Chapter 6
The gastric cancer surgery was still in full swing. Modern operating rooms have various ways to minimize incisions, but things were different in the 1970s.
I looked at the operating table.
The incision was quite large.
Anyway. Professor Overhellman pointed to an artery inside the surgical site, within the open abdomen.
The chief of surgery marveled again.
“I still can't believe it. CT only arrived at Stanford recently, and there's already a student who knows how to read it?”
“Thank you.”
I nodded.
“This is why a thorough dissection is important. It makes the course of the blood vessels easier to see.”
The professor said quietly.
You had to look closely to see it now, and even then it wasn't very clear. It would be a lot easier to see once CT technology improved, wouldn't it?
The surgery continued. The professor steered clear of the vascular variation and followed the artery leading to the stomach.
Only now was the vascular variation clearly visible.
The structure I'd pointed out before surgery.
The moment the professor indicated the blood vessel, the operating room fell silent. My prediction had come true.
“Wow. I doubt even the radiology professors know how to read CT properly yet... I guess the rumors weren't baseless after all.”
“I do study hard.”
“Let's tie off the vessel. Clip.”
The clip clamped down on the blood vessel.
“Yes.”
“You saved this patient's life. Go brag to them once they wake up from the anesthesia.”
I nodded.
Now that we'd tied off the blood vessels supplying the stomach, it was time to remove it.
I handed the liver to the nurse, and the chief of surgery gave me the scalpel again.
“Finish it.”
I solemnly accepted the scalpel.
It wasn't something just anyone got to hold.
With all the blood vessels tied off, there wasn't a drop of blood in sight, even during a major operation to remove the stomach.
You don't see surgical skill like that even today. No wonder Overhellman was Stanford's chief of surgery.
Let's move carefully.
The professor watched my hands intently as I calmly and slowly finished resecting the stomach.
“You have a natural talent for surgery. Is it because Asians use chopsticks so much?”
I stifled a hollow laugh.
I don't think it has anything to do with chopsticks.
“Thank you.”
“Have you considered becoming a surgeon? Stanford has some of the world's best surgeons... Don't you want to learn how to transplant a beating heart?”
It wasn't that I had any special talent. It was just a surgery I'd performed before.
“I'll think about it.”
“A real doctor is one who wields a scalpel.”
Professor Overhellman kept muttering. In any case, the gastrectomy was a success.
It was time to close. The professor picked up a needle and thread and began stitching the incision shut.
***
And then, another line was added to my reputation.
The surgical staff spread rumors quickly.
There was a medical student who could figure out a patient's blood vessel structure just by looking at their face.
There was a student who could read the newly arrived CT scans, something even the radiology professors couldn't do.
The operating room staff nicknamed me Samurai, meaning I was good with a blade.
Good grief.
After the surgery, I went to see the patient in the hospital ward. They must not have fully come out of the anesthesia yet. They were dozing.
I looked at the patient.
Just an ordinary American. They did look a little gaunt, probably because of the cancer.
“Hello there.”
“Who are you?”
“I'm one of the doctors who operated on you.”
“You look awfully young for that.”
I heard that sometimes. Asians look young and all that. And I really was much younger, since I'd skipped several grades...
I scratched my head.
It's not about how you look, is it?
“I saw on your CT that you had a variation in the blood vessels in your liver. I spotted it before the surgery and saved your life.”
“Oh, thank you. Is it a serious condition?”
“The serious condition is your gastric cancer, isn't it?”
“Oh. I see.”
We took out the cancer, so you can relax! Just don't mention that half your stomach is gone.
But it couldn't be helped.
We couldn't leave it in. Radiation and chemotherapy were options, but surgery was generally better.
The patient nodded.
“Your gastric cancer surgery went well. I don't think you'll need any further treatment, but you should take nutritional supplements. Removing part of your stomach can cause absorption problems.”
“Thank you...”
The patient still looked confused, but I left the room and went on my way.
I saved another patient today.
***
My sixth year as an undergraduate. 1976.
My rotations were starting to wind down.
Maybe the word had gotten around. In every department where I rotated, professors were lined up, hoping to recruit me.
