"Kumo no Kaidan" "Staircase of Clouds"
This is... the story of an "unlicensed doctor" who unexpectedly took up a scalpel.
Episode 1 "The Unlicensed Doctor with an Immoral Scalpel and the Two Women Who Love Him"
"Mikotojima Medical Clinic" Ow! It hurts!
Ah... Saku-chan, behave yourself!
Don't go on a rampage, geez!
It hurts! It hurts!
- Aki-chan! hurry up with that anesthesia! - Yes, yes...
Sakuji-san! Geez...
Sukiyo anata I love you
Imademo imademo Even now, even now
Koyomi mo mousukoshi de The calendar just inches by
Don't move around, Saku-chan.
Director, hurry!
Nakitaku naru yoru Those nights, I just want to cry
Sakuji! You're lucky!
Getting caught in a winch like that and yet you've still got your foot connected to you!
- Director! - Don't move!
Yes, you're fine, you're fine.
Saburo!
Oi! Saburo!
Saburo!
I'm sorry.
Saburo!
Okay. Saburo, switch places with her.
Yes.
No, no. Setsuko-san, you go on restraining him.
Me?
Saburo, you stand here.
- Eh? - Never mind and stand here!
Yes.
Aki-chan, switch with him.
Say, is the prescription for the Harada's grandmother ready?
I'm making it right now.
Is Saku-chan's injury that bad?
Speaking of which...
...your wedding's next month, right?
Ah, too bad.
And I loved you, Maki-chan...
All lies!
Thanks.
Where Saburo-kun?
The Director called him in for the operation.
- Again? - That's fine, isn't it?
Well still, it's amazing that he can do it.
Ma'am, I'll bring your medicine out right away!
- Thread 3-0. - Yes.
- Cooper. - Yes.
Aki-chan. Can you switch with him in handing out the instruments?
- Eh? - Saburo, you perform this blood vessel ligature.
- Eh? - Ligature the blood vessels.
You know how?
Yes.
Clamp and tweezers.
Clamp with thread.
- Excuse me, a cooper. - Drop the "excuse me."
Yes.
Sakuji! Shut your mouth and rest!
Can you save my foot?
Can you bring it back to normal?
Eh? Ah...
Please...
...Young Doctor.
Yes.
Tweezers and clamp.
"At that time, I still didn't know."
"What it was he was thinking..."
"...nor what he had stopped thinking about."
"Director's Office" What were you thinking?
Huh?
When you watched what I did in that operation earlier.
Ah... yes.
Tell me what you were thinking.
As I recall...
...in a compound fracture case like this one...
...you normally start...
...by washing it out and then fixing the external wound in place.
Going by theory, you'd be right.
However, instead of fixing the external wound in place, I chose traction.
Why did I choose to use traction instead of fixing the external wound in place?
Because there was a point on the bone where the fracture had pulverized it.
Correct answer.
That was the best treatment I could give with the equipment we have here.
You really have been studying.
I'm only reading the books I borrowed from you...
...that you said I should read, Director.
- Are they interesting to you? - They're difficult.
For someone like me who only went to high school...
Graduate students read far more difficult ones.
- Um... - Huh?
I'm sorry. I should get back to my job...
- Ah. - Eh?
Um, if I could borrow some of your instruments again...
Take whatever you like!
Thank you very much.
Ah...
Um...
Yes?
Where are the clamps?
Clamps?
Ah, thank you very much.
This should be fine.
Ah, and...
Where are the probes?
The probes?
Ah, that's okay, that's okay. Um, if there aren't any, that's okay.
They're supposed to be here, though...
It really is okay.
I'm sorry.
You're keen about your research, aren't you?
Ah, well...
This isn't... um...
"Nurse's Station" Let alone not qualifying to be a doctor...
...he's just a high school grad. He's just a high school grad!
Awesome, isn't he?
He was just a clerk here before he was made to work on X-rays.
To be an assistant on an operation; can you imagine how that must have felt?
Look you two, you can't set this right just by saying "awesome" or "can you imagine"!
Aki-chan, what do you think?
- Eh? - About Aikawa-kun!
He has no medical license and yet he assisted in an operation, right?!
