We're from Teika University.
Yes, we've been expecting you. Please go to the front entrance.
Yes. Yes.
Understood.
They're here.
Okay, got it. They're on the way.
They're through the main gate.
Hey! They'll be here in 5 minutes!
Tojo University Medical School's attached hospital is well known in the Tokai region,
but on the national level it's a little-known affiliate hospital.
But Teika University, a top-ranked national university that towers over central Tokyo,
has come to inspect its enemy's movements.
Dr Nishizaki, thank you for coming.
I hope to learn a lot here today.
You're an esteemed professor at Teika University, what are you saying?
Why is a top-ranked national university hospital interested in a regional private university hospital?
Because there's fierce competition in the field of heart surgery,
between Teika University, which prides itself on being at the forefront of medical technology,
and Tojo University's affiliate hospital, respected for its surgeons' skill with a scalpel.
That's why the cardiovascular surgery department, where I'm on rotation,
is filled with patients from across Japan - no, the world -
here to benefit from Dr Saeki Seigo's skill.
There's one more reason why these universities are competing.
In 6 months, the chair of the Japanese Society of General Surgeons will be chosen.
Sir, it's time.
The chair will preside over all 40 thousand surgeons in Japan.
Rumour says it's a one-on-one contest between
Dr Saeki of Tojo University and Dr Nishizaki of Teika University.
I don't know who leaked this information,
but he's here specifically for today's operation
on a patient with severe valve damage,
as well as diabetes mellitus, kidney failure and other systemic diseases,
who would usually be considered inoperable.
I guess he came to watch him fail with his own eyes.
But Dr Saeki accepted the challenge,
and Tojo University won't accept failure in this operation.
Dr Saeki will start the operation soon.
Could we see what sorts of instruments he's going to use?
Of course.
Film a close-up of the surgical instruments.
Yes, sir.
That is Dr Saeki's...
black pean.
The doctor has arrived.
The heart-lung machine is working correctly.
It's been 20 minutes so far? You're getting better at this, Yokoyama.
Thank you.
Let's proceed without stopping the heart.
He's using the Saeki method here?
I thought he'd definitely stop the heart.
Let's proceed with the on-pump beating-heart mitral valve repair technique.
Thanks for your support. - Thank you.
Excuse me. - DeBakey forceps.
Give Yokoyama the Cooley hook. - Yes, sir.
Scissors. - Here.
This is the technique that shocked the world:
the Saeki method.
In conventional surgery, the heart is stopped
and a heart-lung machine is used,
but with the Saeki method, the operation is performed with the heart still beating.
This greatly reduces the operating time,
reducing the burden on the patient.
It's said this is 100 times more difficult than the conventional technique.
Even though the heart is still beating,
he's making it look simple, isn't he?
It's impressive.
Yes?
Here's the Solulact.
Call Dr Saeki. - Right away.
Don't worry, here's the drip.
It's okay, it's okay.
Excuse me, sir.
Hayata. - Yes?
Okay.
They're saying Miyazaki in the private room had an aortic dissection.
You were scheduled to operate on him tomorrow, doctor.
Miyazaki? He did have some weak tissue. Take him to operating room 3.
I'll go there when this is finished. - You're doing the operation?
This surgery will take another 3 hours. Do you need someone else as back-up?
We have guests today. I can't rush this.
Yokoyama, I've got this, so you go. Please deal with him until I get there.
Yes, sir. This is an important operation for you, doctor.
Leave it to me. - Yeah.
Hey, Kakitani. Take his place as first assistant. - Yes, sir.
Hayata, set up a relay monitor from operating room 3, and an intercom.
Dr Yokoyama is my preceptor.
He's Dr Saeki's main apprentice,
and hopes to become an associate professor next term.
Operating Room 3
Where's the pump? You're slow!
Sera, go and help in operating room 3.
Yes, sir.
It's getting noisy. Is something happening?
There's no problem.
Please watch Dr Saeki's operation carefully.
Excuse me. - You're slow, residents.
Sorry. - Prepare the vascular prosthesis.
You two, attach the camera. - Yes, sir.
Okay, let's connect through to Dr Saeki.
Yes, sir. Excuse me.
I prepared 24 mm. - You can speak now.
