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Useful Knowledge

Sunday October 28

West Didsbury, Manchester, UK

2:10 PM GMT

One of the most recurrent habits for Premier League footballers who played their respective matches on the Saturday is to watch the Super Sunday, which is Sky Sports' flagship live association football programme on television since 1992. On Sundays, a number of high-profile fixtures take place on the 4:00 PM (UK time) timeslot. However, other regular kickoff times on Sundays can also take place at 1:30 PM when there are at least 2 matches to be played on a Sunday.

That habit also caught up Kakeru, Nana, and Yusuke quickly after they first arrived in England. One fixture caught their attention on that particular early afternoon just after lunchtime: Leicester City F.C. vs. Arsenal F.C. at the King Power Stadium. Kakeru and his friends were hoping that Arsenal could be stopped. But by the end of the first half, things didn't go really well for Leicester City.

Rob Hawthorne: Good tackle by Oda on Sera... Now it's Araki for Arsenal... Great through pass for Jenpa! It's 3-0 for Arsenal with only 5 minutes before the break.

Meanwhile, Kakeru and Noriko could only sigh in exasperation at the scoreline while Nana and Yusuke stayed as frosty as they could.

Alan Smith: That was a quality finish by Jenpa, but it all started in the middle of the pitch. Sera has no passing options to go for, and the moment of hesitation allows Oda to steal the ball away from him. Araki picks his spot with a perfect pass between the 2 Leicester City defenders to find Jenpa, and the Cameroonian was not going to miss.

"Man, they are totally useless. Uselsss!" Noriko said.

"I was expecting Sera-san and Takajo-san to have a good performance for Leicester City, but they did nothing good at all today." Kakeru added.

"Credit has to go to Arsenal. It looks like Oda-san had his word in organizing both midfield and defence to neutralize Takajo-san completely. And besides, that silly red card doesn't help Leicester City at all." Nana replied.

"From there, Sera is easily isolated by Oda-san and Araki-san. With Sera and Takajo-san both neutralized, Leicester City are toothless. This match is already done before we get to halftime." Yusuke added.

"Yeah, I guess that's it then. I'm turning this off." Kakeru said before he turned the TV off.

"So, what do you want to do on a Sunday afternoon?" Nana asked.

"Well, I want to enjoy a little football match with local kids. Are they playing in that park on Sunday afternoons?" Yusuke said.

"They always do." Kakeru replied. "Have you been really thinking about this?"

"Sure. After the hectic month we just had, I still owe Brendan and Claire a couple of autographs after all. So it should be a perfect occasion to give them just that, and to have some fun at the same time." Yusuke replied.

"That sounds like a great idea. I'm in." Nana said.

"Me too." Kakeru added.

"I would like to join too." Noriko said.

"Really, Noriko?" Nana asked.

"Of course! I'm in the mood for some today, especially with a rare sunny day at this time of the year." Noriko replied.

"The more, the merrier. It should be really good." Kakeru said.

"I will pick up a few collection cards with my picture and my autograph on each of the cards; it's for the kids. Then we get on the move, OK?" Yusuke said.

"OK!" Kakeru finished.

A short time later, Kakeru and his friends got on their eastwards way to Fog Lane Park, located in East Didsbury. At the moment they arrived at the park, the kids, aged between 8 and 11, were already there playing football under the watchful eyes of the parents who accompanied them. The first kid who spotted Kakeru and his friends was Claire.

"Nana! Kakeru!" Claire greeted.

"Hello there!" Nana greeted back.

"Nice to see you again guys." Kakeru added.

"We didn't know you would come." a boy among Claire's friends said.

"We just felt in the mood to have a match with you guys." Kakeru replied. "Noriko and Yusuke are also here with us."

"Hello!" Yusuke greeted the kids. "Before we get in the game, who wants autographed cards?"

"Me! Me! Me!" the kids shouted altogether as they surrounded Yusuke.

"There are plenty enough for everyone; no need to push. Hey Kakeru, I need some help here." Yusuke called for some order, which got both Nana and Noriko laughing while Kakeru came in to give Yusuke a hand in distributing the autographed cards.

"You're getting quite popular, Yusuke." Noriko said.

"Noriko got that right. The kids already love you after a little more than 2 months in Manchester." Nana added.

Then Brendan and Claire's mother, Olivia, came in to have a little talk with Nana and Noriko: "Yusuke Saeki is already one of my children's favorite players."

"Hello, Mrs. Walker." Noriko greeted.

"Nice to see you again, Mrs. Walker. How are you doing?" Nana asked.

"I'm doing great, thanks. What about you two?" Olivia returned the question.

"October has been quite hectic for us so far, but it's nothing that we can't handle. Yusuke brought up first the idea of coming here today, but we all felt that it was the perfect day to play with the kids, and to clear a few things off our minds before we get back to work tomorrow. The next 2 matches in the League are huge for the standings." Nana replied.

