Chapter 9: Mysteries

Chiba Mamoru gathered his notes that were spread across the podium into one neat pile. "And that concludes your orientation, and first lecture. You will find your first observation assignment posted in the staff lounge."

Ami tucked an errant strand of blue hair behind her ear and gathered her own materials before following the other medical students towards the lounge, as eager as anyone to know which resident she had been paired with for the first week.

"Mizuno-san, might I have a word?" Mamoru called her back before she escaped through the double doors of the teaching hall.

"What can I do for you, Chiba-san?" she asked formally with a slight bow of her head, though her playful smile spoiled the carefully crafted respectful tone just slightly. She couldn't help it – it felt almost strange to interact with one of her oldest and closest friends within the sterile set of social expectations between colleagues. But his stoic professionalism never cracked, and she sobered quickly. She had always been a master of propriety.

"One of the perks of being Chief Resident is that I make the schedule for the residents and students," he said evenly, like he was simply making an observation about the weather.

"Why are you telling me this?" she asked gently, not wanting to assume he was implying he could accommodate her senshi obligations because that didn't really need to be said. Did it?

"I just wanted you to know that if you feel awkward of uncomfortable being assigned to Stone, I can ensure that you are not."

"Are you offering me preferential treatment, Doctor Chiba?" Ami asked coyly, feeling ridiculously pleased that he would consider bending the rules for her. Mamoru had the distant demeanor of a supervising resident down to an art form, but he clearly was acting as her friend with this offer.

"I am," he said seriously. "I want you to get everything out of this experience that you can. And if Stone is a source of anxiety, you don't need to be paired with him."

"So, I take it he told you how we know each other?" she asked, nervously pushing another non-existent flyaway behind her ears, as her cheeks bloomed with an unexpected heat.

"You have nothing to be embarrassed about."

"I'm…" she said, intent on denying being embarrassed, but in reality, she was completely mortified. Not only had she been completely reckless, she then had the nerve to actually enjoy it, and was perhaps, if she was truly honest with herself, craving a repeat experience. Of course, she didn't want to explain any of that to Mamoru.

"Is he a good doctor?" she asked instead.

"He's the very best," Mamoru replied without hesitation.

She smiled back, clutching her notebook to her chest. "Then no, please don't give me preferential treatment. Doctor Stone and I have some sort of facsimile of an understanding. And I want to learn from the best."

"I thought you might say that," he told her with a smile. "If the situation changes, feel empowered to change your mind."

Ami offered him a small smile, "Thank you, Mamoru-kun."

She made her way across the hall to the staff lounge – grateful that her delay had caused the crowd to abate from the post of assignments. Instead, her peers occupied various seats around tables engaged in various conversations with each other and some of the residents on break. She found her name, and immediately smirked at her assignment.

She was shadowing Doctor Zevon Stone for the whole first week.

Mamoru really did know her too well.

As if summoned by her thoughts, the green-eyed blond doctor bounced into the room with dramatic flair, introducing himself with boisterous waving arms and wide grins that showed all his sparkling white teeth. He was so different from the reserved Japanese natives in the room, but most seemed to enjoy his exuberance rather than be put off by it, even if they didn't know how to respond to him.

Goodness knew Ami didn't either.

Doctor Stone turned from one group right into her personal space, and his eyes widened just slightly before his face split in an even wider smile. He offered her a hand, which she took, and he shook it cordially before bowing carefully.

When she reciprocated the sign of respect, he took advantage of her proximity with a soft whisper.

"Have you thought about it?"

Her eyes narrowed and she scowled at him.

He laughed and departed from her side quickly, swinging a stethoscope over his shoulders, eager to introduce himself to everyone in the room.

She continued to glare after him in displeasure. Perhaps, it wasn't too late to take Mamoru up on his offer for preferential treatment.

Zevon bounced into his Attending's office, still unable to wipe the grin from Ami's reaction to him off his face.

"Doctor Mizuno," he greeted. "I want to do a full exome sequencing on Kasshoku Sairasu and his parents."

