Original subtitles

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Dr Miyake, this is for you.

Huh? Why?

-Oh, it was left over from the drive to plant more greenery. -Yes.

I got it from the head nurse.

Look, where you have moss growing, it looks kinda desolate and colourless.

No, it's not desolate.

I'm growing moss. It's a moss terrarium.

Growing moss is my hobby.

-It's your hobby? -So that's how it is.

I thought for sure that you'd be raising some small bug in there.

This is Hinoki moss,

and this one's Arahashiragagoke.

It's like a therapeutic miniature garden.

-You're actually growing moss? -Yes, moss.

Oh yeah, have a look at this.

Look, isn't it beautiful?

It's precious right? Such a vivid green.

Oh, and this one I took with a macro lens.

You can see the droplet of water.

Prized possessions may have little significance to others,

but their importance to oneself,

is proof that love exists.

It's not often you say something good Mr Preacher.

-Extremely rare. -Right? Right?

-You seem pretty happy. -Because he likes praise.

Do you fancy some of this? It's Moroccan sticky rice balls.

-Excuse me, -Miyajima san's gone.

-He's gone? -Yeah, he pulled out all of his IV's.

He must have snuck out.

Miyajima san...

He was the one who drove into a wall without putting the breaks on.

-Let's search for him. -Okay.

-Miyajima san. -Miyajima san.

Miyajima san.

So they have sticky rice in Morocco?

Come to think of it, do Moroccan people even eat rice?

Who knows.

And anyway, what flavour are Moroccan rice balls?

After eating it, you can say if you enjoyed it.

-What flavour? -I'll go and ask.

Oh, hold on, I'll be right back.

Ah, please move closer.

Excuse me, I'm looking for a 30 year old male patient from A&E who just disappeared.

Do you happen to have seen anyone like that?

-Who knows. -Thank you very much.

It must be bad in A&E if they have to go on a manhunt.

-I should help them look... -Next week, there is a conference,

will you be ready for it?

Yes, I collected everything that I was asked to.

Only the materials you were asked for?

-Huh? -We're going to be doing a mitral valve replacement op.

What will you do if they ask you about previous hospital data?

-If that's the case... -Yes, it's not necessary, but you should do it.

If we don't reveal the results of our ops, then we can't do our best.

But if you think about it, wouldn't it be better spending that time dealing with patients

even now, those patients could deteriorate.

And, so? Does that have anything to do with a successful op?

Does it improve your knowledge? I want to help search.

Who are you? A doctor of course.

Well... it's up to you.

I've been up all night, this is really tough.

Ah, I'm sorry.

Why did you leave?

-I'm sorry. -You have no need to apologise.

Would you like to talk about it?

I may be a doctor, but I'm also the chaplain,

the hospital's Buddhist priest.

Perhaps you're worried, or troubled about something,

or maybe just want to talk about something.

Not really.

I just want some relief.

Relief? Is that...

I'm fine.

I just couldn't sleep.

Please let me rest.

-Attempted suicide? -He may have been attempting suicide

when he rammed the car without brakes.

What makes you think that? Did he say something?

He didn't say it but,

-he said he wanted relief. -Is that all?

That's not all, he said he couldn't sleep.

If a patient is restless after lying in bed all day long,

it's quite normal for them to struggle to sleep at night.

It could be depression. Depressed patients often talk about wanting relief.

A&E doctors can't make an accurate diagnosis of depression.

Of course you'd feel low after 2 or 3 days without sleep.

Why don't you try sleeping pills?

If we don't properly investigate, we're only treating the symptoms.

You saved his life, you found out his problem and treated him. Haven't you already done your job?

Healing the body isn't my only job. I want to save the patients.

I want to guide both the mind and body into a healthy place.

-You want to guide? -Yes.

An A&E doctor's job, first and foremost, is to save the life in front of you.

In order for the hospital to function, each position has it's place.

If you're depressed, you need a psychiatric evaluation.

If the patient doesn't want it, there's nothing we can do.

It's just because you don't have the motivation.

Dr Matsumoto,

I heard that you left the hospital earlier to look for Miyajima san.

That's the job of the police!

Your motivation is pointless when it only causes trouble!

There's no need to be so cold-hearted.

-You're a doctor! -It's because I'm a doctor!

Old age, disease, death.

To these three sufferings, add a fourth which is birth.

Buddha taught that these are the root of all human suffering,

that life itself causes suffering.

I want to save patients from the pain of living!

That's the job of a monk isn't it?!

Don't impose it on me!

Miyajima san!

You're not alone!

Don't forget that there are people who need you!

-Is that okay? -Yeah, it's fine.

