PTSD, or Post-Traumatic Stress Disorder.
Tomorrow's operation, I cannot be the operating surgeon.
We are a team.
Asada-sensei, you have us on your side.
My goal now is, to cure as many children like my daughter.
Unlike you who is still trapped in the past.
I'll work hard.. I will defeat the disease for you!
Please.. Asada... sensei..
- The trembling.. - has stopped.
- Are you sure we can do it? - Who are you talking to?
I am.. Asada Ryutaro!
President.
Zdravstvuj! [Hello]
Were you seriously injured, Asada-sensei? Are you OK?
You are a treasure of Meishin, be careful.
- Why do you come back? - Why?
- I forgot something here. - Forgot something?
Meishin is not yet a world-class hospital.
You have to work hard, I'm depending on you. Excuse me.
You..
Long time no see.
What is going on? Noguchi-sensei..
He's very stubborn, what will happen?
I'm going for my rounds.
She's so dejected, what will happen?
Huh?
In that last operation, she screwed up.
- Starting infusion. - Bring me the next IV.
Yes.
Epinephrine connector is off!
Hence.. she's so dejected.
No matter what, she has an oversized head, but lacks combat experience.
What will happen? Hehehe..
The medical tests are getting better.
Soon you can be treated from home.
- That's good, Toru. - Yeah
- Were you at my surgery? - Eh?
Thank you, Magara-sensei, for saving me.
What's the real reason for Noguchi's return?
Not our concern, we are doctors.
I'm back, Shoko.
This is Russian Beluga caviar with Rye Vodka,
- and preserved salted salmon. - Why Russia?
Thanks to President for sending me to China, Li Qiang Zhong introduced me to
an influential figure of Russia's Ministry of Health and Social Development,
Ivan Lobachevskii.
- That's good. - After my talks with Ivan,
he's very interested in Meishin's medical tourism.
There will be many people coming here for health checkups.
This is the list.
And this is
the list of doctors invited from Russia and China.
Of course, when you admit foreign patients,
you'll need foreign doctors and staffs.
Foreign doctors are not allowed to practice medicine in Japan.
That's the system at the moment.
[~Meishin University Hospital Medical Tourism scheme~] ["Special Medical Treatment" draft implementation]
Meishin will be the first in Japan to employ foreign doctors.
Currently, I'm negotiating with senior officials of Health Ministry and Foreign Ministry.
"Special Medical Treatment", your gifts seem a little too exclusive.
I have heartburns, take it back. (TN: heartburn: acid indigestion or pyrosis)
No, no. Every person is born with innate capabilities,
I'm just a roe and it's enough, President. (TN: roe = eggs or the egg-laden ovary of a fish)
Hmm...
Please!
Only you can save her, save my wife!
I know I am selfish by requesting this.
But in the U.S, I read in a magazine that a similar case as my wife was cured by catheter!
Please look through the medical record.
Please. Please.
These past 15 years, I still have not forgotten your face.
Let me..
Kuroki-sensei!
Kitami-san's checkup result is out.
- You know him? - No.
Haruka, sorry. I cannot do anything.
What happened? Are you OK?
Asada-sensei!
It's hyperventilation.
Exhale slowly.
Inhale slowly.
Yes. Calm down.
- It's OK now. - Sorry.
Just in case, relax a little.
- You guys are..? - We are from cardiac surgery.
Cardiac surgery?
Then, you know Kuroki-sensei right?
Yeah.. well..
Please, in any way, Kuroki..
help me talk to Kuroki-sensei.
My wife's life is on the line.
- That.. what do you mean? - Do you know Kuroki?
I used to be his colleague.
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- How is it, sensei? - It's not good.
- Requires immediate hospitalization. - Eh!?
Don't shout, it's no big deal.
There's abdominal aortic aneurysm, and also aortic aneurysm.
- Will she die? Rika.. - Keep quiet!
- Please calm down. - Yes.
Listen up, this ascending aortic aneurysm is still small,
no treatment is required for now.
But..
this abdominal aortic aneurysm,
has grown to about 6cm,
requires immediate treatment.
- Is it surgery? - No, it's catheter.
It's not a complicated treatment. Don't worry.
- That's good. - I told you it's not a big deal.
You should wait until the doctor finishes his words.
Idiot! You did not seek treatment earlier,
- hence this happens. - Who are you calling idiot?
When I was at Kouhoko hospital,
Kuroki was still a novice surgeon, and I'm a middle-level ME.
Kuroki was proud, but he was close to me.
Since you guys know Kuroki, that incident..
We have heard.
At that time, Professor's orders are absolute.
- But, Ross... - If it's this team, we can do it.
No one dared to oppose him.
