Original subtitles

An incredibly skilled cardiac surgeon has come to Tojo from overseas.

Dr. Yukihiko Amagi.

Dr. Amagi decides whether or not to operate based on a gamble.

A devilish man who makes his patients bet half of their assets.

You must bet your life.

He's the only person in the world to perform a complicated operation

called direct anastomosis.

He succeeded at doing it during a spectacular public operation.

The heart is so beautiful

With this, the planning of Tojo's new hospital project,

the Cerisier Heart Center,

was well underway.

Next week's operation is decided,

and I've gathered one hundred million five thousand yen in donations.

I'm happy to hear it.

With this, we'll be able to officially proceed with the construction plans.

Good. I'm counting on you.

It's almost time.

First, we have to fix this design.

Fix it?

SAKURANOMIYA CARDIAC SURGERY CENTER

Hey.

This is a tentative design, right?

It's incredibly tacky.

Tacky?

Oh.

Editor-in-Chief!

Professor Sugai!

Last month's report was truly eye-opening.

An operating method using AI?

-Yes. -That should get you some Impact Factor.

Thank you.

However, it would seem the association is expecting a lot from the new hospital.

With one new hospital, Dr. Saeki could become president of the association.

If you don't do something,

the value of Impact Factor will drop significantly.

Professor Sugai. I'm counting on you.

Excuse me. Dr. Amagi.

-This is bad. -Juno.

-Let me enjoy my morning. -That lawyer Kazuko Tojima is here.

PROTECT THE FUTURE OF MEDICINE.

Kazuko Tojima?

Tojima? Who's that?

A famous lawyer in the medical world.

MEDICAL LAW EXPERT KAZUKO TOJIMA

Medical lawsuits?

There's another absurd dispute going on.

They don't like your methods.

The detailed report came in yesterday.

I was discussing the response with our lawyer,

but I was caught off guard.

A scam?

Atty. Tojima…

We were told we have until next week to reply to your demands.

I have confirmed Dr. Amagi's schedule

and I know he is supposed to perform an operation next week.

Will you hear me out?

Certainly.

Dr. Takashina and Dr. Kurosaki are taking care of it.

Then I'll go shut them up.

It will only make things worse if you go.

If she sues you, Tojo's reputation will take a hit.

And the new hospital project

will remain a dream.

Thank you for waiting.

Let us begin.

GROUP CALL

We've received many complaints that Dr. Amagi is deceiving patients.

To prevent more people from falling victim,

we request that Dr. Amagi be prohibited from performing surgery.

These are our demands.

A scam? I don't think that is--

I have reports on his latest coronary artery bypass surgery.

Due to the patient's ischemic heart disease,

the coronary artery was anastomosed directly?

Identifying the issue in such a narrow space is difficult

and poses an extremely high risk for the patient.

By bypassing the internal mammary artery and coronary artery,

the surgery can be easily completed without removing the veins.

-She knows her stuff. -Her medical knowledge is incredible.

Hey. You can't be here.

-I'm just using the bathroom. -Yeah, right.

Don't worry. I'm not interested in this discussion.

-Hey. Wait up. -Move it. I might leak.

However, Dr. Amagi said

that direct anastomosis was the only possible option,

and he demanded a great deal of money from the patient.

This is clearly a scam.

This concludes our allegations.

We have also received the supervision of Ishin University's top doctor,

Professor Sugai.

Professor Sugai?

Firstly, there seems to be a misunderstanding in your allegations.

Pardon me, but who are you?

Yes, right. Forgive me.

I am an Associate Professor in cardiac surgery, my name is Kurosaki.

Associate Professor?

That's who Tojo has sent to deal with this matter?

What?

We consider this matter

to be a major crisis for the entire medical society of Japan.

And yet,

Tojo University thinks it can be settled by an associate professor?

Is that what you're telling me?

Where's the director?

Yes! Where is he?

The director had prior commitments.

He's--

This is a hospital!

Perhaps you could let us hear the opinion

of the person you have on the phone.

What's this about?

The director is listening, isn't he?

Put him on the line!

Everybody, please calm down.

Please let me explain.

It would appear staying here any longer would be a waste of our time.

I'm Director Saeki.

Forgive me. I had an emergency operation.

Oh sorry, wrong room.

Where's the bathroom?

You're Dr. Amagi, correct?

We would love to hear from you.

I'm sorry, I didn't mean to come in here.