If you fall asleep in a place like that, you'll catch a cold doctor.

Ah, Fujimori san?

Have you just brought someone in?

No, it was just a briefing session for a fire drill.

-You guys go on ahead. -Okay.

I reach retirement age in March, so this year will be my last.

-Really? -Yeah.

How long have I known you for Dr Miyake?

You were still in your twenties when you started here weren't you?

Which means...

...how old?

There's no need to talk about me.

Thank you very much for all this time.

Fujimori san,

You've been doing that job all this time,

has anything ever troubled you about it?

Yeah, it's a job where we're responsible for people's lives,

sometimes it was awful.

If I couldn't save someone, it was heart-breaking.

But even when it was all too much,

it was easier to jump into the fire.

At least that way, I would be able to sleep better.

So, after 40 years, you won't have to take a nap in a place like this.

Sleep soundly every night without worry.

It's the same for A&E doctors right?

But if everyone was like that, the place wouldn't function.

Huh?

I guess you're right.

I'll be scolded by my men for going over the line.

There's someone I feel like I always have to scold too.

It's necessary to have that sort of person too.

Maybe it would have been better to have been a doctor.

I should never have done something so tiresome.

Well I wonder...

which one is harder...

Worldly thoughts again.

It's bad to be a left-hander?! I'll show you!

How dare you harass me!!

Data, data... Shut the hell up Hamada!

Oh, Doctor Monk.

That was a great kick.

Well, before Dr Hamada came,

I was just at the point where I could be entrusted to do surgery.

Now that he's here, I'm spending more and more time on ward duty.

Well, if you don't perform surgery, your skills won't improve.

Once, he let me take part in an operation,

but he called me a slow left-hander. We didn't exactly hit it off.

He totally gets under my skin.

Anyway, as far as the patients are concerned, it's much better

to have a top rated surgeon like Dr Hamada.

While it may be true that Dr Hamada's skills are top rated, his heart is...

second... third... fifth rated?

-He's not a bad person you know. -Huh?

In fact, he's performed many more ops than anyone else and he works hard.

-Oh. -That's why,

other people can't say anything. There'll be an atmosphere.

-We'll feel the pressure. -Pressure?

He'll say 'you're a doctor aren't you?' When that comes from above,

there's nothing I can say in return.

You're a doctor!

He thinks he's telling me something good.

Old age, disease, death.

He gets surprisingly jealous and ends up bad mouthing other people.

Is it just because he's famous?

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

But he just likes being praised.

It's not often you say something good Mr Preacher.

Right? Right?

He's surprisingly simple, isn't he?

No, no, no, I'm not like him.

I'm not like him, I'm not like him.

Right now,

I may not be able to help patients by performing ops,

but at least, no matter what, I can see their treatment through to the end.

-I want to be like-minded. -Like minded?

We're healing the same diseases, so we should be like-minded.

You're right.

What? You say that

so eashi... eashi.. easily

-I'm sorry, I'm hungry. -Huh?

Now this may be awfully pru... pru...

presumptuous of me, but wouldn't it be better for you

to find a place where you can show your own strengths.

You can think about that...

Don't you think that would be good?

Yes.

Blood pressure 61 over 41, pulse 110. Limbs feel cold.

Subcutaneous emphysema in the left thorax.

-Let's go to X-ray. -Okay.

Left lung is completely white. Let's drain the blood.

-A thoracic drainage, prepare the drain. -Moving.

-Okay. -Add another bottle to the IV.

Yes, Aoba emergency centre.

We have a 60 year old man found unconscious on the street.

-Will you take him. -Okay.

Next patient is on the way.

-I'll go. -Yoshida.

-Applying anaesthetic. -Thanks.

Haemothorax?

There's a lot, why?

-Is it intercostal artery damage? -That could explain the amount.

-If it's aortic damage, we'll have to open the chest here. -Here?

The most common aortic damage is to the aortic isthmus.

On arrival to hospital, the death rate is 80%

Tanaka kun, when the CT is done, come and intubate. I need your help.

-Okay. -Contact cardiology.

-But... -I don't care who, anyone will do.

Okay.

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

There is is, it looks like it's over 5 cm.

Excuse me, sorry to keep you waiting.

We've prepared the emergency op, we need specialist skills.

-Please help. -Er, erm...

Dr Hamada and the other surgeons have been in an op since this morning.

This could rupture at any moment. You do it.

You've experienced ascending aortic replacement, haven't you?

Only twice, under supervision.

-This is my responsibility, I'll supervise. -But...

Didn't you want to become like-minded and see patients through to the end?

You're the only one who can do it.

