Original subtitles

Tojo University's newest member,

the incredibly skilled surgeon Dr. Amagi, completed a public operation

where he demonstrated and successfully completed a direct anastomosis surgery.

Operation complete.

The heart is so beautiful.

Dr. Saeki, who is currently developing a new hospital, has nominated Dr. Amagi

to be its director.

However,

not everyone was thrilled at the prospect

of the unconventional Dr. Amagi becoming president.

Placing bets on patients?

A new cardiac surgery hospital is being planned.

The reason I came to Japan…

is to make it mine.

Since when was the new hospital named "Cerisier something-something?"

It's a nice name, don't you think?

All things have a set procedure.

While I did nominate you as director of the center,

I haven't approved your full responsibility yet.

Full?

The Sakuranomiya City Medical Association and the local business union.

How silly.

Just create a fait accompli beforehand.

Why wouldn't I be allowed to pick a name I like?

It won't be understood in this island country.

-Put it back. -If that's so…

Let's host a public operation.

We'll hold it here at the end of the month

and announce it to members of local associations.

Seeing is believing.

You'll have to find a patient. We don't have time.

-Can you do it? -Of course.

I will present them with an incredible show.

We get to see Dr. Amagi operate here at Tojo?

That's so awesome!

So, have they selected a patient?

They've selected a woman named Toshiko Kajitani.

A patient who transferred from the municipal hospital.

Is there a problem?

Mom keeps saying her left shoulder hurts.

What's happening?

But we've given her painkillers already.

I don't care.

She's saying it still hurts.

Well, she does have a cognitive disorder.

What?

Are you calling my mother a liar?

Are you denying her help because she's on welfare?

-Of course not. -Forgive me.

We'll give her more painkillers.

I'll administer it now.

-Thank you. -Do it.

Why didn't you just do it from the start?

Right this way.

I've brought the guest.

Professor Sugai…

Excuse me.

Dr. Takashina, wait.

I want to discuss something with you.

As an apology to you,

I had her prepare this VIP room for us.

Here you are.

I don't gamble.

Horse races are all about information.

Pedigree, jockeys, course familiarity.

By analyzing the data, you can predict the winning horse.

We analyze a patient's test results to predict their condition.

It's just like what you always do.

-Go! Yes! -Just like that! Number 14!

-Go! You got this! -Keep going!

-You can do it! -Go!

Go, number 14!

-Why? -What are you doing?

That's the most popular horse.

The data says that number 14 is the most popular horse.

And you, Ms. Shiino?

Number eight? A winning ticket?

Why did you choose an unpopular one?

Sometimes the data tells us not to follow the data.

You'll lose if you're too passionate about the bet.

Isn't that right, Professor Sugai?

Doctors who place bets are no good.

You, Dr. Takashina,

are more cut out for this.

This is a friend of mine

who runs a company called Mizuno Iron in Sakuranomiya City.

Yuichi Mizuno, angina pectoris.

He needs bypass surgery.

His symptoms aren't critical yet.

The problem, however…

The symptoms appeared after surgery for a malignant thymus.

So you mean normal bypass surgery

will be difficult because they've removed his internal mammary artery?

That's right.

Dr. Amagi would be pleased, I'm sure.

Right you are.

YUICHI MIZUNO

TOJO UNIVERSITY HOSPITAL

We've been waiting for you, Mr. Mizuno.

You're Dr. Takashina, I presume?

I heard from Professor Sugai.

Nice to meet you.

The pleasure is mine. This way, please.

You have already been checked in.

-This is quite a lively place. -Yes.

Here are the records on Ms. Kajitani for the meeting. Please give them a look.

These CT scan results aren't from our hospital.

Oh. These are from the municipal hospital.

We received them from her son.

It says she had an operation for esophageal cancer five years ago.

There's no indication of that in these images.

We'll have to examine it ourselves.

As we feared, the CT scans for Ms. Kajitani were from over five years ago.

And the current situation…

A total LAD blockage?

That's why her left shoulder hurts.

Using a catheter may be difficult too.

Wait. Here. The esophagus has been repaired in front of the heart.

We won't be able to operate through a median sternotomy.

YUICHI MIZUNO

COMPANY PROFILE

Excuse me.

Dr. Amagi, may I have a minute?

Forgive me. I have plans.

This is the candidate for the next public operation.

We think that if you operate,

they may stand a chance.

Sorry, Juno. This patient is a total loss.

What?

No, wait.

