And it keeps a proper diagnosis from coming out.
I understand that much.
This whole outpatient consultation...
For as long as people aren't sure about medicine, a lot of patients who don't know what to do will come.
I'm a pathologist, but...
I'd like these patients to be certain about the treatments they choose.
She came along with the mother.
But having taken the child from one hospital to another...
That girl's certainly caught our interest.
She kept busying herself with the family even after he was discharged.
That's an issue, isn't it?
It's a little too troublesome for the patient.
So?
What am I supposed to say about this Dr. Miyazaki?
Looks like we just have to wait...
Until the day of your retirement, huh?
subbed by kurokouchi @ livejournal #wheresnakanishi2k16
With the advancement of science and technology in the world of medicine,
the accuracy of exams and diagnoses have increased manyfold.
And so many more patients' lives have been saved.
However,
doctors, on the other hand...
It's time already!?
Dr. Kishi, it's time for the conference!
Go on your own today.
Why?
I'm swamped with work today. Right, Morii-kun?
But that's how it is all the time, isn't it?
Oh, of course you're here!
Dr. Kishi, what're you even doing? It's time to go!
What?
Don't you 'what' me!
We're meeting with management today!
Right.
Don't you dare say you forgot! This is the only day you have to come!
The chairman's issuing a brand new management policy, so I'm sure you understand how important it is, right?
That's why you can't come?
We have a conference to go to, though, right?
I can go there on my own!
Well, let's go! We're running out of time!
No, no--Morii-kun!
Help me out here, Morii-kun! Come on!
You big baby.
Dr. Kishi!
Morii-kun! Now hold on--
Right, I'm off too! To the conference!
Excuse me.
It's nice to meet you.
I'm Takashiba from the Radiology Department.
I'm Miyazaki from the Pathology Department.
We're just about in the same section here in the hospital, Radiology and Pathology.
But I don't think I've ever seen your pretty face before.
In the interests of the hospital's plans for rebuilding in the future,
we've been forced to review our current administration.
We'd like all our departments to find ways to increase the profits you can bring to this hospital.
Yes, sir.
Dr. Sada.
Yes?
With regards to setting up outpatient consultation with Pathology,
thank you very much.
We would've never expected Dr. Kishi to go along with it.
Because of that, we're very grateful for your guidance, Dr. Sada.
No, that's not...
It's really no trouble at all.
The patient had a CT scan done to check for bone metastasis.
T/N: Cancerous tumours in the bones.
We observed an irregularity in his second lumbar vertebrae.
T/N: One of the largest bones in the spine.
We believe this to be bone metastasis.
It might be transitioning...
Why not delay his surgery and put him into chemotherapy?
May the Radiology Department chime in?
Regarding this matter,
I, too, managed to get a diagnostic image of the patient.
Go ahead.
I do agree that this is bone metastasis.
Incidentally, I attended the study group you held for it last week.
And I feel like I ought to have a quiz for all of you who viewed the CT scan at the time.
Actually, just now,
and this is embarrassing to admit, but I gave all of you a wrong answer.
I said it was bone metastasis, but I believe it's Pott's Disease.
T/N: Tuberculosis of the spine.
Of course, surely it must just be the former.
But perhaps you could run an MRI scan and study that as well?
I apologise for asking such a thing of you.
That's...
Well, with regards to this case...
Isn't it all right?
When a man of his calibre and experience bows his head,
taking an MRI scan is the least we can do.
Understood.
Thank you very much.
It isn't bone metastasis that ails that patient.
However, what was written on the CT scan's report was "cancer".
That doctor isn't very good at understanding results.
Are you saying...
You did all that earlier to make an MRI scan happen?
The idea of a cancerless patient undergoing chemotherapy was unbearable.
So that's what it was, huh!
It's textbook knowledge, don't you know?
"In interdepartmental conferences, it's critical to speak your mind."
"And when that happens, oftentimes the strategy for treatment changes."
But then...
It's never really that simple, is it?
Right.
Doctors have a lot of pride.
Their need to always be the ones doing the teaching tends to prevent any progress from happening.
Then again, you can find that sort of attitude in just about anyone, too.
I can think of one person.
Rather than depending on others,
try rethinking what it is your department can bring to the table.
Sada
We encourage you to strive for these ideals for the continued development of this hospital.