"Especially on next Saturday, it will be a match that neither side will want to lose. I will be there with my cousin in the middle of the travelling group. Regardless, let's keep the League out of the picture for today." Noriko added.

"You're quite right. Well, enjoy yourselves. The other parents and I will stand watching." Olivia said.

"Thanks, Mrs. Walker." Nana finished.

After receiving Yusuke's autographed cards and leaving those in their parents' good hands for the moment, the kids gathered with Kakeru and his friends for their little game. It was a good old-fashioned and fun drill in which the team of Kakeru, Nana, Yusuke, and Noriko passed the ball around while the children were chasing for the ball until it gets intercepted. Following an interception, the roles would be immediately reversed between passers and chasers. The 4 adults displayed their vast array of skills which included body feints, stepovers, heel flicks, nutmegs, and various moves loved by both skilled footballers and freestylers alike.

Around 20 minutes into the little game, it was the kids' turn to be the passers. However, Brendan mis-kicked a pass that got intercepted by Kakeru. After Kakeru let the play go towards his friends, he went to check on Brendan personally.

"Are you OK, Brendan?" Kakeru asked.

"Yeah, I'm fine." Brendan replied.

"Are you sure? It's not like you to be that sloppy."

"I'm fine, really."

Then Kakeru put his right hand on Brendan's forehead. There was no room for imagination.

"You have quite a fever there. It's better for the moment that you sit with your mother for now; I don't want you to get hurt out there. Please do it for me." Kakeru said.

"OK." Brendan accepted reluctantly, and walked his way towards his mother. However, Kakeru kept his eyes on the English kid. Brendan was also rubbing the left side of his lower back.

"Brendan, what is going on? Are you all right?" Olivia asked.

"I'm fine, Mom... I really..." Brendan then suddenly collapsed on the ground, and started throwing up.


Having heard Olivia's shout, and seeing Brendan down on the ground, everyone stopped playing. Kakeru immediately ran his way to attend the English boy. Within seconds, Noriko also joined Kakeru.

"Brendan! Talk to me. What is going on?" Kakeru asked.

"It... really hurts... low at the back."

"OK, we'll get help." Kakeru replied before he turned to Nana. "You have your phone in your bag, Nana?"

"Yes. I'll call for an ambulance now."

Then Kakeru talked to Brendan once more in order to know a little more about his condition: "Brendan, I need you to tell me and Noriko the truth. Nobody will scold you, OK?"


"Was there something different in the last 2 weeks? Something like a painful feeling when you pee, or do you pee more often than normal?"

"It was painful... and I had to go often... yes, for 2 days last week. I was OK after that... until it came back today." Brendan replied.

"Was there anything odd in the urine?" Noriko asked.


"How did you feel in the last few days?" Kakeru asked.

"Since Friday... I didn't eat much. It's only this morning... that I started feeling pain right here." Brendan replied as he put his hand on the left side of his lower back.

"Thanks, Brendan." Kakeru said.

"What are you thinking, Kakeru?" Noriko asked.

"I'm not 100% sure, Noriko. However, those are typical signs of a pyelonephritis on his left kidney area."

"I only read stuff about it, but I believe you."

Less than a couple of minutes later, the ambulance arrived in the park.

"What happened to the boy?" one of the paramedics asked.

"His name is Brendan. He collapsed to the ground, and started throwing up. He has fever, and complained about low back pain around his left kidney area. It could be pyelonephritis." Kakeru replied.

"You really think so?" the paramedic asked.

"Kakeru Aizawa is studying medicine, Phil. I doubt he would say that out of thin air." the other paramedic said.

"You can ask the hospital to check his blood and urine, but please tell the nephrology department to get ready anyway." Kakeru said.

"OK, I'll call the hospital." Phil replied before he turned towards Brendan. "Brendan, my name's Phil. This is my partner, Joseph. We are the paramedics who will take care of you. What we are going to do is to get you on the stretcher, and take you to the hospital, all right?"

"All right."

"Where is the ambulance going?" Kakeru asked.

"To the Royal Manchester Children's Hospital." Joseph replied.

"Please go with Brendan to the hospital, Kakeru." Olivia said.

"You are sure?"

"I'll call my husband to pick up both Claire and I on his way. Besides, we trust you as a friend of the family." Olivia said before Kakeru replied with a nod.

"Hop in, Mr. Aizawa." Phil said.

"I will try to keep myself updated as much as I can. I'll see you at the Royal Children's." Kakeru said to his friends and to Olivia before he left with the ambulance.

"Is Brendan going to be fine, Nana?" Claire asked. She was still a shocked by the turn of events.

"You have to believe your brother will get better. He's a fighter and, in his mind, he will always win." Nana replied while comforting Claire with a hug.