“I've heard a lot about you from Professors Berg and McDevitt. If you pursue a career as a scholar, you could reach the very top.”
“You'll come to surgery after you graduate, right? With hands like yours, it would be a waste not to operate.”
“Research and the finest techniques both come from clinical work. If you want to reach the top, you need to become an internist. Even the dean is an internist.”
Internal medicine seemed like the best choice.
It was the specialty where I could see the most patients. Research topics and opportunities came from clinical practice, after all, and internal medicine was also the way to rise through the hospital ranks.
Anyway.
Graduation was just around the corner. That meant I had to think about what I wanted to do afterward.
Lately, I'd been thinking about the EpiPen. In the 1970s, it hadn't been commercialized yet.
What is it?
It's a device that lets ordinary people inject epinephrine directly into a muscle. People with severe allergies carry one around.
The principle was simple, but actually making it and bringing it to market would take resources.
If it were commercialized soon, it could save patients at risk of severe allergic reactions or anaphylaxis.
The problem was figuring out how to make it happen.
It was something I needed to think over.
The person I was meeting today was Clayton Rich, the dean of this medical school. Clayton Rich was an internist, too.
The dean had interviewed me when I applied.
I fiddled with my tie.
“So you're the student everyone's been talking about. You've worked hard.”
“Hello.”
“I hear a student found a vascular variation the chief of surgery himself had missed and saved a patient's life?”
“That happened.”
The dean stared at me.
“It's been a long time since I've had a student who made a full scholarship seem worth every penny. I thought the age of geniuses was over... What are you going to do after you graduate?”
Six years' tuition at an Ivy League private university in America.
If I hadn't gotten a full scholarship, it would have cost as much as several cars. It would have been very hard to pay for.
I didn't hesitate at all.
“I'm going to win the Nobel Prize in Medicine. I'll advance medicine and serve humanity.”
The dean frowned.
“Stanford hasn't won a Nobel Prize in nearly fifteen years. Especially not the Nobel Prize in Physiology or Medicine.”
Fifteen years?
People in this other world thought differently. You'd think winning a Nobel Prize was a given.
There were countries that had never won one, after all. But I was confident I could.
I paused before answering the professor.
I already knew which topics would win Nobel Prizes. All I had to do was pursue them.
I had to make sure I got that parking spot.
“I'll win it, Dean.”
“Heh, I like your ambition.”
Professor Clayton just smiled.
Why didn't he believe me?
At the very least, Professor Berg was definitely going to win a Nobel Prize, and Professor McDevitt's research had a good chance of winning one, too.
I bowed my head.
“Just stay at Stanford. Don't run off to Harvard or Hopkins. I'll do everything I can to give you what you want...”
***
And so the day of graduation arrived.
All the students at Stanford Medical School gathered here in their white coats.
For the oath ceremony.
It was a fateful day.
I'd already gone through this ceremony once, but that didn't make the day any less important.
-Oath.
I raised my hand.
-I pledge to dedicate my life to the service of humanity. I will put my patients first.
I wondered how many people would come to the oath ceremony.
I spotted my family among the crowd in the auditorium.
They must have found me in the crowd, because they were waving at me with bouquets in their hands. Unfortunately, our dog hadn't come.
Well, the dog was old.
-I will strive to acquire and share new knowledge with my colleagues and patients.
I'd struggled for a long time after coming to this other world.
I'd spent the past six years doing everything I could to acquire and share new knowledge, just as those words said.
My mother wiped away her tears with a handkerchief. A few people from town had come with her.
-I will practice my profession to the best of my ability and judgment, while preserving my conscience and dignity.
I looked around the crowd. Professor Berg and Professor McDevitt, who'd done research with me, and a few of my lab colleagues were waving at me.
The oath continued.
-Compassion, prudence, humility, dedication...
I closed my eyes.
-Knowledge, wisdom, courage, compassion...
I'd been given the chance to help countless people.
More than I'd helped in my previous life.
I'd been given the chance to build a better world than the one I'd known. That had been true before, and it was true now. That's why I stood at an oath ceremony again.
-All these promises.
-With those who stood here before me and those yet to come as witnesses, I solemnly and freely make this pledge on my honor.