Tachibana-sensei's private life is a mystery.
She's only mentioned having a daughter.
Some reason connected to why a famous neurosurgeon
came to this hospital, to A&D...
Why?
...and says she won't operate.
You told me, didn't you?
Tachibana-sensei says she has a daughter.
She died 2 years ago.
The other day, I went to a grave.
You've been hallucinating, haven't you?
That's right.
What of it?
I know I'm hallucinating.
I need Mao.
It doesn't matter if she's a hallucination.
We'll always be together, forever.
Medical Team
Lady da Vinci's Diagnosis
Subtitles by Candylemon
I'm glad the weather's good, Mao.
Where shall we start?
Ah, over there?
Ah, they have towels.
We'll go there later.
How cute.
We'd like that, please.
Are you sure?
Since it's your birthday today.
Happy birthday, 10-year-old.
- Thanks. - You're welcome.
It's so cute!
Glad you like it.
Ever since you were small...
Hey!
What was that for?
Are you okay?
My shoulder's broken.
No it isn't.
What are you doing, Hikari?
Stepping on the una corda just then.
You can't be a top pianist if you do things like that.
This is because you're distracting yourself with other things.
Concentrate on the piano.
You should think about the piano 24 hours a day.
I'm saying this because you have talent.
Hikari! Wait!
Hikari?
Hikari!
What's wrong, Hikari?!
Hikari...
Hikari?
I could keep on eating hot spring manjū forever.
That's right.
Do you know why they're called that?
- They're steamed at a hot spring? - You'd think so, right?
But most hot springs aren't suitable for steaming them.
Then why the name?
It's simply because they're sold at hot spring resorts.
So they're ordinary manjū?
Tamaru-sensei, how many have you had?
This is my fourth.
You've eaten Iwakura-sensei's share.
She won't let you hear the end of it.
Despite her looks, she's got a sweet tooth.
Hey!
You can't just do that!
What are doing?
Excuse me.
The intensive care unit are requesting we admit a patient.
Here?
It's a patient admitted yesterday.
They've done tests, but don't know what's wrong.
That means it's A&D's turn.
We'll admit her.
Tamaru-sensei and Nitta-sensei,
come with me to intensive care.
The patient is a 12-year-old girl.
She lost consciousness after a piano contest.
She was seen having a seizure.
- After a piano contest? - Yes.
What's her condition?
She regained consciousness yesterday.
This is the patient.
Fujiwara Hikari-chan?
Yes.
I'm Tachibana from Analysis and Diagnosis.
Our department will take care of you from now on.
Okay.
Prepare for examination.
Have we met somewhere before?
Right.
Must be because you're Mao's age.
Fujiwara Hikari's full body CT scan.
There are no abnormalities in the brain or heart.
Her electrocardiogram was normal,
both 12 induction and telemetry continuous monitor.
So the cause is still unknown.
She lost consciousness,
and then had a seizure.
Let's brainstorm possible diseases
not affecting the heart or brain.
Well?
First there's hypoglycaemia,
then hypocalcaemia,
and hyponatraemia.
The blood test results show blood sugar and electrolytes are fine.
It could be drugs, or possibly porphyria.
She has no history of medication,
and she's very young for illegal drugs.
She has no other symptoms of porphyria,
so that's not the cause here.
It may be a nervous system disorder.
Nervous system...
Let's explore that line.
Hippocampal sclerosis
can cause seizures and loss of consciousness.
It fits Hikari-chan's symptoms well.
Let's conduct an MRI
and do a detailed nerve examination and electroencephalogram
to confirm if there's a neurological disorder.
The hippocampus isn't hardened.
No abnormalities in the MRI.
Nothing odd in the neural examination.
The EEG was also normal.
It can't be hippocampal sclerosis.
We couldn't find any abnormalities in the nervous system.
I was so sure it fitted the symptoms.
Hikari-chan seems to be quite famous.
- Really? - Look.
You're right!
It says she won the piano contest.