Operating Room 1
This is Yokoyama. As you can see,
he's in circulatory arrest.
Ah, so it is an aortic dissection, then.
Scalpel.
Dr Saeki can even perform one operation while giving instructions for a different one...
He's superhuman.
Look here.
So there's a tear in the ascending aorta.
Yokoyama, get ready to repair the ascending aorta. - Yes, sir.
I'm going to place the artificial chordae for this patient now.
I'll leave that to you. - Yes, sir.
Take his intercom. - Yes. Excuse me.
Move the monitor. Turn the volume back up. - Okay.
Okay, here comes the hard part. Yes, sir.
Suction.
Don't pull so hard on the Cooley. Yes, like that.
Okay, now let's repair the ascending aorta.
Thanks for your support. - Thank you.
He's in PSVT.
PSVT: Paroxysmal supraventricular tachycardia
Administer anti-arrhythmics. Should we wait?
Don't panic.
We can keep going.
Even with such strong cardiac contractions, he's still going?
Don't worry.
Dr Saeki won't miss by even 0.01 mm.
He's a skilled surgeon.
0.01 mm?
He's thoroughly disciplined.
Dr Saeki is the only person in the world who can use the Saeki method.
He's the only one.
Will Dr Yokoyama be okay?
Dr Saeki should have told him what to do.
Would you mind if I stepped out for a moment?
Ascending aorta replacement complete. Reduce the flow.
Yes, sir. Flow reduced.
I'm removing the clamp.
The heart is beating.
We need a transfusion! - Bring lots of saline and albumin.
Should we stop the heart again?
Dr Saeki said to replace the ascending aorta, so there's no problem.
Should we call him?
Dr Saeki is focused on the artificial chordae repair now.
Don't distract him. Just prepare for transfusion!
You, resident! Get the blood for transfusion! - Yes, sir.
Suction! Gauze, gauze!
There's no blood there! Go to the transfusion department.
4 packs of RBCs. - 4 packs, got it.
RBCs: Red blood cells
Miwa-chan,
prepare the Cooley hooks.
Cooley hooks?
Ah...
He's asleep again?
Wake up...
Room 3! - Got it!
Operating Room 1, Dr Saeki.
Room 3...
Quickly! More! Ah...
Where is it leaking from?
Where's that transfusion set?
Is this it?
Ready for transfusion. Here.
There's no blood pressure. He lost a lot of volume.
There's so much blood, I can't tell where it's coming from!
This is Dr Saeki's patient! If he dies...
I know that!
Should we call him after all?
Teika University are here. Do you want them to see us like this?
I'm sorry.
More suction.
That's ventricular fibrillation.
Set up the DC defibrillator. - Yes, sir.
Nekota?
The pipe. Quickly!
Should we call... that person?
Not him. - But...
He's the only person that can help!
You know what will happen if we call someone like him.
Him?
What do you mean, someone like him?
If you need help, he... - Shut up!
Stay out of this, resident!
Nekota, here's that Cooley hook.
Neko! We don't need anything like that!
Hmph.
Tokai...
Who called him? Was it you?
Gown.
Oh, yes.
Move.
Why are you here, Tokai?
We don't need you. Get out.
Why did you only repair the ascending aorta?
Well? Why?
Dr Saeki said so.
So is that base rupture there because he said so, too?
What nonsense are you talking about?
Are you saying he made a mistake?
A big mistake.
Caused by the monitor.
He only saw the ascending aorta,
and overlooked this tear at the base.
He's right. It's not on camera.
So that's why he said to repair the ascending aorta...
The problem is the surgeon who accepted his orders without question,
and continued the operation without checking the base.
Even if you wanted to “save face”,
you carried on with this misdirected treatment and made the damage much worse.
This is what happens when someone holds the scalpel without thinking things through.
I'll sort out your mess for 10 million yen.
Don't be ridiculous.
Don't talk nonsense! What do you mean, 10 million yen?
Write your resignation letter.
I'll sort out your mess in return for your severance payment of 10 million yen.
He's still in ventricular fibrillation.
They're running out of time.
Doctor...
Doctor! - I know!
Please... help me...
Okay, I'll reconstruct the base. Clamp forceps.
Here.
Move him. - Yes, sir.
Electrocautery knife. Prepare the vascular prosthesis. - Yes, sir.