Meathead
I'm the chairman, yo!
The heart of this hospital consists of every one of you seated here today.
While today's conference went on smoothly,
there really are times we find conflict with other physicians.
And while I say that, it's a trying time for both conflicting parties involved.
Nobody wants to break any rules in here.
You have a point there.
Oh, right!
While I'm here, would you like to take a closer look at my department?
I would, but...
I'm sure Dr. Kishi wouldn't mind.
I'm counting on all of you.
Thank you very much, sir.
What's wrong with you, Dr. Kishi?
Dr. Sada?
First you read manga, then you draw this...
Dr. Sada!
Yes?
We're counting on you to continue improving our departments just as you've been doing.
Just as I've been doing, sir?
Focus not just on bringing in profits, but also find some ways to reduce expenses as well.
There are things you can cut down on, yes?
Just like in the Radiology Department.
I understand, deputy director.
Do come in.
Excuse me.
This is where our department performs diagnostic imaging.
These are all recently taken CT and MRI scans.
Everyday we create about 100,000 sheets like these.
100,000!?
As opposed to x-ray results, we take numbers of photos at a time.
However, in one day we can only check about 5 people's scans.
So one person has 20,000 sheets, correct?
And you can really do all of those?
It's the only way to do it.
Haven't you narrowed the possible diagnoses down yet?
Seven conditions are too many to differentiate from.
This is the most I can be held responsible for.
Well, if that's what you really think, doctor, then I suppose there's no helping it, is there?
In any case, seven conditions is still far too much.
Kitayama-san.
Regarding the results of your endoscopy...
We observed some complications.
Like cancer?
In its early stages, yes.
No...
That's... that's horrible...
That means I can't go back to Africa...
We were helping with development work in the area...
Given that it's in the early stages, we can perform surgery as soon as you do another endoscopy.
Can't I just come back to gynecology regularly before I'm married?
That's all I need to do, right?
We'll move you to the gastrointestinal department, but as far as consultations go you can come to me.
Sorry I was out late!
I took a little peek into the Radiology Department.
Would've been cool if you just took your time.
Work's going just fine down here, right, Morii-kun?
Are you trying to say you get more done when you don't have anyone else here taking up your time?
Damn straight.
It was so nice when this place was quiet...
Is that what you think?
I see how it is now!
When Dr. Takashiba calls me again, I'll take my sweet time listening to him.
He's got a lot more lessons to teach me, did you know?
The gentle way he handled the conference earlier was just marvellous!
It was so different from the way a certain someone turns everyone in the room into his enemy!
Why do you have to make her mad about everything?
I'm too annoyed to eat anything!
Gobbling up food'll fix everything!
You know, it'd be better to kiss Dr. Kishi's ass so we can all get along in the same department, but this girl can't do it.
That's why I'm not just here for business purposes.
Dr. Sada!
Huh?
The gang's all here.
Thank you so much!
Fantastic!
Someone's looking good today!
Oh, really?
The big man himself praised me today at the management meeting.
You have a thing for the chairman or for his power?
Come on, Morii!
Quit it!
Oh, that reminds me!
What kind of doctor is Dr. Takashiba from the Radiology Department?
Dr. Takashiba, huh?
You know, that man was my mentor from way back when.
Are you for real!?
I'm so jealous!
Having that sweet old doctor for a mentor...
Naw, that guy was absolutely horrible way back when!
He gave me a hard time for everything!
Isn't that more Dr. Kishi's style?
Yeah, well, he's not like that any more.
But he'd make me look at a stack of scans this big without any sleep, that guy!
So I did my best, didn't sleep, gave it my all!
And he'd keep doing things his way, pushing this and that, and it was the worst work environment I'd ever been in.
Looking back on it, all I ever did was keep going as much as I could.
And because of that you have the me that stands before you today.
Anyway...
You're asking about him as a co-worker, right? Not a mentor?
But, well, he's about the same.
Talk about merciless!
It really is, isn't it?
Are you done drinking already, Hibako-san?
Good work today.
What's up?
I'm organising some old medical certificates.
Encoding them into the computer database, too.
Sure sounds tough.
By the way...
Dr. Miyazaki was with Dr. Takashiba today, apparently.
She's just a rookie.
It's only natural for her to have a kinder mentor to teach her these things, to get attached to.
What's with you?
