Black Pean (2018) s01e04 Episode Script
Episode 4
1
Forceps. This is
Hanabusa.
Mr. Igarashi's reports were on my desk.
-I'm sorry for misplacing them.
-It's okay.
-You may go back now.
-Thank you.
Two simultaneous Snipe surgeries
were completed at Tojo University.
-Finished.
-Finished.
Everything changed.
Lastly, at Dr. Takashina's request,
we will introduce 20 new Snipe units
to our facilities.
One unit costs three million yen.
Eventually, you will all be entrusted
to perform surgeries with it.
I want each of you to follow instructions
to prepare for this.
With Dr. Saeki's approval,
Tojo's promotion of the Snipe
was fully underway.
We've reached the mitral valve.
Complete.
It's much faster than the Saeki Method
and it's so simple.
The need for skilled surgeons
might really be at its end.
Dr. Takashina got his case data
and was nearing completion
of his Snipe paper.
But there was still one big problem.
The name of the author,
written in the introduction
and the name at the end
of the person in charge
indicate the most important
people involved in research.
The Impact Factor from a paper
is given solely to these two people.
In conclusion,
the person at the end of the Snipe paper
would earn many Impact Factor points
and certainly win
the election for Chairman.
If the former editor-in-chief,
Mr. Kusunoki, is backing you,
I cannot intervene.
I promise to repay you.
I can't publish the paper under your name
as things currently stand.
If that's the case,
then you don't need to worry.
Measures have already been taken.
The battle over the Snipe paper
was nearing its final stage.
All the while,
an emergency conference was held
regarding a new patient's surgery.
Koharu Shimano, seven years old.
Transferred from Teika University.
She was diagnosed
with mitral valve insufficiency.
However, the main problem
lies in her blood.
Her platelet count is extremely low
It will be okay.
making it difficult for her blood
to clot.
With an allergy to blood transfusion
and irregular antibodies,
it's nearly impossible
to do a blood transfusion.
Open chest surgery
would cause heavy blood loss
and would kill her immediately.
Therefore,
the Saeki Method is out of the question.
Why did the professor
accept a patient like that?
I have something important to discuss.
She's a patient I previously cared for
at Teika University.
With repeated heart failures,
she only has a month to live.
Can I ask you to perform mitral valve
surgery on her at Tojo University?
I will consider it.
But for you, completing the paper
is your highest priority, right?
Introducing 20 new Snipe units.
I've supported you
in increasing case numbers.
There's another document.
A copy of a patient's chart.
CHIE KUSUNOKI
It's Mr. Kusunoki's wife.
Her results came back
showing a malignant tumor in her liver.
She's currently undergoing treatment
at Teika University
with a specialist
recommended by Dr. Nishizaki.
It's cutting-edge chemotherapy
only available at Teika University.
Mr. Kusunoki is indebted not only to you,
but now to Dr. Nishizaki as well.
It means that my paper will be published
whether it's your name
or Dr. Nishizaki's that I put at the end.
I'm sure you know what that means.
Won't Dr. Nishizaki help you?
Unfortunately,
-that's a risk I cannot afford to take.
-"That's a risk I cannot afford to take."
Am I right?
Operating to ensure a child's future.
It's a wonderful thing, isn't it.
Very well.
Bring her to Tojo University.
Thank you.
One condition.
I'm sure you get it.
About the paper.
I give you my word.
After verifying her situation,
I've decided to perform Snipe surgery.
The operating surgeon
will be Dr. Tokai.
Dr. Tokai again?
He is skilled, after all.
What did you expect?
Got it, Dr. Tokai?
I decline.
You decline?
The surgery can't be done with the Snipe.
But if there's no other choice
and you need my help,
would you instruct me
to use the Saeki Method?
I don't care what you want.
The professor has found
the Saeki Method to be too risky
and has decided on Snipe surgery.
Got it? This is an order!
What's that?
So this isn't Dr. Saeki's
surgical department.
It's Dr. Takashina's, isn't it?
At the department I know,
all of our mitral valve operations
are done using the Saeki Method.
Nobody was ready to make the switch
when you brought that new toy in.
-Toy?
-Make the switch?
You're all really something.
After all those objections
you had at first,
all I hear now is "Snipe."
You've all done your homework, I see.
-Shut your mouth, Tokai!
-Dr. Tokai
Taking on difficult operations
and succeeding each time.
That's Dr. Seigo Saeki.
That's the Saeki Method.
If you're saying it can't be done
with the Saeki Method
but it would be possible with the Snipe
-You've admitted defeat.
-Tokai!
If you don't need them anymore,
give them to me.
Your black forceps.
Tokai.
I understand.
You have some serious nerve
mocking me
and the black forceps like that.
I assume you came prepared
for the consequences.
You're no longer needed.
You will not be involved in any surgeries
after this.
You have no right to be here.
Get out,
Dr. Tokai.
If it's the doctor's orders
SEISHIRO TOKAI
Now you're the only one who can operate.
Understood?
Yes.
As for the punishment given to Dr. Tokai
Pardon me.