Stop your nonsense.
After that, I lost contact with Kuroki.
My wife.. has severe heart disease, her lung function is also very weak.
Preferably, we do not want to use heart-lung machine.
Hence, I thought of catheter.
But, he refused to listen to my words.
It's understandable.
You look pale.
Thanks to you, catheter patients have been pouring in.
What's the disease name?
Are you seeking treatment at Futaba Central Hospital?
Old disease. No big deal.
You said you returned to Japan to observe our team?
The truth is that, you believe in "team" the most, right?
Long time no see.
You have grown much prettier since we last met.
- What? - Hmm..
We have been depending on you guys for recent operations, Kato-chan.
I leave it to you. From now on, I'll be on the 8th floor like before.
Not 14th floor?
Every person has his own capability, Kato-chan.
Hmm, not bad. After we have this,
it's easier to launch an attack. Thank you.
[Medical Record: Takase Haruka]
- Takase. - Huh?
I want to do Bentall procedure,
don't want to lose to Jounan University.
All right, right, right.
At that time, I will join your operation.
- Really? - Yeah.
We are a team.
- Team? - Yeah.
Team huh? Right.
OK. A toast to the team.
Cheers.
Kuroki!
Hmph.. Team huh?
I've heard from Takase-san.
Did he say any tear-jerking excuses?
- He had the nerve to.. - That does not matter.
Patient wishes for your catheter treatment.
Why do you not examine her?
No matter what circumstances, a patient is a patient.
Curing patients is a doctor's duty.
You.. don't understand.
There's no medical case that is identical to textbook.
- Eh? - Asada-sensei often said that when I was an intern.
Experience is a must.
I know that. Ah, it's so late. I'm going.
Also, he had told me
you can learn much from failures,
so even if you "miss", keep trying.
Before catheter treatment, please take this medicine.
- Yes. - Thank you.
- It'll be OK. - Umm..
- Kuroki-sensei is late. - Recently, his health is not good.
- Could he have fainted? - No way.
- Why such an expression? - Ah, nothing.
- I'm the one being operated. - I know. Hang in there.
- Get a grip on yourself. - I'll be waiting. Hang in there!
- Please. - Please.
Sensei, can Rika really be saved?
Don't worry, catheter is my speciality.
Yeah. Yes. I leave it to you.
Now, commencing abdominal aortic aneurysm
stent-graft placement.
- 18 Gauge. - Yes.
It's been a while, I want to see Kuro-chan's procedure.
Deployed. Let's go!
As usual, such lovely speed.
- Balloon. - Yes.
- OK. Syringe. - Yes.
Inflation.
- Kuroki-sensei. - It's OK.
- This is bad. - Why? "Why?"
Sensei, is the inflation duration too long?
BP is dropping sharply!
Is it abdominal rupture?
No, it cannot be, the stent placement is proper.
Pericardial effusion is observed.
- Ascending aorta aneurysm has ruptured! - What?
- What happened? - I see..
The extended balloon inflation duration
increases the pressure in the blocked region,
which leads to the rupturing of ascending aorta.
- What? - Even if it's Kuroki..
he can't use catheter to treat a ruptured ascending aorta.
Kuroki-sensei!
I'll take over. Inflating balloon, blocking aorta.
Maintain BP!
What are you doing, Kuro!?
Sensei, should we call the surgery?
No, don't call the surgery!
But, pericardial tamponade is worsening!
- Should we perform pericardiocentesis? - Bleeding is still continuing,
if you do that, the heart will stop!
Get moving, Kuro-chan!
Kuroki-sensei!
Patient will die..
What is it?
Leave the ascending aorta to us.
Kuroki, you focus on the abdominal aorta.
No time to lose! Patient may die.
Chest disinfection.
- Give me the drape. - Yes.
- Setting up. - Perfusion from the right subclavian artery.
Blood removal from right femoral vein.
- I'll handle the blood removal. - Norepinephrine one-shot.
Asada..
- They made it. - Yes.
- Pump-ON. - Yes. Full flow.
Stop respiration.
- Sternal midline incision. Scalpel. - Yes.
- Tweezers. Gauze. - Yes.
- "Suction up". - Yes.
Ruptured location confirmed. I'll hold.
- Prepare 24mm graft. - Yes.
- Vascular clamp. - Yes.
Aorta clamped. Plegia start.
Yes.
- Heart's stopped. - Kuroki.
We'll perform the ascending aorta replacement surgery.
You'll continue the abdominal region stent-graft.
But there's no blood flow in cardiac arrest state!
- To determine the stent-graft location.. - If it's you, you can do it!
If it's you..
The stent-graft.