Okay, reconstruction complete. Removing the clamp.
The heart is beating.
Okay, let's carry on.
We'll do an on-pump beating-heart mitral valve repair. Glasses!
Yes, sir. - You aren't using the Saeki method, are you?
DeBakey and Cooley hook. - Here.
Can you use the Saeki method? - I don't know.
But for 10 million yen,
I'd better try.
Excuse me. - Okay, here we go.
“Only one in the world” has become “only two”?
Scissors.
Turn off the heart-lung machine. - Yes, sir.
Black pean. - Yes, sir.
Black pean?
It's a special haemostatic clamp that Dr Saeki always uses at the end of an operation.
It's like a ritual.
Using that means the operation was a success.
Kitajima, tell the patient's family.
Dr Saeki has used the black pean!
Okay, I'm going to operating room 3.
I'll leave the haemostasis to you. - Yes, sir.
3 hours and 10 minutes.
Faster than usual. - Yeah.
He's truly a god.
Okay. That's 10 million.
You can do the haemostasis, can't you?
Move.
Switch in. - Yes.
Take them off. - Yes, sir.
2 hours and 50 minutes?
Tokai.
Well, he's really remarkably skilled.
I can't even come close.
Not in that kind of life-or-death operation...
Director Moriya, let's talk about that other thing later.
Yes.
Then I'll be going. - Thank you.
Saeki is remarkably skilled.
But in the end, he's just a regional worker.
The future of medicine in Japan can't be left to a man like him.
I'm relying on you, Takashina.
Yes, sir.
Notice of Staff Reassignment The following transfers have been announced today.
Was Dr Yokoyama really transferred because of that operation?
Oh, right. He was your preceptor,
Yokoyama Tadashi (Cardiovascular Surgery Dept.) Tojo University Medical School Hospital → Tojo Central Public Hospital
but now you've got Dr Tokai instead of Dr Yokoyama.
Come over here. - Huh?
About Dr Tokai... - Yes?
He's in that back room. Or rather, he lives there.
It's supposed to be a nap room, but since Dr Tokai started using it
it's really more like it's his room.
Excuse me.
Sorry for disturbing you.
What is it?
Taking a nap? - No.
You were in the operating room the other day, weren't you?
Yeah. - I'm Sera, a resident.
Um, what kind of person is Dr Tokai?
I think it's amazing that he saved that patient.
And he used the Saeki method, didn't he?
He even made money from it. - Are you quitting too?
Incompetent people should just die.
Dr Tokai, I'm asking you to... - Move.
No, I'm asking you to take over Dr Yokoyama's patient.
... Move.
Dr Tokai is in charge of your case now,
but he's a bit busy today, so he won't be able to visit you.
Oh...
The first patient under my responsibility, Minagawa Taeko.
Her husband passed away already, and none of her family come to visit her.
She has mitral valve insufficiency,
so Dr Saeki will be operating on her.
It's my job to make sure that she's in top condition when that happens.
We should do the test soon.
The test device is over there. - Right.
Let me tidy this up, Mrs Minagawa. - Huh?
Um, what is this?
It's the new test device. - What?
Dr Tokai said to use this from now on.
Please give me a minute.
Just a minute.
You don't know how to use it? - No...
It's no good...
That's the new test device Dr Saeki brought in for the clinical trial.
They didn't tell you in the handover? - No, I swear.
I really didn't hear anything about it.
Really. And the patient even scolded me.
Well, you were unlucky. - About Dr Tokai,
apparently every resident he's advised has quit early.
My condolences.
Tojo University Hospital
Yes, this is Sera.
This report you wrote about the operation the other day.
0 points. What?
This says that Dr Tokai replaced Dr Yokoyama as the surgeon,
and used the Saeki method.
Yes. - What were you looking at?
What? - All they did was extend the operating field
so that Dr Saeki could do the surgery.
Isn't that right? - That's what Nekota told me.
There's no mistake. - What?
Got it?
The Saeki method is the latest surgical technique and the pride of Tojo University.
There's even a paper on it in the prestigious Japan Surgical Journal.
Even a veteran like Dr Yokoyama couldn't do it,
let alone a new employee like Tokai.
It couldn't happen.
No -
it mustn't happen.
Please rewrite this.