Dr. Tokai.
Director Moriya asked me to tell you
that you should clean up
and be out of here in a month.
They told me to help carry your stuff
to the medical office.
What should I take first?
Do whatever you want.
You're no help.
Why did you say all that?
It's so heavy.
Hey, wait. What's this?
You can take my stuff out too.
What?
Nekota, wait. What's this about?
That Dr. Tokai
He's basically Dr. Saeki's right-hand man.
The surgical department
won't last long now with him gone.
Dr. Saeki has dug his own grave,
you could say.
This guarantees your landslide victory
in the election. In that case
When I win,
I'll leave you in charge of one
of my affiliated hospitals, Mr. Moriya.
It would be a great honor!
I'll be in your care.
-Hanabusa.
-Yes?
Give this to Dr. Tokai.
Me?
Please.
Excuse me.
Um, Dr. Tokai
Want some?
No, thank you, I'm fine.
This is delicious.
Isn't it?
I didn't think rice could be so good.
They say Japanese bodies are made of rice.
Forceps?
Dr. Takashina did countless simulations
in order to deal with Koharu's hemophilia.
To prevent hemorrhaging,
the incision in the heart
must be as small as possible.
The standard is 20 millimeters.
We'll try 12.
Twelve millimeters.
It's the same size
as the Snipe's diameter.
That's our limit.
Even one small slip of the finger
will tear the muscle
and cause massive bleeding.
It can be done in theory.
We'll operate in one week.
Perform more tests
on her blood coagulation.
-Right.
-Okay.
The truth is
there's less than
a five-percent success rate.
Five percent?
Before I finish my paper,
OVER LETHAL DOSE
we must save her.
No matter the cost.
-Soy sauce ramen.
-Looks great.
-Soy sauce chashu ramen.
-Thank you.
-Let's eat.
-Please enjoy.
So, no matter the results
of the operation,
your name will appear in the paper?
Yes. Those were my conditions.
Don't you think it's funny?
Elite adults like you would go
to such lengths for a single paper.
What we want isn't just the paper.
It's Impact Factor.
It really is true.
For a doctor, the Impact Factor
is really like your Michelin stars.
This restaurant became famous overnight
when it received its first star.
That's right.
But for us, those stars
also determine the chairman election.
That's why I'll do whatever it takes.
Even if it makes me look bad.
The winner takes all.
It's a good look. Scars and all.
TOJO HOSPITAL
DR. TOKAI
-Please excuse me.
-Sure.
I have something to ask of you.
Twelve millimeters is impossible.
The procedure will damage
the surrounding blood vessels.
Theoretically, it can be done.
We have to try.
In the days leading up
to Koharu's operation,
Dr. Takashina began to show his worry.
Don't worry, Koharu.
I'll help you get better.
I promise.
Promise.
Yeah.
Dr. Takashina is amazing.
He's doing tests, verifications
and simulations all day long,
then writing the paper at night,
and more testing, on his own.
When does he sleep?
I respect him, honestly.
At first, I thought he was
just a smart-ass.
-But he's way tougher than both of us.
-You're right.
Unlike that sloth Tokai over there.
That's supposed to be our nap room.
You're right.
Which room?
This way!
-What happened?
-Doctor.
Sudden heart failure.
-We need oxygen and a diuretic.
-Okay.
-Mask, please.
-Take over.
-You'll be okay.
-Oxygen, hurry.
Acute MR.
MITRAL REGURGITATION
He needs emergency surgery.
-We'll use the Snipe.
-Right.
Take him to OR one.
I've contacted the head nurse.
-Right.
-Okay.
I've brought the Snipe.
Let's take a look at the mitral valve
with ultrasound.
On screen.
Preparing to insert the Snipe.
Wait. I can see vegetation
on the mitral valve.
VEGETATION = BACTERIAL MASS
If we use an artificial valve,
the bacteria will get damaged and spread.
-We can't use the Snipe.
-Then what should we do?
The large arteries have calcified.
We can't stop the heart.
We must use the Saeki Method.
Don't be absurd,
Dr. Saeki isn't here today!
Um, this patient is Dr. Tokai's patient.
We must call him. He's the only one.
-Go now!
-Right.
We'll perform a central incision.
Get the heart-lung machine.
-Understood.
-Right.
-Take over.
-Miyamoto, take this.
Excuse me, Dr. Tokai!
There has been an emergency
in Operating Room one.
You have to come with me.
I decline.
What?
He won't come?
He says it's because he was ordered
not to get involved by the doctor.
-Can you put him on the line for me?
-Okay.
Excuse me
I'll put it on speaker.
Dr. Tokai, can you hear me? Dr. Tokai?
Be quiet. It's the middle of the night.
It's Mr. Murakami from Room 314.
He's your patient.
He needs mitral valve surgery now.
But we can't use the Snipe.
We must perform the Saeki Method.
We need you.
I told you.
The doctor ordered me not to operate.
But
You're the only one
who can help this patient.
-Blood pressure 50.
-He's in septic shock.
-Give him norepinephrine.
-Okay.