She competed alongside high school students.
- She beat high school students? - Yes.
She has a promising future as a pianist.
She's attracted attention in the music business.
You seem to know a lot about it.
Since she collapsed after the contest,
I decided to read up on it.
And bingo.
In that case, we have to cure her.
Good morning, Hikari-chan.
Good morning.
Oh, drumming practice?
Aren't you a pianist?
I play piano and drums.
And also violin, guitar and flute.
All of them?!
You really love music, don't you?
Yes, I like playing lots of instruments.
Incredible.
You're a musical genius.
I'm really not.
I always make my piano teacher angry.
Hikari-chan, may I ask you some things?
I want to know more about you
in order to diagnose your illness.
Okay.
Have you lost consciousness or had seizures before?
That was my first seizure,
but I've passed out before.
When did it start?
From about a month ago.
About a month ago?
I've had intensive lessons leading up to the contest.
Talented people have struggles, too.
She may be under a lot of stress.
Pardon?
Seizures appeared after she started intensive lessons.
She said she makes her teacher angry.
You think she's being pushed too hard?
Overenthusiastic guidance can develop into power harassment.
Tamaru-sensei, I have a favour to ask.
Of course, that's my intention.
I've gradually got used to Tachibana-sensei using me.
To the point where I said myself that I'd go.
Tamaru-sensei!
Miyabe Kōhei, reporting for duty.
Miyabe-san, what do you want?
I've been chasing after you.
How did you know I was here?
Tachibana-sensei told me.
Eh? Tachibana-sensei?
She thought you might feel bad alone,
so she said I should join you.
Interfering...
- Pardon? - It's nothing.
By the way, what's in the bag?
- A present? - Present?
We'll be taking up the other person's time,
so giving them a gift is common sense.
Sorry for not having common sense.
Don't worry, I'm here to cover for you.
Being a couple is about mutual support.
Has anything changed with Hikari-chan in the past month?
- Changed? - Yes.
It seems her symptoms have appeared
since she started intensive lessons.
We wondered if that's the cause.
Are you saying it's my fault she collapsed?
No, not at all.
Um...
A gift for you.
Miyabe-san!
That reminds me, about a month ago
Hikari started the flute.
Flute?
She plays various instruments besides the piano.
Like the drums, right?
She has a true gift for music.
She can quickly master any instrument,
but looking towards contests
I want her to focus on piano.
We keep butting heads over that.
I can understand that.
Hikari has the potential to become a world-renowned pianist.
I want to help her do it.
Please heal her somehow.
Please.
Hello. Found anything?
Yes, Morita-sensei is enthusiastic
but she's not the type to power harass a student.
So she hasn't put emotional strain on Hikari-chan.
Right.
Found out anything else?
About a month ago she started learning the flute.
A month ago, the flute?
She really likes to play a lot of instruments.
When she starts a new one, she masters it quickly.
Morita-sensei
wants to help her become a pianist,
so they've argued about it.
I see.
The flute...
Hikari-chan, stay strong!
What's going on?
She drank tea and then this happened.
- Tea? - I'll get ready.
Your chest?
Your chest hurts?
- Tachibana-sensei? - It's the heart or lungs.
Pericarditis pneumothorax or pulmonary embolism.
Nitta-sensei, secure a line.
Watanabe-kun, prepare oxygen.
Don't worry, this will be over soon.
This wound...
Tachibana-sensei?
ST lowering, angina pectoris.
Fujimoto-kun, nitroglycerin spray.
Tachibana-sensei?
- Sensei. - Thanks.
I'll just open your mouth.
I'm putting on a mask.
You've got a child patient, right?
Yes.
I heard from Iwakura-sensei.
A girl in elementary school.
I was worried,
so I came to see how you are.
I thought you'd be remembering Mao-chan.
Are you alright?
I'm fine.
It's already been 2 years.
You know that I'm recovering.
Yeah, that's right.
I still have work to do.
I'm fine.
Treat that girl before me.
She'll die if she's left alone.