All sorts of things happen at a university hospital.
Dr Tokai doesn't write papers,
so he can't succeed at a university hospital. In terms of his position,
he's even lower than me. - But...
But he's skilled. Better than anyone else here.
So during operations, we have no choice but to follow him.
Even Dr Saeki doesn't get in his way.
Like with this operation. Sekikawa was originally the surgeon,
but Dr Tokai actually did the operation.
Okay, I'm taking this pericardial patch.
I don't need a prosthetic valve. - Yes, sir.
You don't plan to use the prosthetic valve? That's not what we planned.
I just decided to use the pericardium for an aortic valvuloplasty.
Don't just decide by yourself! - We can treat this patient with his own tissues,
but you want to shove in some foreign body like a prosthetic valve?
Oh.
Excuse me. You're the one in charge.
You do it, then.
No, please continue. - Scissors.
Everyone here looks up to Dr Saeki.
They're all desperately training every day,
so that they can use the Saeki method one day.
But not a single person can do it.
Who can accept that the low-ranked Dr Tokai could do it so easily?
A lot of doctors have left this hospital because of him.
It's true that Dr Tokai's skill helps patients live,
but it kills doctors.
That man is a demon.
This is because of Dr Tokai's ego again, isn't it?
I mean, Dr Yokoyama's transfer. - He wanted to go.
Still, you can't deny the staff shortages in cardiovascular surgery these days.
Patient numbers are increasing, but turnover is getting worse and worse.
So I'd like you to invite this doctor to join your team, Saeki.
What are you planning?
This is Minagawa Taeko. She's scheduled for mitral valve surgery,
with Dr Saeki as surgeon and Dr Tokai as first assistant.
Dr Kakitani will be second assistant.
Why are you speaking so vaguely? Aren't these advance documents too slapdash?
This is for Dr Saeki's surgery, you know. - I'm sorry.
That's enough. Please have Dr Kakitani redo the documents.
You're the one who should be announcing this in the first place, not me.
This next operation will be observed by Ikenaga Hideto, editor of the Surgical Journal.
Doctors publish papers in medical journals,
so they value the so-called “impact factor”, a performance indicator.
That gives the Japan Surgical Journal, the most influential Japanese medical journal, a lot of power,
and its editor has a lot of influence on who is chosen as chair of the Society.
Incidentally, Dr Saeki currently has an impact factor of 77,
and Dr Nishizaki's is 71,
so Dr Saeki is leading by 6 points.
So is this observation part of the chair selection process?
If it succeeds, Dr Saeki will get a lot more votes.
That's all of the announcements. Doctor?
Finally, let me introduce our new lecturer.
He joined the Tojo University Medical School Cardiovascular Department yesterday. Come in.
This is Takashina, joining us from Teika University.
He is an excellent doctor who studied cutting-edge medicine in America.
Since this hospital has a shortage of medical staff,
Director Moriya has personally sent him to us.
Does that mean Dr Nishizaki asked Director Moriya to do this?
To create a position for him at Teika University Hospital after he resigns?
But why bring the enemy's doctor into our hospital?
I'm Takashina. I watched Dr Saeki's surgery here a few days ago,
and I learned a lot.
In return for that,
there's something I'd like to introduce to you all.
It's called a SNIPE.
It's the latest medical device, developed in America,
and it has not yet been used in Japan.
It is mainly used for off-pump mitral valve surgery.
It has the same aim as Dr Saeki's surgery, but using a completely different process.
Anyone can do this surgery just by pressing a switch,
without needing any surgical skill.
The groundbreaking Saeki method developed by Dr Saeki
makes it possible to repair the mitral valve without stopping the heart
and greatly reduces the duration of surgery.
Likewise, the SNIPE method does not stop the heart.
The device inserts a catheter through the apex,
directly placing a prosthetic valve over the damaged mitral valve,
which takes about 1/3 as long as the Saeki method
and does not require the use of a heart-lung machine.
This method is a first in the history of Japanese medicine.
So if we use this SNIPE,
does that mean the Saeki method is unnecessary?
To put it bluntly... - Don't talk nonsense!
You're mocking Dr Saeki! - The Saeki method is the best technique!
Let me ask this. How many doctors at Tojo University,
no - in the world,
can use the Saeki method?