Is that the real reason she was there?
You're heavy, y'know.
When you left your old hospital and came here, Dr. Takashiba took care of you too, didn't he?
Hello there.
I'm Takashiba from the Radiology Department.
Hey.
You were a physician before, weren't you?
You're looking for answers too, aren't you?
If you want to see if my diagnosis for the recently discharged patient is correct, all you have to do is check the record.
When I had my hands tied with something else, the patient was given another treatment.
If their condition's stayed the same...
You can't rely on my technology to see if it's aligned with what you've discovered.
I'm glad to have a new comrade on the team.
You're heavy.
There are things you can cut down on, yes?
Just like in the Radiology Department.
Chief Sada's excitement sure tuckered us out, huh?
Wanna drink more somewhere else?
I'm working early tomorrow.
What is it?
Isn't it all right?
You know you should be schmoozing Dr. Kishi instead, right?
Morii-san...
Why'd you quit?
Med school at Teinan University.
That was your dream for the longest time, wasn't it?
So why in the world did you quit?
Could it be...
... you still want to be a doctor?
In any case,
don't tell anyone I dropped out of med school, okay?
It'd be hell to explain.
So...
Would you do me a favour too, then?
Nao Kitayama, 33 years old.
She visited gynecology complaining about pain in her lower abdomen.
After finding her stomach cancer, she was sent to Gastrointestinal.
Given that she was in the early stages, she had the tumour removed, but later CT scans revealed an abnormality in her liver.
We believe the cancer spread, so she's begun chemotherapy treatment today.
Later on, we'll cut the tumour out again.
Deputy director?
Do you have time to address the Radiology Department?
Do you need anything, Dr. Takashiba?
Just as you said regarding this case, the chance the cancer did spread is indeed very high.
In this past year alone I've viewed many different images just like the presented scans above.
There was a case just like this that proved no spreading cancer.
So, just in case,
what do you think about running more tests to prove the diagnosis?
As usual, you're recommending a test you'd rather have done, yes?
We won't run another test just because you recommended it.
Of course.
Because the cancer's already moved to her liver, doing another test "just in case" isn't so easy.
Her treatment will begin immediately.
Thoughts?
That's right! We should treat it immediately.
Let's start now.
No objections, yes?
Yes, sir!
I understand we don't have any time to waste.
But without a proper diagnosis, shouldn't we at least run another exam?
Kitayama-san's already had her surgery, and she's hoping to finish her treatment.
Furthermore, she's about to be married.
For as long as we're unsure where the cancer is, and given that chemotherapy gives considerable side-effects to women...
If you're referring to her inevitable hair-loss...
What she should prioritise is her life.
We ought to prevent the spreading!
The side-effects can't be helped!
First of all...
We need a full diagnosis.
And we need to run tests for that.
That's what I think we should do as doctors.
You are?
Miyazaki from Pathology.
And if the cancer worsens during this useless test, who do you think will take responsibility for it?
It'll be me.
Now, moving on to the next case...
Hiroshi Saito, a 50 year old male.
He came to the emergency room complaining of stomach pain.
Upon receiving CT and MRI scans...
Kitayama-san,
we're going to start chemotherapy in order to save your life.
But...
After that...
What kind of...
What kind of life will I have?
Why...
Why?
After the proper treatment, there's a high possibility it'll heal.
We'll begin giving you medicine in just a bit.
I heard you attended another interdepartmental conference today.
I remember saying this before,
but the only diagnoses your department gives should be related to scan results.
The Radiology Department isn't a subcontractor of any of the other departments.
I taught you that before, you know, Chief Sada.
You should also be aware of this, doctor.
The way you do things isn't followed by any of the doctors here any more.
Just mentioning the subcontractor issue says enough about your role.
It says enough about me as a diagnostician.
If you'll excuse me.
I'm not going to hear about any more incidents with the way you do things again, am I, Dr. Takashiba?
You should get it by now.
You're absurdly out-dated.
So one person has 20,000 sheets, correct?
You should get it by now.
You're absurdly out-dated.
Please lie down here.
It's an emergency!
The tumour in Kitayama-san's liver didn't recede!
On the contrary, it got bigger.
So it wasn't cancer after all?
In any case, she needs another test.
The chemotherapy worsened it.
Is that all?
Um, when you say 'is that all'...
