CHAPTER 44: THE DOCTORS AUTHORITY (⁠ʘ⁠ᗩ⁠ʘ⁠’⁠)

They sat down to wait. Sarah’s parents tried to make small talk, but their words fell flat in the tense atmosphere...

Leo didn’t even try. He just sat beside Sarah. He could feel her trembling slightly, and he wrapped his arm around her, pulling her close...

"Babe, it’s going to be okay," he whispered into her ears...

She leaned her head on his shoulder, closing her eyes. "I really hope so."

They waited for what felt like minutes. Every time a nurse came out and called a name, they all tensed up, their hearts leaping with a mixture of hope and dread...

Finally, after what seemed like an hour, a nurse with a beautiful and kind-looking face and a warm smile appeared at the door...

"Sarah Sakura?"

Leo’s heart pounded in his chest. This was it. The first step. He squeezed Sarah’s hand one last time and helped her to her feet. Her parents stood up as well, their faces pale with anxiety...

"You should follow me," the nurse said gently and started moving.

They followed her down a long and white looking hallway. She led them into a small, quiet examination room and instructed Sarah to sit on the edge of the examination table... She took Sarah’s blood pressure and temperature, her movements calm, calculated and professional...

"Dr. Aoki will be with you in just a moment," she said before leaving, closing the door softly behind her...

The four of them were left alone in the small examination room. It felt like the walls were closing in on them.

Leo stood by Sarah’s side, his hand resting on her lap... Her parents stood awkwardly by the door. No one spoke. There was nothing left to say. All they could do now was wait for the doctor who held the future of their daughter in her hands...

The minutes in the small examination room stretched into an hour... The air was thick with anxiety...

Leo stood beside the examination table, his hand resting on Sarah’s lap, a small but meaningful point of contact in the most crucial moment in her life, that felt like it was spinning out of control...

Sarah’s parents stood huddled by the door, looking drained and lost, their faces were a mask of fear and regret...

Finally, there was a loud, decisive knock on the door before it swung open...

A woman in a smooth white coat stepped inside, a tablet in her right hand... She was shorter than Leo had imagined, with dark hair pulled back in a neat bun and calculative, intelligent eyes that seemed to take in the entire room in a single glance...

This was Dr. Aoki. She carried an air of calmness and authority that immediately commanded the room...

"Good morning," she uttered, her voice was very clear and direct. She looked first at Sarah, offering her a small but professional smile. "Sarah, I’m Dr. Aoki. I’ve just been reviewing the referral from Dr. Katana."

Her gaze then moved to the others in the room. "And you must be her parents," she said, nodding to them, "and you’re Leo Kuroko." It wasn’t a question. She had clearly been briefed...

"Thank you for seeing us on such short notice," Leo said, his voice steady.

Dr. Aoki’s focus returned to Sarah. She pulled up a rolling stool and sat down, so she was at eye level with her...

"Dr. Katana tells me you had an incident of hemoptysis two nights ago. Can you tell me about it?"

Sarah hesitated, glancing at Leo. He gave her an encouraging nod. "I... I just started coughing," she began, her voice quiet. "And there was blood. Not a lot, but... it was there."

"Any dizziness? Chest pain? Shortness of breath before it happened?" Dr. Aoki asked, her eyes never leaving Sarah’s face...

"I was just tired," Sarah whispered, pinching her fingers.

The doctor nodded, making a note on her tablet. "And you’ve been feeling more fatigued lately? More than usual?"

"Yes," Sarah admitted, nodding frequently...

Dr. Aoki looked up from her tablet. "Sarah, I’m going to be very direct with you, because I believe in being honest with my patients... What you experienced is a sign that your heart is under significant strain. The medications you’re on are no longer enough to manage your condition. Our goal now is to figure out exactly how much your heart function has declined and determine the best path forward. That path, as Dr. Katana mentioned, will likely involve an evaluation for a heart transplant."

She said the word ’transplant’ with a calm, clinical precision that stripped it of some of its verbal terror... It was no longer a vague, monstrous possibility; it was a medical procedure, a step on a path forward...

Sarah’s mother let out a small, choked sob from the doorway. Dr. Aoki glanced at her with a look of professional empathy before turning back to Sarah...