"I also think he will be fine too." Yusuke added.

"We'll let you go with your mom now. We will go to the hospital soon too." Nana said.

"I'll see you there later."

"Stay strong, Claire." Nana said before she let Claire go. And then, Nana, Noriko, and Yusuke gathered around to discuss about Brendan's condition.

"So what did Kakeru say to you over there?" Yusuke asked first.

"He believes Brendan has a pyelonephritis. Without going into full details, it means that Brendan's left kidney might be hit by an infection." Noriko replied.

"Damn. Did Brendan say anything about his first symptoms?" Nana asked.

"He said he had pain while urinating, and he went urinating more frequently often than usual last week. It was like that for 2 days before it appeared to get back to normal. After that, those symptoms reappeared today alongside that fever. He also said he didn't eat as much since Friday."

"Normally, time plays in his favor according to what you said. But we can't say for sure until he gets a full diagnosis on the gravity of his condition. I'm crossing my fingers hoping that it is not too severe, and that it is not beyond the acute type." Nana said.

"Kuwabara kuwabara." Yusuke finished. His last sentence was analogous to the English phrase "knock on wood."

By the time the Walkers, Nana, and Kakeru's friends arrived at the Royal Manchester Children's Hospital, Kakeru was still waiting in the visitors' room while Brendan was still under treatment. At the same time, another person came up alongside Kakeru's friends.

"Hello, Kakeru."

"Hello, Sarah. What are you doing here?"

"When Noriko told me that one of the kids she's acquainted with was brought here, I thought I might introduce myself to him and to his parents since I work in this department during the week." Sarah replied.

"How is Brendan doing, Kakeru?" Timothy, Brendan's father, asked.

"It's hard to say. Since they brought him to the hospital, I don't know what's going on. If the condition is what I believe it is, I guess they took blood and urine samples before they start treating him with antibiotics." Kakeru replied.

The waiting time took several minutes more before someone finally came asking for Timothy and Olivia. The person was a man in his early 40s wearing the outfit of a physician.

"Mr. and Mrs. Walker?"

"Yes?" Timothy asked.

"I'm Dr. Jonathan Montgomery, nephrologist at the Royal Manchester Children's." the man replied, transpiring a slight Scottish accent in his voice.

"What happened to my son? How is he doing?" Olivia asked worriedly.

"First of all, he is doing fine now. If I may, I would like to talk only with you and your husband, Mrs. Walker." Jonathan replied.

"Dr. Montgomery... Kakeru Aizawa is a friend of the family, and he's also studying medicine." Timothy said.

"He was the one who tipped the paramedics to lead my son to the nephrology department upon arrival." Olivia added.

Then Jonathan turned his gaze towards Kakeru. "Is this true?"

"Yes, Dr. Montgomery." Kakeru replied.

"Well, you can stay. I will also ask Ms. Davies here to attend the meeting with us; she's a clinical trainee under my supervision."

Finally, Nana, Yusuke, Noriko, and Claire stayed in the visitors' room while the discussion took place in Montgomery's office behind closed doors.

"Mr. Walker, your son shows typical symptoms of pyelonephritis such as fever, vomiting, and pain to the lower back. Since it's the first time he suffers from it, the condition can be categorized as the acute type at the moment. A pyelonephritis... It's an infection to a part of his left kidney. It came from an infection to the urinary tract which went undetected and untreated."

"I only noticed that he went to the bathroom more often for 2 days during last week, but then it went back to normal. He didn't have any fever until today." Olivia said.

"Symptoms often can come together only in a matter of hours, Mrs. Walker." Sarah replied.

"We performed blood and urine analysis, so we identified the bacteria, and started intravenous antibiotic treatment with the right antibiotics. That intravenous treatment might take between 48 and 72 hours before switching to the use of oral antibiotics if the infection is reduced. We can monitor the infection with imaging techniques like ultrasounds. He should be up for a discharge in 10 to 14 days if there are no further complications."

"Thank God." Timothy and Olivia both sighed in relief.

"He's going to be all right, you see?" Kakeru said.

"I must say that you had the right eye for this, Mr. Aizawa. With the details you provided to the paramedics, we were able to intervene quickly, and we prevented any further damage."

"Well... I spent one of my clinical placements in nephrology back in July. I'm just glad my knowledge proved useful." Kakeru replied modestly.

"You have every right to be very glad about it. Your knowledge was indeed very useful in an emergency situation."

"We will take good care of him, we promise. Brendan is in good hands now." Sarah said.

"Can we see Brendan now, Doctor?" Olivia asked.

"Yes, you can go and talk to him. He would certainly enjoy having familiar faces around him now."

"Thank you, Dr. Montgomery." Timothy finished.

After Claire was allowed to join her parents for the moment, Kakeru went back to his friends. However, the first thing he did was to find a seat and sigh in massive relief for himself. There was a moment of silence; nobody was sure where to start the talking until Nana spoke first.