The patient is receiving welfare.

So that's what's going on.

Come in.

It's wonderful you're dedicated to your work,

but don't forget that your heart is in ruins.

-Who are you? -Pardon me.

I'm the director of Cerisier Heart Center.

My name is Amagi.

I've received word about your operation.

I see.

Oh, you're the doctor who did the public operation.

But I thought Dr. Takashina would be operating on me.

Yes.

Dr. Takashina is a fine surgeon.

However…

he's not number one.

Because you've had heart surgery for thymoma in the past,

a normal operation will be difficult.

Even if we succeed, your mammary artery has been removed.

Within a few years, well… You would die.

Even so, no need to worry.

My direct anastomosis can save you.

OPERATION CONSENT FORM

But there is one condition.

-Condition? -Yes.

You'll have to bet

half of your assets.

You run quite a big business.

Based on your personal wealth,

I'm sure you could miss at least one billion.

One billion?

Your money, or your life?

Which is more important?

Right?

What do you say?

What they say about you is true.

Ripping his patients off their money,

a doctor like the devil himself.

It's all clear to me now.

You're not cut out to be the director of the new hospital.

Isn't that right,

Dr. Takashina?

Unfortunately for you,

Dr. Amagi.

Mr. Mizuno is involved in the new hospital.

He's the director of the local business union.

I'm glad I got to see your true colors.

-That's what this is about? -At the next board meeting,

I'll be making an appeal to rescind your position.

Prepare yourself.

-Let's go. -I want to eat sushi.

Sounds good! Let's go.

-What's your favorite? -Salmon.

Salmon?

Excuse me.

Ms. Toshiko, how's your shoulder--

When is my mother's surgery?

Forgive me.

Please give us a bit more time.

What you really mean is you want to send her to another hospital, right?

I know it's true.

All the hospitals say the same thing.

They all say "We can't help her," or come up with some excuse.

The rich are a higher priority!

That is not true.

Right now,

we are researching the operating method.

Please wait a bit longer.

Please trust me.

That patient scheduled for bypass surgery?

Yes.

But the traditional method will be difficult.

Didn't you ask Dr. Amagi?

He turned it down.

Dr. Takashina.

Can't we use the Darwin to help her?

I see.

It is possible,

but this patient is on welfare, right?

Yes.

I'm sure you know this, but the Darwin is an advanced medical procedure.

It isn't covered by welfare.

I want to help her,

but financially speaking, it might be difficult.

It's always money, huh?

-Juno. -Yes?

Have you found our patient?

Not yet. Take a look at this.

This is Dr. Takashina's patient.

Are you trying to snatch them?

He sure looks like he has money.

-You're prioritizing him, right? -No.

The patient's life is my first priority.

That Mr. Snipe always takes my patients.

I'll find a patient myself.

Find a patient? Where?

Where all the patients go.

SAKURANOMIYA CITY MEDICAL ASSOCIATION

Are you well-connected with the medical association?

No. But…

money always talks in places with a vested interest involved.

Money again?

Sorry to interrupt you.

My name is Amagi.

I'm Sera from Tojo University.

I'm Shingyouji.

What brings you here?

I'm looking for a patient for a public operation.

I hoped you have a patient in one of your hospitals

whom you could introduce to us.

In such a case,

I would be happy to compensate you.

Preferably, I would like you to find me a very wealthy patient.

You…

Do you really think all people in positions like mine

can be manipulated by money?

How utterly disrespectful. You've underestimated me.

I've heard rumors about you.

I've heard…

A greedy doctor who rips off his patients

has come to Tojo.

This city's medical association will have no business with a doctor like that.

Leave.

Making the medical association your enemy is so risky.

Why?

They're the core of the medical world.

They likely control the personnel of the new hospital too.

That's how all those bad rumors about you are getting around.

-Excuse me, what did you say? -Right…

"People only throw stones at trees that bear fruit."

To say it with a Japanese proverb,

"The nail that sticks out gets hammered down."

But…

the jealousy of ordinary people…

is truly futile.

So what will you do?

For your next public operation.

Well… I'll leave it to fortune's favor.

Go pay with this.

Thank you.

I'll use the rest of this cash to go on vacation.

Vacation?

Wait a minute. Why? Now?

The most important parts of running a business

are trust and teamwork.

The selfish ones like him will ruin the organisation.

Dr. Amagi has no more hope for his public operation.

I owe a great deal to the medical association.

Director Shingyouji.