But he was told to do so by Director Muraki, so he couldn't help but do it...
So if your boss tells you to do something illegal, you have to just because "it can't be helped"?
That could be said about us, too.
It's also illegal for us nurses to give anesthesia injections.
- This and that are... - They're the same.
Thanks for your hard work.
- Good night. - Thanks for your hard work.
Isn't this hot?
Thanks for your hard work.
About a year and a half ago when he came to this island...
...I could see it was Setsuko who was helping him out the most with all his problems and such.
It was also Setsuko-san who helped him find a place to live, wasn't it?
- Takaoka-san, don't you know? - Huh?
There was this time when Setsuko-san...
...invited him to her house with a "why don't you come over for dinner?"
So what about it?
It was when her husband had gone on a business trip to Tokyo!
- Eh?! - But he turned her down flat!
Ever since then, Setsuko-san's attitude towards him has been a little...
"There are no more than 500 people on this island..."
Are you okay with it? With him continuing to do this.
Hmm, that's...
People who don't have a medical license shouldn't be allowed to perform medical treatments!
"That's the official stance."
It's insane!
"But it was just whitewash."
"It takes many hours by boat to reach Tokyo..."
"...so the people of such a remote and depopulated island..."
"...have to do outrageous things."
"This island was..."
"...about to turn him into a counterfeit doctor."
"And to that fateful invitation..."
"...he would entrust himself."
"I thought... that was a good thing."
Excuse me!
I was able to find one!
A probe!
Ah!
Thank you very much.
This is just the right size I wanted, too.
"It was with this modest moment..."
"...that he and I made our beginning."
It's a hobby I started while on this island.
Ehh...
On my days off, when I don't have anything in particular to do...
Ohh...
Tools like clamps and probes...
...help me out while making them...
Ehh...
I'll...
...complete this one using them.
Ehh!
You were thinking I was practicing making operations with them, weren't you?
Yeah. After all...
The Director would give me confidence at one time or another.
And then he said, "your hands are so skilled."
I've been applying the techniques...
...used for tying knots in mast strings to the sutures in an operation.
For example, like this one.
And here, too.
I'm sorry.
It's not very interesting, is it?
The Director told me this before.
"He has the beautiful fingers needed to make an excellent surgeon."
Some coffee... I only have instant, though.
The Director adores you.
If you don't want to do this, it's fine just to refuse him.
After all, it is against the law, isn't it?
Even though you don't have a medical license...
...he made you his assistant at today's operation.
I...
To me...
I don't have anything of my own.
Akiko-san...
...I'm grateful to you.
Eh?
You could say the eyes of everyone at the clinic...
...have become cold recently...
...when they look at me...
That's true.
But...
Only you have been different, Akiko-san.
I... appreciate that.
There's something I've wanted to ask you for a while now.
Aikawa-san, you lived in Tokyo, didn't you?
Yes.
Why would you come to a place like this for?
I'm sorry.
Ah, no...
I'll go.
Akiko-san...
...will you be staying on this island forever?
I wonder?
I don't know...
Why?
- Nothing. - Then, how about you?
Eh?
Nothing. So long.
Ah, welcome back.
Takaoka-kun, what's the matter?
You're late.
- For what? - Today is...
...the second anniversary of your father's death, isn't it?
That's next month.
- I see. - Fool.
- Thank you. - Yeah.
Thank you.
- Isn't it fine already? - What is?
After nursing your father for nearly 10 years...
...he passed away...
...and you've become alone.
You're no longer bound to this island, are you?
That's true.
You went to a lot of trouble to get your nursing qualifications so you could go to Tokyo.
It was your dream to work at a major hospital over there, wasn't it?
I'm 39 already, aren't I? Now's too late...
"Now's too late..." again.
It's the same for you, Takaoka-kun.
You're the only one of your classmates who went to a university and became a pharmacist...
...so why did you come back here?
I... Um, well...
I got tired of Tokyo.
What is that?
- So long. - Thank you.
- Aki, what would you think? - About what?
- About our clerk, Saburo-kun. - What would I think?
If the Director, in that tone of his, were to tell him...
