Batista operation.. are you interested in it?
Batista operation
requires an excellent team
Then go form one yourself
This person..
as a nurse, she's first-rate
You will be the first person to join the new "team dragon"
You have decided the 2nd Batista operation team member?
Ijyuuin
What are you saying?
He's just an intern
He hasn't been poisoned by the tea served in this clinic
In Japan's corrupt hospitals
talented doctors are nowhere to be found
Look, Papa Jyuri can swim!
Papa!
Quick look!
flow down
stop blood circulation
yes
next, cutting open chest
- scalpel - yes
What is happening?
I have to help in Batista operation?
Team Dragon member?
Your voice is too loud
I don't have much surgery experience
And also...
Kato-sensei has already agreed
or.. forced to agree
right?
yeah
wait
you don't have to worry
with Asada sensei's guidance
Your skills will significiantly improve
There isn't any outstanding surgeons around here
Makira-sensei
If you don't hurry up
If blood circulation is stopped for more for more than 20 minutes, it may cause brain damage
Sensei
Sensei!
Makira Sensei!
What's wrong, Sensei?
I...
I can't do it!
What's going on?
I don't know
Sensei he... suddenly panicked
Assistant surgeon can you continue the surgery?
Me?
I need 5 minutes to change into surgery outfit and disinfection process
yes
It's been over 5 minutes since the blood circulation is stopped
If they don't hurry up replace the artificial blood vessels and restart the blood circulation...
the brain may not be able to hold up
15 minutes left...
Brief me on the patient
64 year old man
requiring blood vessels replacement at the thoracic aorta
- tweezer - yes
- sucker - yes
How much time since circulation is stopped?
10 minutes
10 more minutes to brain dead
start operating on the thoracic aorta
- scissors - yes
ME! report every 1 minute interval
yes
We have to finish the surgery in 10 minutes
yes
- artificial blood vessels - yes
From the maximum limit of 20 minutes
we are left with 9 minutes
Begin stitching process
- 4-0 Stitching tool - yes
7 minutes left
- How fast.. - Check surrounding blood vessels
yes
2 minutes left!
I'm lifting it up
Get ready
yes
30 seconds left
Almost time limit...
Stitching completed
- Scissors
Heart-lung machine start pumping blood
yes
Just exactly 20 minutes
How close..
Thank god...
Continue on, after stitching... inspect the central nervous system
yes
His honored teacher?
It's illegal to operate on patients you are acquainted with
The patient is his high school teacher who inspired him to become a doctor
But in the middle of operation
his hands began to shake uncontrollably
thus unable to continue surgery
Once you step into the operation room
the only thing that should be in your mind is the patient's life
Only this
Without the courage to perform surgery, don't enter the operation room
Even if the patient is an acquintance of yours?
Any patient is just a patient
Fujiyoshi Sensei
Please lift up your head, Sensei
Sensei!
Sensei, you have done a lot for me
That patient..
was killed by me
If only I had not diagnosed him requiring surgery operation...
It's all because of the myocardial infarction cardiac operation
- A surgery error? - No
the surgical procedure itself is faultless
But..
it's because the hospital administration mistakenly classified the disease as pneumonia
Anyway it's the least unexpected mistake
Because of the disarray state of hospital administration there has been other grave mistakes
Handing patients to the surgery department is my mistake
surgery operation is required right?
You surgeons
think that the only way to save a patient is through the scalpel
Never considering the patient as a living human being
Only by forgetting that the patient is a living human being
surgeons are then able to perform the surgery
By not treating the patient as a human being, it's already a contemptuous act
You are the type that will never be outstanding among your peers
Kato Sensei is looking a doctor specialising in cardiovascular system
requesting a list of suitable patients for Batista operation
Ah
With regards to wretched surgeons like you
I don't care if it's Batista or others
I won't hand over a single one of my patients
Never ever
Fujiyoshi Sensei
As a clinical doctor, he is exceptionally briliant
is worthy to be called an ideal clinical doctor
but.. he is overly protective of his patients
there has been several cases of conflicts between him and the professor of cardiovascular department
It's no wonder..
