Knowledge, Wisdom, Humanity
"Cognitio Sapientia Humanitas" - Motto of the University of Manchester.
Despite Kakeru and Nana's position as professional footballers, part of their respective contracts with Manchester United included some accommodating for their medical studies, which included a long distance education program from the Tokyo Medical University (TMU) in the pre-clinical years. Clinical clerkship placements during the season were under the authority of the Manchester Medical School (MMS), one of the University of Manchester's several branches.
Because Kakeru and Nana had to deal with training sessions, clinical work, and midweek matches, it was impossible for them to keep up the pace and follow the same learning curve as other medical students do during the week. However, no one held it against the 2 Japanese footballers as their various supervising doctors provided very positive feedback regarding their progress in the circumstances. Most of the time, Kakeru and Nana would leave Carrington immediately after training to join the university hospital for the afternoon and even the early evening at times. Although players are advised to have the day off after a match, Kakeru and Nana always took advantage of the full day off to attend their placements at the hospitals, which was something that was appreciated by the supervisors.
For Kakeru and Nana, working in a hospital setting is the best way to keep their feet on the ground through a reminder of what a real job requires out of any person.
Thursday September 14
West Didsbury, Manchester, UK
7:10 AM BST
Kakeru, Nana, and Noriko were taking their breakfast ahead of this routine day of clinical work at their respective hospitals.
"So how are things going for you at Wythenshawe Hospital?" Noriko asked.
"Considering that we are in the first week of our current placement, we are still working on getting familiar with the place. Otherwise, everything else has been great." Kakeru replied.
"It's a nice place to work, isn't it?" Noriko asked.
"Yep." Nana replied.
"So far, I enjoyed every minute of it. I feel like this could be my favorite placement yet." Kakeru added.
"It's probably because the cardiology department reminds you of the time in Kamakura Central Hospital after the heart surgery you had many years ago." Nana said.
"That is a big reason, but the department is top class, and the people in the department have been very kind to me." Kakeru replied. "You're not doing too badly in the Lung Centre yourself."
"It has been decent so far. Nevertheless, you're the lucky one of us two since it matches one of your top interests, Kakeru." Nana said.
"I have been at Wythenshawe in one of my clinical placements in my 3rd year. You're right about the personnel at the hospital: they are really helpful and friendly. When you have quality personnel going with top quality material resources, there's not much that can beat that." Noriko said. “Are patients taking you into football talk?"
"Sometimes they do when they recognize us. It's inevitable in a city like Manchester. Nevertheless, most patients would rather speak about life in general. We enjoy having conversations about different topics with them." Kakeru replied.
"That's good to know." Noriko said.
"It must be quite easier for you to work in one department nowadays for your clinical apprenticeship year. Isn't it, Noriko?" Nana asked.
"It is. Since Trafford General Hospital opened their new orthopedic center, there is a huge array of procedures to which I work with. Day cases and procedures that require an in-patient stay are now carried out there. When you work every day with the same people in that environment, you feel more comfortable and the team chemistry is building up to become a very crucial element during a surgery procedure."
"It's just like in a football team."” Kakeru said.
"You got that right." Nana finished.
7:43 AM BST
By the time Kakeru and Nana arrived at the Univeristy Hospital of South Manchester NHS Foundation Trust (a.k.a. Wythenshawe Hospital), it only took 11 minutes of a drive between West Didsbury and the hospital.
"Whenever I think of this hospital, I can only think about fortunate we are to have a placement that close to our apartment. It could have been a lot worse." Kakeru said.
"I know. We could have been sent to some remote place like Preston. That would have been a bigger problem for us after training." Nana replied
"That's one more reason to make the most of it here, Nana."
"Well, enjoy your day. I'll see you after I'm done on my side." Nana said.
"See you later." Kakeru replied between kisses.
Kakeru and Nana then parted ways to their respective departments. The Wythenshawe Hospital's cardiology department is located in a building named the North West Heart Centre. Upon arrival, Kakeru greeted one of the nurses at the reception area for the department, a 32-year-old woman named Emily Mallory: "Good morning, Emily."
"Good morning, Kakeru. How are you doing today? Had a good evening yesterday?" Emily replied.
"It was really good; it's not like I had to go that hard on myself. I feel like having enough energy for a full day today."
"Good, good. I hope you will have a good time with the patients later today."
"I sure will." Kakeru replied.
"Hello, Kakeru. Hello, Emily." a fellow medical student named Nigel Bentley greeted both Kakeru and Emily as he just arrived.
"Hello." Emily replied first
"Good morning, Nigel." Kakeru said.