...to switch places with him and said, "you perform the operation"?
I wonder...
Well still, if that did happen, he'd probably just run away from the island, wouldn't he?
It was intense for Setsuko-san's daughter-in-law, too, right?
So long.
Incredible!
Whaa! There really isn't anything here.
Whaa! Incredible! Where's the Minsuku? (private home providing lodging for travelers)
- Isn't it that it over there? - That one? OK.
Whaa, it's so pretty. Here, look.
The water's so clear!
Yeah.
Akiko! Akiko!
Akiko, hurry and come!
My head's splitting.
Here, Director.
- Geez... - Good morning.
I'm always telling you this, aren't I?
Please don't get so drunk you get a hangover.
What will you do about the Soneda-san's grandmother?
She's had an asthma attack again, so you should hurry and make a house call on her.
- Saburo. - Yes?
I can't do it... Sorry, but you go.
Eh?
Director!
- Setsuko-san, you go along with him. - Eh?!
Don't worry; it'll be fine.
- Stop joking around! - In that case, I'll go with him.
Whenever the Soneda's grandmother has an asthma attack...
...she's always in a great deal of pain, so it's best if we hurried over.
Please wear this.
Countin' on you.
Geez!
Aikawa-san...
...you've also examined the Soneda's grandmother several times in the outpatient clinic, haven't you?
Will this really be okay?
Letting me perform a house call alone.
Aikawa-san, you know what everyone on the island calls you, don't you?
Thank you... Young Doctor.
Young Doctor! Take this.
- It's okay, it's okay! - Such a thing...
Thank you as always.
Thank you for your hard work... Young Doctor.
- Stop here for a minute. - Eh?
What is it?
Who's that?
She's going to kill herself.
It can't be...
It's dangerous right there.
A huge wave can come up suddenly.
You came in on... the ship that arrived this morning, didn't you?
- Yes. - Where are your friends?
They went diving.
I wasn't feeling in the mood...
...so I told them I might go for a walk.
Is that right.
Um... Is there a way to get to the top of that?
Incredible! Feels so good!
When I first came here...
...I was moved by it as well.
You're not someone of this island?
I came here from Tokyo a year and a half ago.
- Where in Tokyo? - Machida.
I'm from Seijou.
They're both along the same Odakyu rail line, aren't they?
That's true, but I never even once got off at Seijou.
It's about time we headed back.
If you'd like, we could take you around to the cape once more.
Ah, no.
I'll stay here a little longer and then head back to the Minsuku.
I'll be fine, so thank you very much.
It's rare... for young people to come here.
That's true.
Um...
You mustn't do it.
You mustn't.
Thank you very much.
I feel ill...
There aren't any decent young doctors...
...who are willing to come to an island like this. Oi.
Well that's...
That's how it is for me, too.
Therefore, when I hired Aikawa-kun as a clerk...
...I let him help me out to some extent because I thought there was no other way around it.
Everyone on the island knows about this.
Even the village head, Takemura. Even Morimoto, who owns the place where he lives.
That's...
He's diligent, has a good memory...
...and is skilled with his fingers.
More than anything, his fingers are beautiful.
If it only went so far as letting him give blood tests or X-rays or electrocardiograms.
But allowing him to give exams in the outpatient clinic and assisting during operations?!
And he also makes house calls by himself, right?
I don't think that's such a good idea!
So irritating, geez...
On this island, we have but one doctor.
What would we do if something happened to me?
And then if an emergency operation were needed, who's gonna do it?
If we called for a helicopter, it's 40 minutes back to the University Hospital in Tokyo...
And what if there's a storm that day?
A helicopter wouldn't even be able to come!
Well, that's...
One of the guys I went to the university with...
...works as a doctor in Kumamoto.
Seems he collapsed last week from a cerebral infarction.
Ala.
If that happens to me too, what's this island gonna do?
An emergency!
- Ah, an emergency? - Yes. If you would please.
Okay!
Right here?
When you say it hurts, is it there?
Here?
- We've just returned. - Sorry if this hurts. Yes, yes.
- Saburo. - Yes?
Try palpitating him.
Eh?
Director, this is...
