While Akihiko was lounging in the quiet of his apartment, the persistent buzz of his phone shattered the calm.
He glanced at the screen, expecting a trivial message, but instead, an incoming call flashed.
He answered with his usual bluntness. "Hello?"
Kei's voice, composed but clipped, filtered through the receiver. "Dr. Nakamura. Apologies for disturbing you on your day off, but we need you at the hospital. Immediately."
Without hesitation, Akihiko swung his legs off the sofa, already standing. "Understood. I'll be there."
He grabbed his coat in one fluid motion, running a hand through his silver hair to fix himself quickly. On his way out, he typed a message to Ayaka, simple but direct:
'I have an emergency at the hospital. I'll be back soon. Get some rest.'
Oddly, his message went unanswered, just like the others he'd sent earlier. A faint crease appeared between his brows.
"That's… strange." His voice barely left his lips, laced with unease.
Minutes later, his sleek car pulled up at Tokyo Medical Center. He wasted no time, striding briskly through the sterile halls, heading straight for Kei's office.
A sharp knock.
"Come in." Kei called. The tension in his voice wasn't lost on Akihiko.
Inside, Kei gestured to a chair without preamble. "Sit, Dr. Nakamura, We have no time to waste."
Akihiko sank into the chair, his sharp blue gaze focused. Kei's expression was unusually grave.
"I know I originally said one month." Kei began, his voice low but steady, "But there's no one else available. Dr. Ueno is out of town, Dr. Kitagawa and Dr. Yoshida are both in the middle of other procedures, and I…" Kei exhaled heavily, his fingers tightening around a file, "…I'm not permitted to participate in this operation."
Akihiko's brows furrowed faintly. It didn't make sense. Kei was the chief surgeon. Why would he—
Kei slid the patient's file across the desk, meeting Akihiko's eyes squarely. "Open it."
The moment Akihiko flipped the folder open, his pulse froze. His eyes scanned the details rapidly.
Patient Name: Ayaka Yamamoto.
Age: 25.
Blood Type: B positive.
Chief Complaint: Severe abdominal pain, fever, vomiting.
Admitting Diagnosis: Acute appendicitis.
Additional Notes: Fainted post-emesis. History of anemia. Low hemoglobin count. Blood transfusion required intraoperatively.
Kei's voice cut in quietly, but with steel underneath. "Kai brought her in after she collapsed. Her appendix is severely inflamed, risk of rupture imminent. We can't delay. She's unstable, and with her anemia, there's no room for error."
Akihiko's grip tightened over the file, his jaw locked.
For a brief, unwelcome moment, ghosts from the past flickered—flashes of a child on the operating table, blood slick beneath his hands—but he shoved them aside, forcing air into his lungs.
Kei's gaze pinned him. "I'm sorry to ask this of you, Nakamura, but you're the only surgeon I trust with her life. I need you to operate on my sister."
Silence stretched for a beat.
Then, Akihiko straightened, blue eyes burning with clear, resolute fire. "I'll do it." he said firmly, voice devoid of hesitation. "I'll perform the surgery."
Relief flickered in Kei's expression, but it quickly vanished as he stood. "Thank you. OR is being prepped. Dr. Igarashi will handle anesthesia. Dr. Itsuki will assist as second surgeon. I'll inform the team."
As Kei exited swiftly, Akihiko lingered a moment longer, staring down at Ayaka's picture clipped to the file. He ran his thumb over the corner.
"I'll save you, Ayaka..." he murmured under his breath.
With that, he rose and strode to the changing room.
------
In the quiet of the locker room, Akihiko peeled off his clothes with practiced ease, revealing the lean muscle of a body honed through standing long hours in the OR.
Every movement was precise, efficient, yet deliberate—broad shoulders flexing as he pulled on the sterile green scrub suit, the fabric clinging briefly before settling comfortably over his frame.
The lights above cast a pale sheen over his silver hair as he secured his surgical cap snugly, covering every strand.
A mask hung loosely at his neck for now, his sharp features visible, eyes coldly focused.
At the scrub sink, he rolled up his sleeves and began his surgical hand wash with mechanical precision.