"I watched the match yesterday on television. You made quite an impression for a bloke who played only 30 minutes." Nigel said.
"Whenever I'm needed, I only want to make an impact out there." Kakeru replied. "Feeling ready for today?"
"Aye! Let's get the morning meeting done first." Nigel finished.
After a morning meeting that took place shortly after 8:00 AM followed by the daily round of all patients in the ward, Kakeru moved ahead alongside Nigel to get patient histories and examinations done as part of their common project in which they had to do at least a full case history and all physical examinations. One of their patients on the day was a 62-year old man named Geoffrey Stephens.
"Good morning, M. Stephens. How are you?" Kakeru greeted the senior first.
"Well mint, young ones. What about you?"
"I'm all good." Kakeru replied.
"Me too, M. Stephens." Nigel added.
"So what can I do for you today?" Geoffrey asked.
"Well... We were about to ask you if you would be available to help us with a project for our current placement. One of our projects requires us to find a patient where we do a full case history and a few physical examinations." Kakeru replied.
For a moment, Kakeru and Nigel looked at Geoffrey's body language. The 2 young medical students were not sure the answer would be a positive one, so much that they started expecting "no" for an answer. However, Geoffrey smiled in return.
"It's your lucky day, lads. Yes, I will let you do your examinations." Geoffrey said.
"Really? Thank you, M. Stephens!" Nigel replied.
"We really appreciate your help, M. Stephens."
"I'm due to be discharged from hospital early next week, so I'm fine with giving medical students a hand."
Then Kakeru and Nigel sat down, and started the session with questions about Geoffrey's case history.
"What exactly happened so you got admitted into Wythenshawe?" Kakeru asked.
"I had chest pains around 7 weeks ago, and then I collapsed in my house. Normally, I live on my own. But luckily for me, my son was coming to pay me a visit, and called the ambulance when he saw me on the ground a few minutes after I collapsed. At Wythenshawe, I got a coronary artery bypass surgery. The doctors told me that it was a close call because the damage could have been worse." Geoffrey replied.
"I see. You mentioned a son... Do you have other relatives?" Kakeru asked.
"My son is 33 years old, and I also have a daughter who is 28. My wife passed away a couple of years ago... cancer."
"Oh, I'm really sorry." Kakeru replied.
"We're really sorry to hear it, M. Stephens." Nigel added.
"It's OK; I'm finding ways to move on. After all, I still want to enjoy company with my grand-children; that's what she would have wanted from me." Geoffrey said.
“Very good then... Back to the main questions: Do you smoke or did you smoke?” Nigel asked.
"I used to, but quit smoking 2 years ago. I can say that it caught me up, and played its part in those chest pains."
"Any history of cardiac conditions in your family?" Kakeru asked.
"None that I know."
And so the interview on the patient's history went on a little longer. Once it was done, Kakeru and Nigel prepared their patient for their few examinations on particular areas such as cardiovascular, respiratory, and central nervous systems. Kakeru and Nigel knew their tests would be vital for their personal projects. Sometime later and after the examinations were done, Geoffrey gave Nigel a firm handshake, and let him continue ahead.
"Ah, young Mister Aizawa, can I talk to you for just a couple of minutes?"
"Of course, M. Stephens." Kakeru replied before he turned towards Nigel. "Nigel, can you go ahead? I'll join you with the next patient shortly."
Then Nigel left while Kakeru was sitting to have a little chat with M. Stephens.
"When I first saw you in this ward, I was wondering how a professional footballer has come to be a medical student at the same time. How did you do that?" Geoffrey asked.
"It's quite a long story. I'm sometimes surprised myself since there were times early in high school when I was quite a sloppy student." Kakeru replied.
"Can't say what kind of doctor you'll become, but you seem to enjoy cardiology. Why?"
"I have a friend... who lost his older brother in an accident that struck them both at the same time. In order to survive what should have been a fatal wound, my friend received a heart transplant from his deceased older brother. What's special about this friend is that he used to lack confidence in almost everything, but then found the strength to carry on the dream he and his brother once had for their future. My interest in cardiology somehow started when I saw him recovering there. Later on, I read some fascinating stuff about the heart." Kakeru replied, twisting his own personal story a little in order to protect his own secret.
"I see. Instead of dwelling in the past and feeling sorry for himself, that friend decided to do what's best after being allowed to have a second chance thanks to this gift."
"He did so indeed." Kakeru replied.
"It's the same thing for me after my wife passed away. One can cherish fond memories of the past, but has to move forward in order to live without regrets, and do what's best for the time that is given to each of us." Geoffrey said.
"I will surely remember that, M. Stephens. Thanks for the advice and for your help."
