Sensei, are you alright? It's better to take a detailed examination soon.
Bring him to L&P. I'll become L&P's Director.
You can do it. It's the first time for Noguchi-sensei to see him, right?
I'll introduce him after we have finished the inspection.
Sakurai Shuuzou?
What is his disease?
We have to see the examination result to know it,
but probably he forced himself in many years of dedication to the medical treatments.
Many years of dedication to the medical treatments.
All team dragon members are looking up to him.
Especially, if we say what he is for Asada-sensei,
He's like a hero.
Hero...
Yokoyama-san who is an outpatient,
please increase the amount of the diuretic, because his blood pressure will go up in winter.
Ah, also Kawahara-san who is under home treatment
because I've just introduced him to the at-home oxygen,
At night... I understand.
Sensei, for now please think of your own body.
Yeah. I'll take a well rest.
I've also been reminded by Director Arase for that.
Arase... He will change this hospital.
Tomorrow's AR operation will be done by Aoki.
No. No. She is an assistant, the scheduled surgeon is Kashiwada-sensei.
Kashiwada's glove size is 8.
Aoki's is 6. This patient's wound must be handled by 7 cm.
An operation with a narrow operating field. It's better if Aoki who performs the surgery.
The gloves size of each and every surgeons...
Of course I memorize it.
And then, ASD operation for the day after tomorrow, the surgeon is Saeki.
No. He's still on the 3rd year, his experiences...
If young surgeons don't pile up experiences, they won't grow.
The new director, seems to be very enthusiastic, huh?
Anesthetics attend various operations,
then make a rich database.
Director Arase decides reasonable operation rotations for us.
The scene is quite in chaos, isn't it? No.
After what have Director Arase been decided,
The operating time has been drastically shortened,
Patients' postoperative recovery also has become faster.
The main enclosure is Asada.
I have confident in persuading Asada-sensei.
He's not an easy guy as you think!
I think you'll be satisfied if you've seen the result.
Ah right, come to think of it, it's about Sakurai-sensei whom you asked earlier..
This is today's inspection schedule.
He's in a place like this, huh...
Well then, we'll enter you to the contrast medium.
Are you alright? Should we take a break?
No. I'm fine. Please continue.
Please call out Director Sakurai now.
Because of Director Sakurai's false diagnosis,
my life have become a mess.
False diagnosis? False diagnosis?
Hirayama-san, please calm down.
Why does a common bronchial asthma become a heart disease?
Anyway, let's check the medical record... No need.
After I take a re-examination in L&P,
they said that it's only bronchial asthma after all.
Sakurai-sensei's false diagnosis? Yes.
It's surely a bronchial asthma, isn't it?
Different with L&P's accurate diagnosis,
Looks like Sakurai-sensei only did a simple examination with a stethoscope and a medical interview.
Hirayama-san, told her colleagues that she was diagnosed with a heart disease.
It was accidentally heard by her boss,
and it seems that she was removed from her current project.
Told her that it's impossible if she is suffering from a heart disease.
But actually it was a common bronchial asthma.
And with that she came to claim.
Sakurai-sensei gave a false diagnosis. It's unbelievable...
It may be a matter of course...
For him giving a false diagnosis. Noguchi-sensei.
Then, how is it now?
Eh?! Ah! Tomorrow at 10 o'clock,
Asada-sensei will deal with it in behalf of the director.
10 o'clock tomorrow.
Sakurai Shuuzou.
Isn't he your mentor?
I wonder that he might had pushed himself in many years of dedication to the medical treatments.
It's too bad, huh? If it happens to be true.
What did you mean? They said that he's your hero, isn't he?
What are you trying to say?
Many kind of heroes are having secrets, right?
Hirayama-san.
Please let me diagnosed you once again. It's not necessary.
I've checked in L&P, it was a common bronchial asthma.
Sometimes there are things that we don't know with just a result from a machine.
Are you implying that L&P is the one who give the false diagnosis?!
Hirayama-san. Please calm down, Hirayama-san.
Sakurai-sensei isn't a doctor who give false diagnosis.
I believe so.
Do you mean that you are determined not to admit that he is wrong?
No, it isn't.
After we diagnose you one more time, on behalf of Sakurai-sensei...