Okay.

-Dr Hamada. -What?

There seems to be an emergency cardiac surgery in theatre 1.

Who's gone in there? There isn't anyone is there?

It's Dr Kojima.

A&E's Dr Matsumoto is supervising.

That's absurd.

They'll kill the patient, right?

Yes... well.

That one please, cutting. Right, it's cut, thank you.

From the right inguinal region we'll remove part of the femoral artery,

to insert, we'll approach via the 4th and fifth ribs.

-Let's go ahead. -Okay, let's do it.

-No 10 scalpel please. -Okay.

-Left-handed? -I'm sorry.

I can use my right, but it's not very efficient.

For now, please let me use my left.

-Forceps. -Okay.

-Gauze. -Okay.

Gauze please... my field of vision...

Don't panic.

The separation went well.

Yes.

Blood pressure is 40 and dropping.

-Locking forceps please. -Okay.

Can you block the heart side?

Dr Kojima...

I'm sorry, suddenly...

You're scared, if you make a mistake he'll die.

-Dr Matsumoto. -Even without you making a mistake,

is this ruptures, it's all over.

He's a first-time patient,

he may have other illnesses.

Are you going to quit?

-No. -Then hold your nerves.

This is where you are right now, in this kind of place.

I'll clamp.

Metzen forceps.

-Secure that Yoshida. Move the lung. -Yes, okay.

Releasing the aortic block,

No bleeding.

How's the circulation?

No problems.

Great job!

Thank you so much. It's all thanks to you.

It seems, this place...

I really do prefer the operating theatre after all.

You didn't actually need her help did you?

And you?

I see. Well you must be tired.

Honestly, there was nothing I could do.

Oh, what's this? Where's our Dr Kojima?

The op's over, she's in the ICU.

Oh, so it was a success then?

Excuse me.

Excuse me.

Yeah but... Dr Matsumoto is a scary person isn't he?

-That's true. -If you make a mistake it's traumatising.

If you weren't sure you could do it, wouldn't it have been

more conscientious to send him somewhere else?

If I'd have sent him elsewhere, the patient would have died.

While I can't say that Dr Kojima is fast,

her skills are careful and reliable.

With more surgical experience, she'll be a good heart surgeon.

Heart surgery is nothing like A&E.

For you it's hit or miss. If you make a mistake, it can't be helped, you were unlucky.

That kind of treatment, is not possible in the cardiac department, so...

To consider patients unlikely to be saved

and to abandon them,

that's the kind of treatment I won't do.

Is that so.

Then please continue to do it without inconveniencing our department.

Supposing a consequence might be cardiology being sued

by a patient,

that would be a great inconvenience.

So, thank you.

If you'll excuse me.

Every little thing, what is with that guy?

Did I do something?

Move.

If we don't hurry, he'll die.

It's really traumatic.

But there is some truth in Dr Hamada's words, isn't there?

Huh?

It's a little rash to try to save patients that are outside your own field of expertise.

Are you on his side?

Don't tell me you're jealous of Dr Hamada.

That is not true.

Well, I don't agree with the way he put it, but,

what I'm saying is that he does have a point.

Are you saying it's right to be able to pick and choose your patients?

He said he would save anyone, you're misinterpreting his words.

We can't save everyone, there are too many.

-We have to draw the line somewhere. -The misinterpretation here

is the hard fact that you should try to save those who can't be saved.

That's exactly why I've had enough of your zen dialogue!

It's all thanks to Dr Matsumoto.

When I think of A&E, I imagine doing ops everyday on patients you've only just met.

That's something cardiology doctors don't do.

It's made me more determined to study harder.

After all, there are many things you don't know until you've experienced them.

-You say that but... -Thanks for the hard work.

-Ah, Dr Hamada, thanks. -Thanks.

Yes, Aobadai Hospital Accident and Emergency Centre.

-What's the status? -30 year old man found unconscious

in his home bathroom.

Blood pressure 70 over 40, pulse 140. Caused by hydrogen sulphide.

-Miyajima san? -Appears to be a suicide attempt.

Suicide?

There was discolouration in his bathroom sink,

and there was paper covering the gas ventilation...

Why... we worked so hard to save you...

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He's in VF.

-Defibrillation! -Okay!

-Prepare the rack. -Okay.

Stand clear!

-Heart stationary. -Why...

Miyajima san.

I'm not denying you your decision.

I'm just doing what I have to do.

Know your own heart.

It's okay to be yourself.

Miyajima san, let's talk once more.

Miyajima san!

2 minutes have passed.

Come on.

Miyajima san.

-His heart beat has resumed. -It's back.

