Black Pean (2018) s01e03 Episode Script

1
Care to explain yourself, Dr. Takashina?
The paper on the success
of the Snipe surgery
should be here as the headlining article.
I don't see a single article
regarding the Snipe
published in here.
You've completed only two Snipe surgery
cases at Tojo University Hospital,
and the results
have been less than satisfying.
I'm very sorry.
There isn't much time left
until the election for Chairman.
What I need is Impact Factor, you know?
Impact. Factor.
If you can't get me results next time,
the Snipe will be
out of your hands completely.
If you wish to stay in this business,
bring me some results.
After two Snipe surgery failures,
Dr. Takashina had few chances left,
and the pressure was on.
And as no schedule was set
for the Snipe's next use,
he couldn't redeem himself.
It seems there hasn't been
another Snipe surgery since last time.
There's someone
I would like to introduce to you.
As the number of patients
hoping for Dr. Saeki's care rose,
there wasn't a day he didn't operate.
And I got to be caretaker
of two new patients.
The first,
scheduled for operation by Dr. Saeki,
is Mr. Hideo Kusunoki,
suffering from mitral stenosis.
Dr. Tokai will be looking after you
until the operation.
-Nice to meet you.
-Nice to meet you.
And my second patient
was brought in by the clinical
trial coordinator, Kinoshita.
Hayato Tamura, a music student.
He was diagnosed with mitral insufficiency
and he's volunteered
for an emergency Snipe surgery,
hoping to recover in time
for a piano contest in America.
The important thing to note is his father.
If it isn't Mr. Tamura!
A candidate for Vice Minister
of the Ministry of Health, Koji Tamura.
If there are no problems in the test,
we can operate right away.
You can leave the hospital
about a week after we finish.
Thank you.
That Snipe tool is really something.
The surgery that would save
Dr. Takashina's career was decided
and the preparation was soon underway.
-Dr. Sera. Bring me a towel, would you?
-Okay.
What are you doing? Watch out!
Sorry.
Excuse me.
Dr. Takashina seems to be on edge lately.
This is the first Snipe surgery
in a while after all.
Excuse me.
These are Hayato's lab results
and echocardiogram.
The MRI results will be in tomorrow.
-Here you go.
-Thank you.
Sorry for getting angry with you earlier.
It's all right. I'm sorry.
Are you still working?
Given last time's issues,
I have to make many revisions to my paper.
-Anything else?
-No, sorry.
Dr. Tokai never writes papers.
This is new to me.
It's not enough to just write a paper.
What matters is where it's published.
Impact Factor, right?
The most influential Japanese publication,
The Japan Surgical Journal,
has an Impact Factor of seven.
Ten years ago, when Dr. Saeki
first performed the Saeki Method,
it was first published here.
And because of that,
Dr. Saeki became famous overnight.
Since then, the doctor
has published many articles
sending his Impact Factor to 77.
TOTAL POINTS: 77
While Dr. Nishizaki's various papers
are also widely published,
but his Impact Factor sits at 71.
In other words, despite his efforts,
Dr. Nishizaki's vast research
isn't enough to compete.
Only the paper on the Saeki Method
puts Dr. Saeki ahead.
Tojo, an unknown hospital,
became an authority
on cardiovascular surgery
and patients from all over the world
now gather here in Sakuranomiya City
to visit a local hospital.
A single paper's Impact Factor
changed the world completely.
If I can complete the Snipe paper,
I'll be able to overtake
Dr. Saeki's Impact Factor.
And I'll do anything to achieve that.
But I still don't have enough
real-world cases to complete the paper.
I have to ensure the next one succeeds
to garner trust.
By using the Snipe,
we can save more lives.
Could you let me help you?
If the Snipe is put into regular use,
we'll be able to save lives
around the world, as you said.
I think that's a wonderful goal.
Sorry. I've said too much.
Excuse me.
Dr. Sera.
Yes?
Could you gather data for me?
It would be helpful.
Yes. Of course.
However, the next day,
a critical problem was found
Dr. Takashina!
in Hayato Tamura's test.
What is this?
It has come to light that Hayato
is afflicted by cardiomyopathy
and his heart has an unusual ventricular
structure, winding and complex
like a vast jungle.
MITRAL VALVE - HYPERTROPHY
This will make it difficult
to apply stitches
between heartbeats
and reach the mitral valve.
A slight mistake could induce arrhythmia
and kill the patient.
This is an extremely rare case
requiring delicate care.
Performing Snipe surgery on this patient
Are you trying to say you can't do it?
Can you?
It's impossible.
Dr. Takashina, you finally had a chance!