Figured it out?
Is it an appen?
- What's an "appen"? - Acute appendicitis.
Appendix?
We're just in time to take it out. Okay, prep for an operation.
Yes.
Saburo, you join us, too.
- Eh? - You join us.
"In Treatment"
- We're ready now. - Yes.
Saburo.
Yes?
Want to give it a try?
Try what?
- The operation. - Director!
Eh? Ah... I couldn't.
- I can't do it. - You can.
Well, that'd be impossible. I just couldn't.
I'm out of it. My hangover still hasn't settled down.
Director! That's a little...
You've seen multiple appendix operations, right?
Get started.
Setsuko-san.
No matter how many times he's seen it, I feel sorry for him!
He can't do it, so he shouldn't!
How about it, Saburo?
Director! Please behave responsibly.
Aki-chan!
He'll come out of the anesthesia before long, so hurry and finish it.
Proceed following my instructions.
Right here.
Be decisive.
- Clamp. - Yes.
- Muscle hook. - Yes.
- Hook pin and electric scalpel. - Yes.
- Mettsen. - Yes.
That's good. Next, open up the peritoneum.
- Hook pin and mettsen! - Yes.
I'll take this.
If you can see the ileocecum, then insert your finger and search for the appendix.
(ileocecum - valve between the small and large intestines)
If you've found the appendix... what do you do?
What do you do?!
- Pull it out. - Once it's out, then what do you do?
Cut it off at the root.
Su... surround it and make it narrower...
- ...then draw it out! - That's right!
- His sweat! - Yes!
- Thank you very much. - Drop the etiquette!
- I'm sorry. Cl... clamp! - Yes.
Doctors don't want to come to this island...
...not just because it's so far away.
It's because when they themselves become ill, there wouldn't be any doctors around to save them.
Because that scares them, they won't come.
Not having a doctor around...
...is the scariest thing of all.
- Tweezers! - Yes.
- Excising it. - Okay.
You could do it.
That was only because you were there at my side, Director.
Me? I was just support.
Still... I guess...
...that...
I shouldn't have done such a thing...
Thank you.
In that arena, I'm unable to stop you, even using force.
But it would have been serious trouble if anything had happened to the patient.
Yes.
You must never do something like what you did today again.
What you did in there was a criminal act.
Yes.
Just because the Director told you to do it won't be an excuse!
This is an issue involving people's lives.
Yes.
Aki-chan, this goes for you, too.
What on earth were you thinking?
Setsuko-san, thanks for your hard work.
And thanks for your hard work, Young Doctor.
The Director said to give this to you.
Once again.
Thank you for your hard work.
Thank you.
It hasn't lessened this entire time.
Little wonder.
Ah... I'll pass.
I can be an awful drunk.
What I've been doing is terrible...
...all this time.
If...
If my hand...
...had gone crazy then...
I... don't think I could have gotten it back to normal again.
I was surprised.
At... your skill in suturing.
It may be you're even better at it than the Director.
Was it that scary?
That...
I really don't know.
During the operation...
...even though I was doing this terrible thing...
...I wasn't scared.
I just thought, "this is fun."
That's just weird, isn't it?
I guess I will have that drink.
Good morning.
- Good morning. - 'Morning.
- Good morning. - Good morning.
Sorry, but I won't be in for the next 2 or 3 days.
- Eh?! - Where are you going?
Kumamoto.
- Kumamoto? The one in Kyushu? - Yeah.
My friend died, so I'm going out there for his wake and funeral.
Saburo! Take care of things here.
Eh? No...
Um... that would be...
"Mikotojima Medical Clinic"
Thank you very much.
Where's the ship?
Eh?
The ship model.
- Will you do it? - Yes.
Just a little longer...
I see.
- Excuse me! Excuse me! - Someone!
Excuse me! Excuse me!
- This is a hospital, isn't it? - Has something happened?
She suddenly started suffering in pain...
Seems the pain is coming from the area around her stomach.
Anyhow, let's take her inside right away. All of you help out.
Sensei.
Sensei!
Ah... Yes.
Where does it hurt?
Is it an appendicitis?
Well, I'm not sure.