That's right -
just one.
What is the point of such a technique?
On the other hand, anyone can use the SNIPE.
There is a micro-sensor in the tip,
so it can automatically align with the affected part.
It's true, Dr Saki boasts that he won't miss by even 0.01 mm, but -
That's because Dr Saeki is the best surgeon in the world.
The SNIPE is 100 times more accurate, with a precision of 0.0001 mm.
People have their limits,
but technology keeps progressing forever.
I see, so that's your aim.
You want to use your SNIPE to steal away all the patients who come here looking for the black pean. Is that it?
Dr Saeki, you can save at most one or two lives per day, right?
But anyone can use the SNIPE.
The tens of thousands of patients who are waiting in turn for Dr Saeki's surgeries
will be able to have surgery right away using the SNIPE.
We no longer need the “hands of god”.
Oh... but why? What was the reason?
She just says she doesn't want surgery. - Ah...
What should we do? - He was right, all sorts of things happen at a hospital.
Ah, what should we do?
I mean, even if the operation saves me,
I'll still be alone.
To keep living like this...
What are you saying, Mrs Minagawa? You're very lucky.
There are hundreds of patients here now
who want Dr Saeki to operate on them.
That's right, isn't it?
Yes. - Yes.
But so what? I mean...
it's no good.
Mrs Minagawa? Mrs Minagawa, what's wrong?
Mrs Minagawa, are you okay? What is it?
Mrs Minagawa? Doctor, tell me what to do.
Please tell me what to do! - Right.
Um... dopa- dopamine, please. - I'll get it.
And get Dr Tokai! - Yes, sir!
No, I mean Dr Kakitani, please! - Dr Kakitani is in the outpatient clinic.
Then whichever doctor is in charge. - That's you!
Her levels are dropping. She's in shock. Doctor. Doctor?
That's it, intubate, intubate! Intubate her! - Yes, sir.
Go ahead.
Move. I'll do it.
Okay, it's in. Ambu bag. - Yes, sir.
Take over, quickly. - Yes, sir.
Set up the ultrasound. - Yes, sir.
Disinfectant. Place the drapes.
Give me the needle.
Her blood pressure is back up.
Order a CT scan. - Yes, sir.
I'll leave the rest to you. - Okay.
You did well. If that patient had died,
it would be over for Tojo University.
You're really helping me a lot.
That mitral valve operation too...
You did it to stop them from bothering me?
I didn't expect that you'd even succeed at the Saeki method.
Huh? What are you talking about?
Ha. Well, whatever.
There's only one person in the world who can use the black pean.
I imagined it so many times when I was a child.
Becoming a doctor, being faced with that kind of situation,
I wouldn't panic, I'd just coolly save someone's life.
Ah... I dreamed of it over and over.
I finally became a doctor, but...
It's the same for me.
It's no good...
Just like Mrs Minagawa said.
Why are her curtains open?
Huh?
Actually, Mrs Minagawa always had them like that. Not just today.
It's no good...
Patient's name: Minagawa Taeko
Mother
What is it, Mum?
Oh, you finally answered. Did you get that rice?
Yeah, I'm eating it every day. I'll never finish this!
There's no one who'll eat it with you?
Sadly, I'm still eating alone.
How pathetic. You're a doctor,
so you should always have 5 or 6 women on the go.
Why did you even become a doctor, anyway? - Is this why you called?
If so, I'm hanging up. - Oh, wait.
How is Dr Saeki?
Your father would be happy, too.
His son working in the same hospital,
Father: Tokai Ichiro
working with the doctors he studied with.
Work hard for your father's sake, too.
Yeah.
I'll send you more rice. Bye!
Wait- wait!
So I'm still alive, huh?
Dr Sera?
Hey, Mrs Minagawa. Come here.
There.
You've been watching to see when that dried-up cherry tree will flower, haven't you?
Keeping the curtains open all day and all night.
That tree first flowered in the year I was born.
Were you born here too, Mrs Minagawa?
There was a house where those flats are.
I see. - I lived there until I got married.
So that cherry tree and I lived through the Showa and Heisei eras together.
It flowered last year, but this year...
we're both at the ends of our lives.
I went to look at it earlier,
and its buds were growing.
It's withered,
but it's trying its best to blossom this year too.