It cannot be done.
We'll have someone else operate.
Enter.
Dr. Tokai
Dr. Tokai, you'll handle
the Snipe surgery for us,
won't you?
As you say, sir.
Dr. Tokai is taking on a Snipe surgery?
How is this going to end?
Please wait.
I know Dr. Tokai is a skilled surgeon,
but entrusting him with Snipe surgery?
It's a delicate operation
requiring a steady hand.
I can't think of anyone
better for the job.
If you're unsure,
our only other option is to call it off.
I wonder what Dr. Nishizaki
would say about that?
You can act as Dr. Tokai's assistant.
Dr. Tokai as the starting surgeon?
-That's a first.
-I guess it is.
He's usually there as assistant.
-I wonder how it will turn out.
-Me too.
SAITAMA RICE
GROWN IN GYODA
Here's the Snipe's user manual.
Stick it in the mitral valve
and pull the switch, right?
You'll need to take
a complicated route this time.
It will require practice.
I know a guy who practiced
and practiced and he still failed.
Then, it's a waste of time.
Without ever laying a finger on the Snipe,
the day of Dr. Tokai's operation arrived.
We'll now begin mitral valve
replacement surgery with the Snipe.
Scalpel.
What is wrong?
I don't have the faintest idea
Dr. Tokai, what's wrong?
-I'm done.
-What?
You're done?
Dr. Tokai?
What does this mean?
Well, I don't even Mr. Kurosaki!
Let me check. I'll be right back.
What do you mean you're done?
That's what I've decided
as operating surgeon.
Explain yourself.
Both Hayato and we
have been preparing for this.
You're not prepared.
Did even pay attention to the
apical papillary muscles?
The apical papillary muscles
There's nothing we can do.
It was his decision.
-But
-The operating surgeon
is Dr. Tokai.
Get a test on the heart muscles.
-No changes in condition?
-Right.
A surprising discovery
was made upon further examination.
The apical papillary muscles
much weaker than usual.
We won't be able
to insert the Snipe as usual.
If we had tried back there,
the apex would have torn,
causing hemorrhaging.
Seeing such subtle heart movements
How did he notice that?
What are you talking about?
You cannot cancel the surgery.
Allow Dr. Tokai to carry out
the operation.
If it succeeds, it will be the case
we need for the Snipe.
And it will save this paper.
But if we fail
If you fail,
we make sure Tojo University
takes responsibility for it.
Oh, right.
The text is a bit small.
And use a Gothic font.
Dr. Takashina.
Is it really possible to operate on Hayato
using the Snipe?
Of course, it is.
But to do so,
we'll have to reach the mitral valve
without damaging the ventricle.
We have to find a new route.
Will you help me?
Yes.
We'll make an exact replica
of Hayato's heart with a 3D printer.
Amazing!
Incredible.
-It's just like the real thing.
-Yes.
Let's work around the apex
and find a new way in.
Understood.
Introducing Mr. Tamura,
the next Vice Minister
It would appear you're quite the fan
of Dr. Nishizaki and Dr. Takashina.
A fan, you say?
Am I wrong?
I'm a fan of the elite. That's all.
That's why I like Dr. Nishizaki,
and you as well.
A fan, as you say.
I may be out of line asking this,
but why, Dr. Saeki?
Why did you approve
of taking in Mr. Tamura?
On top of that,
you appointed Dr. Tokai as lead surgeon
It would almost appear as if you
are taking a liking to the Snipe.
It's all for the sake of the patients.
It's no use.
Let's try 11 millimeters.
-From a 75-degree angle.
-Right.
We continued our research
on a new route for the Snipe.
Finding an insertion point
by the millimeter away from the apex,
calculating the angle based on heartbeats.
We tried countless times.
They're still at it?
Why the hell is Sera helping out
with Teika's research?
Finally,
-We finally found a route.
-Finally.
Now, we'll be able to use the Snipe.
There's only one thing left
that we can't anticipate.
The surgeon.
You called?
There isn't much time
until the competition.
We would like to operate
as soon as tomorrow.
When do you think it will be?
If that's the case, then we'll hurry.
Right, Dr. Tokai?
Before we do that, I have to ask.
Do you understand the Snipe surgery?
-What?
-Of course, they do.
I explained it myself.
It has been performed twice
at our hospital.
The first time,
the patient's splenic artery tore.
She almost died.
The second, the patient nearly bled
to death due to human error.
Bled to death?
That's the surgery you'll be undergoing.
As they say, "Third time's the charm."
There's a chance of success, however
They also say, "History repeats itself."
Think it over.
-They had issues twice
-What is this about?
