Original subtitles

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Dr Aida, hold on, hold on.

It's not just our place.

All departments are struggling to squeeze in A&E patients.

I refuse!

Orthopaedic Surgeon Ippei Aida

What if I gave you this?

Is that Satori Musume? Pre-debut?

-It is. -I don't have that right now.

It's ultra, ultra premium.

I'll accept.

48 year old female. Consciousness level 1 of 3, pulse 130.

-Can you say your name? -We can't get a blood pressure reading.

Let's take her to CT, quickly.

Monk Doctor Shouen Matsumoto

You're going to feel a little prick.

Miyajima san, it looks like you were unable to brake in your car and you crashed.

Accident and Emergency Doctor Ryoko Miyake

What happened? Did you faint while driving?

Do you remember?

No, a drip's not enough. The aortic aneurysm might rupture.

-Hurry up with the blood transfusion. -Sorry, but we need to do it again.

Is the head monitor okay? The blood pressure's up isn't it?

-Blood pressure on the monitor is fine. -Thanks.

I can't see.

-There, hold that there. -Ah, sorry.

Left-handed...

Why did you become a surgeon?

Cardiovascular Surgeon Tatsuya Hamada

A left-handed, female, cardiac doctor

Cardiovascular Surgeon Mashiro Kojima

is quite a challenge.

-Just hold that. -Okay.

It's A&E, they're asking for support for a an aortic aneurysm rupture.

Sorry, it's not possible.

-Thanks. -I'll take it.

Nobody's free from the cardiac department.

Accident and Emergency Doctor Taro Yoshida

-Nobody? -Shall we try to transfer her?

But she's been turned down 6 times before arriving here.

I'm finished, I'll help.

-Prepare for surgery. -Okay.

Let's move her, 1, 2, 3.

-What's the status? -A triple A impending rupture.

-Blood pressure's falling. -Putting the A-line in...

Taka chan! Taka chan!

I'm fine.

Thank goodness.

Taka chan, you really gave me a fright.

-Ah.. so tired. -Right.

Hey, how did the op on the patient with the aortic aneurysm go?

Well, given that we had no choice...

We've saved her life for the time being.

If I could just calm down.

Recently, cardiology have been refusing all patients from A&E.

Well to be honest, A&E patients

have been causing trouble for all departments.

Of course the regular surgery dept. would have been better.

Don't say that.

-Tanaka kun, you'll join us when your training is over won't you? -No, I won't.

Director of Accident and Emergency Junichiro Tamai

Second Term Medical Intern Reiichi Tanaka

It's relentless, there's no rest and it's quite annoying.

Which makes me wonder, why did you choose A&E?

I was influenced by TV dramas.

You're a drama fanboy? What about you Dr Miyake?

My A&E instructor was unbelievably scary, I couldn't refuse him.

I played janken for it but I lost.

Janken?

I actually wanted to be a general practitioner.

But I was drawn in by a labour shortage, and I'm still here.

-The chairman's scary. -Could you please...

Don't you have any intention of leaving such a demanding place?

I will.

So, why did you choose A&E Dr Matsumoto?

Nurse Saho Nagami

His batteries have run out.

Ahh, he'll be giving off night sweats again.

I'm afraid to see people die.

But A&E is the place you're most likely to see people die.

One of my friends drowned right in front of me.

I couldn't help him, and he died.

I invited him to go fishing.

Ahh, worldly thoughts!

Hey.

You've come back so soon?

I've just been to the pool.

Etiquette?

There's been a request for a doctor.

A junior high school boy is drowning in Okami river.

Drowning? But it's the middle of winter?

Who's going?

Shall I go?

No, I'll go.

Tanaka kun, will you join him?

-Aobadai A&E department. -Ahh, thanks for coming.

How long has he been underwater?

According to the person who called, it's already been 20 minutes.

20 minutes...

What do you think?

When drowning, breathing stops but the heart continues for a while.

You just need to resuscitate.

But...

after 25 minutes...

Help me Ma chan! Ma chan, help!

Hajime!

Help Ma chan!

Ma chan!

Hajime!

We've found him!

No, w w wait... you have to be kidding!

-Do you mind? -Okay.

Ahh, it's cold!

Hey, come on!

Come on!

He's hypothermic, body temperature at 30°.

-We'll get him warmed up. -Okay.

That kid...