It was my project that has been approved for the first time, after I joined with that company.
And yet, I had been removed from it due to the false diagnosis.
Do you understand how frustrating it is?
Anyway, I will bring this to a law suit if there's no formal apology from the Director.
That's a shame, isn't it? A false diagnosis.
I'm this kind of person. Please.
Your mentor's condition is worse than what we imagined.
I see.
Nevertheless, is the false diagnosis true?
There's no such thing for Sakurai-sensei.
Better not to talk about this for now. Go to see that patient again,
you can suggest her to examine herself.
Ah, Sakurai-sensei's examination result has come out just now.
Aortic arch aneurysm. As I expected, it's the worst heart aortic aneurysm, huh?
Nevertheless, if it's us, we can save him.
Yeah.
Sakurai-sensei's illness isn't only a heart disease.
Cerebral aneurysm. A brain aneurysm as well...
Furthermore, it's the most difficult operation, which is on the tip of the basilar artery.
It doesn't have a strange size, I suppose that either of them are bursting soon.
The worst aneurysm on the heart and brain?
Asada seems to have expected the possibility of a heart disease.
However, he also unexpectedly had a brain aneurysm.
That's why he gave a false diagnosis.
Because if it's an aortic arch aneurysm,
There should be a chest pain and an uncomfortable feeling during swallowing.
If there's also a cerebral aneurysm,
Headache, cramp, numbness on the leg and arm, or paralysis.
There's a possibility to had a visual field defects.
It's not strange when he get some troubles during his practice.
A brain aneurysm...
It doesn't have a strange size, I suppose that either of them are bursting soon.
Anyway, hero is thing that carrying secrets, right?
Sakurai Shuuzou.
Yes. Well then, please take care of tomorrow.
I'll go to see Hirayama-san. We can't leave this as it is now.
I will stay here all day today.
Is it okay? The development of the artificial heart...
I don't join them at time like this.
Katou, it's helpful.
Good morning. What's the matter?
Bad news! It's the audit. The Medical Superintendent from the Ministry of Health, Labour and Welfares.
Ministry of Health, Labour and Welfare? Medical audit?
Based on the Medical Service Law, from now we'll conduct a medical audit of the Sakurai General Hospital.
Why does Ministry of Health, Labour and Welfares come to us? Moreover, without any announcement.
We have concluded that there's an urgent needs to know the current state of this hospital.
Why?
Isn't that obvious?
Why does Noguchi-sensei?
It seems that Sakurai-sensei has given a false diagnosis, doesn't it?
Actually the patient who had been given a false diagnosis also come.
Hirayama-san...
I have a responsibility to response the patient as the adviser of L&P which had given the right judgment.
I have asked the audit to attend.
Then, please hand in the related documents such as medical licenses, patient's medical records, etc.
Please let me see the documents.
This way.
Please hand in the medical related documents. Over here.
I think it will be found in the audit. Hero's secret.
Medical equipment operation manuals are verified.
The implementation of management committee medical safety are verified.
Did Noguchi-sensei make the Ministry of Health, Labor and Welfare,
purposely come here just for investigating the false diagnosis?
Could you also show us Director Sakurai's medical license?
Ah, Ok. I'll bring it to you now.
I'll conduct an interview for both of you
about the medical treatment system in this hospital, including the false diagnosis.
This is a medical record that was diagnosed by Director Sakurai, isn't it?
He diagnosed the heart disease only by using a stethoscope and an interview?
You can guess most of heart diseases by using those two things.
Without doing any detail examination,
He told to the patient that she need to undergo a heart surgery.
Don't you think that is a problem?
It because he was thinking of her for not forcing herself.
As the result, he has given a false diagnosis.
We will able to know whether it's a false diagnosis or not, after we diagnose her one more time.
I was surprised after doing a detailed examination of the medical record.
The number of cases for the high level surgeries in here,
are far exceeding the standard value of a small and medium-sized hospital.
What then?
High level surgery has a high NHI point.
National Health Insurance (NHI): one of insurance programs available in Japan. When the insured person uses a medical facility that accepts NHI, they will only need to pay part of the cost.
Aren't you are forcing yourselves for sake of the profits?
How can that be?