Dr. Tokai. I'm begging you to come.
Please, Dr. Tokai.
-Saline, hurry!
-Right.
Body temperature is at 39 degrees Celsius.
The vegetation is peeling off.
We must perform the Saeki Method now.
At this rate clumps of bacteria
will spread through the body.
We're out of time.
Dr. Saeki
The head nurse
-Miyamoto, a gown.
-Okay.
The doctor just returned from his seminar
and rushed over to assist us.
-Take over.
-Okay.
Fill me in.
Acute MR from infective endocarditis.
And vegetation on the mitral valve.
-That's why you can't use the Snipe.
-Yes, that's correct.
We'll remove the infected area
and repair the valves.
Pardon me.
-Scalpel.
-Clear the field.
-Where are those suctions?
-Sorry. Coming right away.
No need.
My finger will guide me.
The Saeki Method.
Metz.
Metz.
-Black forceps.
-Right.
Incredible.
This man really is a god.
Compared to Dr. Tokai,
He's
Professor!
Thank you so much.
Sorry for the commotion.
We tried to call Dr. Tokai, but
I told him to stay out of it.
There's no problem.
These were unforeseen circumstances.
You did everything you could.
Dr. Takashina.
Treatment doesn't always
go according to simulations.
If he's going to follow
the doctor's orders now,
I wish he would have agreed
to do Koharu's operation.
Dr. Tokai said
he has never let a patient die.
I was hopeful that Dr. Tokai
could take care
of Koharu's Snipe surgery as well.
Why did he decline that one order?
Isn't that why?
What?
Isn't that why Dr. Tokai said no?
MOM
What is it?
What's with you? Someone sounds sleepy.
Are you eating well?
Every day.
Japanese bodies are made out of rice.
How many times are you going to say that?
What do you want?
I sent some for you to give
to Dr. Saeki as well.
What?
He's taken good care of both
my husband and my son.
Make sure he gets it, will you?
-Bye!
-Hey, wait!
He's good.
He sure is. I bet you could do it too.
Hello, Koharu.
-Hello.
-Hello.
-Do you like soccer?
-Yes.
I'll be able to play soon, they said.
Dr. Takashina promised
to make me all better.
That's great.
When your surgery is done
and you're all better,
let's play soccer with Dr. Takashina.
Yeah.
So, as soon as the child's operation
is finished you'll have the paper, right?
Yes. I'm sure you'll be pleased.
Isn't it a dangerous operation?
If it fails,
Dr. Takashina will have to take
responsibility as operating surgeon.
The paper is nearly complete.
And so is Dr. Takashina's role.
If it fails,
we will just remove Dr. Takashina's name.
RICE
Why do you have so much rice?
Don't touch it.
Sorry.
Koharu would die of blood loss
within 24 hours of surgery.
I'll help you get better.
I promise.
Promise.
Dr. Tokai.
You're almost done with the paper, right?
If you are, I don't see the need
for doing this surgery.
It is true that whether we fail
or succeed,
it will not affect our seniors.
They only care about my paper.
I'm fully aware of it, too.
But this surgery
Koharu was born
with a deficient mitral valve
and I've seen her in pain.
As hard as I tried, I wasn't able
to give her the help she needed.
The reason I first
took an interest in the Snipe
was my hope to save Koharu.
The Snipe exists because of her.
After bowing down
and begging the professor,
I was able to bring it to Japan.
This time, betraying the professor
and swearing loyalty to the enemy,
I've finally made it
to the deciding moment.
If I can't save her,
neither the Snipe nor the paper
will be complete.
I've finally made it this far.
I've practiced the operation 30 times.
And all 30 times,
I killed her.
While it's feasible in theory,
with my current skill,
it's impossible!
I thought if we had the Snipe,
if we had the newest technology,
we would be able to save her.
Koharu is counting on me.
She believes in me.
I promised
I would save her.
But as things are,
I may not be able to save her.
I might end up
taking her life.
Dr. Tokai.
Use the Snipe.
And help me.
That's some excuse.
Why don't you kill her?
Or how about
you die yourself?
It's impossible with that Snipe.
Move it.
Dr. Tokai.
Why did you say it's impossible?
Do you mean to say
that even in your hands,
the Snipe would still fail?
No matter a surgeon's skill,
you can't operate with a dull knife.
The Snipe's blueprints.
Why do you have these?
The issue is that the body
of that thing is too large.
Those are Koharu's CT scans.
If we don't want to damage the veins,
we'll have to go through them.
Through the veins?
With a catheter?
If we enter the veins through her thighs,
we'll arrive at the heart.
But that route will lead us
to the right atrium.
RIGHT ATRIUM
The mitral valve is near the left atrium.
LEFT ATRIUM
MITRAL VALVE
A catheter can't go
through the septum wall.
That's why the Snipe was developed
to reach the mitral valve directly.
-Using a catheter is old-fashioned now.
-Listen to me.
We'll attach the Snipe
to the catheter.
The Snipe's artificial valve system
on a catheter?
There's a small tear in her septum wall.
We'll go through there.