We're going, hurry.

He's in VF.

Defibrillator!

Move!

Still in VF.

His body temperature isn't rising.

-Shall we start ECPR? -Well...

ECPR: Extracorporeal cardiopulmonary resuscitation

-It'll be for nothing. -Huh?

No... let's start ECPR.

-Prepare the IV. -Okay!

Removing the clamp, perfusion commencing.

It's flowing.

What does the sternum ECG show?

-It's VF. -Tanaka, defibrillator.

Okay.

Please step back.

Chairman Wakako Shibusawa

What happened here?

The doctors went out to a drowning victim.

I'll get it cleaned up right away.

A drowning...

-How's the flow? -It's fine.

Dr Matsumoto...

Going again, please stand back.

-It's back! -Securing the PCPS circuit.

-Okay. -35° please.

-Pass me a 4-0 line. -Okay.

There's a small glimmer of hope.

I wonder.

We'll see tomorrow.

What was that earlier? That negative reaction?

Survival after 25 minutes,

never mind regaining consciousness would be a miracle.

Yeah but...

don't you think this is different?

Even if hypothermia helped the treatment,

the best outcome might be a vegetative state.

There's nothing more that I can do.

Look at the patient in front of you,

you're not in the past any more.

Erm..

Your son was holding onto this when he was rescued from the river.

Inside,

is the pen that his father gave to him.

His father

was killed in an accident when he was in junior school.

Why did he go into the river?

Was this what he was looking for?

When the rescuers were looking for Okazaki kun,

Dr Matsumoto...

started chanting something like a sutra.

Like a bad omen.

It may have just been the cold, but his hands were shaking.

Is Dr Matsumoto on the same level as ordinary people?

When it comes to things like fear?

Well of course, anyone would.

-I guess so. -Yeah, well.

Are you smoking?

-It's too cold outside. -It's none of your business anyway.

Lung cancer patient Hohei Ariga

I'm going to die anyway, so let me do what I want with no regrets.

Even if it kills me, it's my choice.

Yes.

Choosing how to die is the same as choosing how to live.

Buddha also says that you should live without regrets.

Don't regret the past, don't worry about the future.

Take good care of the present.

That's not possible.

That's true.

Even I have regrets.

What are you talking about? You're a monk.

Excuse me.

What the hell?

Hey!

Earlier...

Wait, wait wait, hey!

Wait, come on! Wait, wait wait!

Why a monk?

I'm a monk and a doctor.

I was with the ambulance at the river earlier.

-Oh. -You were there too right?

What happened?

-You know something, don't you? -I don't know...

anything.

Even if the people around you don't blame you,

even if the people around you forget,

you will remember.

You'll blame yourself for the rest of your life.

Is Okazaki going to die?

He's trying really hard to live.

What happened?

I dropped Okazaki's pen case from the top of the bridge.

He went into the river to get it.

Why did you do that?

I was walking my dog the other day,

Okazaki was joking around and he gave me a fright.

The dog slipped out of the lead,

we still haven't found him.

I just wanted to cause a bit of trouble.

That pen case

was a memento from Okazaki san's father.

There should have been a pen in it.

I shouldn't have done it.

I shouldn't...

Doctor.

Please help.

I want to...

I want to apologise to Okazaki san.

There's really nothing we can do now right?

-It will be a miracle if he wakes up. -Honestly, we did everything we could.

It's in the hands of God now.

Can't Dr Matsumoto do some kind of prayers or something?

No he can't, he's riddled with worldly desires right now.

If he finds out we ate his share of the ramen, he'll definitely get bent out of shape.

Well, hurry up and eat it.

Please save this child.

Hajime.

Please.

Hey hey!

You're the doctor monk right?

-Master. -It's been a while Shouen.

Religious teacher Enmei

I apologise for the long silence.

So, did you have a request for Hajime?

Divine blessings are the greed of transient life.

You should want compassion.

Hajime kun bears the burden too.

I'm sorry, against my better judgement,

I am praying for a miracle.

Is it difficult?

Being doctor and monk?

Well Shouen,

staying a monk

would have been the easier path.

But endeavour as much as you can.

Yes, I will do as you teach.

Take good care of the present.

Treat each patient in front of you.

Look at the patient in front of you, you're not in the past any more.

A secret Buddhist?

Dr Miyake?

While I think of it, could I ask you a favour?