We'll explain it again shortly.
What is this, Dr. Tokai?
-I just told them the truth.
-No.
You threatened them,
by the way you said it.
What will we do if they opt out?
We'll cancel the operation.
Like we said, it's either going to be
you or me who leaves.
If nobody undergoes Snipe surgery,
I will be kicked out of here.
Is that your goal?
To be quite frank,
I don't like the idea of you operating.
But as a team, we must cooperate.
Let's quit this bickering.
This is the new Snipe route
we've come up with for Hayato's surgery.
We'll be able to put this in the paper.
We'll follow this route for the Snipe
during the next operation.
HAYATO TAMURA
NEW SNIPE ROUTE
RECYCLE BIN
Wait, Dr. Tokai!
What did you just do?
I trashed it.
Don't mess with me!
Do you understand your job?
Dr. Takashina, stop. Please.
Please.
We don't need it.
I've already decided on a route.
I'll insert the Snipe
28 millimeters to the left from the apex.
Approaching from an 83-degree angle,
reaching the mitral valve
without damaging the left ventricle.
In fact, there is no other way.
You have any problems with that?
If papers could save people,
we wouldn't need doctors.
I do have a problem.
My pride as a doctor.
An unpublished doctor wouldn't understand.
You wouldn't know how much time
and effort we put into it.
If you had ever participated in research,
you would understand what you've done.
Papers are everything to us.
I recognize you're a skilled surgeon.
But without all the thought
that goes into it,
you're not a real doctor to me.
You're just a lowly craftsman.
You're giving me such praise.
You'll make me blush.
We don't need it.
I've already decided on a route.
NEW SNIPE ROUTE
I'll insert the Snipe
28 millimeters to the left from the apex.
Approaching from an 83-degree angle,
reaching the mitral valve
without damaging the left ventricle.
In fact, there is no other way.
We have worked so hard
to discover a new route,
but Dr. Tokai was able to do it easily.
What is this about, Dr. Nishizaki?
We asked for urgent care.
If there is a chance of death,
we want to use the Saeki Method.
That Dr. Tokai
may have said something misleading,
but there is no problem.
I've entrusted my trusted colleague,
Dr. Takashina, to explain everything.
Thanks to Dr. Takashina's
ardent persuasion,
Mr. Tamura once again
agreed on the Snipe surgery.
Please read these documents.
Mr. Tamura has requested
that Hayato's operation
be performed this Sunday.
Dr. Saeki will be away
on business that day.
It's a direct request from the next
Vice Minister of the Ministry of Health.
It's all the same to me.
That schedule works for me.
Then it has been decided.
Thank you for your time.
Dr. Takashina.
You have a great responsibility.
What do you mean?
Dr. Nishizaki sees the Snipe
as a simple tool to win him the election.
Aren't you tired of him
always pestering you
for results for your paper?
Dr. Takashina.
I would like to offer you
an official position here.
You can continue your research and testing
on the Snipe as much as you would like
here at Tojo University.
But this is Dr. Nishizaki's research.
No, it's yours.
I want to support your research.
The Snipe currently still requires
a skilled surgeon.
Our hospital will help bring it to life.
Are you trying to poach me
along with the Snipe?
The name written at the end of your paper.
That name represents
the head of the research done.
All you need to do,
is write my name there.
Are you telling me to
cut off Dr. Nishizaki?
We can change the rules, if necessary.
Wasn't it you who said that?
We're friends, not enemies.
Meanwhile, preparations
for Mr. Kusunoki's surgery next week
were progressing steadily.
Okay, we're done.
I feel so lucky to receive
your care, Dr. Saeki.
I'm extremely grateful.
I thought of checking on your condition
before my trip to Tokyo tomorrow.
Thank you so much.
Just in case, we'll take
a coronary angiogram next Monday.
Okay.
-Put it in the order.
-Yes.
I would like to offer you
an official position here.
All you need to do,
is write my name there.
The fateful day finally arrived.
Excuse me. It's about Mr. Kusunoki.
I scheduled a coronary angiogram.
-Orders from the professor?
-Yes.
He told me to hurry,
so I've set it for Monday.
-We'll do it after this.
-What?
Yes. Make preparations.
Wait. I'm not sure I can
on such short notice
Come in.
A great success, I see.
As expected from you, Mr. Ikenaga,
as editor-in-chief.
Me? I haven't done a thing.
My predecessor did all the real work.
All of the Journal's current editors
were selected
by the former editor-in-chief.
He's expected to make an appearance today.
I'll introduce him shortly.
Enjoy yourselves.
It was almost time for a second try
on Hayato Tamura's Snipe surgery.