And also..
when he was a student, he had a WPW* syndrome medical history *(Wolff-Parkinson White)
A heart abnormality disease?
On top of this
His daughter...
also suffers from a heart complication
Ventricular Septal Defect (VSD)
and is currently admitted to the cardiovascular department in this hospital
His daughter?
A tear of approximately 1 centimetre in the heart chamber walls
Although it is just a subtle tear size
but it seems it has been decided that she requires surgery operation
But
Fujiyoshi-sensei insisted using only internal medicine
relentlessly refusing surgery
Because of this starting another dispute
I heard it's Asada who saved the patient
yes
Is it?
You must be tired, right?
You..
like to eat kibi dango?
Ah?
There's a job vacancy at hospital in Okayama
You go there
Go eat some kibi dango and take a good rest
You can leave now
Ex... Excuse me...
Then.. Asada-kun
I would like to watch you doing surgery in person
but I've been busy lately
But finally
next friday morning I'm able to set aside 2 hours
What kind of surgery you like me to do?
It's not a difficult surgery
It's to treat a hole on heart chamber walls
It seems the patient is the daughter of Fujiyoshi-sensei of cardiovascular department
Once we get his approval, then you would be doing this surgery
Iryu Team Medical Dragon Karte: 03
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timing: tianj raw: chiisana_tantei
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How is your condition?
Already much better
but don't push yourself too hard
yes, Thanks
Ah! Ijyuuin Ijyuuin Ijyuuin
Hmm..
That girl.. is she the new nurse?
It seems so
Strike!!
I can't wait anymore..
That kind of outgoing girl is really my type
Don't you
feel she has an aura of a leopardess?
Asada Sensei
Why is it Asada again?
If you observe carefully
Rather than a leopardess, she's giving an impression more of a fox
Right?
What's going on with you?
Why are you so distressed?
You'll be bald soon
Leave me alone
Come with me
Come with me for a while
I've heard you are called on to join Asada's team?
You've known?
I do have inside information
How pitiful...
being asked to join such a low success rate surgery team like Batista team
you will definitely face much trouble being in the team
How sad..
A "trash" will only look up to other "trash"
Bye-bye Arigato Sayonara
Professor Karasuma
the daughter of Fujiyoshi Sensei who is under your department's care
Is her surgery preparation in place?
Thank you for your concern
This surgery operation, if successful, will add to our total success cases
We would accept the surgery request of this patient wholeheartedly
Papa
Are you feeling fine? Jyuri
Yes..
But..
Right up to just now... it's been hurting
It's because Sudo-sensei has just given you few doses of medicine
ok?
It doesn't hurt anymore, right?
Papa...
Why aren't you treating my sickness?
Papa
You are also a doctor right?
In this hospital
there is a rule that we cannot treat our own kins
Mmm..
Jyuri
has to go for operation?
That's not happening...
the medicine will cure your sickness
ok?
I really want to go home...
The tear in your daughter's heart chamber walls is 1 cm long
Professor Karasuma has decided she has to go for surgery
yes
But based on my assesment,
surgery is not needed
Internal medicine alone is enough to fully cure the sickness
Well.. as the doctor-in-charge,
I have to report to the Profesor Karasuma...
Whatever the professor had said about surgery, it's not needed at all..
Not handing over the medical report?
Yes
He would not hand over his daughter's medical report
He firmly believed
his daughter's surgery
is only decided between the professors
thus, he is still trying to find a reliable skilled surgeon
but this matter could not wait any more
What do you mean?
Professor Noguchi.. he
does not trust you one bit
If you don't demonstrate your skills
I don't know what would he say
In another hospital that I know..
there is a patient requring aortic arch replacement surgery
aortic arch replacement surgery?
There's a lot of parts needed to be stitched
It's a surgery operation that requires the heart to be stopped
so it's like a race against time
Even to top surgeons, the operation is very difficult
the duration in which the heart is stopped is roughly around 60 minutes
In the past
you used 45 minutes to complete such surgery
If you demonstrate such proficiency
Professor Noguchi would have no reason not to recognise your skills
I got it..