Doctor Mizuno lifted one arched eyebrow from the report she was writing, and gave him the "You will not interrupt my train of thought. You will wait until I am ready to speak with you" glare.

He took the seat on the other side of her office and twiddled his thumbs impatiently.

Several minutes went by.

"Full exome sequencing is only to be considered when all other diagnostic options have been exhausted due to the expense. Kasshoku has been under our care for under two months in total. We cannot have already explored all the most likely explanations for the child's cryptogenic seizures."

"Hear me out," he asked, expecting the automatic dismissal, but he was well prepared for it. "You are correct that we haven't exhausted all the normal routes, but we have already eliminated the two most likely suspects. And now, we're essentially just throwing darts in the dark and hoping to hit something. If the patient has something rare, which we've already established he probably does, it may take months or years of testing before we get lucky. That will cost the hospital a lot. Not to mention, we could be costing the patient so much simply because we are not aware of already established treatment methods. And the hospital will have to cover all the 'treatment of the symptoms' approaches we'll have to take, when there could be a more cost-effective treatment already established."

"Rare syndromes typically don't have a lot of treatment options, due to the fact that they are rare and haven't been researched extensively."

"True, but it would still be short-sighted to avoid this exome sequencing and getting a true diagnosis immediately. The savings in the long run just on diagnostic testing will be significant!"

Mizuno Saeko sighed, as she tapped her pen against her notes rhythmically, seemingly contemplating his argument. Finally, she looked up at him again.

"I will have to talk to the Chief of Medicine to get special approval just to get it considered. I can make you no promises."

"I understand," he agreed with a sharp nod of his head.

Before he could say more, his pager went off, as did hers. Less than ten minutes later, he was on the patient floor and in the scarred coma patient's room.

"His skin lesions have darkened," the nurse reported.

The blond resident took a careful look – the bruises had turned into a deep purple, almost black. It did not bode well.

"Are his labs back? What have his last bacterial cultures shown?" he prompted.

"They have been negative sir."

"Negative?" he turned to Saeko. "This doesn't make sense."

She nodded in agreement. "What is his platelet count?"

"86,000."

The two doctors shared a look – the number was far too low – about half of what they wanted it to be, and could be a source of the patient's chronic bruising.

"Perhaps, the lesions are not a hematological infection, but internal bleeding?" his attending suggested.

"Blood pressure's normal. Red blood cell count is unusually high."

She dismissed the observation. "A high red blood cell count rarely has negative side effects. You said all the bacterial strains have come back negative? What about influenza or strep?"

"Negative as well."

"It's more likely to be an unknown virus," Zevon concluded out loud. "That would be difficult for us to detect."

The O2 alarm went off – Zevon glanced at the screen – oxygenation was at 88% and dropping.

"Pay that no mind," the nurse told them, as she quickly silenced the alarm. "I've been having trouble with that sensor all day and just waiting for a replacement to arrive."

And sure enough, the respiratory rate was normal, which it wouldn't have been if the oxygen was low. But his heart rate was a little bit higher than he would have liked.

He turned back to the patient, continuing to examine the lesion on the patient's neck. It was so dark in color, he wasn't sure the low platelet count could really explain it. That was when he noticed the patient's lips were an unhealthy shade of blue.

"He's in oxygen deprivation!" he barked. "Oxygenation down to 76%. Get me the tank!" But the patient wasn't gasping for breath; his respiratory rate remained normal. His attending followed his lead in this instance, aware that as a resident his knowledge of emergency protocols was more current than her own. They intubated him, but the numbers remained low, and his heart rate was climbing.

"I need a crash cart!"

The nurse was already wheeling the cart to the bedside. Seconds later, he went into cardiac arrest. But Zevon was already ready with the paddles. He placed them precisely on his patient's exposed chest.

"Clear!" he shouted, warning the other caretakers to step back.

The intervention had no effect. He tried again anyway.

After three attempts, Zevon tossed the paddles aside in disgust, and glanced at the analog clock on the far wall. "Time of death is four fifty-two," he reported.