We'll now perform mitral valve
replacement surgery with the Snipe.
-Scalpel.
-Here.
-Electroscalpel.
-Here.
Avoid the lungs after incision.
-Gauze ball.
-Right.
Here we go.
Dr. Nishizaki expressed zero concern.
Please observe.
-Tourniquet.
-Here.
Forceps.
-The Snipe is ready.
-I know.
MITRAL VALVE - HYPERTROPHY
-Inserting the Snipe.
-Keep it down.
Twenty-eight millimeters to the left
from the apex.
At an 83-degree angle.
With such ease, Dr. Tokai is incredible.
HIDEO KUSUNOKI
The Saeki Method.
While carrying my name,
it is a medical procedure
performed on the mitral valve
while the heart continues to beat,
"on beat," as we say.
Excuse me.
-Never before has
-What is it?
Mr. Kusunoki in room 304 has gone
into shock. Ask Dr. Saeki what to do.
Cardiac tamponade
CARDIAC TAMPONADE
He's giving a speech.
He can't give orders.
This is Dr. Saeki's patient.
Don't let him die no matter what!
What should we do?
Looking good.
We'll soon approach the hypertrophy.
MITRAL VALVE - HYPERTROPHY
This is where it gets tough.
Amazing. In such a narrow route.
He's reading the heart's movement.
-Dr. Sera.
-Right.
-Yes?
-It's Mr. Kusunoki in room 304.
He's in shock. Cardiac tamponade.
Is there someone who can help?
We need assistance!
Mr. Kusunoki is having
a cardiac tamponade.
It must be a ruptured aneurysm.
-How did you know?
-The professor ordered the test.
We'll take a coronary angiogram.
Right
For it to happen now
Give me that. We need emergency surgery.
Dr. Sekikawa can't do it.
And Dr. Saeki is out.
-He won't last 30 minutes.
-What should we do?
Dr. Tokai.
No. If we stop now,
we won't be able
to insert the Snipe again.
-This is the only route.
-But Mr. Kusunoki
Dr. Tokai.
Nekota.
-Left side?
-Got it.
-Mr. Kusunoki, can you hear me?
-Dear!
This is bad. He'll die like this.
Doctor!
Someone, hurry!
What are you doing?
Continue the operation!
Dr. Tokai!
I can't be in two places at once,
so I can only save one of them.
Who will you save?
-What?
-No
Who will you kill?
I can't make a decision like that.
If it were me,
I would save both.
Both?
How?
Tell them to bring him next to us.
-What?
-Tell them now!
Okay. Bring him to operating room two!
Okay. Dr. Sekikawa
Nekota?
Operating Room 2 is ready.
Mr. Kusunoki?
-Hurry up!
-Right!
Are you going over there?
What will you do with this patient?
Take over.
You continue the operation.
I have to continue?
What's wrong?
Do you plan on just standing there
until I get back?
But
You know that there's only one route.
If you continue with the right timing,
it'll work, right.
Continue with the right timing?
You know it's not that easy.
Aren't there any real doctors here?
No?
Aren't there any real doctors here?
Fine.
Dr. Takashina.
What are you doing?
Dr. Tokai, get back there!
Do you plan on continuing?
-These are the surgeon's orders.
-But
The route only opens when the heart beats.
I know that!
We have to try.
Why from the left?
Incisions are done in the center.
Move it.
Opening from the left?
I'll start with
the coronary artery aneurysm.
-Scalpel.
-Here.
Why open up from the left?
A median sternotomy is standard.
An incision in the center of the chest.
Why make it harder and go from the left?
Hey.
Yes?
-Excuse me.
-Get that off. You do it.
Okay.
-Video.
-Okay.
It's on.
-Sternal retractor.
-Right.
OPERATING ROOM ONE
Monitor on.
It's taking longer than expected,
but it's under control.
I think we can do this.
We got PSVT!
PSVT in room one!
PSVT Did they hit the muscle?
No. It's just arrhythmia.
Administer verapamil.
Dr. Tokai says to administer verapamil
since it's regular arrhythmia.
We've been told to administer verapamil.
Two surgeries at once?
What is this man capable of?
Here's the verapamil.
-Hurry!
-Right.
-Anesthesiologist, hurry.
-Right.
Damn it
Dr. Takashina
-Metz.
-Here.
Aneurysm suture complete.
-Already?
-Electroscalpel.
-Open him up. Raise the bed.
-Right.
We'll bypass the aneurysm
and stabilize blood flow.
This is a difficult operation.
What's going on there?
Irregular heartbeat
If they miss by even one millimeter
They'll hit the muscle
and kill the patient.