Skilled doctors occasionally show reckless valor.

We cannot let dangerous doctors run freely.

You are correct.

Dr. Takashina,

or should I say, Director of the new hospital?

For the public operation, let us use the Darwin

and carve out the future of Sakuranomiya City.

Yes.

That's what I hope for.

If Dr. Amagi doesn't return in time for tomorrow's conference,

please permit me to complete the public operation.

You? The public operation?

Yes.

The patient will be the director of the Sakuranomiya union, Mr. Mizuno.

We'll use the Darwin to operate using a new method.

It should generate some buzz.

Very well.

I'll allow it.

Thank you.

YUKIHIKO AMAGI

Does it hurt when I raise your arm?

It looks fine.

When does it hurt, Ms. Toshiko?

I'm sorry.

Forgive me, Takatoshi.

I'm sorry I can't always be with you.

I'm sorry.

Are you Dr. Amagi?

Dr. Saeki told me I might find you here.

I guess he's not here.

-Dr. Sera! -You scared me.

Come, now! There's an emergency patient.

What?

-Who's on duty? -The thing is, he asked for you.

-The doctor will be here soon. -Over there?

-Yes. -Not you.

-Excuse me. -Dr. Sera.

Sorry.

Mr. Kajitani?

Woah.

What happened?

I'm going to touch it.

Can you feel this?

Why didn't you call an ambulance?

I didn't want to be taken to some random hospital

and be charged a bunch of money.

-It's free for welfare recipients. -You fool.

It's my mother who's on welfare.

I work my ass off.

Can't you tell by my uniform?

Right.

-We'll have to bring you in right away. -Wait.

I don't need an anesthetic or anything like that.

It's expensive to get anesthesia, right?

I can handle it. Just…

-Just sew it up for me. -Don't take these wounds lightly.

If this gets infected, you could die.

If you die,

what will happen to your mother?

Fine.

Do what you have to do, doctor.

Okay.

You can't use worker's compensation?

You were injured at work.

If I do that,

I'll be fired immediately.

I don't have anywhere else to go.

I have no choice but to do dangerous work.

Really…

I wish…

we could have lived together forever.

But I can't afford to pay for Mom's care by myself.

So you separated households and got her on welfare?

I know I'm making her uncomfortable.

But you see,

I'm giving all I have to my job.

Doctor.

Please help my mother to get better.

Please.

If so, leave it to me.

Dr. Amagi.

I'll operate.

But it will be a public operation.

But you said it was impossible earlier.

She's on welfare. It's too expensive.

I didn't say anything about welfare.

-What? -However.

There is one condition for her to receive surgery by me.

Condition?

You'll have to win a 50-50 chance bet.

The wager is half your assets.

A bet?

I don't have anything to bet.

I know that.

Your mother's assets are zero. Half of that is still zero.

In other words, it will be done for free.

Really? You'll do it for free?

In return,

you, her son,

must bet your life.

What?

We will perform on-pump surgery for the tricuspid valve.

Dr. Amagi isn't here after all.

No matter his skill,

if there is no patient…

Anyone else have any announcements?

Dr. Takashina.

It appears Dr. Amagi won't be in attendance,

so I would like to present the public operation.

Dr. Takashina?

A public operation?

Go ahead.

Sorry to keep you waiting.

Dr. Amagi.

Hello, Dr. Takashina.

You started it for me.

How kind of you.

I would like to tell you about the public operation.

The patient is Toshiko Kajitani, 80 years old with angina pectoris.

We will perform bypass heart surgery using direct anastomosis.

I've just finished explaining the procedure to her family.

Here is the consent form.

Isn't that patient on welfare?

You plan on operating for free?

On that note, Dr. Takashina's assistance

is not needed.

Sorry to tell you, Dr. Amagi,

but direct anastomosis will not work for Ms. Kajitani.

Did you not notice?

TOSHIKO KAJITANI

Ms. Kajitani has a history of esophageal cancer,

so we can't perform a normal incision.

We must enter from both sides.

We will then empty her lungs with the heart-lung machine.

But Ms. Kajitani…

also has…

a history of brain hemorrhaging.

Because of a high risk of hemmorrhage we can't use a heart-lung machine either.

Your operation isn't possible.

The Darwin is our only chance.

I can't believe Dr. Amagi made an oversight.

Do you still plan on operating?

Excuse me.

Ms. Shiino.

We've received consent from Ms. Kajitani to use a nitric oxide synthase inhibitor.