-Answer them. -If you insist, sir.

Go ahead, Mr. Amagi.

We are skeptical of the method called direct anastomosis

and believe it is a dangerous and irresponsible operating method.

Can we hear your opinion?

All of my direct anastomosis operations currently stand at a success rate of 100%.

Where is the danger you mention?

You, Mr. Amagi,

trick your patients into believing your method is the only way

and demand half of their assets, it seems.

I do not trick them.

That's just how valuable my operations are.

We also hear you are placing bets with your patients.

Right, I'm sorry.

I didn't explain about that.

Heads.

Tails.

Pick a side.

-Why do you think I would-- -Oh?

So you don't like losing?

Heads.

Too bad.

That means you're dead.

You need God on your side to receive surgery from me.

That's nonsense!

So you're telling me,

the rumors about you

are all true?

It doesn't matter.

I have never

gone against any of my beliefs.

I understand.

We have reason to believe Tojo University has violated Article 246

of the Penal Code regarding fraud.

We will begin preparing a lawsuit.

Anything else to say?

A lawsuit?

Dr. Amagi's operations

will be canceled immediately.

Sir…

Regarding the other issues,

I would like to consult my lawyer before moving forward.

We at Tojo sincerely apologize for the trouble we have caused.

That went well, didn't it?

Why don't you all go ahead?

Should I yield to political power?

Hey! Can't you see Dr. Saeki just protected you?

If Atty. Tojima does file a lawsuit,

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

This is extremely risky

for both you and Tojo University.

If you want to keep your role in the new hospital,

you can't afford any risks.

Well then,

I'll be leaving for a while.

-Dr. Kakitani, we're meeting our lawyer. -Right.

Sekikawa, you and I will go ask for cooperation from the Medical Association.

Okay,

We don't have much time.

Yes, sir.

What is this about?

It's entirely by accident that you happen to work here.

Mom…

Are you really going to sue us?

Of course I will.

This hospital is wrong.

You should resign at once.

Working here with Dr. Amagi and playing a role in his scam…

Can you really say with confidence that your work is just?

I…

I…

This is…

my job is…

Excuse me.

Dr. Sera.

It is true that Dr. Amagi can be easily misunderstood.

But he is not deceiving people.

His operations work.

You won't get far without objective proof.

Either way, you'll be hearing from me again soon.

Mom…

So, Atty. Tojima is your mom?

She goes by her maiden name, Tojima, even after her marriage.

Mom?

Mom!

-Are you all right? Can you hear me? -Mom!

-Mom, can you hear me? -Are you all right?

There is a 99% blockage in her right coronary artery.

She'll need surgery right away.

-It can't be… -But Dr. Amagi and the others are…

They're not here right now.

I've had a lot of experience in bypass surgery.

May I operate?

Please help her.

We will now perform coronary bypass surgery for unstable angina.

Yes, sir.

Tweezers.

Scalpel.

-Electroscalpel. -Here.

It feels hard.

What's wrong?

Heavy calcification in the anterior descending artery.

-Beaver scalpel. -Here.

-It's no good. -What?

If we continue like this, we could damage the coronary artery.

We can't create a bypass.

But… we've already opened her up?

Doctor!

Dr. Sera!

We'll bypass the right coronary artery and close the chest.

-Right! -Bring the partial clamp right away.

-Yes, sir. -Hurry everyone.

Ms. Hanabusa.

I'm so sorry.

I wasn't able to help.

-No, it's not your-- -Forgive me.

It's not your fault.

With calcification like that,

a bypass would only have caused hemorrhaging.

If we can't perform coronary bypass surgery…

Direct anastomosis.

It's the only way, right?

I'll talk to Atty. Tojima.

The operation failed, didn't it.

This won't be easy to say,

but the bypass procedure we had planned isn't possible.

To fix your heart,

direct anastomosis is the only option.

Please accept Dr. Amagi's operation.

Please.

You can't decide for me.

Well, you'll have to win a bet

and offer half of your assets in order to get me to operate.

You…

You're not a doctor.

You're a con man.

I won't.

I will not accept surgery from you.

Well then,

Well then, feel free to go ahead and die.

Why do you have to talk like that?

What?

Did I say something wrong?

Will changing my attitude help save patients' lives?

Don't be scared of a little calcification of the artery.

Right.

Don't worry about words, Juno. Work on your operating skills first.