So please wait a bit longer.
It will definitely blossom this year too.
I'd better see it then.
When it flowers properly.
Yes.
I should try my best, too.
Yes.
This patient had an episode of shock. Open-chest surgery would be dangerous for her now.
What are you talking about?
Editor Ikenaga of the Japan Surgical Journal is here too.
If we cancel, it won't just look bad for the Society chair selection,
but he won't even seem fit to manage Tojo's patients.
Shouldn't we change to a different patient, then? - We can't do that.
We already emailed Ikenaga the details of this patient.
But if the patient dies, we'll lose everything.
Of course, it will be difficult to use the Saeki method under these circumstances.
But even if we postpone this, the patient will only get weaker.
Then we'll have no choice but to give up on surgical treatment for her.
Seems like you have a big problem.
Takashina has a suggestion regarding Minagawa Taeko's surgery.
Instead of the Saeki method, what about using the SNIPE for this operation?
Open-chest surgery like the Saeki method would be a burden on the patient.
But the SNIPE only requires a 4-cm incision.
The SNIPE is really ideal for this case.
But the SNIPE hasn't been approved by the Ministry of Health yet, has it? That needs to be solved before the operation.
If the university hospital ethics committee approves it, then it should be okay.
And Dr Saeki is head of the ethics committee.
You're taking advantage of our problems to use Tojo University as a test site for the SNIPE!
If you have a problem with it, should we cancel the operation altogether?
No, that's...
We need to think about our priorities.
Be stubborn, cancel the operation and save face for Tojo University,
or prioritise the patient's life and use the SNIPE
for a new, real achievement.
You'll be throwing out the Saeki method,
but the best and only way to overcome this problem is the SNIPE.
Actually, you should be begging for my help.
Begging? - But if you think of it as
Tojo University being the first place in Japan to announce this new technique,
shouldn't we be happy about this?
We'd just be borrowing Teika's technique.
And if someone other than Dr Saeki performs mitral valve surgery here...
We can change the rules if we need to.
That's my motto.
We can't lose a life because we're stuck following the rules.
I think we should accept Dr Takashina's suggestion.
I know what my priority is:
the patient.
But for Tojo University's sake,
this operation absolutely cannot fail.
Tokai and I will be the assistants.
Don't be stupid! Forget about Tokai, but you, Dr Saeki?
It's fine by me. This surgery doesn't need assistants, anyway.
It's just in case. Okay, Tokai?
If you say so, sir.
But can I say one thing?
If I have to take over in the middle of this operation,
I want him to write his letter of resignation, but...
Is that okay?
Well?
That's fine. But if I succeed,
then you will submit your own letter of resignation, Dr Tokai.
For the sake of this hospital.
From what I hear,
you're the biggest nuisance for the medical staff here.
Make sure you turn up for the operation.
In summary, the standard operation takes 4 hours,
but this method takes less than one hour.
It also drastically reduces the burden on your body.
Oh. - If you agree,
please sign here.
Ah... Dr Sera.
Yes?
I'd like to hear your opinion.
Oh no, I...
Answer her, Doctor Sera.
I...
I think you should do it.
It's okay.
Is that okay?
Was that really okay?
What do you think, Dr Tokai?
Doctor? Doctor?
Stop that, please say something!
She's your patient.
She's your patient! - I'm going to change.
Okay.
Oh, are you a medical resident?
Yes. - My name is Kinoshita.
Clinical trial coordinator?
What did you think of the genetic tester?
The test device from before?
Clinical Trial Coordinator A mediator who finds doctors and patients to test newly-developed drugs or medical devices in clinical trials.
Yes. - Ah...
Well, I was a bit confused at first, but I got there somehow.
Thank you for your cooperation.
Not at all. What are you doing after this?
We have a study group meeting. - A study group?
Um, excuse me.
Aren't we just eating French food?
What sort of study group is this?
This laser scalpel was developed by Daiichi Juuko.
It has a new CO2 laser attachment,
so its cutting ability is on a different level.
Like that.
Yeah. Well, I'll pick out a few people for you. - Thank you, as always.
Do you always accept this kind of wining and dining?
It's a study group. - What do you mean, you'll “pick out” patients?
They aren't objects.
They are objects.
You...
Don't you have a heart?