It's as solid as a board...
- What are her vital signs? - Blood pressure, 60.
- Anyhow, attach an IV to her. - Yes.
- Thanks for coming! - What's happened?
It's an emergency! Please help out!
- Well? - Setsuko-san.
I got the gist of it from Aki-chan.
It's not an ordinary case, is it?
- Her consciousness is cloudy. - Are you okay?
Most likely bleeding has occurred in her abdominal cavity.
- What about the doctor helicopter? - They said it's impossible with these winds.
And I can't reach the Director's cell phone!
Why?! Geez, he should have arrived in Kumamoto by now!
And at a time like this!
- Anyhow, let's get a transfusion going. - Putting a mask on you.
What's her blood type?
I heard from her fellow travelers. She's a type A.
We should have some type A blood for patients with anemia around.
Are you okay? Hang in there.
- She's bleeding! - Eh?!
Get some towels.
Could it be...
...an ectopic pregnancy?
An "ectopic pregnancy"? (a complication of pregnancy in which the embryo implants outside the uterine cavity)
I'm going to loosen this a little.
Anyhow, we need to perform a laparotomy and stop this bleeding quickly.
Run a check for a pregnancy reaction, too.
Sensei...
Let's watch her condition for a little longer.
We can contact an emergency hospital and discuss it with them.
We don't have that kind of time.
Aikawa-san, you'll have to do it.
No...
This is life-threatening.
Wait... Please wait a moment!
Hey, where are you going?!
Fully open her IV!
"Laparotomy: removal of blood clots from within the abdominal cavity."
"Confirm the uterus in the pelvic cavity..."
"...and then follow the fallopian tubes that extend out from the uterus."
"Check for any swellings indicating ectopic pregnancy and for massive hemorrhaging and adhesion."
- A call has come in! - From the Director?
- Who then? - The patient's father.
My name is Tasaka.
Hello?
- Yes. - Are you the doctor?
Ah...
I received a call saying my daughter had been brought in to you there...
...so I wanted to know the details of her condition.
Yes...
Hello?
Um... She was in pain...
...and felt pressure on her stomach...
Her complexion is a pale blue...
Her pulse and blood pressure are weak, too...
- Hello? - Yes.
I'm thankful to you for speaking so clearly to me.
I have a hospital here in Tokyo.
A hospital...
If my daughter has an ectopic... I suspect she has an ectopic pregnancy.
What is my daughter's current condition?
Is she in a state of shock?
I put an IV in her right away...
Currently... she's receiving blood we had stored...
Currently... her consciousness is vague.
She should have an operation immediately.
Please, take good care of her.
Yes.
- So long... - Ah.
Excuse me, but what is your name, Sensei?
I'm... Aikawa.
Aikawa-sensei...
...please save my daughter's life.
Yes.
I will do my best.
Sensei! What's going on?
- Is Akiko gonna die? - Hey Sensei, tell us.
Please let us take blood from you. Those with type A.
- Yes! - You two come with me, please.
I've moved her to the treatment room.
She had a pregnancy reaction. You have no choice but to do it.
If this fails... it means major trouble.
Well, but...
We can't leave her in this condition.
But I guess if we allow an unlicensed doctor to perform an illegal operation...
...then we'll be complicit as well.
Then! Then! Are we to just stand around quietly...
...and watch as she dies?
Yes, hello... Hello, Director?!
Oh, how's it going over there?
Director, where are you right now?
Where am I?
In Kyushu. At Kumamoto.
We have an emergency.
It's a phone call from the Director!
- Dir... Director. - What's her blood pressure?
It's currently at 80.
Continue with the transfusion while performing the laparotomy right away.
- Are you listening?! - Yes.
Because there is a fetus wrapped in a mass of blood...
...the first thing to do is remove that. Most likely it's in the fallopian tube.
After that, perform a tubal ligation.
Once you open up the abdomen, her blood pressure will drop rapidly, so be quick!
If you can't find where the bleeding is coming from, close up each and any place that is bleeding.
Anyhow, stop that bleeding!
Answer me if you understand!
Director...
My... My power is...
Do it without complaining.
If you don't do this, that patient is dead!