Thank you.

Nitric oxide synthase inhibitor?

Just like Dr. Takashina said,

a normal operation won't be possible.

This is the candidate for the next public operation.

WELFARE RECIPIENT

ESOPHAGEAL CANCER BRAIN HEMORRHAGE

So what did I do?

Are you Dr. Amagi?

Dr. Saeki told me I might find you here.

Here are the documents about the clinical trial medicine.

NITRIC OXIDE SYNTHASE INHIBITOR

I placed a bet on clinical trials.

If we use the nitric oxide synthase inhibitor…

BLOOD OXYGEN LEVEL

…even while the lungs are collapsed,

we can maintain blood oxygen levels,

making the operation possible.

Hear that?

Well,

all under God's guidance.

It seems theoretically sound. That concludes the conference.

Dr. Amagi, about Ms. Kajitani.

Thank you very much.

It was my mistake to assume that you declined because of the welfare situation.

Forgive me.

I'm so relieved.

Even though the Darwin surgery was too expensive,

Ms. Kajitani will receive your operation.

Well, Juno,

it sounds like you think everything has been resolved.

True, if we use the medicine, the operation will be possible.

But the success rate of this operation

is still zero percent.

What?

So as expected, Dr. Amagi knew of the risks after all.

So it will be Dr. Amagi's one-man show again.

No, that isn't necessarily true.

What?

Yes, the medicine makes the operation possible.

But there is one more big risk.

The public operation may fail?

Yes.

Which means…

DAY OF THE PUBLIC OPERATION

Here, please.

YUKIHIKO AMAGI PUBLIC OPERATION

-Mr. Mizuno. -Greetings.

What's this?

I'm surprised to see you've come to see your enemy in the spotlight.

Well… I wouldn't miss such an exciting show.

It might…

Yes, I see.

Let's sit back and enjoy the show.

Juno.

Juno.

It's time.

Okay.

Dr. Takashina.

I've prepared the Darwin in operating room two.

Are you sure we'll need it?

I want to be prepared for anything.

We can't let the patient die in front of all these people.

Thank you for waiting, everyone.

Preparations are complete

and we'll now broadcast from the operating room.

YUKIHIKO AMAGI PUBLIC OPERATION

Ladies and gentlemen,

thank you for being here today.

Feast your eyes on a world-first operation.

This time, I would like to try something new.

I'll set a time limit of 30 minutes.

Please enjoy this thrilling show that results from having a time limit.

What is this?

This time, incisions will be made from both sides,

and the right mammary artery

will be connected to the coronary artery.

The doctors will have to open the chest, perform the operation,

and close the patient back up within 30 minutes.

NITRIC OXIDE SYNTHASE INHIBITOR

All set.

Dr. Amagi, we're ready.

Now then. Let the show begin.

-Tweezers. Scalpel. -Right.

Tweezers.

-Scalpel. -Here.

-A time limit? -Just one mistake and they're through.

Is this a joke?

Putting a life on the line?

No.

Dr. Amagi knew of the risks involved with this medicine.

What?

Is there a problem with it?

The effects of this trial medicine they're using

only last 30 minutes.

CLINICAL TRIAL MEDICINE SAFETY AND RISKS

Effective for 30 minutes?

So you plan to use the Darwin as a backup?

Right.

If it's within the time limit,

the medicine will continue to work even if we collapse both lungs.

I see.

So that's why Dr. Amagi set the time limit?

Five minutes elapsed. Two minutes behind schedule.

Left opening complete. Tweezers.

-Right. -Juno.

I don't have time to wait for you today.

I'm sorry.

-Think you can speed it up a bit? -Yes.

-Let's go. Metz. -Here.

He's fast.

Dr. Amagi's real strength.

Graft removal complete.

We'll move to mammary protection.

-Right. -Right.

-8-0. -Here.

They completed the connection so fast.

Can they really do this in 30 minutes?

Next is direct anastomosis.

But…

TIME REMAINING

Direct anastomosis in 15 minutes?

It takes 15 minutes to close the chest.

They won't make it.

Fools.

A pointless struggle.

Even Dr. Amagi wouldn't make it in time…

What will they do?

-Ready? -Yes.

What?

What's this?

Juno, it sounds like you think everything has been resolved.

But the success rate of this operation is still zero percent.

What?

That's why this time…

I want you to operate.

Now, the real fun begins.

I'm ready.

We will now perform a MICS off-pump direct anastomosis operation.