"I want an autopsy," Doctor Mizuno ordered sharply. "They need to analyze tissue samples from every organ and from those lesions. We need to find the mechanism of this disease," she growled, "because that respiratory failure made absolutely no sense."

Ami softly tapped the door to the office that Zevon Stone shared with three other residents, peering through the window. She was quickly waved in and she slipped inside, bracing herself to fend off the flirtatious resident.

But Doctor Stone barely glanced in her direction as she took the seat next to his desk, his attention stolen by a series of textbooks, patient charts, and the glowing laptop screen.

"I'm a bit busy at the moment, Mizuno-san," he told her absently. "Perhaps you should talk to Chiba-san about whatever you need."

She relaxed into the chair, the tension between her shoulder blades dissolving at his continued lack of attention. "What are you working on?" she made herself ask.

He sighed. "Just trying to solve the latest impossible medical mystery."

"Perhaps I can be of aid?" she offered.

Green eyes turned to her then, and considered her for a moment before finally offering a small smile.

"It definitely wouldn't hurt to talk out everything I've noticed so far. I need to be prepared for an emergency meeting with Doctors Mizuno and Kinasuto this evening."

"Kinasuto?"

"Infectious disease specialist," he explained.

He laid it all out for her.

"So basically," she summarized back to him, listing off each symptom on her fingers. "We have a mystery disease that is characterized by unique symptoms including abdominal pain, a dry cough, skin lesions, seemingly minor respiratory distress, and unexplained dropping oxygenation. We have had no recoveries so far, and one fatality. The fatality in question died as if he was experiencing respiratory failure, but his lungs were in perfect working order? Wouldn't this suggest that the cells themselves weren't receiving oxygen?"

She chewed on her lips thoughtfully with all the new information. "Perhaps oxygen isn't making it to his heart?" she hypothesized.

"But that would cause his heart rate to skyrocket," the blond resident objected. "We saw that only at the very end."

"So, the heart was receiving oxygen then. The blood was not?"

"What would the mechanism even before a blockage between the heart and blood cells with no signs of cardiovascular disease?"

Ami shrugged. "We're clearly in uncharted waters here. Perhaps the pathologist's report will reveal something."

He turned away, his eyebrows furrowed as he considered their discussion.

The blunette smiled softly at his expression. She liked this side of him. The side that showed a doctor completely dedicated not just to providing standard care, but digging through every mysterious clue, determined to solve the puzzle this disease represented. He clearly cared deeply about his patients.

The blond resident sighed before glancing at her again. "I hate waiting for reports."

She laughed. "I imagine waiting for answers is always irritating."

He glanced at the analog clock on the far wall. "I still have some time before my meeting. Would you like to meet my favorite patient?"

She nodded, rising to her feet. He sprang upwards with a wide grin like a child on Christmas morning. She followed him through the same hallways he had guided her through the day before to a patient room. A child of about four or five occupied the bed. He turned toward them as they came in, and the boy's face lit up at the sight of the green-eyed doctor.

The dark-haired child held out a closed fist. Zevon reciprocated and they shared a fist bump, and Ami felt her heart melting at the precious sight.

"Hey there, little brownie. May I introduce you to a friend of mine who is going to be following me around a lot this week to help figure out what's going on with you?"

The boy nodded.

"Mizuno-san, this is Kasshoku Sairasu. He is here because we are trying to diagnose the cause of his epilepsy. We have been unable to completely control his seizures with anti-seizure medications, and are hoping if we can pinpoint the cause another treatment will be more effective."

"It is an honor to serve you Kasshoku-san," Ami greeted with a slight formal bow of her head, though her lips were spread in a wide grin. "I hope we have some answers soon!"

"Are you going to bring me stickers and balloons too?" the boy asked, eagerly.

Her blue eyes drifted toward the doctor at her side, and he smirked at her and then shrugged.

"I will see what I can do," she agreed. Surely, Usagi had a stash of stickers and toys, if evidenced by the birthday cards and party invites she received from her friend and would be willing to donate them to such a noble cause.