There was a risk of hemorrhaging.

So what?

Listen.

There are plenty of ways to save a patient.

The problem is…

you just don't know how.

I heard about Atty. Tojima.

How the tables have turned.

This is our chance.

You ought to remember the key to victory.

The gambler obsessed with money. That's our opponent's weakness.

The skilled player exploits that weakness and spreads rumors,

incites civic groups,

and infiltrates the enemy's stronghold.

The patient collapses.

The enemy has made a mistake.

That's the time to strike.

Ms. Hanabusa!

What is it?

-Your mother was just released. -What?

Hello?

You've been released?

I'm sorry. There's something I have to do.

-What? -I'm hanging up.

I'm busy.

Mom. Wait!

ISHIN UNIVERSITY

We've been waiting.

What the hell?

I believe that for me, this is a trial,

and an obligation.

We, at Ishin University,

have decided to perform bypass surgery,

fully covered by insurance.

The operating surgeon will be Dr. Noda.

Invented by Ishin University,

this is the medical AI, Elcano.

By feeding it patient data,

it instantly gathers reports from around the globe

and analyzes the most appropriate method for performing the surgery.

It then leads us through surgery using advanced video analytics.

A doctor's control tower, you might say.

Removing the need for brilliant doctors…

If this succeeds, Dr. Amagi is toast.

Can they perform the bypass with all the calcification?

This is dangerous.

Hey, Dr. Sera.

I would like to offer my body as a test of this new technology.

We would like to explain the details of this new AI-powered surgery.

-Dr. Noda. -Please watch this.

According to the analysis,

this data from research at the University of Massachusetts,

shows that using an angiogenic agent as a medicinal cure

falls under insurance and is the ideal treatment

for the most appropriate approach.

After regenerating the blood vessels,

it is possible to bypass the new vessels.

Did the data mention anything about direct anasto… something or other?

Not a word.

My heart…

I was told only Dr. Amagi could fix it.

He really is a con man after all.

Thank you. I understand.

Please sign here.

I, too,

have one condition.

Condition?

Please hold a public viewing for my operation.

The reason I'm entrusting you

is to bring justice to medicine.

In order to finally prove that other methods are possible,

and to show that doctors like Dr. Amagi aren't needed.

It's important.

Am I wrong?

No. You are exactly right.

Very well.

Behind our backs,

this discussion was taking place.

Meanwhile, Ishin University conducted clinical trials

according to the data of the cutting-edge AI tool Elcano,

and they were able to resolve the calcification issue.

Using this AI technology,

they published a report on a method possible for any doctor to perform.

PUBLIC OPERATION ANNOUNCED

Ishin plans to regenerate blood vessels, and perform a regular bypass surgery.

AI sure is something.

-Yes. -It was a good experience for you, Juno.

Yes, it was.

Doing that won't help improve your operating skills.

-I won't improve if I don't practice. -No.

It's not skill that you need. It's art.

-Crap. I have to go. -What's wrong?

I have to meet Ms. Hanabusa and Atty. Tojima.

A date?

-With her mom too? -It's not like that.

Dr. Kurosaki has asked us to put an end to this.

You're putting in a lot of effort for a job that doesn't pay.

Good luck.

So this "art" you're talking about,

is it all for money?

See you later.

I guess your procedure was right after all, in a way.

Well…

Thank you.

So, how long have you two been dating?

-Oh, no… -It's not like that between us.

We're just coworkers.

It's true.

I'm just her coworker.

Really? You'd make a good couple.

Actually,

we have something to ask of you.

Please.

Please reconsider the legal action against Tojo.

I'm asking too.

You're being used as a guinea pig for AI.

-You don't have to do this-- -Didn't I tell you to resign?

Someone will get hurt by Dr. Amagi's careless methods.

I have to protect them.

I have to fight for justice in the medical system.

You're always like this.

Mom.

Justice.

What is justice anyway?

Is that…

more important than your life

and than your own family?

Yes, it is.

Humans are weak.

That's why…

justice is precious.

I respect her, you know.

My mother.

She always…

helps the weak.

She stands for justice.

She's strong.

When she talks about helping people.

Using justice as a shield,

what can I say against that?

My mother.

She's always right.

She stands for justice.

What is justice anyway?

I don't want her to die.

I would pay any price to help her.

I want to help my mother.

-Good night. -Get home safe.

CERISIER HEART CENTER

You love this place.

