Saijô no Meii 13

*******For use in Trinity BAKumA scanlations ONLY*******

p132:

Mikoto: Surgery... without any scars?

Nasuka: Yes.

Nasuka: I'm willing to do anything for that!

Nasuka: So please...

Nasuka: Doctor... I beg of you!

Mikoto: .....

p133:

Ayame: Hmmm...

Ayame: Surgically remove an ovarian cyst without leaving behind any scars,

huh.

Mikoto: Yeah.

Sena: Oh, dear... this is quite a situation.

Sena: No girl would want scars on their body, and on top of that this girl

is a current junior idol dreaming of becoming an actress...

Sena: I mean, I understand how she feels, but a scarless operation? Is

that really even possible?

Ayame: Exactly.

p134:

Ayame: What the hell did my brother refer this kid to you for?

Ayame: Since it is him we're talking about, there's no doubt that he's

trying to set up a trap for you, but...

Ayame: If it's a procedure that doesn't exist, then you can't really screw

it up either.

Sena: Oh, wait!

Sena: I think I understand.

Sena: The associate director must actually be a huge fan of this girl!

Ayame: No way.

Ayame: I thought I was bad, but the guy we're talking about doesn't show

his emotions, and is the ultimate narcissist.

p135:

Ayame: From way back, when beautiful women confessed their feelings for

him, my brother would treat them like idiots and send them away.

Ayame: The very reason that he's not afraid to use whatever means to rise

to the top is because he really thinks he's been chosen by some god or

something.

Ayame: I can't imagine a guy like that would even consider becoming a fan

of somebody else.

Sena: Oh... is that so...

Ayame: Anyhow, enough about my brother... what are you going to do about

this, Mikoto?

Ayame: Ovarian cysts, unlike other kinds of tumors, don't easily become

malignant so it may be possible to just let it be...

Ayame: but even so, leaving it for too long is dangerous as it may

rupture, or predispose to ovarian torsion.

Mikoto: Exactly.

p136:

Mikoto: So that's why I decided that I should operate on her according to

her wishes.

Ayame: Is that so?

Ayame: Well, good on you.

Sena: That's great.

Ayame+Sena: !!!
What did you say??!!
What do you mean, doctor??!!

Ayame: We can't do it, that's the whole problem!

Sena: Yes, yes, exactly!

Mikoto: It can be done.

Mikoto: There are actual cases...

Mikoto: You definitely know about it.

p137:

Ayame: Wha.. you don't mean...?!

Ayame: N.O.T.E.S.???

Mikoto: That's correct.

Sena: What's that? Something up North?

Ayame: Not North, it's NOTES.

Ayame: Natural Orifice Translumenal Endoscopic Surgery (NOTES).

p138:

Ayame: In other words, it is endoscopic surgery, where you insert the

endoscope through a natural orifice of the body: the mouth, the vagina or

the anus, in order to perform abdominal or thoracic surgery.

Ayame: In the US in March 2007 and France in September of the same year,

there have been cases of successful cholecystectomies (gall bladder

removal) through the vagina.

Sena: Oh wow, that's amazing! You mean that kind of procedure

actually...!?

Ayame: Yeah, that's right.

Ayame: However, Mikoto, NOTES hasn't been registered yet as a standard

medical procedure...

Ayame: and unlike the cases in the States and France, this isn't a

cholecystectomy, we're trying to remove an ovarian cyst! That means

there's an angle problem, since you need to go from the mouth through the

stomach lining in order to carry out the excision.

(Author's Note: in order to go through the vagina, the endoscope must be

bent to almost a U-shape, making it terribly difficult to cut)

p139:

Ayame: If you were to do it, it would be a world-first. You can't do it

without passing it through the hospital's ethics council.

Mikoto: I know.

*: Ethics Council: a committee that approves new procedures such as NOTES

according to the associated humanitarian and ethical aspects.

Mikoto: However, she is a minor, so we first need the consent of her

parents.

Mikoto: So it depends on whether she can persuade her parents...

Mikoto: So we go from there.

Mikoto: So you're really okay with this?

p140:

Mikoto: As I just explained to you, this operation, if we go ahead with

it, will be a world-first.

Mikoto: Furthermore, there is the danger that when we penetrate the

stomach using the endoscope, that the stomach contents will leak into the

peritoneum*.

(* Translators' note: abdominal cavity surrounding the internal organs,

but normally sterile and closed from the outside world)

Mikoto: Hence there is the post-op risk of peritonitis*, making this a

highly dangerous procedure.

(* inflammation of the peritoneum, which can be life threatening)

Nasuka: I understand.

Nasuka: But I still want to go ahead with it.

Mikoto: Right.

Mikoto: Mrs. Sawa, is this fine with you?

Mum: Yes...

Mum: I leave Nasuka in your hands.

Mikoto: ....I understand.

Ayame: That's unusual...

p141:

Ayame: In times like this, it's usually the mother who has trouble

consenting...