"I really appreciate it, young Mister Aizawa. Make the best out of everything. Good luck for your 2 careers." Geoffrey finished as both he and Kakeru gave each other a firm handshake.
Kakeru could feel the sincerity and the kindness in Geoffrey's words, so much that it brightened up Kakeru's day for sure. Every single contact with a patient was a good learning experience for Kakeru, but the contact with Geoffrey was more than just a valuable learning experience for the young Japanese man.
After performing a few supervised examinations on a few other patients and attending a presentation on how to review imaging studies, all over the next few hours, Kakeru and Nigel finally managed to have a little break between working sessions as they sat down in a small kitchen for the afternoon tea.
"Of everything we have today, I must admit that I still mostly enjoyed the time we spent this morning’s patient after the round... the one we 'recruited' for our full case project." Nigel said.
"I enjoyed his company too, Nigel. I hope he will soon play with his grand-children again; he deserves it after everything he had to go through." Kakeru replied.
"Your fiancée, Nana Mishima, is also having a placement here at Wythenshawe, right? The other day, I heard from a friend in the Lung Centre that he saw her there."
"Yes, she does, Nigel. We were lucky to be given our current respective placements in the same hospital."
"It must feel really good to have your sweetheart both studying in the same institution and also being a teammate on the pitch. Isn't it, Kakeru?" Emily asked.
"Yeah, it is something really special. I never thought things would turn out that way when we finished high school, but I'm very happy it did."
"Did you have to prove anything to United, except for the tryout, when they came in for both you and Mishima? I once read that Sócrates had to convince the board of his Brazilian club that he can both study medicine and perform on the pitch before they let him continue studying." Nigel asked.
"When United came to recruit both of us, Sir Alex already trusted us. I would lie to everyone if I said that no one at the club was worried about how we would deal between medical studies and the demands of being a professional athlete. Some people on the board of directors were very skeptical in our abilities to cope with everything, but we used that skepticism to motivate ourselves. And then we worked things out." Kakeru replied.
"That's very good to know. Sometimes I feel the footballing environment in this country lack intelligent and educated people, mainly because people still believe football should still be a working class game." Nigel said.
"That's what one of my friends in Manchester said. She is a big United fan, but she just can't find a solid reason to cheer for England because too many coaches don't put brains and skills above physical attributes." Kakeru replied.
"Then may both you and Mishima continue proving your doubters wrong for a long time." Nigel replied with a big smile.
"What kind of physician do you and Mishima want to be after your respective playing careers?" Emily asked.
"It's not set in stone just yet. Both Nana and I have strong interest in orthopedics in our way to graduate in sports medicine, but she also has a solid interest in working with children while I’m really enjoying my time in the cardiology department so far." Kakeru replied.
"If she enjoys working with children, then it might be a good preparation before she becomes a mother eventually." Emily remarked.
"It's... It's too early for us to think about that now." Kakeru replied, slightly red-faced by Emily's last comment.
"Of course I was teasing you, silly."
"I'm more or less in the same boat as you, Kakeru. I have a girlfriend that I really love. We have known each other since childhood, and I look forward to get engaged with her probably early next year. Even after we get married, it is still way too early to think about kids now. I guess it's about knowing when the right time is." Nigel said.
"How would one know when the right time is?" Kakeru asked.
"It's hard to explain, but you just know it when it is the right time. For example, I have a 3-year-old son, and I'm now 32. But still, I knew it was the right time to have my first child. What matters most is that both you and your spouse talk to each other, and then both get ready to commit yourselves when the moment of making the decision comes." Emily replied.
"There you go." Nigel said.
"Well, thanks for the wise words." Kakeru said before he finished his tea.
"Anytime. It's a shame you don’t spend many full days at the hospital. I'm sure people like me would enjoy talks like this during breaks." Emily said.
"I know, but I will make the most of those." Kakeru replied before he looked on his watch. "Oh! We have to go to the presentation now, Nigel."
"All right, Kakeru. Let's go!"
"Enjoy the rest of the day, lads." Emily finished.
5:25 PM BST
Kakeru followed the mid-afternoon presentation on a cardiac clinical issue, and then read on the effects of various cardiovascular drugs on patients during the second half of the afternoon. Towards the later stages of the day, Kakeru was finishing the day by writing up his daily reports in his designated office for the time of his placement in the cardiology department. For anyone working as a physician, healthcare specialist or as a medical student, it was the time when notes taken during the day have to be converted into concrete and official paperwork. At the time, Kakeru was the only person left in the office room for medical students.
"Man, what a day! Cardiology sure involves a lot of knowledge and hard work. Good thing I'm enjoying this kind of stuff because it would be hard if I didn't." Kakeru said out loud.