If we can get to the mitral valve,
we'll only have to replace the valve.
Using a catheter like that
What's the point of new technology
if it can't be used?
Old methods have their strengths.
Medicine isn't always
about progress alone.
But there's still one problem.
A complicated operation like this
You're the only one who can do it.
I'm not allowed to.
You heard what the doctor told me.
So that's what this is.
From the very start,
you wanted to be the operating surgeon.
What will you do?
I have something
to talk to you about, professor.
I would like to request that Dr. Tokai
perform Koharu's Snipe surgery.
Please permit him to return
to the operating room.
Bowing your head for a man like that
Wasn't it you who wanted him out?
Please permit Dr. Tokai
to be the operating surgeon.
It's fine by me.
It was me, after all,
who ordered him to operate
with the Snipe in the first place.
Dr. Tokai will do the surgery.
There should be no issue.
In medicine, having the right tools
is a necessity.
But so is having skill.
Be there to assist him
and give him your support.
Of course, I will.
I promise we will succeed.
The fateful day finally arrived.
-Has it started?
-Soon.
We will now perform off-pump
mitral valve surgery using the new Snipe.
-Ultrasound.
-Here.
-Bring that closer.
-Okay.
Okay.
Dr. Tokai is really the operating surgeon?
-Guidewire.
-Here.
Snipe preparations complete.
-New Snipe, please.
-Okay.
I'm going in.
It's in. Take over.
-Catheter.
-Here.
They attached the Snipe's artificial
valve system to the tip of a catheter.
That should help prevent hemorrhaging.
Did Tokai ask you to hand over
the Snipe blueprints?
I was only helping to make
this surgery a success.
Arriving at the right atrium soon.
RIGHT ATRIUM
Already in the right atrium?
Who knew he could use
a catheter as skillfully as that?
We reached the right atrium.
They're in.
Next is the hard part.
They'll have to break through the wall
that connects to the left atrium.
It seems they planned on passing through
a small hole in the patient's heart,
but even a slight miscalculation
could cause a blockage
and lead to cardiac abnormalities.
And in this case, even sudden death.
Can they really push it
through something so narrow?
Dr. Tokai.
Proceed through the septum wall
on my signal.
When the hole is at its widest point
I'll give the signal.
SEPTUM - MITRAL VALVE
Not yet.
Not yet.
Now!
We're through.
SEPTUM - MITRAL VALVE
We're in the left atrium.
-Wow!
-They did it!
On top of Dr. Tokai's skills,
Dr. Takashina has the brains
and knows Koharu's condition best.
The best team.
All right. Now, to replace the valve.
We're at the mitral valve.
Dr. Tokai.
Valve replacement complete.
The valve is functioning!
-Yes!
-Amazing!
Amazing!
They did it.
I'll finish up.
Dr. Tokai.
Thank you.
We'll close up the septum hole.
-Take over.
-Okay.
What you said to me before,
is that how you really feel?
If you don't need them anymore,
give them to me.
Your black forceps.
Tojo University will be seeing
significant growth.
This is the transitional period.
You don't need to worry.
I just ask that you continue
to support me.
Believe in me.
I give you my deepest gratitude.
Do you understand it now?
It's more than just Teika's research.
Because of its practical use
at Tojo University,
the Snipe's potential has been realized.
If we work together,
your ideal world
where healthcare is provided
equally to everyone
can become a reality.
I will definitely make it work.
Believe in me.
I'll be looking forward to the paper.
Dr. Tokai.
Why is it that you're loyal
only to Dr. Saeki
and no one else?
Do you trust him that much?
Well, it doesn't matter.
So what will it be this time?
I'm ready to pay what you ask.
I'll lend it to you.
What?
Next time, it won't be money
that I'll ask you to pay with.
Don't believe him.
Dr. Seigo Saeki.
Don't believe him.
When he feels threatened,
that man won't hesitate
to cut ties with anyone
as he sees fit.
Anyone at all.
Even his closest allies.
Another fateful day arrived.
JAPAN SURGICAL JOURNAL
Forgive me. But you must understand.
Whatever punishment you choose to give me
I will accept.
I'll be excused now.
So everything is going according to
your original plan?
I'm impressed.
Unfortunately, that's a risk
I cannot afford to take.
But I'm sure Dr. Saeki will accept.
Just pretend to go along
with their proposal.
Use them to your heart's desire.
If the operation succeeds,
we'll have a great case in our hands.
With that, you'll be ready
to finish the paper.
The Impact Factor
will go to Dr. Nishizaki,
and of course, to me.
That's it.
I have no more use for Tojo.
There's an infection
in her heart's septum.
When the kid leaves, so do you.
May I use the Darwin?
Show them the real strength
of Teika University.
It's showtime.
Let's go.
Koharu has always believed in you,
Dr. Takashina.
You said we can change the rules.
The Darwin research
can't be taken from us.
Dr. Takashina is off the team.
Move it!
I want to change the world
of Japanese medicine.
Aren't things working out well for you?
Pretty words alone
can't save a single life.
This is nothing.
Watch me do it.