I will go over it in details next time
next time?
I'm sorry
What is this about?
Why do I have to work in the ER?
to improve your medical skills
a surgeon continously hone his skills by performing surgery operations
ER provides the best opportunity for this
But I haven't agreed to join Team Dragon
I understand
Huh?
You decide whether you want to join or not
Please explain your actions
Why did you ask Asada to help out in ER?
patient for Batista
have you found him?
still in progress
I see
If you don't hurry up and find one
Professor Noguchi would release Asada, isn't it?
He must be worried that
when this happens
he can't just leave behind a "trouble-maker" reputation before being forced to leave
During this period of time,
I'm keeping him busy in ER, not that bad right?
Asada
is a surgeon of cardiac surgery department
But Professor Noguchi
had already approved it
Is this an exchange for hospital fees of the foreigner?
Of course
Besides, I'm only asking him to do necessary tasks
Actually, I plan to invite him temporarily
but he seems to take an interest on ER
so..
there's nothing I can do, right?
Hey, are you ok?
45 year old man
fallen from a stair 7 metres above ground
JCS 20
Blood pressure 70/40
Heartbeat 24
Respiratory rate 22
Blood oxygen concentration 92%
- Change bed - yes
One, Two, Three
Taking out the stretcher
Report blood pressure, examine pupil
That's not neccessary...
checking for internal damage
- Ultrasonography - yes
Blood
Oxygen
Monitor
Monitor is here
- Prepare balloon - yes
prepare O- blood
- inserting tube - yes
Bring O- blood
Excuse me... it's best you wait for examination result first
patient has internal bleeding shock from the broken pelvis
blood first
- Prepare it quickly - yes
- Use the bombe - yes
Not needed
- pump it with your hand - yes
blood pressure decreasing
- ok - yes
quickly bring the blood
- prepare tranquilizer - yes
Hold him down
- or the bleeding will worsen - yes
bring the sheets over
what?
tightening the pelvis
sheets
Who the hell is he?
the anesthetist, Arase-sensei
Inserting blood
- Lifting him - yes
1, 2, 3
Put him down chest, pelvis, X-ray
I can't accept the way Asada does things
Without checking carefully blood type
transferring the blood
That's how a "star" does things
at a situation involving life and death
That's right, but...
Gondo-kun..
You
You rejected the acceptance of the foreigner without permission
Who said you could do that?
Well, that was because...
there was a problem with..
I am here in ER and
there are two rules to follow
first
obey me
second
make sure you do it
understood?
Kitou...
who is she?
in the ER field
graduated from Hamond Univerisity in Chicago, she is currently holding a professor position
She was recruited by the superintendent of Meishin ER
Then why is she favoring Asada?
What she want is international recognization
by increasing the survivor rate of Meishin ER
So at international conference
she can catch attention and impress when presenting her thesis
that's why she needs Asada's ability which was trained under NGO
There are too many enemies before the Batista Operation
Do you have any business to discuss now?
At that university,
there is a patient with cardiac aortic aneurysm
So?
I am going to transfer that patient over to let Asada operate
It's a demonstration for the professor
why do I have to help in Fujiyoshi-sensei's daughter operation?
Stop whining, little brother
Hey, 76kg
did you transfer to ER?
76kg...?
no
I'm just helping there temporarily
outsiders don't have to work so hard for that ungrateful woman
You are disturbing my nap
Hey? who are you
I am an anesthetist in ER
43kg
Is your weight 43kg?
how rude, I am not that heavy!
Is it?
Just right
He guessed the weights correctly
excellent anesthetist
just by looking at the patient on the surgical bed
he could tell the weight of patient with 5kg of deviation
He's a more fascinating person than I had thought
Not bad..
Professor Karasuma
I am strongly against the operation
my daughter will be treated with internal medical treatment only
we shouldn't perform unecessary surgical operations on kids that has no physical strength
you
always go against my decision
just recently, a patient with weak physical strength
died of internal pneunomia during the operation
have you forgotten?
it doesn't happen that often
also, I heard that the head surgeon this time
is extraordinarily brilliant
you have heard of the rumor too, right?