I wanted to show you the finished blueprints.

What?

Amazing.

An ocean view from every window.

Including the operating room.

The deep blue ocean spreading out, right outside the window.

Seagulls soaring freely high in the sky.

And a row of cherry blossom trees along the seaside.

I can't wait to see it.

I've never heard of a doctor doing architecture before.

Listen, Juno.

Even I will die someday.

But…

the building won't.

Architecture is…

like a song.

Tourists visit the Colosseum

to listen to songs from people of the past.

I want to make Cerisier Heart Center that kind of place.

A place where people will gather to hear music long after I'm gone.

That's the kind of hospital I want.

Can you imagine that, Juno?

Finally, the fateful day of the public operation arrived.

What you will witness today is our revered medical AI technology,

an operation born from the data gathered by Elcano.

PROTECT THE FUTURE OF MEDICINE

We will operate based on Elcano's analysis and instructions.

Regarding the anterior descending artery--

Today,

this AI will wipe the names of genius doctors

out of the history books.

We'll see how it goes.

…and perform bypass surgery.

Let's begin.

Please refer to the 3D imaging.

3D imaging, okay.

Please refer to the electrocardiogram.

Electrocardiogram, okay.

Please check the patient number.

Patient number, okay.

Preparations complete. Patient 259063.

Please begin coronary bypass surgery.

Roger.

Following Elcano's instructions,

we will now begin coronary bypass surgery.

Tweezers. Scalpel.

Internal mammary artery detachment complete.

Please begin anastomosis.

This is the blood vessel.

-Roger. Beaver scalpel. -Right.

-We've got bleeding! -Calm down. Elcano?

Cut with micro scissors and insert the 2.0 shunt tube.

-Roger. Micro scissors. -Here.

-2.0 shunt tube. -Here.

Confirmation that the bleeding has stopped.

As you can see,

Elcano reads the data from the screen

and helps us proceed with the operation.

Surgery can be done

even without experienced doctors and nurses.

Elcano has the entirety of medical history covered.

So this is a medical AI…

They actually regenerated blood vessels.

They'll be able to perform a bypass.

What a time to be alive.

Bypass complete.

BYPASS COMPLETE

Elcano, how's the blood flow?

Blood flow, stable. Heart condition, stable. No bleeding detected.

Vitals, stable. Bypass operation complete.

Well done, doctor.

Ladies and gentlemen, this is the future of medicine.

VF.

-Perform cardiac massage immediately. -VF!

VF.

Perform cardiac massage immediately.

I'll massage the heart.

-VF. Perform cardiac massage immediately. -No. What's going on?

-VF. Perform cardiac massage immediately. -Doctor! What should we do?

Hurry!

That's not enough! Bring more!

VF? Now? Why?

Did the bypass get clogged and cause ventricular fibrillation?

Why?

-The flow was fine. -Doctor!

-Your orders? -What should we do, Elcano?

Elcano!

Myocardial ischemia is progressing. Please check settings.

What's going on?

Myocardial ischemia is progressing.

-Please check settings. -It can't be.

Has Elcano made a mistake?

-It's Dr. Sugai. -Myocardial ischemia is progressing.

Please check--

What are you doing? This is live!

But doctor…

-What should we do? -Get the heartbeat back.

Use the heart-lung machine! We must succeed.

Transfusion! Needle and thread!

-Right. -Yes, sir.

It's not improving.

This is bad.

Professor. What should I do next?

Unfortunately,

we'll have to put the blame on Tojo.

-That's what we'll say. -But, professor…

That's the truth.

Myocardial ischemia is progressing. Please check settings.

Mom…

Ms. Hanabusa.

Yes?

What are you doing? Get a grip!

Please save Ms. Tojima!

Still no heartbeat.

Ladies and gentlemen,

unfortunately, Tojo's initial response…

What are you doing here?

The problem isn't the AI. It's the new medicine you used.

Ms. Tojima was skeptical herself.

REGARDING REGENERATED BLOOD VESSELS

MORE CASE STUDIES NEEDED

A paper on the new medicine?

Yes.

Atty. Tojima has done research herself.

-I think she's nervous about the surgery. -I understand.

There are several patient studies from the University of Massachusetts.

Let's find them.

REPORT ON NEW MEDICINE

We discovered they were hiding the side effects of the new medicine.

If there are indeed side effects,

that would be calcification in the vessels not operated on.