The rhythmic scrubbing—fingers, palms, under nails, wrists, forearms—was almost meditative.
Water cascaded over his skin, the antiseptic scent sharp and biting, rinsing away everything except the growing weight in his chest.
He entered the operating room moments later, hands raised, not touching anything.
A nurse approached swiftly, helping him don the sterile surgical gown, then sliding gloves snugly over his long fingers.
Every motion was seamless, controlled.
Across the table, Dr. Itsuki nodded once in acknowledgment. The room buzzed faintly with preparation—the hum of machines, the rustle of drapes. Dr. Igarashi stood by the anesthesia machine, monitoring Ayaka, who lay unconscious, her breathing steady beneath the oxygen mask.
Akihiko took a long breath and stepped forward, eyes settling on her pale face, vulnerable under the harsh lights.
"All right." he announced clearly, voice calm but commanding. "Patient: Ayaka Yamamoto. Female, 25. Diagnosed with acute appendicitis. Secondary concerns: anemia, low hemoglobin. Blood transfusion ready. We proceed with the laparotomy appendectomy."
He glanced around once, ensuring every member of his team was ready, then focused wholly on the delicate, controlled incision below Ayaka's right lower quadrant.
Akihiko's gloved fingers gripped the scalpel firmly, the sterile steel gleaming under the harsh overhead lights.
His breath was steady, but the tension coiled beneath his cool exterior was palpable.
He cast one more glance at Ayaka's pale face before lowering his gaze to her abdomen.
"10-blade scalpel." he requested.
The nurse passed it promptly.
With control, Akihiko made a precise McBurney incision over the right lower quadrant—small, clean, cutting through skin and subcutaneous tissue with ease.
The layers parted under the scalpel's blade as he spoke steadily, voice calm but clipped:
"Metzenbaum scissors."
The scissors were placed into his waiting hand.
He delicately dissected the fascia and muscle layers, exposing the peritoneum. No wasted motion.
Every movement is smooth, methodical.
"Army-Navy retractor." he ordered next.
The retractors were positioned, pulling apart the incision gently but firmly, giving him clear visibility. The assistant surgeon, Dr. Itsuki, adjusted the field as Akihiko nodded.
"Clamp."
Once the clamps secured the surrounding tissues, Akihiko carefully lifted the peritoneum, making a small incision into the abdominal cavity.
Warm saline dampened gauze was passed to suction any minor bleeding.
A faint sheen of sweat formed beneath his cap, but Akihiko's hands remained steady as steel.
"There it is." he murmured under his breath as he located the inflamed appendix, swollen and angry-red, dangerously close to rupturing.
His jaw tensed slightly, but he masked the growing dread knotting in his chest.
"Babcock forceps." he instructed, and the nurse handed it to him.
He gently grasped the appendix, lifting it out carefully to avoid tearing.
"Pulse is stable, but hemoglobin's still low." Dr. Igarashi called from the anesthesiology station, monitoring Ayaka's vitals. "Blood transfusion starting now."
Akihiko nodded curtly. "Keep her stable."
He continued. "Mosquito clamp."
He clamped the mesoappendix vessels swiftly, stopping any bleeding, then used ligatures to tie them off securely.
"Scissors."
He cut the vessels cleanly, every action precise, controlled.
Next, he tied off the base of the appendix using a silk suture, double-checking the knots.
One misstep could cost her. But his hands didn't falter, even as his heart pounded heavily in his ears.
"Scalpel."
With one final, deliberate motion, he excised the appendix, placing it carefully onto the instrument tray.
"Area's clear. No perforation. Irrigation, please."
Warm saline was flushed into the abdominal cavity, ensuring there were no residual contaminants.
He suctioned thoroughly, leaving nothing behind.
"Let's close."
He worked swiftly but meticulously, layer by layer. Peritoneum. Fascia. Muscle. Subcutaneous tissue. Skin.
"Suture."
With deft movements, he stitched her skin closed, neat and clean. He could feel the weight of each pull, but he kept his breathing even.
Finally, he stepped back slightly, glancing at Dr. Igarashi. "Vitals?"
"Blood pressure stable. Pulse normal. She's responding well."