It's Asada-sensei, who came for the Batista operation
Asada?
he is a very devoutful surgeon
while working in the department of cardiac surgery
he helps out ER as well
he probably likes cutting so much
there is no problem
you are a staff of this department, therefore you have to obey my decision
or else
before cutting your daughter, I will cut you first
This kid has a premature cardial defect?
If you would hand over her to the surgery department
I am nurse Satohara
I am Ijyuuin
You don't have to look at me like that
I'm not going to operate on her now
All of you
are you satisfied as long as you can perform surgery on a patient?
I won't hand over the medical report
This kid
has always been alone
I'm always busy working
Even after marriage or after this kid is born
I neglected my family to take care of patients
Yoshino-san, how are you feeling now?
My wife finally had enough of me and left us
It's no surprise
Having lived a wealthy life since young
Of course she wouldn't want to be with
a person working day and night, yet having a low monthly income
I forcefully fought for Jyuri's adoption rights
decided I would raise her
with my own hands, to be a great person
But..
- Ah, Sensei.. wait.. - yes
Recently I've been..
I started getting busier
Let me take a look..
I was always the last
to pick her up in kindergarten
Papa!
Jyuri
Let's go home
yes
usually
whenever I say "Let's go home"
she gives me a shiny smile
even though there is nothing at home
no warm food waiting..
or a gentle mother..
but..
when I say "let's go home"
shiny smile..
can you believe it?
this child,
after the divorce with my wife,
hasn't asked about her mom, not once
not a single once
she's worried for me
she had seen all the fights I had with my wife
she understood everything
on top of that, caring for me
at such a young age...
but, I couldn't do anything for her
can't cure her illness...
can't even take her home...
her heart failure is caused by me
I made her heart bad
It's me...
Fujiyoshi Jyuri 7 years old premature cardial defect
only by forgetting that that the patient is a living human being
surgeons are then only able to perform surgery
He must like to cut
if you disobey
I will have to cut you before cutting your daughter
this girl has premature cardial defect?
do I have to be operated?
Ijyuuin, do you drive to work today?
yes
there was a call just now that
there is an ICD implentational surgical operation at Yokohama Mirai Hospital tomorrow
could you take it there?
this is implementation recorder
yes
how about that one... Is he training you well?
that one?
the Team Dragon
stop it
I have nothing to do with that team
hey
heading to Mirai Hospital also?
Me too
ride me
How did he hear it.. that guy
Operation on cardiac aortic aneurysm ?
the patient is in Yokohama Mirai hospital
I want to meet him before the operation
before the operation?
are you attempting it?
that hard of an operation?
are you out of your mind?
Fujiyoshi-sensei!
are you serious about transferring her to a different hospital?
yes, I am serious
what if the professor knows this?
you won't be able to stay in the department
I will quit the department
to work at any hospital in countryside, and live on for patients and her
Fujiyoshi Sensei
Stop!
This is my decision
sorry for not letting you do the operation
how could a doctor like you
survive in the department until now
have a destination?
I have contact at Yokohama Mirai Hospital
I will go there for now
what a coincidence
we're heading there too
ride with us
You can't do it?
yeah
please understand
if professor from Meishin go against me
my position will be threatened
I understand
looks like it didn't work
it was expected
they just want to save themselves
what now?
I will find a hospital outside of Meishin branch
Ijyuuin-kun Let me out here
yes
Thanks
Hey
you're seriously quitting Meishin?
none of your business
Papa
yes?
where are we going?
yeah
wait ok..
Asada-sensei?
are you alright?
His heart stopped beating..
he used to have WPW syndrome when he was at school
Ijyuuin! His heart has stoppped
call an ambulance!
yes
yes, please
Asada-sensei
in this traffic
it will take more than 10 minutes for ambulance to arrive
brain will run out of oxygen in 10 minutes
we won't make it
Papa!
wake up!
Papa!