Just like when you closed the chest and ran away.

If so,

what would you do this time?

Side effects causing blood clots?

That's…

This is what happens when you don't look into the risks of side effects.

Please get out of my way.

Excuse me?

So you'll listen to AI and let your patient die?

Then I'm taking over.

What do you think you can do?

-You can't even perform bypass surgery. -That's right.

-I failed last time. But-- -Then move it!

I can do it now.

Move it.

Excuse me.

We'll take down the blockage and reconnect it to the calcified LAD.

Clamp the mammary artery.

Bulldog.

Hurry!

-Right. -Wait!

This is Ishin's operation. I won't let Tojo stand in the way!

You haven't even seen my face.

Just say another doctor took over.

Let him do it. This is good for us.

If we succeed, just say he's an Ishin subordinate.

And if he fails,

it means Tojo University killed her.

-Micro tweezers. Metz. -Right.

Blood vessel disconnected. Now restarting bypass surgery.

Dr. Amagi!

I'm glad you're here.

Dr. Sera told me to find you.

Find Dr. Amagi.

I know he'll be somewhere nearby.

Okay.

This looks like a mess,

but I'll watch over him.

What?

What will you do next time?

Direct anastomosis…

is the only way.

Even for bypass surgery,

there are many methods.

Close your eyes and picture it, Juno.

-Picture it? -Yes.

For instance, repairing a calcified LAD.

There is only one cm without calcification

that lies three cm away from the diagonal branch behind the LAD.

Expand it and look at the back.

If you anastomose there,

you can reconnect it to the LAD.

Did you picture it?

Surgery is imagination.

You're still a little young to know that.

Wait.

Let me picture it.

Though it wasn't pretty,

but for an ordinary person it would be considered art.

With the goal of saving the next patient.

-I'll detach the LAD. Metz. -Here.

Detachment complete.

First, we expand with 6.0.

Expanding with 6.0.

-Mosquito forceps. -Mosquito.

Next is the calcification.

-Beaver scalpel. -Here.

-1.5 shunt tube. -Okay.

-1.5 shunt tube. -Here.

He's halfway there.

Now for the rest.

-7.0. -Right.

And expand it

ever so lightly.

Please confirm the tools. Suture graft with 8.0.

We'll use 7.0.

-Obey the Elcano! -Please be quiet.

8.0 isn't strong enough for this graft.

-Water, please. -Right.

I'll join them with 7.0.

Switching to 7.0.

-Amazing. -Is that really Dr. Sera?

Elcano is following Dr. Sera.

Please suture with 8.0.

-I'm using 7.0. -It's saying 8.0!

-7.0 will tear the tissue! -You can't keep doing that.

You can't keep trusting AI.

You must face the patient in front of you.

-Metz. -Here.

Anastomosis complete.

I'll unclamp the internal mammary artery.

Complete.

Dr. Amagi.

-She's bleeding! -Gauze.

Gauze, please.

-Internal bleeding. Please take action. -Why?

Why?

-Elcano. -Unknown bleeding.

Please confirm settings.

-See? I told you you couldn't do it. -Unknown bleeding.

-Please confirm settings. -You killed this patient.

Unknown bleeding. Please confirm settings.

Dr. Amagi.

What do I do?

Tell me.

So this is what you were hoping for?

How unfortunate.

We couldn't save the patient from Tojo University.

Direct anastomosis is the only way.

Dr. Amagi!

The vessels were too weak.

It went well until the suturing.

What a pain. I guess I have no choice.

-Where are you going? -Me? I'm going home.

Wait. Please, wait!

Please operate.

I know how she can be,

but she's still my dear mother!

Please…

Please save my mother!

And?

Don't you get it?

You'll have to bet half of your assets if you want me to operate.

-We don't have time for that. -Well then,

what will you do?

I'm out of here.

Wait!

I'll do it.

Instead of my mother, I'll do it.

Please let me.

Well then,

now, we'll test your luck.

Unknown bleeding. Please confirm settings.

Take your pick.

Heads or tails?

Heads.

It's tails…

This patient chose bypass surgery herself!

You have a 4% success rate.

You're much more helpful than those fools.

That's why you lost the bet.

That goes for your mother too. A failure.

You're not doing direct anastomosis?

-No way… -The will to live.

Our job is to give shape to that.

Isn't that a doctor's pride?

Subtitle translation by: Tom Grathwol