Akihiko's shoulders relaxed fractionally, though his expression remained stoic. The weight pressing down on his chest slowly eased.
He gave a final nod. "Surgery complete. Excellent work, everyone."
The scrub nurse assisted in removing his gloves and gown.
The scent of antiseptic lingered, but as he stripped off his mask and cap, his sharp blue eyes flicked toward Ayaka, still unconscious on the table, chest rising and falling beneath the anesthesia mask.
He took a step closer, standing by her side for a heartbeat longer than necessary, voice low but firm—almost like a silent promise.
"You're safe now."
-----
The moment Ayaka was wheeled out of the OR and into recovery, Akihiko peeled off his gloves and gown, scrubbing a hand over his face.
His body was still thrumming from the intensity of the procedure, but he barely registered the fatigue.
He gave quick post-op orders to the nurses—monitor vitals closely, continue transfusion as needed, administer antibiotics—and ensured all was stable before stepping out of the sterile zone.
As he made his way down the hallway, Kei was already there, waiting just outside.
His expression was composed, but the faint tightness around his eyes betrayed the stress he'd been holding in.
"How is she?" Kei asked, voice low but urgent.
Akihiko met his gaze directly. "The surgery went smoothly. No perforation, no complications. She's stable. She'll need close observation, but she's safe."
Kei's shoulders finally sagged, his chest releasing a breath he hadn't realized he'd been holding. "Thank you, Dr. Nakamura..." The words were quiet, but carried weight.
Before Akihiko could respond, another figure appeared from down the hall—Kai, his face pale, brows furrowed, clearly rattled.
"Kei—how is she? Can I see her?" Kai asked, his voice tight, eyes darting between them.
Kei immediately approached, steadying a hand on Kai's shoulder. "She's fine. Dr. Nakamura handled it."
Kai glanced over at Akihiko briefly but looked no less anxious, almost fidgeting on the spot.
Kei gave his brother a firm but calm look. "Listen. I want you to go sit in my office. You've got that online lecture scheduled anyway, right?"
Kai hesitated, clearly reluctant. "But—"
Kei gently but decisively cut him off. "You don't need to pace around here. I promise you, Ayaka's in the best hands. Dr. Nakamura is one of the best surgeons here. She's out of danger."
Kai still looked conflicted, but finally nodded. "Okay... just let me know the moment she wakes up."
"I will." Kei assured him. "Go."
Kai gave a final glance toward Akihiko, muttering a quiet thank you under his breath, before reluctantly heading down the hall.
Once Kai disappeared around the corner, Kei turned back to Akihiko. For a brief second, something softer flickered in his eyes—gratitude, perhaps something more—but he simply gave a nod.
------
The recovery room was quiet except for the rhythmic beep of the heart monitor and the faint hum of machines.
Ayaka lay still on the bed, her face pale but peaceful, her chest rising and falling slowly, even breaths.
An IV line trailed from her arm, oxygen mask now removed, and the faint color was beginning to return to her cheeks.
Akihiko stood by the edge of her bed, his hands shoved into his scrub pockets.
For a moment, he simply watched, drinking in the sight of her alive and safe.
The sterile scent of antiseptic still clung to his skin, the fatigue of the surgery weighing on his shoulders—but none of it mattered.
She was here. She had made it through.
A nurse entered quietly to check her vitals and whispered, "Everything looks good, Dr. Nakamura. Stable."
He nodded silently, eyes never leaving Ayaka.
Time seemed to blur in the soft light of the recovery room. Minutes passed. Maybe longer.
Then, finally, he saw the faint flutter of her eyelashes. Her brows knitted slightly as if trying to register where she was.
"...A-Akihiko…?"
Her voice was faint, hoarse.
Without hesitation, he leaned in closer, his cool voice uncharacteristically gentle.
"You're okay." he murmured. "The surgery's over. Please rest first."
She blinked slowly, her gaze hazy, lips parting as if she wanted to say something more—but exhaustion pulled her back under before she could.
Akihiko straightened, exhaling a quiet breath, his expression unreadable. But the hand he rested briefly on the bedrail lingered longer than it should've.
"You scared me..." he whispered almost inaudibly, voice barely above the hum of the machines.