Save her.
Hikari-chan developed angina pectoris.
A 12-year-old child did?
Angina is lifestyle-related,
so it mostly occurs in adults.
The coronary artery that sends nutrients to the heart
narrows for some reason
so not enough blood reaches the myocardium.
It's often caused by arteriosclerosis,
but in children it can be caused by a congenital disease.
The after effects of Kawasaki disease or Takayasi disease.
I checked with her parents.
She has no history of either disease.
We're back to square one.
We know now she has angina.
If we can find the cause of that,
we may discover why she originally collapsed
But how do we find out?
We'll examine the heart in detail using cardiac catheterisation.
The symptoms are always the key.
It's the only way.
Tachibana-sensei is right,
we'll do a cardiac catheterisation.
Okay.
There's no sign of arteriosclerosis.
No abnormality of the coronary artery.
We were sure this was angina pectoris,
but it may be something else.
Administer acetylcholine.
An acetylcholine load test?
If it's vasospastic angina,
we have to induce coronary arterial contraction
to see where stenosis can be done.
Won't it be too much of a burden for a child?
If we don't do it we won't know the truth!
We have to save Hikari-chan!
What's wrong, Tachibana-sensei?
Tamaru-sensei didn't say anything wrong.
Why are you so upset?
Tamaru-sensei, prepare acetylcholine and isosorbide nitrate.
And a pacemaker, just in case.
Are you sure?
Tachibana-sensei is right.
There's a high probability of vasospastic angina.
It's a heavy burden for a child,
but if we're careful she'll be fine.
Okay.
That's right, isn't it, Tachibana-sensei?
Yes.
The tests revealed vasospastic angina.
An epicardial artery spasms and narrows,
temporarily stopping blood flow to the heart.
That's treatable with medication, right?
For normal vasospastic angina.
What do you mean?
When Hikari-chan was brought here
she had a seizure and loss of consciousness.
We still haven't found the primary disease.
That's true.
We need to find that.
Could the vasospastic angina be related to the primary disease?
When she was brought in her electrocardiogram was normal,
and she didn't complain of chest pains when she lost consciousness.
We should think of something else.
I'm home, Mao.
Welcome back.
I see.
That girl's been working hard.
She's blessed with a talent for music,
and may become an international pianist.
That's amazing.
You saved Hikari-chan's life.
So I'm determined to save her, but...
You don't know what's wrong?
She's had fainting episodes for a while,
then had convulsions and was taken to hospital.
The CT showed no heart or brain abnormalities,
but we found vasospastic angina in her heart.
It's one thing after another.
I don't know if they're connected.
But the symptoms started a month ago, right?
It's all happened since then.
Like a domino effect.
If non-dominoes are added to the line,
or if the interval space is too big,
the dominoes will stop, right?
That's right.
For the dominoes to keep falling,
they have to be all in a row.
If the first domino hadn't fallen,
we wouldn't have this situation.
What was the first domino?
If you know that...
Hikari-chan, stay strong!
What's going on?
She drank tea and then this happened.
Tea?
I like playing lots of instruments.
About a month ago she started learning the flute.
I've passed out before.
From about a month ago.
So that's it.
Have you found what's wrong with Hikari-chan?
Probably.
The trigger was trivial.
But without that, there'd be no disease.
The trigger...
We're going to confirm that now.
You want me to play the flute?
Tamaru-sensei desperately wants to hear it.
What?
I know it's annoying, but could you let her hear?
- I don't mind. - Really?
Sorry about this, Hikari-chan.
Even though you're a patient.
Tamaru-sensei, apologise to Hikari-chan.
Why me?
Why would anyone else do it?
Hurry up and apologise.
I'm sorry.
My flute's in my backpack,
so can you get it out for me?
- Tamaru-sensei. - Yes.
Here.
What tune would you like?
- Anything is fine. - Okay.
- Ah, Hikari-chan! - She's unconscious.
Don't worry.