Furthermore, The death rate of the patients in this hospital is high.
False diagnosis, number of cases for the high level surgeries, and patient's death rate.
And then, there's one more problem.
The amount of the account receivable.
We suspect that there's a embezzlement of the medical fees.
There's definitely no such thing.
Account receivable?
We have many patients for the size of a small-medium hospital.
However, our financial situation is bad.
In other words, does it mean that the cause of the deficit is because of the embezzlement
without returning the medical fees?
To think that Director Sakurai, out of all people is doing an embezzlement...
Why does L&P have a partnership with a hospital like this?
Come in.
Did you find Director's medical license?
Not yet. I wonder where did he put it...
What is it?
Please let me diagnosed you once again.
The audit is now involved, you are afraid that they will investigate about the false diagnosis, aren't you?
I'm worrying about your body.
In case in your heart...
Whatever happens, you want to diagnose me with a heart disease, don't you?
That's enough.
Arase. There's something that I want you to check.
Got it. I'll try to search it immediately.
Director. Bad news. Asada's Mentor...
You haven't found it yet?
Yes. It was submitted in the general audit, wasn't it?
I was collecting the nurses' licenses.
We leave it to Director for the doctors' part.
There isn't any Certificate of Specialty or Recognition from the Institution displayed in here, is it?
As expected, no matter how do you think it is, the amount of these account receivables are unnatural.
Director said to the patients who are unable to pay,
that they can do the payment later when they are able to pay.
Even if we stopped him, he said that it's for the sake of the patients.
Although your financial situation is this worse,
The medical fees can be paid anytime? I can't believe it.
That's the person who is called Sakurai-sensei.
Where is Director's medical license? Seems that it can't be found anywhere.
I think it has been kept somewhere...
Medical license of Asada's mentor?
The medical audit came. Noguchi-sensei's suggestion.
What is that sneaky old man thinking?
Anyway, could you please ask Sakurai-sensei, where he keeps it?
That's impossible.
Sensei, I'll put the A Line.
He got a cramp attack just now.
A cramp attack? Yeah.
We have injected him with a sedative drug, he's stable now,
But, he's still not able to speak. I see.
I'll contact you, after he has regained his consciousness.
I understand.
Sakurai-sensei got a cramp attack?
It seems that he is stable now,
but his consciousness...
Surprisingly, the attack occurs at a good time, huh?
It's no use trying to search it. The medical license can't be found.
What do you mean?
He has been enrolled at a medical school, but hasn't been graduated.
In other words, he hasn't take a national medical practitioners qualifying examination.
Sakurai Shuuzou. He's an unlicensed doctor.
What did you say? There can't be such a thing.
Then among these people here, is there anyone who have actually seen his medical license?
Inohara-san?
I will tell you about your hero's secret in details.
This chair is uncomfortable, huh?
Sakurai-sensei has worked as a director in this hospital for a long time.
There's no way that he doesn't have a medical license...
How nostalgic this is...
This is the proof that your hero is an unlicensed doctor...
Year 1968. Sakurai Shuuzou was a medical student at Teito Medical University.
At that time, even if you have graduated from the medical university,
you would be an intern for 1 year, without having any medical license and salary.
The students stood up, demanding to abolish that intern system.
Sakurai Shuuzou was the leader of that movement.
I also participated in that movement.
Surely he was a hero 46 years ago.
Year 1968
Academic degree and post are bounded as bait without a salary by the medical office.
That's right!
We demand to abolish the intern system!
Sakurai Shuuzou
Yeah!!
We create our own future!
That's right! That's right!
Noguchi Takeo
We...
He was really cool back then.
are ready to fight!
There's a rumor that the riot police come to the university...
Will this be alright?
There's no way we can stop our fight in here.
If we give up now, we'll always be under the feet of the university and professor.
We are doing a part-time job on duty for a living, although we don't have any medical license
and we are being forced to do the medical office's chores without knowing what we are doing.
We joined here to become a doctor in order to save many patients.
Not for the sake of authority or making money.
If we don't take action now, nothing will be changed.
Let's fight until the end! Ok!
Sakurai and friends barricaded themselves at the university until the end.
Be obedient!
But in the end, he was arrested for squatting.
