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Chapter 3 - Rules and Systems


tl by dan luffey

sign: Musashino Dialysis Clinic
1: Good job today.
2-4: riiiing

Chapter 3 - Rules and Systems

1: Minagawa-saaaan.
2-3: dash
4: You came quickly.
5: Yeah, I was near the station.

1: What did you want to talk about?
2: Nothing...
3: I just wanted to chat with someone.
4: Hey, sensei...
5: What are you really thinking about doing from here on out?

1: I dunno...
2: just work my hardest.
3: No, not that.
4: I mean about us.
5: Like I said, I want to grow up
6: and stay with you forever, Minagawa-san...umm...
7: So, what am I, then?
8: Just a little bonus for when you grow up?
9: What's wrong?
10: What happened?

1: Hey, sensei...
2: What would you do if I quit being a nurse?
3: You quit?
4: I didn't say that.
5: It's a hypothetical question...
p: vroom

1: Why were you at the station, anyway?
2: Huh?
3: Well, um...
4: Hmm...okay then, I have a hypothetical question for you...
5: If you knew a friend of yours might die in ten years, what would you do?
6: Come on...is this another one of your patients?
7: You don't care about me at all, do you?

1: Asshole!!

1-2: booop
3-4: vvvvbb

1: There is only one way for end-stage renal failure patients to be free from dialysis...
2: A kidney transplant.
3: A transplant, huh?
4: Sounds scary...
5: If the transplant was successful, she'd have a functioning kidney again...
6: All she would have to do is take immunosuppressants, and she'd be able to live a normal life.
7: But in order to have a transplant, we'd need someone to offer up their kidney...

1: Brain death...?
2: What if we could get a kidney from a brain dead patient who died of a cerebrovascular disease or an accident?
3: But...
4: Each person has two kidneys in their bodies, but only having one poses no problems.
5: If you give that person one of your kidneys, then they'll be back to normal.
6: I still haven't asked Akagi-san if she herself is doing the dialysis.
7: Minagawa-san still isn't answering...maybe it'll be a while until we're back on good terms again.
p: booop

1-2: clack

1: Many of the patients in the urology department have prostate cancer.
2: Treatment differs depending on the stage of the cancer, as do opinions on what treatment method is best for each stage.
3: Each treatment method is decided based on an inspection of the stage of the cancer, its malignancy, and the patient's age, among other variables.
4: Main treatment methods include surgery, radiation therapy, hormone therapy,
5: or chemical therapy through anticancer drugs.

1: I'm currently in charge of five patients.
2: Each of them are at different stages of the cancer, different malignancy levels, and different ages.
3: We're here.
4: Hirai-san,
5: unfortunately, you are currently in Stage D, a very advanced stage of prostate cancer.

1: You said that you had received hormone therapy at your previous hospital.
2: This therapy used to work well, but lately it hasn't, and your prostate has gotten larger.
3: This is why you can no longer urinate.
4: sniff...
5: And bone metastasis is what's causing your hips to hurt.

p1: pat
p2: throb
1: Let's discuss this further before deciding on a final treatment method.
2: For now, how about we just try to focus on learning how to withdraw your own urine
3: so that you can go home sooner?

p1: drip
1: I've been so confused for months...
2: but now, I feel like my head's finally cleared up...
3: Thank you very much...
4: for telling me the name of my disease...
5: You can use small doses of morphine to lessen your hip pain.
6: You also have the option of anticancer drugs and radiation therapy,
7: but I cannot strongly recommend either of them.

1: I will provide the therapy that you want to the best of my ability.
2: So...you didn't encourage the use of anticancer drugs.
3: Got an objection?

1: No...
2: I just thought you were more of an extreme person, Kondou-sensei.
3: Anticancer drugs are a valid option...
4: and there are even other non-consensual drugs available...
5: But thinking of the patient's age, increasing the time he's able to spend at home may make him happier in the end...
6: The doctor can't decide what's the best treatment for the patient.
7: That sounds like common sense.
8: I thought you were good at breaking rules?

1: Breaking the rules
2: still doesn't change the system.
3: That reminds me, sensei,
4: was that friend in dialysis you were talking about Akagi-san from surgery?
5: Huh?
6: I heard about it from the head nurse there.
7: I didn't notice it myself either.

1: She said Akagi-san's in her eighth year of dialysis.
2: She's been hiding it from everyone, though.
3: So she really was...
4: Kondou-sensei...
5: Can you introduce me to a transplant doctor?

1: Why do you want me to?
2: Are you going to offer up your kidney to her?
3: Well...I'm not sure what I can do yet, but...
4: As a doctor, I can't just ignore it...
5: So then you're doing it for yourself.
6: Fine.
7: I'll introduce you to a transplant doctor.

p2: bzzzzzz
1: bzzzz
p4: twist

1: Nice to meet you.
2: I'm Kondou, from the urology and advanced transplant medicine departments.
3: He's my husband.
4: It's his fault that I have this name now.
sign: Kondou Mutsumi (*Kondoumu = Condom, Tsumi = Sin)
5: bzzzzz

1: I just thought it was such a waste of good space out here.
2: I've heard about you.
3: Saitou-kun, the phimosis guy.
4: Anyway, Saitou-kun, I'll jump right into it.
5: Do you know how many offers for organ transplants I've had from brain death donors in the past decade?
6: Huh?

1: It's up to you whether you want to think that's a little or a lot,
2: but the point is, brain death organ transplant surgery isn't a viable medical option.
3: Patients who need kidney transplants number in around 12,000, you see.
4: So it's 1 kidney for every 100 people.
5: Let's do the transplant.
6: Otherwise, she'll just gradually keep curving toward death.

1: It's possible for living donors to give kidneys.
2: And lucky for us, we're all born with two kidneys.
3: So, unlike hearts, you can actually take them out of living people.
4: Parents and siblings can donate,
5: couples too. To be honest, it could even be a completely random person.
6: Last year, approximately 1,000 kidney transplants were made.
7: So one out of every twelve patients were served.

1: That's the gist of kidney transplants.
2: Instead of 1/100, it's 1/12.
3: That seems pretty hopeful, no?
4: There are a ton of people around you who've donated their kidneys.
5: You probably just haven't noticed.

1: See, kidneys can be transplanted not just from brain dead bodies, but from people who've hearts have stopped too.
2: Out of those 1,000 transplants last year, about 800 of them were from living people.
3: Anyway, the point is, living transplants are a common thing.
4: The first thing you should do is bring her to me as an outpatient.
5: Then I'll be able to answer any questions you two have.
6: There's no need to hesitate...

1: This is in order to save a life.

1: Well?
2: What are you going to do?
3: I'm going to meet with Akagi-san and encourage her to get a transplant.
4: Do you know why he plays with RC cars on the roof?
5: Huh?
6: Because he's got nothing better to do.

sign: Musashino Dialysis Clinic
1-2: haaaaaah

1: It isn't for anyone's sake.
2: It's simply to save a life.
3-5: klak
6: Akagi-san!


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