Hey, it's been confirmed, he used low concentration hydrogen sulphide, 294ppm.

-Let's check the guidelines for acute intoxication. -Okay.

Hey Granny.

This feels good. It was empty so I borrowed it.

You're all so tired.

Yeah.

-Is Dr Miyake off today? -No.

Huh, maybe she went to the shop.

She's amazing Dr Miyake,

Dr Miyake always,

every day, puts on her make-up, does her hair,

commutes to work, works overtime.

She works so diligently as a matter of course.

It's hard for women as they get older.

In such a tough place of work, there are all kinds of emotions at play.

But no matter what, day after day, she keeps on going with her regular expression. It's amazing.

But you Dr Matsumoto, it shows on your face.

I can tell straight away if you're in a good mood.

Well that doctor,

is a little careless.

We've been looking for that for ages.

What?

Nothing.

Huh, the remote control.

Where was it? It's been so inconvenient...

Aobadai Hospital Accident and Emergency Centre.

Requesting an ambulance to Tachibana district, 2-12-3.

A fire broke out in a print works, there are several injured.

-Who's going? Obviously today... -I'll go with Dr Miyake.

-Okay. -Right.

I'll leave it with you.

Over here! People in need of rescue!

What do you want to do Captain Fujimori? Wait for the response team?

Are you okay? Situation report!

You'll be okay. Do you have any other pain?

-I Don't. -I'm going to put this on your left hand.

Okay, please transfer this patient first.

-Partial second degree burn to the right hand and right foot. -Thanks.

Do you need more people?

-We don't. -Okay.

What's going on?

It's a secondary disaster. In the process of rescuing someone,

the captain's been pinned beneath a falling panel.

The captain's in there?

Please wait! It's in danger of collapse.

Please don't go beyond the barrier.

Secure! Get it secured!

Don't increase the number of injured people.

Captain Fujimori rescued!

Captain Fujimori?

I'll be scolded by my men for going over the line.

Lowering! Lowering!

No...

Lowering, lowering!

-Captain! -Captain!

-Stretcher! -Okay!

-Fujimori san! Fujimori san! -Ready, set, 1,2,3.

-Hurry. -Get it on, watch his leg.

-Move the leg. -It was dangerous, so the Captain went by himself.

I'll do the tracheal intubation. When we've secured 2 lines, we'll move him.

Got it, let's hurry and bring him in!

Captain!

At least we'll have to give him an infusion. I absolutely have to save Fujimori san.

-You know him? -I first met him when I was a medical intern.

He's the one who taught me about rescue scenes.

-A large amount of soot has adhered to his airway. -Severe respiratory burns.

Also, carbon monoxide poisoning and an estimated 70% burns.

40% is second degree, 30% third degree.

A burn index of 50.

50? He's just had his 60th birthday so his PBI is 110...

-Suction. -Okay.

-What's a PBI of 110? -It's adjusting the burn index to someone's age.

PBI (burn prognosis index) = burn index + patient's age

An indicator of mortality among burn patients

Surviving anything over 100 is tough.

-Let's go to CT. -Stretcher.

After that, sustained blood dialysis in ICU.

-Get ready. -Hurry!

Let's transfer, ready, set,

1, 2, 3.

-Begin cardiac massage. -Okay.

-Adrenaline. -Okay, preparing the adrenaline.

I'll take over.

-Set timer for 2 minutes! -Okay!

-I have the defibrillator. -Monitor!

-Yes, I'm on it! -Are the family here yet?

I'll get them right away.

This way.

-Father! -Dad!

Dad, dad!

Dad.

We did everything we could, but it wasn't enough.

He passed just a moment ago. I am so sorry.

Fujimori san...

Your husband's rescuing

saved lives.

Dad, wake up, dad.

Father, thank you for all your hard work.

Now you can sleep in peace.

He dreamed of all the people he couldn't save,

and he would jump in the night.

You can sleep soundly now.

But even when it was all too much, it was easier to jump into the fire.

At least that way, I'd be able to sleep better.

Sleep soundly every night without worry.

Father...

Why is this happening...

Taka chan? Are you awake?

Excuse me, he's just opened his eyes.

-Taka chan, Taka chan, Taka chan. -Miyajima san.

Please squeeze my hand. Can you squeeze it?

Miyajima san, how are you?

Please don't try to slip away again.

Miyajima san,

Why were you in the courtyard the other day?

That's where I go to rest.

Even though my body and soul are exhausted,

sometimes I just can't sleep.

Somehow, when I lie in the courtyard, I can sleep well.

I'm surprised people haven't found out. There's moss below the tree,

it's so calming.