Then he was expelled from school. When the riot police came,
I wasn't there. I have escaped.
The hero defeated and fell.
Even if he was expelled from school, if he enroll to another medical university...
We had waited him to do that.
He said that the real fight is from now on.
But we couldn't catch his whereabouts since then.
He really ran away.
Saying nothing but an ideal, he only provoked us then left in the middle.
Sakurai who has been expelled from school, didn't take a national medical practitioners qualifying examination.
In short, he doesn't have any medical license.
Me who had no where to go, had no choice but to return to the medical office.
Because we participated in the student movement,
The top position got their eyes on us and gave us bad treatments.
Nevertheless, we endured and become a doctor in the end.
And yet he's taking refuge in such place,
continuing his life as a hero.
Sakurai Shuuzou is an unlicensed doctor. This is the truth.
Katou-sensei. Something terrible has happened.
It seems that Director Sakurai is an unlicensed doctor.
What? He had been expelled from the medical school,
then he have continued his practice without having any medical license.
Are you alright? What's the matter?
Are you alright? Are you alright?
Call the doctor. OK.
Pull yourself together! Are you alright?
What's the matter?
As the result from the inspection, Sakurai Hospital will definitely be closed down.
It will be a trouble, if you happen to be Sakurai's subordinate, who is an unlicensed doctor, won't it?
Before that, please come to L&P.
I'm the one who is appraising you more than anyone in the world.
I don't want to make you to do the same thing as me at that time.
Don't be fooled by Sakurai anymore.
I...
I believe in Sakurai-sensei.
Why do you trust such a fake doctor?
Asada-sensei, Hirayama-san is...
She complained of having difficulty in breathing then collapsed at the lobby.
I've listened to the wheezing on her both lung fields. It's an asthma attack.
Blood pressure 45 of 75. Heart rate 112. Saturation 91%.
Increase the Oxygen to 5 liters. Ok.
Asada.
Please prepare ?-blocker. OK.
Did you say ?-blocker? What a stupid thing.
It should be ?2-stimulant if it's a bronchial asthma, right?
If you use a ?-blocker, her breathing will stop and worst it will leads her to death.
Your medical license will be stripped due to a medical malpractice.
She's not having a bronchial asthma.
It's a cardiac asthma.
What are you saying?
The specialist in respiratory medicine in L&P, has diagnosed her after taking a CT.
It has been determined as a bronchial asthma, ?2-stimulant it is.
If it based on L&P's diagnosis, it's a ?2-stimulant.
However, if it based on Sakurai-sensei's diagnosis,
It's ?-blocker. Which one is it?
Do you want to kill the patient by believing an unlicensed doctor?
I've brought the ?-blocker.
Asada.
Stop it. Don't use it.
NO!
What a stupid thing.
The attack has been subsided. Why?
When Hirayama-san was filled with emotions,
Are you implying that L&P is the one who give the false diagnosis?
I learned that there's a engorgement in the jugular vein. Furthermore...
What is it?
There's also an edema of lower limbs.
This is obviously the symptoms of cardiac asthma.
Moreover, according to Sakurai-sensei's medical record,
There are systolic murmur from the auscultation and also a split of the second heart sound.
That's why I used a ?-blocker.
Why? Do you mean that L&P's diagnosis is wrong?
They didn't check her heart in L&P.
Kitou.
I was asked by Arase.
If you check the medical record, she did went to the department of respiratory medicine.
But she didn't take any diagnosis at the department cardiovascular medicine.
In other words, her lung was examined, but her heart wasn't.
Then what if she examined her heart properly?
I guess she would know that it was a cardiac asthma.
It doesn't necessary mean that Sakurai isn't an unlicensed doctor...
Please have a look on this. It was in the storage room.
It seems that director was somehow graduated from an overseas medical school.
Overseas?
Harvard Medical School?
Stupid.
They has determined that it's a forgery. It's not a forgery.
When I was an intern in Chicago,
There was a rumor everywhere that there was a young genius Japanese surgeon in Harvard.
Flexible way of thinking. Instantaneous judgment. Overwhelming technique of speed.
That genius surgeon's name is...
Sakurai Shuuzou.
Everyone was idolizing him.
Everyone wanted him to continue as a doctor in America.