-Yes. -At Miyadera's house.

I'm so glad, so glad.

I'm so glad you're safe Teru kun.

Yes, it's open.

Hajime's Father Kenji Miyadera

Oh.

You came.

I'm sorry for not contacting you sooner.

-Erm... -Really...

Hajime's sister Aya Miyajima

How many years has it been?

Aya...

-This is from my mentor. -From the head priest?

-Yes. -He shouldn't have.

This is...

dried persimmons.

Did you go to visit my brother?

Yes.

I'm sorry to bother you without warning.

No, no no, I'm happy you came.

I still can't believe it...

little Teru kun is a doctor now.

Aya, will you make some tea to go with these persimmons?

-Ah, please don't go to any more trouble. -It's fine, it's not much.

Please wait.

-Hajime, come quickly! -Okay!

-It's huge! -Ah, a fish just jumped out!

Let's hurry so we can set up.

You shouldn't shoulder so much of the burden.

Well, no... I mean...

I think a doctor's work must be hard,

it's something I just can't imagine.

So... look after yourself.

You too.

Yeah.

Please do come again.

I guess you're pretty busy right?

-I'm sorry. -Thought so.

Ariga san, the doctor's just going to drain the excess peritoneal fluid.

Okay.

Is that okay, please stay in a comfortable position.

-Does it hurt? -It doesn't hurt much.

If I just close my eyes,

all the regrets in my life come to the surface.

-Regrets? -The manner in which you die

is the same as the way you live.

That's what a monk told me.

I thought that I should die without regrets for the past,

but it's hard.

You remembered,

the story of Buddha.

-Dammed monk... -Ah,please don't move.

I am also a doctor.

-You're a monk doctor? -I'm still inexperienced with regards to people.

If there are no emergencies, then I read sutras in the chapel morning and evening.

If you like, why not come and study with me as a friend?

That's not funny.

I'm done here, I'll come back again.

As we planned, his body temperature is rising slowly.

But no change.

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We've had a request from another hospital, a patient with abdominal aortic aneurysm on the verge of rupture. Should I accept?

A cardiac patient?

And one in need of emergency surgery...

Also... he's homeless.

He's had appointments refused at 17 hospitals.

-Homeless? -Yes.

Then we'll bear the cost for his treatment?

-What shall we do? -Hmm, I'm going to ask cardiology.

Okay.

It's smoky, don't you just love inhaling all this smoke?

That's right.

Oh...sorry.

-You're in the way. -Sorry.

Can you take a patient with an abdominal aortic aneurysm?

-Who's asking? -Dr Matsumoto.

It's a triple A on the verge of rupture, diameter is...

-6 cm. -6 cm.

-Can you do help? -How old?

A 56 year old man, he fell ill on the streets.

He's homeless? Unfortunately, I'll have to refuse.

What's with that attitude.

Well it can't be helped.

I'll do the operation.

Check the operating theatre and call Dr Yoshida and the anaesthetist.

But if he's homeless, director Tamai won't like it.

What he doesn't know won't hurt him.

-Huh? -The end justifies the means.

'The end justifies the means' is a phrase that originally derived from Buddhism.

Buddha's teaching tells us...

Hurry up and get ready.

Okay.

Tanaka.

I'm Tanaka from A&E. His blood group is unknown.

-How many units of type O do we have? -Ready, set, 1,2,3!

-Tanaka, transfusion. -We don't have time, it'll have to be type O.

So for that, we have 8 units.

-Should I call Dr Miyake? -They'll be struggling over there.

-Ambu bag please! -Okay.

He needs an emergency op, please make room.

-Okay, thanks. -Prepare the emergency cart please.

-Yes. -Intubate.

Erm... Dr Hamada,

There's only suturing left, I'll do it with Dr Segawa.

-You can go to A&E. -What?

Then, you can leave.

-Huh? -It's fine to go.

-Closure wire please. -Okay.

Pleased to meet you, let's both do our best.

-Scalpel. -Okay.

-That's... -The central blockage.

An aneurysm in the renal artery.

Where would you like to block it off?

That's quite severe isn't it?

First, let's make space for the aortic clamp.

-Metzen. -Okay.

-Ah! -Tanaka, suction.

Okay.

The blood vessels are getting brittle with age.

Still hesitating? You're clever in your own little way.

Dr. Hamada.

