Polite Dissent

Chapter Synopsis (continued)
After another brain surgery², Kenma bumps into Dr. Becker who warns him not to get involved in hospital politics. He talks briefly to a nurse³, and then has an unsettling encounter with the Turkish wife who accuses him of letting her husband die. Apparently, Tenma was originally supposed to operate on her husband, but was shifted at the last minute to the celebrity patient. She blames Tenma for the subsequent death of her husband.

Later, while eating dinner at a fancy restaurant with his girlfriend, Tenma is mulling over what the Turkish woman said. He has read the chart and thinks that he could have saved the man’s life had he been the surgeon⁴. He suspects he was pulled away from the original case because the singer was more famous and would bring more prestige to the hospital. His girlfriend gets upset that he is obsessing about this during their dinner, and pointedly tells him that “not all people are created equal.”

As the chapter ends, there has been a brutal murder of an East German expatriate family. The mother and father are dead. The daughter survives but the son has sustained a bullet to the brain and is in critical condition. Dr. Tenma is paged…

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Footnotes:
^2. Dr. Tenma is performing more brain surgery here, but the exact nature of the surgery is hard to determine. It is safe to assume that it involves the area of the brain known as the cerebellum because that is where the pyramis is.

^3. Dr. Tenma tells the nurse to increase the patient’s Inovan 3 gammas. Inovan is one of the brand names for the drug Dopamine. Dopamine is a class of drugs known as a pressor and it is used in critically ill patients to keep their blood pressure high. It is given by an intravenous drip in tiny amounts. A “gamma” is a term some doctors use for a microgram. In the United States, Tenma would have told the nurse to increase the Dopamine drip by 3 “mikes.”

^4. The Turkish construction worker suffered a blow to the head during a construction accident. This tore open one of the blood vessels in the head leading to a large subdural hemorrhage (a subdural hemorrhage occurs outside the membranes surrounding the brain, while a subarachnoid hemorrhage occurs between these membranes and the brain). The pressure from this large hemorrhage herniates the brain, pushing it down toward the spinal column. This injures the brainstem, which is unfortunate as the brainstem controls many of the basic functions of life including breathing and heart beats. A severe injury to this area of the brain is fatal.

Tenma feels that if he had been the surgeon, he would have been faster at drilling a hole in the skull (craniotomy) to relieve the pressure and would have been able stop the brain from herniating.

Tags: comics medicine herniation dopamine naoki urasawa monster