Kitayama-san is suffering, you know!
Because you believe her disease has spread, we'll change the treatment.
Once we stop the chemotherapy, we'll administer antibiotics.
But we still aren't sure what she's afflicted with.
How do we continue with her treatment without examining it in full?
If the antibiotics reduce inflammation, then we'll continue with the chemotherapy.
Wouldn't it be better to take a sample of her liver for examination by the Pathology Department?
So you'll insert a needle into her liver?
That's a burden for the patient!
What do you think, Dr. Takashiba?
I have no objections.
Why didn't you try persuading him?
The one who makes final decisions on treatments are the physicians.
And how does that help Kitayama-san?
That's the rule.
What kind of rule...
It leaves no consideration for the patient!
Dr. Miyazaki, I understand what you feel right now about your patients.
But...
Please remember this.
The stronger you feel about something,
the bigger your chance of failure.
It's a cruel thought, but we have to progress under the hospital's rules.
I think...
Once the month has come to an end...
I'll turn in my resignation letter.
But why?
Aged soldiers always leave the war.
That's all I can say now that I am who I am today.
To think I believed I'd learn a lot from a good doctor after all that trouble...
"Aged soldiers always leave the war."
What's that even mean?
I never thought he'd turn out like this!
What is it?
He isn't quitting.
He's being fired.
What do you mean?
At the time he joined the Radiology Department, there weren't CT scans then. Only x-rays.
Because reading x-rays could be done by any doctor, the Radiology Department used to be subcontractors.
Then CT scans popped up, and with that diagnostic images became critical to the medical world.
Working in the Radiology Department became an important role to play.
Then science and technology continued to advance, increasing how many images were taken at a time,
and diagnosticians were driven away.
With that...
We're not even close to being done.
Looks like we can't go home today either, huh?
Those dedicated to diagnosing images alone became another subcontractor to the physician.
But while that man has to read tens of thousands of scans in a day,
he still comes to conferences,
brings himself out specifically to adjust diagnoses,
and pushes other doctors to the truth.
So he doesn't belong anywhere.
Contrary to your beliefs, a nice man doesn't equal a good man.
He failed, you know.
He sure did.
Isn't it cruel to say something like that?
I'm only stating facts.
It's thanks to Dr. Takashiba that diagnostic imaging's become more accurate!
He's saved a lot of patients' lives, you know!
You can't convince me to just leave a man like that alone!
So you tell me.
You don't think it's strange, Dr. Kishi?
Don't you think it's the smart choice?
"Aged soldiers always leave the war."
But that's...
That man...
is finished.
So.
I'm going home.
Nice work, everyone.
Good work to you, too.
You heard all that?
I came to give Zakki a cake.
You know, you said a whole lot of terrible things just now.
You said it yourself.
After all this outpatient crap, the next move is burning the Radiology Department's doctors.
I also don't pay that any mind.
None of this silly hospital management stuff.
What're you saying at a time like this?
You understand, don't you?
If you don't learn how to adapt, then you'll become extinct.
Zakki!
Want to eat some cake?
I'm sorry for asking you to come all this way, Dr. Hosoki.
No, it's really all right.
Dr. Okazaki, the man in charge...
While I do think he's a good doctor,
I sort of...
want to...
talk about him...
I'd like to listen, if you're all right with me.
Kitayama-san?
Where does it hurt?
Kitayama-san's gotten worse! Call the deputy director!
Kitayama-san, it's going to be all right!
Are you all right?
Oh, doctor!
What're you doing in here?
Kitayama-san, where does it hurt?
Put a needle in!
Yes, sir!
We'll take your blood pressure.
Get out of here.
Now!
Kitayama-san, please be a bit more patient.
How could this happen?
A pathological change had her liver being infected, leading to symptoms of peritonitis.
T/N: The result of a fungal or bacterial infection caused by an abdominal injury.
That's...
It seems all our attempts at treatment backfired.
We've got to properly diagnose her and find the right treatment as soon as possible before it gets worse.
Let's do an exam!
We need to do a needle biopsy.
Putting a needle in without taking any liver tissue.
Not like that deputy director'll admit shit.
But he's got to understand the circumstances!
Why won't he do anything?
He's never seen anything like this before.
He's probably ashamed to admit his failure.
But this is a matter of life and death!