-Thank you very much! -Please carry on, I'm just looking.

What's the patient's condition so far?

Wow... not bad.

The vessel anastomosis is sewn so neatly.

You've been able to progress in that field too.

-4-0 thread please. -No no no, you should use 5-0.

-Er, okay. -It's 4-0.

-Okay. -Oh.

-Make some space. -Uh, okay.

There on the left-hand side, is a previous reconstruction.

Judging by the operative field, it should have been the left?

I chose the option where we could return the flow more easily.

-Well you say that... -Dr Matsumoto, the obstruction is rupturing.

-Hold it back. -Okay.

-Where's the bleeding coming from? -Ah... that's wrong.

Wrong, wrong.

Isn't it that the lump is being pierced by the inferior vena cava?

-Suction. -So on the left?

...lower, lower.

Blood pressure's at 60.

Hurry, you're not quick enough, come on.

Here.

-Hold it. -Okay.

How long since the clamp was used?

-32 minutes. -Oh... it's going to take too long.

You need to get the renal artery block removed,

-or he'll suffer from kidney failure. -Ah, enough!

Every little thing, you're as annoying as a sister-in-law!

Sister-in-law.

If you're not here to help, then leave.

Fine.

Right... next.

Gown please.

Ah, okay.

-Erm, I'll have a gown too. -Er, okay!

It's bleeding again. It's coming from the left branch.

-Tanaka, hold that. -Okay.

-Hold it securely Yoshida. -Okay.

Ta dah! I'll do the reconstruction.

-Dr Matsumoto, look for the bleeding. -Got it.

-Tweezers please. -Okay.

-5-0 thread. -Okay.

-Yes, thanks. Dr Kojima. -Yes?

-We need to expand the area to avoid the renal vein. -Okay.

Excuse me, thanks.

That's neat.

-Thread here. -Okay.

Thank you very much.

Thanks to you both, we were able to save him.

No, your ability to stay calm in the face of an unexpected situation shows your experience.

It was a great learning experience.

Me too, I found emergency treatment to be...

how should I put it, an illuminating experience.

But we just saved a homeless guy right?

Just because he doesn't have money,

you can't just do nothing and watch him die.

What I mean is do they even have the will to live?

Even if you can save them, with such inadequate living conditions, the prognosis is poor.

Above all, they have no hope for the future so there is little motivation to live.

Even so, if there is so much as a 1% chance that they can live,

it's our job as emergency physicians to do our best to save them.

Isn't that just a doctor's ego?

The fact you want to save everyone.

Because you can't do that, can you?

I want to help people who have the desire to live.

There are patients all across Japan who seek my skills.

Some of them even come a long distance by plane.

I want to use my efforts

for their sake.

-Erm, Dr Hamada... -So from here on...

I don't think I'll be in a position to receive emergency patients.

Thank you for understanding. Dr Matsumoto is like that.

A respectable disregard for profitability.

Isn't it a nice feeling, being able to do your job,

thanks to the money that we're earning in the cardiac department.

Approximately how much is each heart operation? Yes, you.

Huh, erm...

No, too slow. Dr Kojima?

-About 2 million yen? -Yes, that's it approximately.

In a year have about 200 cases which comes to around 400 million.

The other doctors manage to do 100 cases at 200 million.

Which together makes 600 million.

The profits earned from there

are what prop-up the emergency department.

If you can, please don't interfere with our work.

Well than.

But why did he have to talk about A&E like that.

-Ah, it's so irritating. -Why did he have to keep going on about it.

At time like this we need erm.. ze... zen dialogue.

-Just give it to him. -But he's a monk, he can't speak ill of others.

I'm so pissed off with that jerk!

Huh? What's with that blathering prattle?! The nerve!

And what the hell is that false smile? Huh?

Is it just because he's famous?

Because he's been on TV? He's so great!

Huh? Well I've been on TV too!

Huh, why?

Pandas.

I went to Ueno to see pandas and I was inter...

That guy pisses me off. Why did he do that op? I don't get it.

Was what A&E did so terrible?

Well, they were too hasty.

Cardiovascular Surgeon Shuji Segawa

-Too hasty? -It's reckless to act so hastily.

A first-time patient, little opportunity for examination,

his blood vessels were ragged and haemorrhaging.

You were struggling to sew because you were in a panic?

-Well, it was okay though. -It was okay?