Subtitle translation by: Tom Grathwol
Forceps. This is
Hanabusa.
Mr. Igarashi's reports were on my desk.
-I'm sorry for misplacing them.
-It's okay.
-You may go back now.
-Thank you.
Two simultaneous Snipe surgeries
were completed at Tojo University.
-Finished.
-Finished.
Everything changed.
Lastly, at Dr. Takashina's request,
we will introduce 20 new Snipe units
to our facilities.
One unit costs three million yen.
Eventually, you will all be entrusted
to perform surgeries with it.
I want each of you to follow instructions
to prepare for this.
With Dr. Saeki's approval,
Tojo's promotion of the Snipe
was fully underway.
We've reached the mitral valve.
Complete.
It's much faster than the Saeki Method
and it's so simple.
The need for skilled surgeons
might really be at its end.
Dr. Takashina got his case data
and was nearing completion
of his Snipe paper.
But there was still one big problem.
The name of the author,
written in the introduction
and the name at the end
of the person in charge
indicate the most important
people involved in research.
The Impact Factor from a paper
is given solely to these two people.
In conclusion,
the person at the end of the Snipe paper
would earn many Impact Factor points
and certainly win
the election for Chairman.
If the former editor-in-chief,
Mr. Kusunoki, is backing you,
I cannot intervene.
I promise to repay you.
I can't publish the paper under your name
as things currently stand.
If that's the case,
then you don't need to worry.
Measures have already been taken.
The battle over the Snipe paper
was nearing its final stage.
All the while,
an emergency conference was held
regarding a new patient's surgery.
Koharu Shimano, seven years old.
Transferred from Teika University.
She was diagnosed
with mitral valve insufficiency.
However, the main problem
lies in her blood.
Her platelet count is extremely low
It will be okay.
making it difficult for her blood
to clot.
With an allergy to blood transfusion
and irregular antibodies,
it's nearly impossible
to do a blood transfusion.
Open chest surgery
would cause heavy blood loss
and would kill her immediately.
Therefore,
the Saeki Method is out of the question.
Why did the professor
accept a patient like that?
I have something important to discuss.
She's a patient I previously cared for
at Teika University.
With repeated heart failures,
she only has a month to live.
Can I ask you to perform mitral valve
surgery on her at Tojo University?
I will consider it.
But for you, completing the paper
is your highest priority, right?
Introducing 20 new Snipe units.
I've supported you
in increasing case numbers.
There's another document.
A copy of a patient's chart.
CHIE KUSUNOKI
It's Mr. Kusunoki's wife.
Her results came back
showing a malignant tumor in her liver.
She's currently undergoing treatment
at Teika University
with a specialist
recommended by Dr. Nishizaki.
It's cutting-edge chemotherapy
only available at Teika University.
Mr. Kusunoki is indebted not only to you,
but now to Dr. Nishizaki as well.
It means that my paper will be published
whether it's your name
or Dr. Nishizaki's that I put at the end.
I'm sure you know what that means.
Won't Dr. Nishizaki help you?
Unfortunately,
-that's a risk I cannot afford to take.
-"That's a risk I cannot afford to take."
Am I right?
Operating to ensure a child's future.
It's a wonderful thing, isn't it.
Very well.
Bring her to Tojo University.
Thank you.
One condition.
I'm sure you get it.
About the paper.
I give you my word.
After verifying her situation,
I've decided to perform Snipe surgery.
The operating surgeon
will be Dr. Tokai.
Dr. Tokai again?
He is skilled, after all.
What did you expect?
Got it, Dr. Tokai?
I decline.
You decline?
The surgery can't be done with the Snipe.
But if there's no other choice
and you need my help,
would you instruct me
to use the Saeki Method?
I don't care what you want.
The professor has found
the Saeki Method to be too risky
and has decided on Snipe surgery.
Got it? This is an order!
What's that?
So this isn't Dr. Saeki's
surgical department.
It's Dr. Takashina's, isn't it?
At the department I know,
all of our mitral valve operations
are done using the Saeki Method.
Nobody was ready to make the switch
when you brought that new toy in.
-Toy?
-Make the switch?
You're all really something.
After all those objections
you had at first,
all I hear now is "Snipe."
You've all done your homework, I see.
-Shut your mouth, Tokai!
-Dr. Tokai
Taking on difficult operations
and succeeding each time.
That's Dr. Seigo Saeki.
That's the Saeki Method.
If you're saying it can't be done
with the Saeki Method
but it would be possible with the Snipe
-You've admitted defeat.
-Tokai!
If you don't need them anymore,
give them to me.
Your black forceps.
Tokai.
I understand.
You have some serious nerve
mocking me
and the black forceps like that.
I assume you came prepared
for the consequences.
You're no longer needed.
You will not be involved in any surgeries
after this.
You have no right to be here.
Get out,
Dr. Tokai.
If it's the doctor's orders
SEISHIRO TOKAI
Now you're the only one who can operate.
Understood?
Yes.
As for the punishment given to Dr. Tokai
Pardon me.
Dr. Tokai.