More than the patient's life, a doctor's pride is everything.
And we just roll over and--
Like hell I will!
What do we do...
Well, we'll need someone from Radiology to do the needle biopsy.
Then let's tell Chief Sada to ask the deputy director about it!
Like he'd do that.
He works for that man.
Then someone who isn't under him...
What?
I'm in Pathology, girl.
I'm saying it has to be Dr. Takashiba!
I'll ask for his help!
Excuse me!
Where's Dr. Takashiba?
He's gone home, I'm sure.
Thank you.
Aww, man!
We can't meet the deadline at all!
What do you expect from the Showa Era way?
Let's ask the deputy director to reduce our diagnoses for us.
Maybe Dr. Takashiba can do something about it.
Dr. Miyazaki, what're you doing here?
Nothing.
Excuse me!
First of all, we need a full diagnosis.
And we need to run tests for that.
That's what I think we should do as doctors.
What kind of rule...
It leaves no consideration for the patient!
And how does that help Kitayama-san?
So you were here all along.
Having you here with me... it sure brings back memories.
Now all these medical records are electronic.
No matter how you look at it, everything is new.
Machines,
and people.
Heard you were quitting this place.
My subordinates won't do things the way I tell them to.
My superiors won't listen to me.
My eyes are open,
and no matter how much I looked for answers and taught them,
in the end, instead of observing those at the top
I slowly got buried in this organisation, myself.
This is both unfortunate and sudden, but Dr. Takashiba's gone into retirement.
Therefore we ask you to please cooperate with the changes that follow.
Yes, sir.
This lessens the burden on Chief Sada's shoulders, too.
At the very end,
I wouldn't want to bother anyone else.
The past 40 years, I threw myself into my work relentlessly.
And now the people of the Radiology Department have come into their own as doctors.
Or maybe that's the idea I cling to.
But the way I do things...
It's a clumsy way of going about it, isn't it?
And with that...
Do you resent it?
The advent of CT scans.
It changed you diagnosticians from subcontractors to something else entirely, changing work conditions, too.
And yet in the end it's the power of the other departments that lead to the lives of patients being saved.
Do you resent that fact?
No.
So this is self-pity, ain't it?
Just you patting your own damn butt.
You just want the power to do more, don't you?
What a shame.
You listening?
All that you are...
is a failure.
And you can't do squat.
As a doctor?
You lost.
And that's why you thought of quitting this place.
Even with all your experience...
our Miyazaki's still better than you'll ever be.
She has value as a doctor.
It's dangerous as hell that she loves patients,
but that's just what she believes in.
And she'll follow her beliefs to the very end.
You, meanwhile?
You're fading out.
That girl can quit being a doctor any time she wants to.
You could see that yourself, couldn't you?
Kitayama-san!
Blood pressure!
It's a good thing this was reported.
"Aged soldiers always leave the war."
You're right about that.
After you leave, maybe the capabilities of CT scans will improve even more.
Maybe we'll save even more patients' lives.
And by all means, bask in the glory of your former life. I hope you enjoy spending the rest of it patting your own ass.
Anyway.
Work's gonna pile up like hell, so I'm heading back.
Oh, before I forget...
I'm sure you're still interested in it.
Deputy director Okazaki's patient, see, she's suddenly showed symptoms of peritonitis.
It ain't your usual rodeo show.
Dr. Takashiba!
What do you think you're doing?
I'm here to ask the deputy director to allow a needle biopsy for Kitayama-san.
It's impossible.
But...
A needle biopsy can only be done by a radiation diagnostician.
I'll do it for you.
But you'll break the rules...
A while back it would've been disastrous to do this, yes.
But once you see how I do things, you'll realise Dr. Kishi's still an immature boy.
Let's go.
It's time to save that patient.
Right!
The anaesthetic and biopsy needle?
Here!
Morii-san.
This is it.
Got it.
For you.
Take a look.
All right.
What did you do to my patient?
Dr. Takashiba, what's the meaning of this?
Who approved this exam?
This is a serious offence!
I take full responsibility on the matter.
You're rebelling now?
At the very end you still couldn't quit peacefully...
Can we please have some quiet around here?
Our pathologist is making a diagnosis.
We didn't ask for a diagnosis.
So?
I'm done.
Your diagnosis?
Amoebic dysentery.
