On September 20, 2013, an operation lasting more than twelve hours came to an end. After about fifty-four hours in the ICU, I was able to return to a regular room.

The order is a little reversed, but I will look back on the days leading up to surgery.

From the day I was admitted on the 11th, the tests to confirm pancreatic cancer began. First came MRI and endoscopic ultrasound from the duodenum toward the pancreas. The next day, with a similar endoscopic procedure, a needle was inserted from the duodenum and a biopsy sample was taken directly. That sample was examined over roughly thirty-six hours to determine whether it was cancer.

The result came out as scheduled on the 13th. Surgery was also confirmed. Thankfully, it did not turn into the worst kind of Friday the 13th. Rather, knowing that I could have surgery gave me a certain relief. That day, Dr. Ito and my wife could not arrange a time together, so the full explanation for both of us was postponed.

On Sunday the 15th, we received Dr. Ito's explanation. I suppose that was the official disclosure. The pancreas had atrophied, and the mass in the pancreatic head was confirmed to be cancer. The CT image suggested possible lymph node metastasis, but that could not be confirmed without surgery. She was considering extending the operation and removing those lymph nodes as well.

Every explanation was crisp. There was no hesitation. She spoke bluntly, cutting through misinformation and wishful thinking without hesitation. It was strangely reassuring. When I asked, "So that is radiation exposure, isn't it?" she answered immediately, "Yes." She said radiotherapy would not cure this and had many side effects, and that she was pained by the number of people who avoided surgery after being misled by stories of experimental treatments. My wife and I both concluded that a second opinion was unnecessary.

By the way, perhaps because she had been called in on a Sunday, Dr. Ito was wearing jeans, pedicure, and high heels. She looked like an actress playing a doctor in a television drama. I would bet that outside the hospital nobody would guess she was a doctor.

We also met Dr. Inoue, who would perform the operation. He was apparently a cheerful Osaka-dialect talker, but that day there was no room for humor. His pathological explanation was almost the same as Dr. Ito's, and he mainly explained the surgery. Removing organs was not the hard part; reconnecting them was. In particular, suturing the pancreatic duct to the intestine would be difficult, and whether to complete it this time would be decided after opening the abdomen. At the Red Cross they spend about twelve hours on this operation. Some hospitals finish in half the time, but their policy was to proceed almost absurdly carefully. After surgery I would probably lose about fifteen kilograms. I might regain five, but ten kilograms down was certain.

My wife and I both liked him very much. He too was straightforward. My wife's verdict was, "A surgeon should not be an authority figure. It should be someone young, in their forties."

If my body could not endure the period after surgery, there would be no point in operating. From Monday until the day before surgery, I underwent tests even more detailed than a full medical checkup: three consecutive days of endoscopy, the colonoscopy that had not been completed during the checkup, chest and abdominal X-rays, CT, cardiac ultrasound, leg ultrasound, an ophthalmology exam, questions from anesthesiology, explanations and questions from the ICU, and questions from the operating-room nurse.

Because controlling blood sugar was especially important, a full urine test began on the 16th. Every urination was collected to measure the total amount of sugar excreted in a day. The first test showed about seven times the normal amount, and I was treated by fasting. In other words, for almost a week the only thing I put in my mouth was water.

Preparation for admission meant both preparing the body and preparing for life in the hospital room. For the body there was blood sugar adjustment, insertion of catheter lines for anesthesia and infusions, a line from the wrist and another through a vein in the neck reaching near the heart, removal of body hair, and even cleaning the navel.

For daily life there were clothes, gauze and other consumables for after surgery, drinking water, and preparations against boredom. I brought two PCs, power supplies, Wi-Fi setup, and documents needed for an imminent move. I had written that preparing for one or two months in hospital was serious business, but it was even more hectic than I imagined.

Then came surgery. Ten days after cancer was suspected, seven days after it was confirmed. At last, the operation.

In the room I changed into surgical clothing and headed to the operating area with yesterday's neck infusion line attached. At the entrance, about four groups were waiting. I wondered what kind of traffic jam this was, and realized it was a queue for surgery. Across a stainless-steel boulevard, operating rooms lined both sides. The sight was astonishing. I genuinely felt that this latest technology was going to save me.

For this operation I decided to hear only the outline and not worry about the details. That was probably wise. The moment I heard that epidural anesthesia would be inserted through the spine, I remembered the trauma of anesthesia for kidney stones. But this time Dr. Hosokawa from anesthesiology spoke gently and loosened me up. Perhaps it was also technical progress. I felt almost no pain, and then plunged straight into darkness.

In fact, that is all I can write about the surgery itself.

When I was awakened in the ICU, it felt as if no time had passed. My wife told me, "I saw the organs they removed and touched the tumor." After that I fell unconscious again. I spent about fifty-four hours in the ICU, but it did not feel as if I had just undergone a procedure in which my abdomen had been opened in a large J-shape and the inside worked on. Later I measured the scar. It was thirty-five centimeters. It felt almost like having been cut open for ritual disembowelment.

To my surprise, my abdomen hardly hurt at all. On the second day, with a nurse beside me, I practiced walking. I spent about two hours away from the bed watching television. It was completely different from what I had imagined.

On the third day, I returned to a regular hospital room.