The cause of Hikari-chan's seizure
was transient loss of consciousness.
Hikari-chan.
This is what triggered the fainting.
Right.
The very first symptom in the chain.
The first domino to fall.
Tamaru-sensei, ask Iwakura-sensei
to get parental permission for cerebral angiography.
- Cerebral angiography? - That's right.
The unknown disease has been revealed.
We will now begin cerebral angiography.
Hikari-chan,
you may feel a headache and nausea,
but if your limbs feel numb tell us immediately.
Okay.
Let's begin.
I'll inject local anaesthesia.
Check vitals.
- It's here. - I'll add the contrast agent.
Uematsu-sensei, take notes.
Keep your head still.
Yes.
This settles Hikari-chan's illness.
It's spontaneous occlusion of the Circle of Willis.
In other words,
it's moyamoya disease.
Arteries at the base of the brain
gradually constrict and block blood flow.
Tiny arteries enlarge to compensate,
creating a tangle that resembles threads of smoke.
The blockage can cause cerebral infarction,
and if the narrow arteries tear it causes cerebral haemorrhage.
If bleeding occurs, it's likely to be fatal.
Hikari-chan developed vasospastic angina
due to coronary artery contraction.
That's where the hint was.
What do you mean?
When Hikari-chan developed angina,
there was hot tea just beside her.
It's likely that
she blew on the tea to cool it and hyperventilated.
A spasm narrowed the coronary artery
causing vasospastic angina.
When considered with the seizure
and loss of consciousness she was brought in with,
I suspected the problem lay in the brain.
In other words, that it could be
narrowing of the cerebral arteries.
The blood vessels of the brain contracting
caused the seizure and fainting.
Since the contraction was temporary,
it wouldn't show on CT or MRI.
That's why we missed it.
Hikari-chan began losing consciousness about a month ago.
Around that time,
she also began practising the flute.
If playing the flute caused her to hyperventilate,
the cerebral arteries would contract
and she'd lose consciousness and may have a seizure.
It's consistent with the symptoms of moyamoya disease.
Precisely.
The angina pectoris and moyamoya disease
both showed symptoms when she hyperventilated.
Moyamoya can only be cured with revascularisation.
Indirect revascularisation involves dissecting a scalp artery
and suturing it to the surface of the brain
with indirect bypass surgery.
With indirect bypass surgery
it takes months to improve the blood flow.
Given the increasing frequency of her attacks,
she needs direct bypass surgery
to increase blood flow immediately.
Since it's neurosurgery,
you're the expert, but...
But Tachibana-sensei doesn't operate.
We have Nitta-sensei.
She was in neurosurgery before switching to cardiac surgery.
- Nitta-sensei can... - I'll do it.
Wasn't not doing surgery
a condition of you working here?
You've avoided it all this time.
That's right.
Then why now?
Because I have to save Hikari-chan myself.
Why have you always said before that you won't operate?
I'm not saying it now.
That doesn't answer my question.
Tachibana-sensei.
Yes.
Are you sure about this?
Yes.
Fine.
The surgeon will be Tachibana-sensei.
Nitta-sensei will assist.
Are you sure?
I trust Tachibana-sensei.
Tomorrow, we will perform Fujiwara Hikari-chan's bypass surgery.
- Yes. - Yes.
- Tachibana-sensei. - Hm?
May I have a moment?
What's going on?
The reason you haven't been operating
is because of your hallucinations, right?
Isn't that why you left your previous hospital?
And now suddenly you'll operate?
I have no choice.
For that patient alone.
Is this about your daughter?
Is it something to do with Mao-chan?
Tachibana-sensei,
since the first time you saw Hikari-chan
you've been acting strangely.
Fujiwara Hikari-chan?
Have we met somewhere before?
Must be because you're Mao's age.
And when you saw her back,
and the large scar there...
Tachibana-sensei?
During cardiac catheterisation
you suddenly became agitated.
If we don't do it we won't know the truth!
We have to save Hikari-chan!
You were clearly upset.