If you have a heart, can you save lives?
A skilled doctor can get away with anything.
It's just like Dr Takashina said.
People like you shouldn't be doctors.
I'm leaving.
Now, the real issue. - Yes.
There's something I'd like you to look into.
And so we reached the day of the operation that would affect many people's fates.
Okay.
Oh--
Why is Dr Nishizaki here?
Apparently editor Ikenaga suddenly suggested he should join us.
Come on... pick up!
This is Minagawa Taeko. Here.
Dr Tokai! Dr Tokai!
Dr Tokai!
Isn't Dr Saeki doing the procedure?
Apparently they're showing off a new technique.
Are all the actors in position?
Let's unveil the SNIPE.
SNIPE?
I'm grateful to be on such an unmatched stage.
Surgery is surgery. There's no difference.
By the way, I don't see Dr Tokai.
Sera! Where is Dr Tokai?
I can't find him. I can't contact him either.
Tsk...
I'm sorry. Tokai isn't here.
It's time, so Kakitani will assist you.
He's a nuisance right up to the end.
It doesn't matter if he's here or not.
Now, let's begin case number 847,
SNIPE off-pump mitral valve repair.
Dr Sera. Dr Tokai wasn't in the ward either.
I'll search the break room one more time.
It's true. The assistants don't even come out of the wings.
In that case, please go and have a cup of tea.
Thanks.
Oh! Have you seen Dr Tokai?
No, he wasn't in there. - Did you look properly?
Huh? - The sofa.
Sofa?
Dr Tokai! Dr Tokai!
What are you doing? The operation has started! - Don't shout.
Are you afraid you'll lose your bet with Dr Takashina? - Huh?
Are you running away? Come on. Let's go.
What is it?
Sending to printer...
Where are you going? - Move.
Neko-chan! Give that print-out to Dr Kurosaki. - Okay.
And don't mention my name. - Yes, sir.
At long last, it's time. The SNIPE.
Dr Nishizaki, I'm starting.
Is that the SNIPE?
It's something my apprentice brought back from America.
This came into the medical office. - What is it?
Dr Tokai, hurry up!
The SNIPE has entered the apex.
The SNIPE has passed through the left ventricle.
The SNIPE is about to reach the mitral valve.
This is Kurosaki. Can you stop the operation for a moment?
What is it?
I just received a new document about the SNIPE.
It's unpublished, but it says that during SNIPE operations in America
there were many cases of accidents,
including fatal cases.
Excuse me. Doctor, here it is.
We didn't hear about this!
Dr Takashina, did you deliberately keep this information from us and our patients?
What is this about? - It's true that some accidents did happen.
You've done your research.
Who gave you this information?
Tokai.
Sorry I'm late.
I see, so this was your doing.
Nurse. - Hayata.
Yes.
So why are you here now? It's already over.
I'll take this patient from here. You can take your toy and leave.
This patient has no strength left. If we stop now, she'll die.
The doctor and I will continue the surgery, so we still have time.
You're not starting the Saeki method now?
The SNIPE would be safer. - That thing kills people.
This technique will save tens of thousands of lives in future.
I'm not talking about the future, I'm talking about now!
Only the SNIPE can save this patient's life!
The SNIPE will definitely work. I'm confident of that.
Let's continue the operation.
Use the SNIPE. Tokai, Dr Takashina is in charge here.
I'll take responsibility for everything.
You, turn up the sound. - Yes, sir.
Let's resume.
Doctor!
It's done.
And a new era has started.
Dr Nishizaki, we've succeeded.
Excuse me.
Dr Tokai, did you get that SNIPE document
from that coordinator we met yesterday?
That's why you met her last night, isn't it?
Um...
Are you really leaving the hospital?
Why would I? - What?
He's the one leaving.
What are you talking about?
The SNIPE succeeded, didn't it?
You're the one who lost the bet.
We'll see.
You're awake? The surgery went without a hitch.
It was a success.
Now you can rest without worrying about--
Ah... Where is Dr Sera?
Sera?
What do you mean?
That old lady is going to die soon.
What? Why?
What's wrong, Mrs Minagawa? - It hurts here.
Where does it hurt? - Here!
Why?
What do you mean, she'll die? - Don't shout.