"Awesome!" the boy gushed, clapping his hands together in delight.

Ami definitely understood why this little boy was Stone's favorite. The child was clearly no stranger to the hospital environment and remained upbeat and positive despite all his medical hardships.

Perhaps she could text Usagi now. She'd love to be able to give the boy reason to smile.

Zevon sat amongst nearly half the hospital's staff in the lecture hall as Doctor Kinasuto ran them through the new protocols they were expected to follow to minimize transmission of the disease as well as recognize a spiraling patient. The blond resident was already familiar with the protocols, as he had in fact helped draft them the night before, but he was required to get the training anyway.

"We haven't identified a method of delivery for the disease as of yet, so we are operating under many precautionary measures," the tall woman began. "The standard obvious protocols include isolating affected patients, wearing disposable smocks that are discarded upon exit of an affected patient's room, and always wearing gloves and face masks within an affected patient's presence. Washing hands is always in your protocol, but it needs to be doubled in these instances."

Ami stood abruptly in the middle of the presentation, and made eye contact with Mamoru. He nodded in acknowledgment and waved her away. Zevon frowned at the non-verbal interaction. It was clear that Mamoru knew where she was headed, but if she had known she needed to leave early, why hadn't she informed him? He was her direct supervisor – not Mamoru.

"To identify a potentially affected patient there are several unique symptoms you should be watching out for. The first is usually a respiratory cough and skin lesions. We have found lesions in the mouth, face, armpits, and chest. Based on other disorders, we suspect the rash would begin with the soft mucus tissue of the nose, throat, and mouth, and spread from there. The lesions may start out as a simple reddish mark on the skin, gradually turning to blue, and finally to a deep purple. This progression is contraindicated and once a patient reaches this point, they are unlikely to survive."

Zevon knew that Ami and Mamoru were friends, but he also knew that neither were the type to breach any kind of protocol. So why did neither of them think to inform him of her planned absence?

"The respiratory failure that we have observed in two cases that led to patient death did not progress as typical respiratory failure does. In both cases, oxygenation plummeted while the respiratory rate remained steady. We recommend that you order your nurses to set up a second oxygen sensor, so that you have two numbers to compare. You should not assume that your O2 sensor is not getting a good reading if oxygenation starts to fall."

The addition of the second O2 sensor had been his own idea, and both Kinasuto and Mizuno Saeko had seized upon it as a good practice in this particular strange context.

"This is all we know at this time. We don't currently have a good understanding of the underlying mechanism of the disease. We are waiting on Pathology's reports on the autopsies. We currently have no viable treatment options, but the longer you keep your patients alive, the more likely they will live long enough to benefit from any treatments we do develop in the future. Thank you so much for your time."

The audience immediately broke into a gentle murmur as the staff began to compare notes and reactions. The blond wasted no time in chasing Mamoru down before his friend could slip away into the crowd.

"Where did Mizuno-san go?" Zevon asked without preamble.

"She had a personal matter to attend to. I didn't ask for further details," Mamoru explained, as he wove his way through the exiting crowd.

"Then why did she come to the briefing at all? She was only there for ten minutes."

Mamoru laughed, his hand rubbing the back of his neck, "You don't know her very well yet. She will be here for every minute that she is able."

"Why did neither of you think to inform me of her absence?" he asked, puzzled. Mamoru and Ami both seemed to obsess over the details, and the lack of communication from either of them seemed completely out of character.

"She only just heard before the meeting had started. I think she just didn't find you until after Kinasuto had started her presentation."

Zevon thought back. He had been in his office until just a minute before the scheduled lecture. The explanation made sense, but… something still seemed off. Especially the way Mamoru was avoiding his gaze. The resident shrugged off his suspicion. He was probably reading too much into things. Mamoru had plenty of reasons to be a bit stressed and focused on other things besides interns needing to take an afternoon for person reasons.

"Gentlemen!" Saeko poked her head into the hallway outside their shared office.

"There was another youma attack. You both are needed in the ER."

"Between mystery epidemics and paranormal monsters, we never get a break!" Zevon complained.