You've never been like that before.
You knew Hikari-chan, didn't you?
What on earth happened with her?
She took her place.
Took her place?
Mao is dead, but Hikari-chan's still alive.
Do you remember
the bombing incident at Mitsui Movement Square 2 years ago?
The case where an engineering graduate
carried out a terrorism-like attack.
Mao and I were there.
And so was Hikari-chan.
It's so cute!
Glad you like it.
Ever since you were small...
Hey!
Mao...
Mao, are you okay?
You need treatment.
Treat that girl before me.
But you're...
I'm fine.
She'll die if she's left alone.
Save her.
Okay.
Teddy...
I'll be back soon.
Wait for me.
Are you alright?
She's badly hurt.
She needs urgent treatment...
I'll take you to an ambulance.
I'll lift you up.
Mao, I'll be back soon.
We were caught in that explosion.
Mao asked that before her,
I treat Hikari-chan who had fallen nearby.
Hikari-chan had a serious back injury
and was in a critical condition.
I left Mao there,
and carried Hikari-chan to the emergency services,
who had rushed to the scene.
We're nearly there.
Excuse me.
Her back is badly hurt.
Please get her treatment urgently.
You'll be okay.
Ah, w-wait!
- You need treatment, too. - I'm fine.
No, we'll stop the bleeding.
Come this way.
Everyone, calm down, please.
- No, it's not safe! - My daughter!
My daughter's still over there!
Let go!
After I handed Hikari-chan over to the emergency team,
a second explosion occurred
and I wasn't able to go back for Mao.
While I was helpless,
in the rain...
Mao waited for me to help her.
Stay back.
Stay back, it's not safe.
Mao... Mao! Mao!
Mao, are you...
Mao?
Mao!
Hey! No! Mao!
Mao! It can't be! Mao!
You can't be...!
- Mao! - Let's go.
Mao! No! No!
No! No!
NO~!
Save Mao!
MAO~!
MAO!!
NO!
Mao was already dead.
And Hikari-chan lived,
in spite of that injury.
If Mao hadn't asked me to treat her first,
it would have been Hikari-chan who died.
Hikari-chan lived on in place of Mao.
If I let Hikari-chan die,
Mao will have died for nothing.
That's why...
I have to save Hikari-chan.
For Mao's sake, too.
So that's what happened.
Yes.
I hadn't expected that.
But will everything be okay?
If Tachibana-sensei operates,
she may have a hallucination.
Only Tachibana-sensei can do this operation successfully.
But if anything happens...
I'll be there to support her.
We will succeed.
You're indebted to her, aren't you?
Now it's your turn to help her.
Tachibana-sensei will operate?
Yes.
She said herself that she would.
She said it herself...
Not doing surgery was her condition for joining A&D, right?
That's right.
That was the condition.
Director Kitabatake,
why didn't she want to operate?
I don't know either.
That's ridiculous.
We can't trust a surgeon who refuses operations.
What if something goes wrong?
The whole hospital will be held responsible.
You say it was her own decision?
Yes.
In that case...
I will take responsibility.
Director Kitabatake!
So will I.
She's my subordinate.
Iwakura-sensei, too...
You'll be fine.
We'll move you to the operating room.
Sensei, I'll leave her in your care.
Yes.
Hikari, you'll definitely get better.
Mao...
I'm going out now.
I can't find Tachibana-sensei.
She may not have come in.
That's odd.
What shall we do?
I'll phone her.
Next week, the final episode
Shiho's fate...
That incident changed her life dramatically.
You mean you're prepared to die?
We have to operate as soon as possible.
I won't be able to see you anymore.
I can feel the love of everyone in A&D.
I'm glad I came here.
Hikari-chan's condition suddenly changed!
Someone is suffering.
You have to help!
Tachibana-sensei can do it.
You might have a hallucination,
so I can't let you do it.
You have to make a choice.
I'll always be with you.
Now and forever.
Mao...
Thank you.
The ability to save people is something special.