"Is everything OK, Kakeru?" Nana asked.

"I'm OK, Nana. I was right about Brendan's condition: he has an acute pyelonephritis. The doctor said that Brendan should be able to get out of the hospital in 10-14 days if everything goes right in the treatment."

"Then it's good for him. I guess you're feeling a little stressed out." Yusuke said.

"I do. It was the first time I had to react in an emergency medical situation. I also had to use my knowledge to narrow down a possible diagnosis in the process of helping someone." Kakeru replied.

"I can understand you, Kakeru. At the same time it was scary, you felt the adrenaline while doing so; this is why you feel stressed out." Noriko said.

"It's alright, Kakeru. What matters most is that you were of great help to Brendan and to the people who can treat him." Nana said as she wrapped her arms around Kakeru to comfort him.

A few seconds later, Sarah and the Walkers arrived back to the visitors' room.

"Hey, Kakeru. Brendan is asking you to come and see him." Sarah said.

"What for?" Kakeru asked.

"I don't know. He really wants to have a talk, just the two of you." Olivia said.

"All right, I'll go."

Sarah then led Kakeru towards Brendan's room before she closed the door after Kakeru moved in. Brendan was already lying on his hospital bed with the left arm connected to the intravenous infusion set that was stuck on the pole standing at the side of the bed.

"Hello, Brendan."

"Hey, Kakeru."

"You gave us quite a scare earlier out there."

"Sorry about it."

"It's all right, Brendan. At least, you will only get better from now on."

"What about my friends at the park?"

"Don't worry. Claire will get in touch with them, and tell them that you will be fine. You just need to take a rest for now."

"How did you know what my problem is? Mom told me the ambulance guys took me to the right place because you told them what I have."

"There was a boy in Japan at the hospital where I was working during summer. I only read about what signs he had when he was admitted, but they matched yours. I took a chance in guessing, and the doctor here said that I was right in the end."

"Why do you want to become a doctor? Dad once told me that footballers can have the fun life they want when they work hard to become as good as you." Brendan asked.

"It's because as much as I love football, I also have to think about what I would do next when I'm done with playing in many years from now. I just enjoy helping lots of people to get better." Kakeru replied.

"You can be a coach or a pundit in the future if you want to."

Kakeru laughed a little before he replied: "Coaching? No, I don't think I would ever be able to command that kind of respect and authority. I'm just too kind as a person to do that for a living. As a TV pundit, I might do it sometimes. But that is not where I see my second career after retiring. And besides, there will always be lots of people I can help as a doctor. Being healthy is something we all want."



"Now that I think about it, I should have asked Mom to take me to a doctor last week. It's just that..."

"You didn't know how to ask for her help, is that it?" Kakeru asked.

"Yep. I felt it was embarrassing to ask help for that."

"There is never anything embarrassing in asking for help. From the moment you don't do it, you just run away from your own problems... until they come back even stronger, and hit you even harder."

"You really think so?"

"It happened to me when I was a little older than you are. Because I didn't seek nor accept help from others for a long time, it took me a long time to solve my own problem. But once I accepted that help, and followed advice from trusted people, I was on the right path for good even though it was painful at times. Don't be afraid in seeking help in anything. Why? Because there is always someone out there who knows how to help you out with his or her useful knowledge."

"I promise to remember what you just said. Thanks for helping me, Kakeru."

"Anytime, Brendan."

"Will you play on Wednesday in the League Cup, before the big League match against Liverpool next Saturday?"

"Maybe, maybe not. If the manager asks me to play, I will give the other team a hard time as always."

"Have a good game in the next time." Brendan said.

"Thanks. Stay strong." Kakeru finished, and then left Brendan's room.

"So what did you two talk about?" Nana asked.

"About why I want to become a doctor as well as about why I don't see myself anywhere else after my playing career. We had a little talk about when to seek help whenever one has a problem." Kakeru replied.

"You sure made a long way since the days you were that timid boy who had so little ambition, and who didn't want any help from others in order to overcome that mental block." Yusuke said.

"Yeah. I don't think many people would believe me if I told them how I was so lacking in confidence at such a young age."

At the same time Kakeru, Nana, and Yusuke continued their little talk, Noriko was lost in her own thoughts.

"Are you OK, Noriko?" Yusuke asked.

"I'm fine. I was a little distracted, that's all."

"I guess we are all a little worn out for today after all of this. What about we get home to recharge our batteries for today?" Kakeru asked.

"Yeah, I really need it." Nana replied.

"Me too." Yusuke added.

"Let's go then." Kakeru said.

As the group of 4 young adults moved on, Noriko still had the same thought in her mind: 'Your brother really is special, Suguru-san. If you can see what he has become so far both as a player and as a future physician, I'm sure you would be very proud of him.'

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