Then the phone rang, prompting Kakeru to answer.
"This is the cardiology department, Wythenshawe Hospital. Kakeru Aizawa's speaking."
"Hi Kakeru! I finished my day here. What about you?" Nana asked at the other end of the line.
"I'm almost done with writing the daily reports. Just give me 5 or 10 minutes at the most to wrap this up, and then I'll get to you."
"OK then. I'll see you in a few minutes." Nana said.
"See you later, bye." Kakeru replied before he hung up the phone.
Around a little less than 12 minutes later, Kakeru finally made his way to the parking lot where Nana was already standing by their SUV.
"Sorry for making you wait, Nana. It was quite a day in there, but a good one though." Kakeru said.
"It's OK, Honey. Tell me more inside the car; it's starting to rain." Nana replied before she gave her fiancé a quick kiss on his cheek.
After Kakeru and Nana went inside their SUV, they carried on with the discussion.
"Well, ladies first. How was your day?" Kakeru asked.
"It went OK, but I must say it is never easy at all when I'm the center of attention to all medical students. Guys were flirting with me while female students are a little jealous that I'm engaged to you." Nana said.
"Well, I know how you feel. I have been the center of attraction for the girls in high school since I earned my first appearance with the U-21 national team."
"Kakeru!" Nana shouted, slightly offended by the last remark.
"OK, OK, I take that back. Despite all of that, you know I only kept my eyes on you after all of this time. There's no reason to lose your cool because you receive extra attention in the working place. We already went through that back in Japan." Kakeru said.
"I know, but this is Manchester. We are almost looked at like Royalty even though we didn't ask to be."
"Manchester, Japan or anywhere else, we will always have to go through some extra attention because of what we are achieving. Still, this is no reason to feel that uncomfortable. After all, you endured a Nadeshiko Japan coach who was quite a perverted freak."
"Thank God the JFA replaced him with someone more serious on the job. But yeah, that was a lot worse." Nana replied before she let out a chuckle. "Thanks for nailing on the right head, Kakeru."
"My pleasure. I always thought that was the worst."
"OK then. What's your story for the day, Kakeru?"
"A quick morning meeting, rounding of all the patients, and then Nigel and I went to examine a few patients. It's about getting history, and performing a few examinations on a few patients as long as we get enough material for one full study case. The first patient we saw for that was a very interesting senior who was very kind to us."
"That's interesting. Tell me more." Nana said.
"After we finished the examinations, he talked with me 1-on-1 for a couple of minutes. He asked me how I came into medicine as well as one or two other subjects. There was one thing he told me, and it was something worth remembering of an advice." Kakeru replied.
"What did he say, Kakeru?"
"He said that one can cherish fond memories of the past, but has to move forward in order to live without regrets, and do what's best for the time that is given to each of us. He experienced a big loss, but followed those words to heart in order to get through and move on."
"He said that?" Nana said.
"Yep! As he told me, he wants to enjoy more time with his grand-children."
"That's good for him then. What else came in today?"
"After that, we had a few other examinations on other patients, a lecture on how to read imagery studies, and a lecture on the topic of pericarditis. Very interesting stuff and there’s always something new coming in every day."
"I wish I was in your department, Kakeru. Your face lights up after every day you spend there."
"I hope you will in one of your future placements. If that happens, there's a nurse named Emily. She's a good person to talk with about everything, especially about life as a mother."
Realizing that he slipped the word "mother" out of his mouth, Kakeru stammered, and tried to make Nana forget what he said last: "Ah! Never mind! Never mind! I just said that Emily is a very nice person to talk with, that's all. Ha! Ha!"
Then Nana smiled, and put her right hand on Kakeru's left hand. "You would like to see me as a mother?"
"What? No... Well, yes, but only a few years in the future... when it's going to be the right time, you know." Kakeru said.
Without waiting any further, Nana leaned from her seat towards Kakeru, and landed a kiss on his lips. "I feel the same as you, Kakeru. I'm not ready for kids yet, but I will eventually be. That right time, we will find it together in a few years. I promise."
"When that day will come, I know you will make a wonderful mother."
"Thanks, Kakeru. It means a lot to me." Nana replied before she remembered that she and Kakeru had to be on their way home. "Oh, shall we go or do you want to sleep in the parking lot?"
"Of course. Let’s go home then. We have to think about tomorrow's small training session" Kakeru replied. "The Toffees are coming to town on Saturday, right?"
"Yep! That's going to be a good test for us." Nana said.
"As always." Kakeru finished as he started up the SUV’s engine, and started driving on the way home.