Director Moriya asked me to tell you
that you should clean up
and be out of here in a month.
They told me to help carry your stuff
to the medical office.
What should I take first?
Do whatever you want.
You're no help.
Why did you say all that?
It's so heavy.
Hey, wait. What's this?
You can take my stuff out too.
What?
Nekota, wait. What's this about?
That Dr. Tokai
He's basically Dr. Saeki's right-hand man.
The surgical department
won't last long now with him gone.
Dr. Saeki has dug his own grave,
you could say.
This guarantees your landslide victory
in the election. In that case
When I win,
I'll leave you in charge of one
of my affiliated hospitals, Mr. Moriya.
It would be a great honor!
I'll be in your care.
-Hanabusa.
-Yes?
Give this to Dr. Tokai.
Me?
Please.
Excuse me.
Um, Dr. Tokai
Want some?
No, thank you, I'm fine.
This is delicious.
Isn't it?
I didn't think rice could be so good.
They say Japanese bodies are made of rice.
Forceps?
Dr. Takashina did countless simulations
in order to deal with Koharu's hemophilia.
To prevent hemorrhaging,
the incision in the heart
must be as small as possible.
The standard is 20 millimeters.
We'll try 12.
Twelve millimeters.
It's the same size
as the Snipe's diameter.
That's our limit.
Even one small slip of the finger
will tear the muscle
and cause massive bleeding.
It can be done in theory.
We'll operate in one week.
Perform more tests
on her blood coagulation.
-Right.
-Okay.
The truth is
there's less than
a five-percent success rate.
Five percent?
Before I finish my paper,
OVER LETHAL DOSE
we must save her.
No matter the cost.
-Soy sauce ramen.
-Looks great.
-Soy sauce chashu ramen.
-Thank you.
-Let's eat.
-Please enjoy.
So, no matter the results
of the operation,
your name will appear in the paper?
Yes. Those were my conditions.
Don't you think it's funny?
Elite adults like you would go
to such lengths for a single paper.
What we want isn't just the paper.
It's Impact Factor.
It really is true.
For a doctor, the Impact Factor
is really like your Michelin stars.
This restaurant became famous overnight
when it received its first star.
That's right.
But for us, those stars
also determine the chairman election.
That's why I'll do whatever it takes.
Even if it makes me look bad.
The winner takes all.
It's a good look. Scars and all.
TOJO HOSPITAL
DR. TOKAI
-Please excuse me.
-Sure.
I have something to ask of you.
Twelve millimeters is impossible.
The procedure will damage
the surrounding blood vessels.
Theoretically, it can be done.
We have to try.
In the days leading up
to Koharu's operation,
Dr. Takashina began to show his worry.
Don't worry, Koharu.
I'll help you get better.
I promise.
Promise.
Yeah.
Dr. Takashina is amazing.
He's doing tests, verifications
and simulations all day long,
then writing the paper at night,
and more testing, on his own.
When does he sleep?
I respect him, honestly.
At first, I thought he was
just a smart-ass.
-But he's way tougher than both of us.
-You're right.
Unlike that sloth Tokai over there.
That's supposed to be our nap room.
You're right.
Which room?
This way!
-What happened?
-Doctor.
Sudden heart failure.
-We need oxygen and a diuretic.
-Okay.
-Mask, please.
-Take over.
-You'll be okay.
-Oxygen, hurry.
Acute MR.
MITRAL REGURGITATION
He needs emergency surgery.
-We'll use the Snipe.
-Right.
Take him to OR one.
I've contacted the head nurse.
-Right.
-Okay.
I've brought the Snipe.
Let's take a look at the mitral valve
with ultrasound.
On screen.
Preparing to insert the Snipe.
Wait. I can see vegetation
on the mitral valve.
VEGETATION = BACTERIAL MASS
If we use an artificial valve,
the bacteria will get damaged and spread.
-We can't use the Snipe.
-Then what should we do?
The large arteries have calcified.
We can't stop the heart.
We must use the Saeki Method.
Don't be absurd,
Dr. Saeki isn't here today!
Um, this patient is Dr. Tokai's patient.
We must call him. He's the only one.
-Go now!
-Right.
We'll perform a central incision.
Get the heart-lung machine.
-Understood.
-Right.
-Take over.
-Miyamoto, take this.
Excuse me, Dr. Tokai!
There has been an emergency
in Operating Room one.
You have to come with me.
I decline.
What?
He won't come?
He says it's because he was ordered
not to get involved by the doctor.
-Can you put him on the line for me?
-Okay.
Excuse me
I'll put it on speaker.
Dr. Tokai, can you hear me? Dr. Tokai?
Be quiet. It's the middle of the night.
It's Mr. Murakami from Room 314.
He's your patient.
He needs mitral valve surgery now.
But we can't use the Snipe.
We must perform the Saeki Method.
We need you.
I told you.
The doctor ordered me not to operate.
But
You're the only one
who can help this patient.
-Blood pressure 50.
-He's in septic shock.
-Give him norepinephrine.
-Okay.
Dr. Tokai. I'm begging you to come.