"This is going to be a lot to take in," she responded. "And it’s okay to be scared. But my job is to give you the facts and to create a plan. Our first step is to run a series of tests. We need a new echocardiogram to get a clear picture of your heart’s size and function. We’ll do a cardiac MRI for a more detailed look at the heart muscle. We’ll also do a right heart catheterization to measure the pressure inside your heart. It sounds like a lot, but each test gives us a crucial piece of the puzzle."

Leo, who had been listening intently, spoke up. "We made a list of questions."

Dr. Aoki nodded, turning her attention to him. "Good. Ask them."

Leo pulled out his phone. "What are the stages of heart failure? Where is she right now?"

"Heart failure is typically staged from A to D," Dr. Aoki explained patiently. "Stage A is being at risk. Stage D is advanced heart failure, where patients have severe symptoms even at rest. Based on your recent symptoms, Sarah, you are likely in late Stage C or have progressed to Stage D. These tests will tell us for sure."

Sarah’s father, who had been silent until now, finally spoke, his voice shaking. "And the transplant list... how does that work?"

"The evaluation is comprehensive," Dr. Aoki said, addressing him directly. "It involves medical testing, as well as psychological and social evaluations to ensure the patient has a strong support system, which is critical for a successful outcome." Her eyes moved to Leo and then back to her parents. "Once a patient is approved and listed, their position on the list is determined by medical urgency, not just time spent waiting. The sicker you are, the higher you are on the list."

The forced logic of it settled heavily in the room. To get a new heart, she had to be sick enough to be at the top of the list, but healthy enough to survive the surgery. It was a terrifying tightrope walk...

"What about the risks?" Leo asked, his voice tight.

"There are always risks," Dr. Aoki responded honestly. "The surgery itself is complex. And after the transplant, the biggest challenges are organ rejection and infection. It requires a lifetime of powerful immunosuppressant medications and very careful monitoring. It’s not a cure; it’s a trade-off. You trade one set of problems for another. But it is a chance at a longer life."

She stood up and moved to the examination table. "Alright, Sarah. I’m just going to listen to your heart and lungs."

Her movements were gentle and efficient as she placed the cold iron stethoscope on Sarah’s chest and back, asking her to take deep breaths. Leo watched her face, trying to read her expression, but it remained professional and unreadable...

After a few moments, she finished and stepped back. "Your heart rate is a little fast, and I can hear some fluid in your lungs. It’s consistent with what I’d expect."

She turned to face all of them. "Here’s what happens now. I’m admitting you to the hospital today, Sarah."

Sarah’s head shot up. "What? Why?"

"Because of the hemoptysis," Dr. Aoki explained firmly. "I’m not comfortable with you being at home right now. I want to get your fluid levels under control with IV diuretics and monitor you closely while we begin the evaluation process. We can get most of the initial tests done right here over the next few days. It’s the safest and fastest way to move forward."

The idea of being admitted, of being trapped in the hospital, was clearly terrifying to Sarah. She looked at Leo, her eyes watery and wide with panic...

He stepped forward, placing his hand on her arm. He looked at Dr. Aoki. "How long?"

"A few days, maybe a week, depending on how she responds and how quickly we can get the tests scheduled. It’s the best course of action."

Leo looked down at Sarah, whose face was pale. He knew this was another blow, another loss of the normalcy she craved for. But he also knew the doctor was right. The time for pretending was over, it was a do or die affair...

He knelt in front of her, so they were at eye level again. "Hey, babe," he exclaimed softly. "It’s okay. A few days. I’ll be here the whole time. I’m not leaving. We’ll do this, just like we said. One step at a time. This is the next step."

Sarah looked from his steady gaze to Dr. Aoki’s calm and confident face, and then to her parents, who were nodding in agreement, their own fear overshadowed by the doctor’s authority. She took a shaky breath and nodded...

"Okay," she whispered.

Dr. Aoki gave a small, approving nod. "Good. I’ll have my nurse come in to start the admission process. I’ll see you again this afternoon on my rounds."

With that, she turned and left the room, leaving the words with her...

Leo stood up and squeezed Sarah’s lap...