Mamoru laughed. "You would get bored."

"Probably," the blond conceded with a bright grin.

Ami looked up from the book she was enjoying from the comforts of the resident lounge when she heard one of the office doors open. She watched, with a small frown as Stone slipped out, his shoulders slumped, and his usually humorous green eyes downcast. He caught her gaze, and offered her a small smile, but it did not reach his emerald orbs.

"What are you doing here so late?" he asked.

"Mamoru is my ride home," she said by way of explanation. Truth was she didn't actually need Mamoru to get home, but it had been their original plan before the youma attack and she thought that he could use the company since Usagi was currently slightly out of commission and couldn't come herself. "You okay?"

"We lost four more patients today," he confided. "Three to trauma, and another to the mystery disease."

"I'm sorry to hear that. What do you need?"

He shrugged. "It's a part of the job. Some losses you feel harder than others."

"And what was hard about these losses?"

He took a seat next to her on the lounge chair.

"I just felt helpless. Sometimes, you do everything right, everything that can be done, and it's just not enough. Those deaths are easier somehow to deal with because you know you did your job. But when you are presented with something you don't understand, where you just don't know what you're dealing with and therefore don't know what to do," he shrugged. "That feels like you're doing someone a disservice – letting them down. Because it's our job to know how to heal people."

She put a comforting hand on his arm.

"You sure you still want the job?" he asked with one eyebrow raised playfully.

She smiled back. "Well, you clearly need some help."

He barked a laugh. "Thank you, Mizuno-san. Somehow, I feel a bit better having you on my team."

"Ami," she offered.

"What?"

"My friends call me Ami."

He grinned. "Thank you, Ami-san."

"My pleasure, Zevon-san."

Mamoru came in through the main door, and Ami quickly rose to her feet, certain he was anxious to leave. She waved a casual goodbye to her supervisor of the week, delighted that they were becoming friendly without the entangled tension from their first meeting making things awkward.

"Good night, Zevo-kun," Mamoru said.

"Night, Mamoru-kun!"

Mamoru pushed open the door into the main hallway, and gestured for Ami to proceed him. She smiled and ducked through the door, and he followed her closely.

The second the doors fell closed behind them, Mamoru wasted no time. "How is Usako?"

"She's fine Mamoru-kun," Ami reassured quickly. "Just a twisted ankle. I'm sure you'll have her up and about in three seconds flat!"

"Why didn't she come to the hospital? I could have seen her between patients or procedures or meetings," he rambled, a hand nervously sweeping through his inky black locks.

Ami couldn't help but be amused by his anxious, and mostly misplaced, worry. "I'm certain she didn't want to draw attention to you."

"But she's been in pain for hours," he objected, as if that was the worst possible reality.

"She's survived far worse," the blunette attempted to placate him.

"Don't remind me," Mamoru grumbled.

Zevon walked silently about twenty paces behind his friends. They had both clearly assumed he had remained behind in the lounge, and not followed them ten seconds after they left. And so, they hadn't filtered their words at all.

There was clearly a secret between them. Part of him felt he shouldn't pry. If there was one thing he had learned about his time in Japan, it was how much the the people valued their privacy.

But another part - the curious inquisitive part - wanted nothing more than to unwrap and solve this mystery.

He now had a lot to think about.

A/N:

This update is so overdue! But you see, I had to figure out how I wanted my disease to work. And that took a lot of research and talking to a real life infectious disease specialist (also one of my best friends, so it wasn't like I didn't have access). And I wanted it to thread into my plot, but still be kind've both sort've believable and completely Sailor Moon. It took forever, but I'm so excited about it!

And I have no idea how I survived without a beta. Because the first draft of this chapter was beyond rough! And I just didn't want to fight it anymore! But then TinaCentury betaed the whole thing and pinpointed like exactly what needed to be addressed! She helped me make it SO MUCH BETTER! She's also the best – because she had to catch up on the whole story to be able to beta this chapter. Thank you so much for your time and perspective Tina!

Reviews are love!