- You.. - If it's Kuroki-sensei, you can do it.
I will support you. Give Kuroki-sensei a mask please.
Yes.
- Cutting ascending aorta. Scalpel. - Yes.
- Tweezers. - Yes.
- Metzenbaum. - Yes.
Gate cannulation.
- Follow me. - Yes.
- Seldinger needle. - Yes.
- Prepare graft. - Yes.
- Teflon felt. - Yes.
- 4-0 Prolene. - Yes.
Wow!
- Prepare stiff wire. - Yes.
- Asada and Kuroki's... - Collaboration.
- Metzenbaum. - Yes.
- Stent-graft. - Yes.
- Follow me. - Yes.
- No problem with pump? - Yes. It's OK.
Wire is placed.
Proximal anastomosis completed. Next is the distal.
- Teflon felt. - Yes.
- 4-0 Prolene. - Yes.
- Deploying. - Yes.
Here we go!
Distal anastomosis completed.
Deflation.
Placement done. Stent-graft placement procedure completed.
- Flow down. - Yes.
Ascending aorta replacement surgery.. completed.
- All right! - All right!
Thank God.
You had to rely on Asada,
you have failed, Kuro..
Ah.. Thank God.
You are saved now, thank God.
- Don't cry, idiot. - I..
I'm sorry.
No matter what, I've let you down, and you have suffered.
Today, I came to apologize sincerely.
Forget about my wife's case. Goodbye.
Are you still at Kouhoku?
6 months after that incident, I quit my ME job.
Not only me, the others left the hospital.
After such an incident, there's no way we can stay on.
Now, I'm just a humble medical equipment manufacturer.
No matter what, we were opressed by the Professor,
and we betrayed you. We are the worst.
Sorry, Kuroki.
Ah.. you guys are the worst.
- That team.. is the worst. - Yeah.
But..
here, in this hospital, there is the best team.
Your wife's disease, cannot be cured by catheter.
But if it's them,
if it's that team, it might be possible.
Kuroki.
I'll ask them.
Asada.
There's a patient I want you to operate, can I ask?
Who?
My... comrade.
The wife of my past comrade. Please help her.
This is a copy of the patient's medical record.
All right.
Good morning. Cardiac knots?
I want to try practicing a little.
Eh.. not bad.
Sensei, weren't you once called "Faint-hearted Ijyuuin", right?
That Ijyuuin-sensei
is now so excellent.
I will soon be a "God-hand" too.
Don't be complacent, idiot.
I'm going for my rounds.
This is the proposed plan for today's council meeting.
- Prepare it earlier! - Sorry.
This is the first Russian patient brought by Noguchi.
Lydia Natalia. Her?
Yes. world-renowned pianist. Requires a "Triple Valve" operation.
Triple Valve? (TN: Triple Valve = Mitral, Aortic, Tricuspid valves)
Because of her travel plans, her operation is scheduled at 10 December.
I hope you can operate.
Asada will be on operating on another patient that day.
Takase-san's wife?
Yeah. Bentall total arch replacment.
- Total arch? - It's an urgent operation.
The hospital we are going to, has a great medical team.
I see.
That's good. Yeah. OK.
Two operations on the same day? It's impossible!
Both operations are extremely difficult,
we absolutely cannot fail.
We don't have enough members, we have to re-schedule.
It's OK.
- I've called someone. - Who?
- Comrades. - Comrades?
The best.. comrades.
- It's been a while. - Yeah...
- I cannot wait. - Let's go on a rampage.
This is Meishin University Hospital budget plan for this year.
Is there any questions?
I have an emergency motion.
President Kito's restructuring plan is obsolete,
unable to fulfill the standard of 21st century international medical industry.
What are you saying?
I propose a motion to dismiss President Kito. Let's do a voting.
No objection! No objection! No objection! No objection!
Do you think I have been leisurely traveling around visiting China and Russia?
I have long completed the work in the foreign countries.
I have been travelling around visiting these council members.
Your helper has been working for me.
Thanks to him, I had seen your plan in advance.
After all, you are just a surgeon.
Surgeons, should just return to where he belongs.
Miss Kito. Sorry, Kito-sensei.
Noguchi Takeo sensei has been appointed as the new President.
Xie xie. Xie xie. Spasíbo. Spasíbo. (TN: Xie xie = Thank you in Chinese Spasíbo = Thank you in Russian)
Arase-sensei.
- This.. - Yes.
As you've seen, I have become the President.
Chronic myeloid leukemia.
And, he had his first symptoms while in America,
- and has relapsed many times. - Almost no treatment was done?
There's no possible treatment.
- Long time no see. - Long time no see, great-sensei.
- Long time no see. - Yeah.