Ayame: This person is unusually calm...

Mikoto: In that case, could you please sign this consent form?

Mum: Yes.

"Squeak squeak"

Mikoto: Well, take care then.

Mum: Thank you very much, doctor.

Ayame: ...seems that it all went a little too easily.

Sena: You think so?

Sena: It's probably because, as fellow woman, she understands her

daughter's feelings about scarring her body.

Ayame: Yeah, whatever.

Sena: Oh, that's right!

p142:

Sena: Now that I think of it, Dr. Ayame, something amazing's happened.

Ayame: What do you mean?

Sena: Because of fear of the associate director, there haven't been many

staff volunteering to join the department...

Sena: But recently 3 young doctors expressed an interest in pediatric

surgery.

Ayame: Hmph.

Ayame: Are you sure they're not a bunch of useless goons?

Sena: No no, that's not so.

Sena: I checked things out myself for that very reason.

Sena: All three seem to have good reputations for their skill, and on

their way to the top!

p143:

Sena: Dr. Ayame, if you don't hurry up and move to our department (from

cardiothoracic surgery), places in pediatric surgery are going to fill up!

Ayame: Hmph, well, fill up all you want.

Sena: [Oh, come on~~ You gotta be joking~~]

Ayame: Even so, everything's going as predicted.

Sena: [Wait up, Dr. Ayame~~ PWEEEASE~~]

Ayame: No matter how much brother tries to get in the way, Mikoto's

reputation is spreading within the hospital, through the nurses and even

people like this...

Ayame: Even fairly recently, we successfully completed a procedure of a

standard- enough to get the attention of the medical world.

No one will be able to stem the tide.

Ayame: But I am worried that this "tide" may be too strong...

Sena: [What would we do without you, Dr. Ayame~~?]

Sena: [Dr. Saijou and I are counting on you~~]

Ayame: I don't know about reviving pediatric surgery, but if, at this

stage, the situation arises that chairman Taira comes to esteem Mikoto...

p144:

Ayame: There's no doubt that brother will REALLY try to destroy Mikoto!

Sena: I'm exhausted!

Ayame: You sure are stubborn.

Sena: Well, that is my strong point!

Ayame: That's the spirit! Use that to endure the Ethics Council.

[Seating arrangement]

Bottom four below the square: leftmost label reads: In attendance:
Then, names under the circles are (left to right): Maria, Ayame, Nasuka,

Mother

Bottom side of square: left label reads: Applicant for procedure:
Name next to circle: Mikoto

Starting from lower left side of the square, going clockwise:
Council member (Citizens' representative)
Council member (Lawyer)
Vice-chairperson of the council (Associate Director Kiryuu)
Chairperson of council (Director Noguchi)
Scribe
Council member (Chairman Taira)
Council member (Director of Internal Medicine)

Ayame: You probably haven't had to sit in one of those council meetings...

Ayame: The seating arrangement is something like this.

(Author's note: Typically, as above, the ethics council is comprised of a

couple of medical doctors, one legal professional, and one layperson to

represent public interest. )

Ayame: Not only the director Noguchi and my brother, the associate

director, but chairman Taira will be there as well as a council member...

Ayame: It'll be quite an intimidating council meeting.

[GULP...]

p145:

Ethics Council of Heisei Central Hospital

Sena: Uhmm... so... who was chairman Taira again?

Ayame: On the right, further in from us.

p146:

Ayame: The one giving off that "old man from the mountains" type of

atmosphere... that's chairman Taira.

Sena: Oh... oh.

[Chairman of the Board of Directors of Heisei Central Hospital, Masamori

Taira*]

*The characters for Taira and Masa can be pronounced as 'Heisei'.

Sena: Uh... and the monk over there looks scary...

[Head priest of Hanshoku Temple, Ryu Kuroyanagi]

Ayame: He's the citizens' representative, it's typical for them to be

monks like that.

Ayame: It seems that there are a lot of old men in this council.

[Director of Internal Medicine, Hitoshi Nekota]
[Lawyer, Hajime Suzuki]

Ayame: We've been called here just in case there's a funeral.

Sena: EEH???

Sena: Is that for real?

Ayame: I'm kidding.

p147:

Ayame: Oh, don't get too nervous.

Ayame: Of course this council meeting concerns the application for the use

of NOTES...

Ayame: But if we were to make a bad impression on chairman Taira, it will

probably become impossible to revive the pediatric surgery department...

Ayame: So this is a real important meeting.

Sena: Tha, that makes me even more nervous!

Ayame: [he he he]

Ayame: I know.

Sena: This man... I really hate him... I really really hate him...

Noguchi: Alright then, I'd like to open the ethics council inquiry.

p148:

Noguchi: However, there is one problem, and I'm afraid that this council

dismisses this application for the use of NOTES.

Noguchi: The problem being that by the mother of Nasuka Sawa, Mrs. Megumi

Sawa...

Noguchi: The consent for this operation has been withdrawn.

[!?]