I understand.

I was the same.

I'm an industrial engineer.

In work, I'm usually surrounded by electronic equipment.

It was a job I liked, I got on well.

Then a new boss came in.

You people have no value, we were told.

The accident happened while I was thinking about work.

Before I realised, I had crashed.

I didn't expect to be saved.

We worked hard to save you.

While I was here, the sound of the medical equipment made me feel uneasy.

It reminded me of work and I just couldn't sleep.

I just had to get out of here.

I walked over to the courtyard.

And fell into a deep sleep.

When I left hospital, I really thought I'd do my best.

But again...

I couldn't help think about returning to that company with that boss...

In hospital, there are people who have it so much harder than me.

Who are desperately trying to live.

I wondered...

if my life had any value.

There may not be disease or injury,

but living...

sometimes, just being alive is tough.

Doctor, do you feel that way too?

Well it's...

it seems that's just part of life for human beings.

So Buddha teaches.

But,

if you kill yourself,

the important people around you...

won't be able to sleep, will they?

Life can be cruel.

No matter what your boss says,

you are treasured by your wife.

What you are trying to do,

is no different from what your boss is doing... to people.

I don't think you're considering your wife's feelings.

The summary of Goto san's discharge last week,

I haven't had it yet. Who's in charge?

Dr Matsumoto.

Dr Matsumoto again, where did he go?

He might be with Dr Miyake. They're working together at the moment.

Dr Matsumoto's always forgetting.

I'll take this one.

Dr Miyake's not here, it's her loss.

That's right.

Ah... that's Dr Matsumoto's.

Good evening.

Today, I'm here as a chaplain.

Being born, growing old,

becoming ill, dying.

The very act of being born,

and that of life itself causes suffering.

I am just like you Miyajima san,

I had a feeling that Dr Miyake would be right.

Dr Miyake?

Yes, earlier, she spoke to me.

She said that she was sure you'd come and talk to me.

She said that it was extremely rare,

but that you could be helpful,

and that it's okay for me to just take what I need.

Yes, very rare.

Right now, for my sake,

and for my wife's sake,

I will get proper mental health treatment.

It may be a struggle though.

Yes.

Could you please not disturb me Dr Matsumoto.

Huh, how did you know?

Ahh... I just wanted to skip work and forget about it for a while.

Don't start preaching.

-Sorry. -Huh?

You and the patient both had similar feelings.

-I tried to push my opinions on you... -Hey, look at that.

This is Sugigoke.

It's beautiful isn't it?

Yeah... I guess.

You've been to the moss temple right?

-No... -You're kidding.

Call yourself a monk?

It's the wabi-sabi of the world, moss is.

I don't even...

The line...

cross it once in a while.

Maybe it's okay to get emotional from time to time.

After all, if it's going to cause you sleepless nights.

Dr Hamada, you asked me the other day

for all the department's mitral valve replacement data.

All the data?

I've tried to put it together in my own way, so it's easy to understand.

It seems that what you were trying to say is that reflux is likely to recur if the atrial fibrillation is not cured.

-Oh, yeah, I guess. -And also, Moroccan people

do eat rice, but they mix it with salad and use it like a vegetable.

So, if you'll excuse me.

So she actually looked that up?

What a fool.

Speaking of that, were you okay afterwards?

With that damned Dr Hamada.

Well I guess so, still working on the ward though.

I see.

But when I'm on the ward

I notice things that you might not notice in the ops.

I've still got a way to go as a doctor.

No, as a person.

In Buddhist ascetic practice, it's not enough just being struck.

-It's better to be struck by a waterfall -That's true.

Oh, using an example like that with a monk,

-That's embarrassing. -No, no, no.

You should say that kind of thing more often.

-Huh? -Oh, what is it, what is it?

Oh yeah, Ananda.

Why don't you come to A&E? Like Ananda.

A who?

Ananda was Buddha's disciple, he was with him until the very end.

He made a suggestion to Buddha...

Dr Kojima to operate?

While it's true that Dr Kojima is not the fastest, but,

somehow she has a foolish enthusiasm,

under my guidance she'll become a leading heart surgeon.

Nurturing is one of my strong points, even if I do say so myself.

In Seimei University, cardiology's Katsuya Nomura,

No, cardiology's Eddie Jones, or cardiology's Anzai...

Yes, it's Kojima, okay.

Vascular damage? Okay.

Yes, I'll be there in 1 minute.

Ah, Dr Kojima, I have something important to discuss.

I'm sorry, there's an emergency!

-1, 2, 3. -Sorry I'm late.

That was two minutes.

-Over here! -Okay.

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