Dr. Takashina.
Metz.
-Bypass complete.
-Impossible. You're too fast.
-Bypass complete.
-Thank God.
-Blood pressure, 72.
-What?
It won't stabilize. Why?
Because of the patient's
narrow mitral valves.
To save him
We'll need the Saeki Method.
Dr. Tokai can do it.
-Heart-lung machine.
-Right!
-Blood pump!
-Okay!
Room two. Bypass complete.
We'll perform the Saeki Method.
Blood pressure 70-40. Heart rate 110.
-Hurry.
-Right!
Wait.
Blood pressure 72. It won't stabilize.
Dr. Takashina.
If we continue like this,
the patient will surely die.
So you plan on just letting him die?
I can't do it.
I know the limits of my own abilities.
Gown.
-Dr. Tokai.
-Here.
How? What about the other operation?
I'll take over.
I got this one. You finish up over there.
-The Saeki Method? Me?
-No way.
Dr. Tokai. I've brought it.
Use the Snipe.
The Snipe?
I opened that patient up on the left.
Insert the Snipe from the apex.
That was your plan from the start?
What is this about?
He was planning on using the Snipe
from the beginning.
With the standard central incision,
the apex isn't exposed
and the Snipe can't be inserted.
But doing it with such ease
What skill!
-How were you able to verify it
-Do it.
Surgeon's orders.
Understood.
Dr. Takashina
Dr. Takashina.
We'll perform mitral valve surgery
with the Snipe.
-Let's begin.
-Yes, sir.
-We'll apply stitches to the apex first.
-Right.
MITRAL VALVE - HYPERTROPHY
-Snipe.
-Here.
Inserting the Snipe.
Using the Snipe on both patients
It's in.
Blood gas analysis results. Here.
Approaching mitral valve.
We've made contact.
We're at the mitral valve.
Finished.
Finished.
They did it.
-It was a success!
-Thank you.
-Can you apply sutures?
-Yes.
A once-in-a-lifetime double Snipe surgery.
That man
has the devil's skills.
I see. So it was on Dr. Tokai's orders?
And it seems both of them
used the Snipe, apparently.
-The Snipe?
-Yes.
I see.
Thank you, Dr. Saeki.
-It's nothing.
-About my predecessor
It appears he has fallen ill
and he won't be in attendance today.
He'll be better soon, I'm sure.
My son was saved by the Snipe.
As for the election,
my close relationship with the lobbyists
and voting board members
will benefit you.
That is very encouraging.
Please send them our regards.
Until next time.
Well done, Dr. Takashina.
Now, the real test begins.
I promise I will complete my paper soon.
For you, Dr. Nishizaki.
It's almost time.
Excuse me.
Dr. Tokai. Mr. Kusunoki is being released.
They're looking for you.
Thank you for everything, Dr. Saeki.
I'm glad you're feeling better.
I promise to repay you.
Thank you, everyone.
-Please take care.
-We will.
Excuse us.
Why did they leave through the back door?
Mr. Hideo Kusunoki.
He's the former editor-in-chief
of the Japan Surgical Journal.
The Journal's editors
are greatly influenced by him.
If the Surgical Association finds out that
someone as influential as him
didn't go to Dr. Nishizaki for
heart surgery, but instead came to me
it would lead to unfairness
in the elections.
You mean
I would save both.
The reason Dr. Tokai saved both is
No matter how well-written
your paper may be,
whether or not it ends up being published,
will depend entirely on whose name
is written at the end.
Will it be Dr. Nishizaki?
Or me?
I just realized Dr. Tokai didn't make
any demands this time, did he?
-What?
-It's just
He usually doesn't help without payment.
Dr. Tokai.
Congratulations on a job well done.
You had your hand in not one,
but two Snipe surgeries.
Can I ask for your cooperation again?
Is he really such a bad guy?
Thanks to him, the patients were saved.
You don't get it. He's the devil.
Excuse me. Dr. Tokai?
I'm here for Mr. Igarashi's reports.
Excuse me.
Forceps?
This is
If you don't need them anymore,
give them to me. Your black forceps.
You're no longer needed.
Our biggest problem
is the blood transfusion.
The Snipe exists because of her.
I bet everything on this.
There's less than
a five-percent success rate.
Is that why Dr. Tokai said no?
If we fail, we will just remove
Dr. Takashina's name.
I will succeed for sure.
You're the only one
who can help this patient.
Why don't you kill her?
You heard what the doctor told me.
With my current skill, it's impossible!
What will you do?
Believe in me.
Don't believe him.
Subtitle translation by: Tom Grathwol