But what you mean, she'll die?! - Get out of the way.
Here.
An amateur like you probably can't tell,
but Takashina set this up.
Dr Sera! Doctor! - There it is.
Dr Sera, are you here? - Yes!
Dr Sera? - I'm here!
Please come quickly. Mrs Minagawa suddenly got worse.
Okay. - Contact the operating room.
Yes, sir.
Mrs Minagawa! - It's just normal postoperative pain.
I just gave her a painkiller.
Mrs Minagawa! - Dr Sera...
Mrs Minagawa, are you okay? - It hurts, doctor...
Mrs Minagawa, do your best. Mrs Minagawa?
Mrs Minagawa!
Dr Sera...
What's this? - The abdominal CT scan from when she was admitted.
Mrs Minagawa... - An aneurysm?
Her splenic artery could rupture and-- - It already has.
There's a major haemorrhage in her abdomen.
Mrs Minagawa...
Contact Dr Saeki. - Yes, sir.
Mrs Minagawa... - Why is she haemorrhaging?
The surgery should have gone perfectly.
For her heart, yes.
You didn't look at anything else, though.
If you just put a new valve over the dodgy old valve,
and instantly improve her circulation, you ought to know that would cause damage elsewhere.
That's why I stopped you.
There was a fatal case similar to this one.
You checked it, didn't you?
Before the surgery,
you checked this woman's CT scan properly, didn't you?
You said she'd be fine if you put in the new valve, didn't you?
If you've killed this woman, you should die.
I see. But she's your patient.
I'll leave it up to you.
Is there a problem?
It's fine.
Mrs Minagawa, hang on there. It's okay. Please keep trying!
Do your best.
Here she is. - Yes, sir.
Okay, let's move her. 1, 2, 3.
We're doing an emergency splenic artery aneurysm repair.
How's her blood pressure? - It was at 60 just now.
Bring the disinfectant over quickly. And drapes.
Electrocautery knife. - Here.
She's bleeding more than expected. Suction! Gauze, gauze.
Let's do another transfusion! - Yes, sir.
Transfusion! Gauze! - Yes, sir.
Bring more gauze!
Damn it, she's bleeding too much.
Gauze, gauze. - Here.
Ready for transfusion.
It's no good.
Gauze, gauze.
Blood pressure is at 50.
4-0! Here.
Doctor.
Doctor!
Will you write a resignation letter?
I'll help in return for your severance pay.
Stop messing around. This isn't the time!
Do you know what's happening? There's too much blood! I can't see where the damage is!
If we can't stop the bleeding, she'll die!
Then do it yourself!
Damn it.
Gauze.
How much should I pay?
How much should I pay for you to save her?
She's my patient.
She was looking forward to seeing the cherry blossoms.
She agreed to the surgery because she trusted me.
So as a doctor, I have to save her.
But...
But I...
Even though I'm a doctor, I can't do anything.
I can't stand it, but you're the only one who can.
If you'll save her for money, then I'll pay you.
So please, save her! I'm begging you!
Please! Please!
Please!
There's no time. You'll have to help.
He has no experience with surgery.
I'll do it. - Wash your hands. Quickly.
Yes, sir.
I see. So Tokai is doing the operation.
I understand.
I'm sorry.
Suction! Suction! Hurry up! - Blood pressure is at 50.
Bring a large needle. - 26 mm.
Push it in. More suction. - Yes, sir.
Scissors. -Here. Move! -Here's the 26-mm.
Blood pressure is 49. It's dropping.
I can't tell where the blood is coming from.
When that happens, you should pull it straight out.
Hold this. - What?
Hold it! - Yes, sir!
Quickly!
Needle. - Here.
Scissors. - Here.
Okay, I've stopped the bleeding. - Her blood pressure is recovering.
60. 70.
One hundred million.
What?
Until you finish paying it off,
spend your whole life working here for me.
Tojo University Hospital Old Building
Patient's name: Minagawa Taeko
The splenic artery aneurysm.
You knew about it, didn't you?
You let Takashina do the SNIPE operation even though you knew.
You predicted that far ahead.
At least this should keep Takashina quiet for now.
Good job, Tokai.
You really are helping me a lot.
Name: Iinuma Tatsuji Part imaged: Chest
Attending Physician: Tokai Ichiro