Please, Dr. Tokai.
-Saline, hurry!
-Right.
Body temperature is at 39 degrees Celsius.
The vegetation is peeling off.
We must perform the Saeki Method now.
At this rate clumps of bacteria
will spread through the body.
We're out of time.
Dr. Saeki
The head nurse
-Miyamoto, a gown.
-Okay.
The doctor just returned from his seminar
and rushed over to assist us.
-Take over.
-Okay.
Fill me in.
Acute MR from infective endocarditis.
And vegetation on the mitral valve.
-That's why you can't use the Snipe.
-Yes, that's correct.
We'll remove the infected area
and repair the valves.
Pardon me.
-Scalpel.
-Clear the field.
-Where are those suctions?
-Sorry. Coming right away.
No need.
My finger will guide me.
The Saeki Method.
Metz.
Metz.
-Black forceps.
-Right.
Incredible.
This man really is a god.
Compared to Dr. Tokai,
He's
Professor!
Thank you so much.
Sorry for the commotion.
We tried to call Dr. Tokai, but
I told him to stay out of it.
There's no problem.
These were unforeseen circumstances.
You did everything you could.
Dr. Takashina.
Treatment doesn't always
go according to simulations.
If he's going to follow
the doctor's orders now,
I wish he would have agreed
to do Koharu's operation.
Dr. Tokai said
he has never let a patient die.
I was hopeful that Dr. Tokai
could take care
of Koharu's Snipe surgery as well.
Why did he decline that one order?
Isn't that why?
What?
Isn't that why Dr. Tokai said no?
MOM
What is it?
What's with you? Someone sounds sleepy.
Are you eating well?
Every day.
Japanese bodies are made out of rice.
How many times are you going to say that?
What do you want?
I sent some for you to give
to Dr. Saeki as well.
What?
He's taken good care of both
my husband and my son.
Make sure he gets it, will you?
-Bye!
-Hey, wait!
He's good.
He sure is. I bet you could do it too.
Hello, Koharu.
-Hello.
-Hello.
-Do you like soccer?
-Yes.
I'll be able to play soon, they said.
Dr. Takashina promised
to make me all better.
That's great.
When your surgery is done
and you're all better,
let's play soccer with Dr. Takashina.
Yeah.
So, as soon as the child's operation
is finished you'll have the paper, right?
Yes. I'm sure you'll be pleased.
Isn't it a dangerous operation?
If it fails,
Dr. Takashina will have to take
responsibility as operating surgeon.
The paper is nearly complete.
And so is Dr. Takashina's role.
If it fails,
we will just remove Dr. Takashina's name.
RICE
Why do you have so much rice?
Don't touch it.
Sorry.
Koharu would die of blood loss
within 24 hours of surgery.
I'll help you get better.
I promise.
Promise.
Dr. Tokai.
You're almost done with the paper, right?
If you are, I don't see the need
for doing this surgery.
It is true that whether we fail
or succeed,
it will not affect our seniors.
They only care about my paper.
I'm fully aware of it, too.
But this surgery
Koharu was born
with a deficient mitral valve
and I've seen her in pain.
As hard as I tried, I wasn't able
to give her the help she needed.
The reason I first
took an interest in the Snipe
was my hope to save Koharu.
The Snipe exists because of her.
After bowing down
and begging the professor,
I was able to bring it to Japan.
This time, betraying the professor
and swearing loyalty to the enemy,
I've finally made it
to the deciding moment.
If I can't save her,
neither the Snipe nor the paper
will be complete.
I've finally made it this far.
I've practiced the operation 30 times.
And all 30 times,
I killed her.
While it's feasible in theory,
with my current skill,
it's impossible!
I thought if we had the Snipe,
if we had the newest technology,
we would be able to save her.
Koharu is counting on me.
She believes in me.
I promised
I would save her.
But as things are,
I may not be able to save her.
I might end up
taking her life.
Dr. Tokai.
Use the Snipe.
And help me.
That's some excuse.
Why don't you kill her?
Or how about
you die yourself?
It's impossible with that Snipe.
Move it.
Dr. Tokai.
Why did you say it's impossible?
Do you mean to say
that even in your hands,
the Snipe would still fail?
No matter a surgeon's skill,
you can't operate with a dull knife.
The Snipe's blueprints.
Why do you have these?
The issue is that the body
of that thing is too large.
Those are Koharu's CT scans.
If we don't want to damage the veins,
we'll have to go through them.
Through the veins?
With a catheter?
If we enter the veins through her thighs,
we'll arrive at the heart.
But that route will lead us
to the right atrium.
RIGHT ATRIUM
The mitral valve is near the left atrium.
LEFT ATRIUM
MITRAL VALVE
A catheter can't go
through the septum wall.
That's why the Snipe was developed
to reach the mitral valve directly.
-Using a catheter is old-fashioned now.
-Listen to me.
We'll attach the Snipe
to the catheter.
The Snipe's artificial valve system
on a catheter?
There's a small tear in her septum wall.
We'll go through there.
If we can get to the mitral valve,
we'll only have to replace the valve.