Blood pressure at 80 over 40. Pulse is 100.
The surgery...
...will begin.
Please work with me.
- Please work with us. - Please work with us.
Scalpel.
- Tweezers. - Yes.
- Hook. - Yes.
Pin hook. Electric scalpel.
Mettsen.
Pin hook.
Clamp!
Mettsen.
- Setsuko-san, suction! - Yes. Yes!
- Gauze! - Yes!
- More gauze! - Yes!
- Hey, give me a towel! A towel, please! - Yes!
Here you go!
- I can't see! Raise the intestines! - Yes!
Remove the blood clots from the abdominal cavity... Remove the blood clots from the abdominal cavity...
- Give me more towels! - Yes!
- More towels! - Yes!
Her blood pressure is dropping!
- Setsuko-san, suction more of this blood! - Yes!
- Where's the gauze!? - I just added some more!
The blood isn't stopping!
- Can you find where she's bleeding from? - I don't know...
I don't know!
Blood pressure at 70 over 30! Pulse is now 110!
- Where is it?! - Blood pressure is dropping!
- Where's the gauze? We need more gauze here! - Is this it?!
No. Is this it?!
- Ah, no! Where is it? - Anyhow, remove the blood!
I'm doing that!
- Blood pressure at 40! - We need to add more blood!
Pumping... Should we try pumping?
- Do it! - Yes!
What's her blood pressure?!
I can't measure it!
Let's... stop this already!
Please sew her.
Eh?
Anywhere is fine, just sew! Stop this blood!
Vasopressor! (Medication to increase lowered blood pressure)
Suction!
- Clamp! - Yes!
Hurry!
- Hurry. Please hurry! - Thread!
Hurry!
Blood...
"Mikotojima Medical Clinic"
What's her blood pressure?
It can't be measured.
Her pulse?
It can't be felt.
She's finished...
I killed her...
She isn't dead yet.
She continues to receive a transfusion.
We gathered 400cc from everyone on the island...
It's no use!
You saw, didn't you...?
How badly and horribly...
...I carved up the insides of her abdomen...
There was nothing I could do but just sew her up.
In the mass of blood we took out...
...there was also the fetus.
I killed her...
Sensei. Sensei!
Aikawa-sensei!
Take a look.
She'll be fine.
You saved her.
You've saved her.
A call! From Tokyo!
- Hello. - Is this Aikawa-sensei?
Yes.
How is her post-operative condition?
Currently...
...she's in a stable condition.
I see.
As for her fertility, I guess after this...
...from here on it could be said she'll be infertile...
That's...
It isn't possible that Akiko-chan could have had an ectopic pregnancy.
There must be some kind of mistake.
May I?
- Hello? - Yes?
My name is Ngami, with the Surgical department.
Could you tell me in detail the progression of the operation?
Are you saying what caused her intraperitoneal hemorrhaging wasn't ovarian bleeding?
Yes.
What was her hCG? (hormone produced by the fertilized egg after conception)
It was positive.
It was clearly hemorrhaging into the abdominal cavity...
...and she had fallen into a state of shock.
While transfusing blood...
...I decided I should perform an emergency laparotomy.
I see.
And, did you find a fetus?
There was one.
It was an accurate diagnosis.
Nogami-san.
Saki-chan.
I heard Akiko-neechan was in some kind of trouble?
She's okay now.
Did you know, Nogami-san?
That Akiko-neechan had gone to such a remote island.
You hadn't heard...
Onee-chan kept her going to a place like that...
...a secret from both her parents as well as her fiancée.
You'll...
â€¦be just fine.
You were... a doctor.
I'm not particularly happy about this.
Huh?
You didn't have to go and save me.
Still...
Thank you very much.
"Possibly, even at that time..."
"...just what sort of person this man was..."
"...was someting I might not have known yet then, either."
"And, as for himself..."
"...he might not have realized either..."
...just what kind of person he was himself."
"Not yet, at that time."
This Drama is fictional All names, including island and hospitals are fictional.
In addition, the practice of medicine by unlicensed persons is prohibited by law and parts played in this drama by nurses such as giving anesthesia are also prohibited by law.