Monday, July 10, 2023
Carrington Training Complex — dical Departnt
9:00 AM BST
Five days had passed since the decision was made in Bergamo and the flight to Manchester had happened and the contracts were signed Saturday evening at Carrington while Ten Hag watched, and in those five days Manchester United had played two pre-season friendlies without Demien while he remained in limbo awaiting dical clearance, and the first match against Leeds United in Oslo had ended 2-0 while the second against Lyon in Edinburgh had finished 1-0, and both results had co without his involvent because protocols required dical completion before squad integration.
The car arrived at Carrington at eight forty-five with Marco beside him in the back seat and the driver navigating through Monday morning traffic that moved steadily despite the hour, and when the security guard at the gate checked credentials before waving them through Demien saw the multiple training pitches spread across the facility where grass was perfect and lines were fresh and youth teams were already running drills on distant fields while first-team pitches sat empty because the senior squad wouldn’t train until afternoon.
The Manchester United crest appeared on the main building as the car parked and Demien grabbed his bag from the trunk before following Marco toward the entrance where United’s head physio Steve McNally was waiting just inside the glass doors, and his handshake was professional while his expression showed the practiced calm of soone who’d conducted hundreds of these examinations.
"Morning," McNally said, and he turned without waiting for a response. "This way. Robin’s already set up and the cardiac team’s ready. We’ll start with basics and work through everything. Should be wrapped by one if nothing unexpected shows up."
Marco stayed beside Demien as they walked down a corridor lined with frad photos of United legends.
"Four hours standard?" Demien asked.
"For sixty-two million, yeah," McNally said without looking back. "We’re thorough."
They walked past the first-team dressing room where the number fourteen shirt already hung in Demien’s assigned locker with WALTER printed across the back, and the sight of it created a brief tightness in his chest before they turned left into the dical wing where clinical white walls and examination equipnt replaced the football atmosphere.
Dr. Robin Chakraverty stood beside a padded examination table and his greeting was brief before he indicated Demien should change into the dical gown that had been laid out, and Marco took a seat in the corner with his phone while Demien stripped down and put on the thin cotton material that felt cold against his skin.
9:15 AM — Baseline asurents
The first stage was basic and chanical and required no thought from Demien beyond standing on the scale and holding still while asurents were taken and recorded in the digital system.
Height confird at one hundred eighty-three centiters and the nurse noted it matched Atalanta’s records exactly, and weight ca in at seventy-six kilograms which was two kilograms heavier than his last dical in Bergamo but within acceptable range for muscle gain during off-season, and body fat percentage asured at nine point two percent using bioelectrical impedance technology where the handheld device sent a current through his body and calculated composition based on resistance.
Blood pressure cuff wrapped around his upper arm and the automated machine inflated before deflating slowly while numbers appeared on the screen showing one hundred eighteen over seventy-six, and Dr. Chakraverty nodded once before writing sothing on his clipboard because the reading was textbook normal for an elite athlete.
Resting heart rate asured forty-two beats per minute when the pulse oxiter clipped onto his index finger, and the doctor’s expression showed approval because low resting heart rate indicated strong cardiovascular conditioning from years of professional training.
"Good baseline," Dr. Chakraverty said while making notes. "Everything here matches what Atalanta sent us. Blood draw next."
The phlebotomist entered with her cart and Demien sat in the chair while she tied the rubber tourniquet around his bicep and tapped the vein in his left arm until it raised enough for the needle, and the sharp sting lasted two seconds before she was drawing vials of dark red blood into tubes labeled with different colored caps.
"Full panel," she explained while switching vials. "Liver function, kidney function, complete blood count, tabolic markers, hormone levels. Standard transfer screening to catch anything that might not show symptoms yet."
Five vials total before she withdrew the needle and pressed gauze against the puncture site, and Demien held pressure while she labeled each tube and placed them in the transport container that would go to the lab.
Urine sample collected in the adjoining bathroom where the sterile cup sat waiting on the counter, and when he returned the phlebotomist took it and added it to her cart before leaving the room.
Fifteen minutes elapsed. Baseline complete.
9:30 AM — Cardiac Screening
The cardiac technician arrived with a portable ECG machine on a rolling cart and directed Demien to lie flat on the examination table, and the cold gel applied to ten points across his chest made him inhale sharply before electrode pads were pressed firmly against his skin and connected to wires that fed into the machine.