I'd never do an operation like that.

That's right. It's too scary.

-I'm not scared. -Yeah, you're not scared.

I'm saying that I'm not easily scared.

What? Are you saying I scare easily?

Ahh, oh yes... next time, I'm going to ask Suzuki san to do the op.

What flavour is this?

I'll just go and ask.

Excuse me.

What the hell was 'sister-in-law' about?

Move! If we don't hurry, he might die.

He doesn't remember me at all.

He's breathing unaided.

His vitals are stable too.

At this rate, we'll be able to move him to the general ward.

Isn't it good.

Yeah.

But it doesn't mean he'll regain consciousness.

1 or less! that's the score I'm giving you out of 10 right now.

Why?

Isn't now the time to remain positive?

Didn't you become a doctor because of a friend who drowned?

Sorry.

I overheard you talking to the cleaner the other day.

Why are you so obsessed with your work?

It's been incredible, all this time.

But is it your punishment?

It's not punishment.

It's not? Then what?

I don't know.

Dr Matsumoto? Dr Matsumoto?

Takeshita san from ICU,

-his blood pressure's stabilised. -Yeah, okay, that's good.

-Continue to keep an eye on him. -Okay.

And then la.. la.. lap...

la.. lapro.. pro..

-laproscopic surgery. -With Sawada san.

-Yes, Sawada san. -You're hungry aren't you?

-The Hungarian fair is still on. -No no no.

With ramen, the noodles will just get soggy.

I won't get to eat it. It's always the same.

-See. -The pork soy soup was delicious.

-Huh? -Hungarian pork stock.

-You ate it? -Yeah.

-Didn't we? -Yeah.

-Yeah? -Yeah.

-You ate it? -Yes.

-You have to be kidding. -But you weren't there.

Anyway, you said they'd get soggy.

Huh... what happened?

Here, I found it.

Come on!

Okazaki...

Give it to him.

Okazaki.

I'm so sorry.

Sorry.

Okazaki kun!

Okazaki kun can you understand me?

Thank goodness.

Thank goodness.

It's good isn't it?

Okazaki,

I'm sorry.

I'm so sorry.

That's why you should never give up in A&E.

What's that?

What happened?

A miracle.

Yes, hello.

Ah, hi.

Is that Teru kun?

What is it?

Well...

If you're interested,

would you like to have a drink with me this Sunday?

Yes.

Thanks.

That's made me happy.

Yes.

How's Shouen lately? Not causing trouble I hope.

That guy was being a burden to Buddha

for his own selfishness.

Yu chan, all doctors are inexperienced,

if they are unable to save a patient, they feel out of their depth.

The feelings of guilt for the patient and regret build up like a coiled spring.

To be so afraid of people dying

isn't typical of a doctor, but if his selfishness is helpful,

then that's fine by me.

Good morning.

Well, he's still got a way to go though.

Thank you so much

for saving me.

It's nothing, I'm really pleased.

Thank you.

Thank you.

Goto san wanted the chance to thank you no matter what.

Thanks for the courtesy.

-About his medical expenses... -I heard.

You found his family didn't you?

I'm sorry... I'm so sorry.

Dad!

He wanted to apologise.

He just wanted to see his family again and apologise.

His whole life has been held back by regrets.

Mistakes and regrets of the past can make a person.

Nobody is homeless from the start.

Please accept A&E patients as much as is feasible.

I understand. Please contact me if you have any unusual cases.

Medical cases are not personalities.

Please see the patients.

As expected of a monk. I'll find it enlightening.

So annoying.

What's with that guy, yuck.

Thank you so much.

I'm completely in your debt.

No, I'm so so glad, you've completely recovered.

Doctor, over here...

It's great that he found it.

Doctor, can you keep a secret?

What?

This pen,

is not the one my dad gave me.

What??!

Ah, nothing.

But it's okay.

Because he found it for me,

I like this pen even more.

I think my dad would approve.

I see.

He was searching for a pen that couldn't be found.

Even if he found it, that wouldn't mean his friend could come home.

Even if it was the wrong one, it might make someone happy.

Hey, what is this?

'Best 10 mandala's in the world'.

The end justifies the means if it's for the patient.

I'll make sure you never get a transfer.

What? Is that the kind of thing a doctor says?

Go to hell!

Is that the kind of thing a monk says?

What?

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