T/N: An intestine infection caused by an amoeba that can cause severe diarrhoea with blood.
Please find the dosage for metronidazole as soon as possible.
What are you trying to say, pathologist rookie?
After seeing the patient's condition, how could you come to a diagnosis like that?
We will acknowledge no such thing!
This department releases diagnoses with 100% certainty.
Nobody could possibly predict amoebic dysentery.
We saw no such symptoms on that young woman!
She didn't have diarrhoea, nor did she have mucous or blood in her stool.
Deputy director?
What?
Before you flap 'em ugly lips, isn't there something you have to do first?
Hold on--Dr. Kishi!
Do you have any idea who you're speaking to?
The attending physician who failed both in diagnosing and in treatment.
Isn't your patient suffering right now?
Improving management is all well and fine.
But don't you think there's something else you have to think about improving before you move on?
The most important thing, even before cost-cutting,
is making sure that while you're working
you keep that useless pride of yours away.
You know, once word of your misdiagnosis comes out, you can say bye-bye to hospital profits.
Enough! What are you insinuating?
You're just a pathologist!
It's because I'm a pathologist that I can say this.
For as long as you're a doctor...
My words are absolute.
I think that will suffice.
We'll make the preparations!
Professor Nakaguma?
Where did Chief Sada go?
He's not here.
That's horrible...
Everybody?
Thank you for everything.
Excuse me.
Thank you for all your hard work.
Thank you for all you've done.
Thank you.
I'm off.
Thank you for your help.
Well then, this is it.
Nobody came to see you off.
Isn't that awful?
It's all right.
The best number of people to treasure is two.
This is just fine.
Thank you.
No, thank you.
Thank you for everything.
I would've liked to work with you a bit more.
Me too.
I'm glad we got to meet, Dr. Miyazaki.
You know, if Dr. Kishi's any indication,
you'll be a brilliant doctor, too.
I don't resemble him at all!
All he does is annoy me.
Thank you for all you've done.
Looks like someone else came.
Honestly, doesn't it seem flashier when you're fashionably late?
Sucks for you, though.
Someone as troublesome as you who doesn't even realise how much shit he causes could only ever have a mentee like this guy.
Some things never change.
Like all your awful points.
You've always been like this, anyway.
花びらが 風に吹かれ
Hanabira ga kaze ni fukare
Petals are floating in the wind
I fell into your trap perfectly.
You wanted her under my care to get me to realise my feelings sooner, didn't you?
命のように散っていく
Inochi no you ni chitteiku
Scattered like many little lives
What's he talking about?
ただ追いかけて 悲しみもなく
Tada oikakete kanashimi mo naku
Go ahead and chase them let the sadness melt away
Who knows?
What the hell was that?
You brat.
途方に暮れるんだろう
Tohou ni kurerundarou
Isn't this how we reach the end of the road?
What's going on?
Doctor, what's this all about?
涙拭かないと ほら
Namida fukanai to hora
Even if you don't wipe your tears away, look
God, you're still here.
桜が綺麗だよ
Sakura ga kirei dayo
The cherry blossoms are beautiful
It's time, Dr. Kishi! Time!
Time for what?
The management meeting, genius!
That's just another meeting, isn't it?
Everyone's just going there to ogle the chairman.
Honestly, you and your ridiculous logic never fails to...
Look, if you don't go now, you'll be late.
壊れそうなほど
Kowaresouna hodo
These fragile limits
Now hold on! You listen here!
You understand? God, what even is this!?
Dr. Takashiba sent us a letter down here in Pathology.
胸が苦しくて
Mune ga kurushikute
Might twist your chest in pain
Open it up.
It's for the inauguration of a special diagnostic imaging clinic.
明日が見えなくても
Ashita ga mienakute mo
You might not see a hope for tomorrow
Looks like it's by a hospital that doesn't have its own Radiology Department.
ただ歌うしかなくて
Tada utau shikanakute
But for now, just keep singing
What a happy ending.
Looks like he gets to keep working like that after all.
言葉じゃないものが
Kotoba janai mono ga
It isn't something you can explain with words
Professor Nakaguma?
The guy wrote a testimonial in there, even!
心に咲き誇れ
Kokoro ni saki hokore
Let your heart bloom proudly
あの桜みたいに
Ano sakura mitai ni
Just like those cherry blossoms