Asada-sensei
Ijyuuin
- Bring over the ICD that is to be delivered to Mirai hospital - what?
excuse me
please take care of her
hurry, bring it
what are you planning to do with it?
to connect the ICD directly into the heart
we need to apply brief electric shocks to get the pulse back
not possible
we haven't checked the VF with electrocardiogram...
if the state is not VF
and also...
ICD is not used for this circumstance
this is the only way
Impossible...
you are cutting him here?
we should wait for the ambulance
they won't make it in this traffic
Hurry! bring the ICD!
I can't!
I can't do it..
how can he do it in this condition..
isn't this the same as crime?
If he were to fail..
then I am over as a doctor
Ijyuuin!
Calm down... ambulance will come soon
Soon..
Ijyuuin!
Stop it
what you are doing is crime
By not saving a life that could be saved
that is also a crime !
it's VF
open it
connect it
yes
ok
move away
going
it's not working
one more time
there is pulse
resusciated!
This place..
where am I?
you're on hospital bed at Meishin
Asada-sensei had
performed ICD implanting operation on you
Sensei
Asada-sensei
is a good surgeon
Jyuri's operation
it is not that hard of an operation either
when doctor treat the sickness of their own kins
they will forget to maintain the composure, and make wrong decisions
sorry to say this, but
aren't you the case?
how is Jyuri?
she's fine
the other nurse is taking care of her
really?
she's a good child
she understands that you are sick
didn't whine even once
I was surprised
I couldn't do anything for her again
what?
I always cause trouble to her
I'm supposed to be the parent
what are you saying?
Jyuri understands
that for the sake of the patients
you're sacrificing your sleeping time working tirelessly
How you feel sorry for not
spending more time with her
She understands your love for her
That's why she is waiting without whining
Jyuri is
worrying about your health
more than her own
my daughter's medical report
I will show you
This is her
heart electorocardiogram
Indeed..
there is still a shunt on the VSD
but
my daughter's shunt flow
rate is 25%
normally it is 30%
and there isn't any sign of pulmonary hypertension
surgeons are always
happy when they see the rate 40%
even 30%
sometimes they try to operate even at 15%
but even at 15%
there are cases when operation is required
that is right
the operation
when is it?
you fell yourself
are you weak-kneed now?
when is the surgery?
no need
no need to cut
that is my diagnosis
Like you had said
there is no sign of pulmonary hypertension
no cloud around the mitral valve too
the blood from the tricuspid shows no sign of leakage
as long as you continue the internal medicine treatment
it will clog up as she grows
my decision is
same as yours
aren't you supposed to cut her in front of professor?
cutting or not cutting
I am making the decision
I don't need to leave a scar
on my daughter's chest?
but
you shouldn't keep her in this hospital
transfer her quickly
hospital near the ocean
since she likes the ocean
Papa!
Jyuri!
Papa!
let's go home
Papa
let's go to ocean again
yes
your daughter
I heard you transferred her
yeah
I have asked my sister take care of her for a while
Professor Karasuma is very angry
perphaps in 6 months, or within a year
he will make up reasons and banish me to one of the branch hospitals
aren't you going to quit
the department?
Batista is a difficult operation
I can't let surgeons handle everything
also
don't you need a professional in your team to
to handle the post-operation treatment?
Because patients have flesh living bodies
although we only met recently
but, with a person like you that is enough
what do you mean?
you argued with Profession Noguchi again?
and you didn't operate Fujiyoshi-sensei's daughter?
I never said I will operate to begin with
I said I will decide after checking the medical report
we still have the cardiac aortic replacement surgery right
we could show that one
what's wrong?
I could finally meet him..
yeah
finally
"God Hand" has arrived
that patient was
given to North Japan University
Kirishima asst. professor of
cardiac surgery department at that university had performed the operation
music
let's begin
flow down
starting to stitch out
4-0
amazing
no wasteful movement
I have heard from rumors
but never imagined to be this good
it's like an accurate machine
your previous operation, the time the heart was stopped
it was 45 minutes right?
Kirishima asst. professor
finished in 39 minutes
operation done