However, he returned to Japan.
He said that he want to contribute to Japan's medical care.
If there's a clinical record in America, you can obtain a medical license in Japan.
Try to search it properly at the place where the certificate of graduation from Harvard is located.
Sakurai-sensei's medical license should be found there.
It's alright now.
Director Sakurai's diagnosis was right, wasn't it?
When you were re-examined at L&P,
You didn't tell about the heart disease that Sakurai-sensei had diagnosed, did you?
I was afraid to be told that it was really a heart disease.
I only told about the bronchitis.
L&P heard about Hirayama-san's case,
They only checked your lung then diagnosed it as a bronchial asthma.
It seems that your works is hard, huh?
Yes. The cough can't be stopped at night.
There's sometimes when I can't breath.
Please restrain coffee as much as you can.
and it's better for you to sleep early at night.
Yes.
If I joined with that heavy project as it was,
By now I... The proper name of the disease is ASD.
Atrial septal defect.
ASD: characterized by a defect in the interatrial septum allowing pulmonary venous return from the left atrium to pass directly to the right atrium.
As for your condition now, we will cure it immediately with a surgery.
Please tell this to Sakurai-sensei.
Please say "sorry" and "thank you" to him.
Why did Director Sakurai's certificate of graduation from Harvard is in the storage room?
He's not a person who shows off his career.
Because he is a person who hate that kind of thing the most.
For Sakurai-sensei, no matter which school you are graduated from,
examining a patient as a doctor is nothing more than a process.
Where is Director-sensei? He's not here at the moment.
What's the matter?
Even though my son has been examined here for a long term,
I couldn't afford the prescription charge... Oh, Negishi-san!
I accept Director's offer about paying it later when I can afford it.
Thank you very much. Because of that, my son has also been recovered.
Please send my regards sincerely.
I understand.
The large numbers of account receivable. It seems like it's not an embezzlement, isn't it?
Have you believed on us?
Why do the death rate of this hospital is high?
When you see the medical records,
There are a lot of patients who have terminal cancer and patients who are abandoned by other hospitals.
We have done some interviews to the families.
They said that here is the last refuge when you are rejected in any hospital.
Sakurai-sensei didn't give up until the end to have them examined.
Everyone has been saying so.
It's so Sakurai-sensei, right?
The result of the audit,
I want you to show us a few recommendation of improvements,
however, it has been decided that there's no problem in the hospital management.
Has Sakurai-sensei never talked about his past even once to you, Inohara-san?
It would be great if he told even a few about himself, wouldn't it?
I'm thinking that Sakurai-sensei is a victim of Japan's medical care system.
In Japan, even though the doctors are working hard for the sake of the patients,
the management will become tight. And in the end, the doctors themselves who will be broken down.
The more skillful the doctors are, huh.
We need an environment where we don't have to rely on to one god's hand.
With the power of business,
I want to save not only the patients but also the doctors.
It had been troubling you, isn't it?
Is Hirayama-san alright? Yes. She thanked you.
I see.
A doctor who is Harvard medical graduates, huh?
Is that why you were friend with the doctor from the U.S army?
Nevertheless, that Noguchi...
Geez, he is a troublesome guy. Noguchi at that time...
Did you know about Noguchi? Yes.
I want to be a doctor in order to save patients.
I see. Don't ever forget that feeling.
He said that he wanted to be a doctor in order to save patients.
He said that heatedly more than anyone. That sneaky old man did?
Sakurai Shuuzou has carried through his own dream.
He's going through a completely different path with you.
Nothing can be changed in such a naive dream.
That's why you throw away your dream, and stood at the powerful side?
As anyone can see, I'm the winner.
I'm entrusted to control Japan's medical care.
Different with the director of that dilapidated hospital.
That's right.
But in truth, didn't you want to be a doctor like Sakurai Shuuzou more than anyone?
I want to be a doctor in order to save patients.
I see. Don't ever forget that feeling.
Asada-sensei. There's only one thing that I want you to understand.
Me and Noguchi-sensei are business partner.
However, me and Noguchi-sensei are different.
Hello.
Ijyuuin-kun. There's an important thing that I want to talk about.
Important thing?
I want to meet and talk now. What?