-Tweezers, Metz. -Right.

-I'll close the right side. Tweezers. -Here.

3-0, please.

Dr. Sera?

It can't be.

Direct anastomosis and closing the chest at the same time?

At the same time?

-Micro tweezers. -Here.

-8-0. -Okay.

Ridiculous.

Stitching the coronary artery with such a narrow line of view?

-Metz. -Here.

Operation complete. The heart is so beautiful.

The heart is so beautiful.

Less than three minutes.

-Up to you, Dr. Sera. -Right.

-3-0. -Here.

Less than two minutes.

-Water, please. -Okay.

Thirty seconds remaining.

Ten seconds.

Only ten seconds.

Seven seconds!

Finished.

They really did it…

in 30 minutes.

Put the Darwin away.

I want to say "good job," but we're not done yet.

Let's go, Juno.

What?

Hold on…

-They got us. -No.

A barbaric operation like this.

I won't accept it.

I'll have them sued at the next board meeting.

Thank you for watching our operation today.

I would like to ask a favor of you all.

You see,

today's patient was a welfare recipient,

unable to afford the high price of surgery.

Because of that, I would like to ask for your help…

by requesting donations.

I'm sure some of you may think this is unreasonable

but for the sake of the new hospital,

which will continue to save thousands of lives, from the bottom of my heart,

I hope you are willing to lend a hand.

Huh?

What?

Okay, okay.

-What is it? -Go collect the money.

What?

If you don't, today's operation will be free.

-Now? -Yes.

-With this? -Yes.

-In here? -Hurry.

Seriously?

Everyone,

please place your donations in this bag.

Thank you.

Thank you for your support.

Well done.

Thank you.

-Good work! -A marvelous surgery.

-Thank you. -I'll support you!

-Your donation, please. -I'll pay you!

Good job!

-Thank you. -I'll support you.

-Do your best! I'll root for you! -Well done.

You did good.

-Thank you. -Here's mine.

Ladies and gentlemen,

if I could have another minute of your attention, please.

This photograph

is of a patient who was admitted last week in an emergency.

He was admitted after a metal pipe burst

and deeply pierced his thigh.

As a matter of fact, he is the son of today's patient.

He surely was very worried about today's operation.

While I'm sure he wanted to be here, the harsh reality is that

he had to make money to pay for the operation.

Even after sustaining such an injury,

he would still have to work.

The reason is…

he was denied worker's insurance by his employer.

But the problem is…

What's regrettable

is that his employer,

a participant in the new hospital project,

is none other than Mizuno Iron.

To think that a company denying the safety of its workers

is involved in the new hospital project…

I believe this issue…

might have to be brought up at the next board meeting, should it not?

-Pardon me. -Hey.

Sugai, wait!

Sugai!

What?

President Mizuno.

You were watching the operation?

Stop wasting time and go get your surgery.

You won't be able to receive Dr. Takashina's Darwin surgery

if you're on welfare.

Take care.

Mr. Mizuno--

What is this about?

Tell us the truth!

Doctor.

Thank you for joining us today.

It has been a while,

Dr. Shingyouji.

TOSHIKO KAJITANI

Mom.

It turned out well.

Thank you, Takatoshi.

I'm happy to see her doing well.

I cannot thank you enough, doctors.

You got lucky this time.

If you spoke of this,

you'd be called a traitor and would be fired immediately.

You showed determination.

Here are the donations we received from the operation.

What?

Money?

We hope it will support you while you look for a new job.

What?

Thank you.

You're almost like a god.

No…

He has taken his own cut, you know.

Juno.

What?

CERISIER HEART CENTER

What? Here?

You're building it here?

Cerisier is French for cherry blossom.

I want to make a cherry blossom grove here.

I see.

-So that's why you named it that. -Yes.

Cherry blossom trees have a life span of 70 years.

Does that length remind you of anything?

What?

It's the same as people.

I want to create a hospital

that cherishes both the lives of people and the sakura trees.

We still have a lot of work to do.

As doctors.

That's right.

This is clearly a scam.

Should I yield to political power?

You won't be able to work as doctor in Japan.

-How long have you been dating? -Mom!

Feel free to go ahead and die.

This is the medical AI, Elcano.

Did you earn Impact Factor?

Obey the Elcano!

You must face the patient in front of you.

It means Tojo University killed them.

Dr. Amagi, what do I do?

Surgery is imagination.

Subtitle translation by: Tom Grathwol