"Stay completely still," the technician said while positioning the final lead. "This asures your heart’s electrical activity. Any abnormal rhythms or conduction issues will show up on the trace."
The machine humd and the paper began rolling out with the characteristic spikes and valleys that represented each heartbeat, and Demien watched the ceiling tiles while his heart beat steadily and the seconds stretched longer than they should have because lying motionless while being monitored created awareness of every sensation.
Ten minutes of recording before the technician reviewed the printout and made notes, and her expression stayed neutral which ant nothing obviously wrong had appeared.
"ECG looks clean," she said while removing the electrodes and wiping away the gel. "Echocardiogram next."
The ultrasound equipnt was already set up beside the table and Dr. Chakraverty took over for this portion because reading cardiac ultrasounds required more specialized training, and he applied warm gel to Demien’s chest before placing the transducer probe against different positions while the monitor displayed real-ti images of his heart.
The probe moved systematically—left parasternal view first showing the left ventricle contracting and relaxing, then apical four-chamber view displaying all four chambers and the valves between them, then subcostal view from below the ribcage, and the doctor was silent while capturing still images and taking asurents that appeared as yellow lines across the moving structures.
"Chamber sizes normal," Dr. Chakraverty said while the probe moved to a new position. "Wall thickness looks good. Valves functioning properly. No regurgitation visible."
The assessnt continued for twenty minutes while blood flow patterns were examined using Doppler ultrasound that showed velocities in different colors, and when the doctor finally removed the probe and handed Demien paper towels to clean the gel his expression showed satisfaction.
"Structurally sound heart," Dr. Chakraverty confird while saving the images. "Now we test it under stress."
10:15 AM — Exercise Stress Test
The treadmill sat in the center of the room with monitoring equipnt surrounding it and a crash cart positioned against the wall in case of ergency, and Demien stepped onto the belt while the cardiac technician attached a fresh set of electrodes to his chest and wrapped a blood pressure cuff around his upper arm that would inflate automatically at intervals.
"Bruce protocol," the technician explained while programming the machine. "Starts easy and increases speed and incline every three minutes. We’re looking for how your heart responds to progressive exertion and how quickly it recovers after."
The belt started moving at three kiloters per hour with zero incline and Demien walked slowly while his heart rate climbed gradually from resting forty-two to sixty beats per minute, and the ECG trace continued scrolling across the monitor showing each beat in real-ti.
Three minutes passed and the machine beeped before increasing to four point seven kiloters per hour with five percent incline, and Demien’s breathing deepened slightly while his heart rate rose to ninety beats per minute, and the blood pressure cuff inflated to take a reading that appeared on screen as one hundred thirty over eighty.
Stage three brought six point eight kiloters per hour at ten percent incline and Demien was jogging now while his heart rate pushed toward one hundred twenty and sweat began forming on his forehead, and Dr. Chakraverty watched the ECG trace carefully looking for any ST-segnt changes that would indicate ischemia or abnormal conduction patterns.
Stage four at eight kiloters per hour and twelve percent incline had him running properly and his heart rate climbed to one hundred forty-five while his breathing beca rhythmic and controlled because his aerobic conditioning was elite level from years of professional football, and the technician called out "Blood pressure one forty over eighty-five" while the cuff deflated.
"Two more stages," Dr. Chakraverty said. "Push to target heart rate."
Stage five brought nine point seven kiloters per hour at fourteen percent incline and Demien’s legs burned while his heart rate hit one hundred sixty-five and his breathing was deep but still controlled, and the ECG showed clean sinus tachycardia without any concerning changes.
Final stage at eleven kiloters per hour and sixteen percent incline lasted ninety seconds before Dr. Chakraverty said "That’s enough" and the machine began slowing imdiately, and Demien’s maximum heart rate had reached one hundred seventy-eight beats per minute which was exactly where the calculation predicted for his age.
The belt decreased to walking speed and Demien cooled down for five minutes while his heart rate dropped to one hundred ten then ninety then seventy-five, and the recovery curve was steep and smooth which indicated excellent cardiovascular fitness and autonomic nervous system function.
"Perfect response," Dr. Chakraverty said while reviewing the complete data. "No arrhythmias, no ischemic changes, rapid recovery. Cardiac system cleared."
Forty-five minutes of cardiac screening complete by eleven AM.
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