru waved as he left the office.
Ueda reciprocated the smile as he turned to rearrange some files. Just as he was about to start, he craned back his neck, watching the naked blue sky that day, with only the faintest wisps of white, like breathy caricatures sponged across its bare expanse. It was a beautiful day indeed. He almost thought it might be the brightest day in his life.
“Enjoying your leisure?”
Ueda spun, a bit surprised at the sudden greeting. It didn’t take him too long to recognize the tanned guy with raven hair, leaning against the door, grinning towards him.
“What are you doing here?” was his first question.
Ryo shrugged. “I was transferred here.”
It took Ueda a few seconds to process the information before he replied, “You were supposed to be the transferred doctor? But... Why? You love your department.”
Ryo picked himself up, walking towards the window to join Ueda watching the nice wide blue sky. It was heart-warming indeed. “I was thinking that you might probably be right,” Ryo paused, looking at Ueda’s confused look. “It’s time for me to chase over something concrete rather than chasing over uncertain mirage.”
Ueda stared back at the doctor, not quite getting where Ryo was leading to. But when Ryo leaned in and capture his lips in a light, soft kiss, Ueda was stunned. And it was at that moment Ueda thought he might get what Ryo tried to say, and maybe words were no longer matter between them. It was just a warm kiss, lasted for a few seconds as Ryo broke the kiss and stared down to the copper-haired guy.
“I enjoyed our teamwork,” Ryo whispered, feathering his words across Ueda’s cheek, as Ueda lowered his lashes. “You taught me the excitement in this field of work again. I kinda wanted to continue working with you.”
Ueda’s lips curved into a smile. “It’s amusing how the great Nishikido-sensei is proposing a nurse to work with him.”
“It’s Ryo,” Ryo interrupted.
“Yeah, sure, Nishikido-sensei,” Ueda chuckled.
“My, my, it looks like I’m going to be a bit busy making my stubborn boyfriend to behave.”
Ueda rolled his eyes. “You are so full of yourself, Nishikido.” But when Ryo reached out and cupped Ueda’s head, drawing them for another kiss, Ueda knew it seemed they were done talking. Deep inside, he secretly wished Nakamaru won’t be back for lunch. He definitely wouldn’t mind being left alone this time.
~The End~
Glossary:
MO: Medical Officer
Echocardiogram: A kind of ultrasound procedure performed to review the layers and valves of the heart, usually done and reviewed by Cardiothoracic specialists. Yerp, I’m implying that Ryo is a cardiothoracist here~ ;)
ERCP: A procedure where a camera was inserted through your throat down to your stomach, mainly used to observe the bile duct and liver.
Hartmann: It’s a type of fluid that used to replace mild blood loss or to correct low blood pressure. Was put in a bottle of 500ml called ‘pint’.
Hypovolemia: A situation where you lost your blood volume either because you peed too much or maybe you’re bleeding too much.
Tachycardic: A situation when your pulse is too fast.
Diastolic: One of the measurement of blood pressure. It’s kinda hard to explain precisely, but well, it shows part of the pressure of your heart.
ABG: Acid Blood Gas and Lactate, one of the blood investigation to measure oxygen saturation.
FBC: Full Blood Count, one of the typical blood investigation. White cell count are included, which indicates if the patient got infected or not.
CVP: Central Venous Pressure. A concise method to measure blood volume.
CVL: Central Venous Line. The type of line that we insert through the arm, neck or leg straight into the heart. Usually inserted through the arm. This procedure needs a high knowledge of blood vessel positions because it might misplace and went to the brain instead which can cause death. Or it can accidentally hit and collapse the lungs which make the patient can’t breathe. For more accuracy, US-guide (ultrasound) is highly recommended. Beginners who are learning this technique would definitely need strict supervision.
Trendelenberg: A position where we lie someone with his head lower than his legs.
Registered nurse: Nurses that was specially trained and certified to take care of critically ill patients. They are usually working at places like ICU, NICU, emergency department etc. Their skills are very good and they are definitely a big help to the doctors. They are actually even better than some doctors. These type of nurses are definitely not someone you should take for granted.
Sando-K: A supplement potassium tablet used to slowly correct the low potassium inside our body.
Thiazide: A diuretic drug that makes us pee more. That’s the layman word. Hehe... But it’s prone to make the potassium low. If it was combined with Slow-K, it would reverse the effect and increase potassium highly.
Hyperkalemia: the situation where the potassium in blood are raised. Please note that low or high concentration of potassium in blood can kill someone. *gasps* OMG I’m teaching how to kill people!! XD
Inotrop: A drug that prevent the muscles to contract.
Povidone: An iodine solution used to clean wounds. IDK, I think most of you knew this already.
Pyloric stenosis: A disease where the stomach obstructed due to scarring. Usually genetic if they are children. If it happen in elderly, it usually caused by chronic gastritis. No meds can be used, except operations.
Gastrojejunostomy bypass: A type of operation when you cut the small bowel and attach it to the stomach. It’s more like we’re making a new way to overcome a permanent obstruction.
ASD: Atrial Septal Defect. A genetic heart disease where the heart had a hole between the upper chambers. Usually only found out when the patient reached adult age because it usually didn’t show any signs when they were young.
ECG: I think you knew this already. Electrocardiogram, the drawings of grass on a paper with small boxes. You know... Hehehe...
Gauze: A light, open-meshed fabric of muslin we used to cover a wound.