Using a catheter like that
What's the point of new technology
if it can't be used?
Old methods have their strengths.
Medicine isn't always
about progress alone.
But there's still one problem.
A complicated operation like this
You're the only one who can do it.
I'm not allowed to.
You heard what the doctor told me.
So that's what this is.
From the very start,
you wanted to be the operating surgeon.
What will you do?
I have something
to talk to you about, professor.
I would like to request that Dr. Tokai
perform Koharu's Snipe surgery.
Please permit him to return
to the operating room.
Bowing your head for a man like that
Wasn't it you who wanted him out?
Please permit Dr. Tokai
to be the operating surgeon.
It's fine by me.
It was me, after all,
who ordered him to operate
with the Snipe in the first place.
Dr. Tokai will do the surgery.
There should be no issue.
In medicine, having the right tools
is a necessity.
But so is having skill.
Be there to assist him
and give him your support.
Of course, I will.
I promise we will succeed.
The fateful day finally arrived.
-Has it started?
-Soon.
We will now perform off-pump
mitral valve surgery using the new Snipe.
-Ultrasound.
-Here.
-Bring that closer.
-Okay.
Okay.
Dr. Tokai is really the operating surgeon?
-Guidewire.
-Here.
Snipe preparations complete.
-New Snipe, please.
-Okay.
I'm going in.
It's in. Take over.
-Catheter.
-Here.
They attached the Snipe's artificial
valve system to the tip of a catheter.
That should help prevent hemorrhaging.
Did Tokai ask you to hand over
the Snipe blueprints?
I was only helping to make
this surgery a success.
Arriving at the right atrium soon.
RIGHT ATRIUM
Already in the right atrium?
Who knew he could use
a catheter as skillfully as that?
We reached the right atrium.
They're in.
Next is the hard part.
They'll have to break through the wall
that connects to the left atrium.
It seems they planned on passing through
a small hole in the patient's heart,
but even a slight miscalculation
could cause a blockage
and lead to cardiac abnormalities.
And in this case, even sudden death.
Can they really push it
through something so narrow?
Dr. Tokai.
Proceed through the septum wall
on my signal.
When the hole is at its widest point
I'll give the signal.
SEPTUM - MITRAL VALVE
Not yet.
Not yet.
Now!
We're through.
SEPTUM - MITRAL VALVE
We're in the left atrium.
-Wow!
-They did it!
On top of Dr. Tokai's skills,
Dr. Takashina has the brains
and knows Koharu's condition best.
The best team.
All right. Now, to replace the valve.
We're at the mitral valve.
Dr. Tokai.
Valve replacement complete.
The valve is functioning!
-Yes!
-Amazing!
Amazing!
They did it.
I'll finish up.
Dr. Tokai.
Thank you.
We'll close up the septum hole.
-Take over.
-Okay.
What you said to me before,
is that how you really feel?
If you don't need them anymore,
give them to me.
Your black forceps.
Tojo University will be seeing
significant growth.
This is the transitional period.
You don't need to worry.
I just ask that you continue
to support me.
Believe in me.
I give you my deepest gratitude.
Do you understand it now?
It's more than just Teika's research.
Because of its practical use
at Tojo University,
the Snipe's potential has been realized.
If we work together,
your ideal world
where healthcare is provided
equally to everyone
can become a reality.
I will definitely make it work.
Believe in me.
I'll be looking forward to the paper.
Dr. Tokai.
Why is it that you're loyal
only to Dr. Saeki
and no one else?
Do you trust him that much?
Well, it doesn't matter.
So what will it be this time?
I'm ready to pay what you ask.
I'll lend it to you.
What?
Next time, it won't be money
that I'll ask you to pay with.
Don't believe him.
Dr. Seigo Saeki.
Don't believe him.
When he feels threatened,
that man won't hesitate
to cut ties with anyone
as he sees fit.
Anyone at all.
Even his closest allies.
Another fateful day arrived.
JAPAN SURGICAL JOURNAL
Forgive me. But you must understand.
Whatever punishment you choose to give me
I will accept.
I'll be excused now.
So everything is going according to
your original plan?
I'm impressed.
Unfortunately, that's a risk
I cannot afford to take.
But I'm sure Dr. Saeki will accept.
Just pretend to go along
with their proposal.
Use them to your heart's desire.
If the operation succeeds,
we'll have a great case in our hands.
With that, you'll be ready
to finish the paper.
The Impact Factor
will go to Dr. Nishizaki,
and of course, to me.
That's it.
I have no more use for Tojo.
There's an infection
in her heart's septum.
When the kid leaves, so do you.
May I use the Darwin?
Show them the real strength
of Teika University.
It's showtime.
Let's go.
Koharu has always believed in you,
Dr. Takashina.
You said we can change the rules.
The Darwin research
can't be taken from us.
Dr. Takashina is off the team.
Move it!
I want to change the world
of Japanese medicine.
Aren't things working out well for you?
Pretty words alone
can't save a single life.
This is nothing.
Watch me do it.
Subtitle translation by: Tom Grathwol