Original subtitles

This is my wife's car.

Make me ... a promise.

That you ... become a good doctor.

- You're quitting? - I'm just sick and tired of it ...

Dealing with the other people here.

Let's change this place together.

This hospital ... needs you.

I'm sorry, Minagawa sensei.

You eat dinner before you go to cram school.

I'll be cooking for you.

You'll still make it in time.

Cram school's from 6:00, right?

What? You're hungry already?

Just wait a little longer ...

Oops!

Minagawa sensei!

Sagara sensei!

Anyway, you just wait until I get home.

Bye.

- Excuse me. - It's all right.

- Your son? - Yes. My junior highschooler is always eating!

Oh, that's right. You're a mom, Minagawa sensei.

- Do you live around here? - Yes, right near here.

Wait!

Do you live near here too?

No, I just happened to be driving by.

I was just looking for a snack.

So you're having bell peppers ... for a snack?

- Oh, I just happened to pick it up. You want it? - Uh, sure ...

Huh?

What are you doing shopping at this time? Aren't you working?

No, the other hospital took back their offer.

- Took it back? - Uh-huh.

I got a call from Mita Central Hospital to tell me that.

So, what are you doing now, Minagawa sensei?

I'm unemployed.

I'm so glad. ... I mean, I'm so glad I came into this store.

What a lucky coincidence!

This is great.

- A general diagnosis department? - That's right.

First-time patients would first go to the general diagnosis department.

For example, let's say a female patient comes in.

She's got stomach pain, but she's not sure if she should go to internal medicine or the gynecologist.

So first she goes to general diagnosis to determine what the problem is and is then sent to the appropriate department.

- This way ... the patients won't be sent all over the place ... - Sagara sensei!

And the doctors too ... won't have to see patients that have a problem outside their field.

Then they can be used more effectively, and earn their pay.

- We understand that but ... - The perfect doctor for general diagnosis would be Minagawa sensei.

Her specialty is internal medicine, and the other evening she made a superb diagnosis of the emergency care patient who had kidney cancer.

Director ...

Let's have Minagawa sensei come work for us again.

But ... I ...

I chose to quit myself ...

- I couldn't ... - Oh, no. That doesn't matter Minagawa sensei.

- See. Don't you agree!? Great! It's decided! - Hey, wait a second here.

The other day when discussing the nighttime emergency care I told you the same thing ... I never asked you to tell me how to run this hospital.

Saying you want to start up a new department is easy, but ...

We shouldn't hesitate to make changes to the hospital if it's for the benefit of the patients.

Director ...

If we open a general diagnosis department ...

We'll get more patients.

- OK, let's make a general diagnosis department. - What!?

Thank you very much.

I'm really glad I get to work with you again, sensei.

Sagara sensei.

Yes?

You planned to do this from the start, didn't you?

From the start?

Did you really show up at that supermarket by accident?

You were waiting for me, weren't you?

Waiting for you?

You knew I didn't have a job ...

And planned to bring me back here.

Now I see what you mean.

Wait a second ...

Don't tell me ... I lost the job at Mita Central Hospital because of ...

That was you, Sagara sensei!?

Sagara sensei ...

Was this your plan?

You wanted to stop me so badly ...

That you finagled some way ... to keep me from getting that other job.

But ...

For what reason did you want to stop me so badly?

That's it!

Because you felt that to change this hospital, you needed me.

That's right.

I can't believe you!

I'm very serious about this.

I'm going to turn this into a great hospital.

Please help me do this, Minagawa sensei.

Let's do this together.

You have no idea what a terrible thing that was.

OK then ...

Why don't you give me a good slap.

Wha?

- Ow! - I look forward to working with you.

Thank you.

What seems to be the problem?

My left arm feels numb, but I don't know where to go.

Then first you should go to the general diagnosis department.

- Can you feel when I touch you now? - Not really.

OK ... let's check your reflexes.

I don't think this numbness is an internal medicine problem.

First we'll get you x-rayed then send you to orthopedics.

Why did we suddenly start a general diagnosis department?

- The administrative director and I made the decision. - I bet it was Sagara.

- Why would he have any say? - He's trying to take control of this place!

- Moriyama sensei. - He's junior here ...

But he's showing off his skill ...

And acting like he's the ace surgeon here!

- Suguru-chan. - Who's more important, me or that guy!?

Suguru-chan, of course!

You know that, don't you!? You'll be taking over this hospital someday, right?

The reason I hired Sagara sensei is because he's a help to this hospital.

Which means ... he's a help to you too, right?

Don't worry. If he steps out of line, I'll let him know who's boss.

Our ace surgeon is ... Suguru-chan.

I take that back. ... It's MORIYAMA SENSEI.

- Damn right. - Yes, it is!

It'll be just fine.

Hey ...

- I wanna wear a tiara like this. - How much is it?

- The rental fee? Uhm, 120 thousand. - Forget it.

- Ken-chan, why do you have to be stingy because you lost money on the stock market? - Of course I am! I lost 20 million!

You'll earn it back in no time. You're a doctor, after all.

It's not that easy ...

Oh! I gotta go.

Fumi ...

I'm going to decided on the dinner menu with mom.

- Get the cheapest one. - What!?

- I'll leave it to you ... - Good.

I'll message you about it later. Bye.

This is terrible.

Terrible?

In whose eyes?

Huh?

You should never say things are terrible so easily.

Especially if you're a doctor who's looking after very sick patients.

I lost a lot of money on the stock market.

Then it's a good chance for you to start concentrating on your real job.

You went to great pains to become a doctor, so don't waste your time on those things!

What the hell is with that guy?

36.8 degrees.

- How are you feeling? - OK.

- Did you eat all of your lunch? - Yes.

He can't actually look like that.

I'm telling you, it's true. The doctor there looks just like a toilet brush.

- A toilet brush!? - Isn't that crazy!

It sure is.

I'll be back this evening.

You must be kidding!

No, I swear it!

Even if a nurse is a little unsure of herself ...

If she always smiled, patients would prefer her ... over a nurse whose perfect but never smiles.

Who does he think he is!?

Minagawa sensei.

Tah-dah! ... Have a look at this.

Pudding!

It's brand new.

Sure looks good. Here, have one.

- Thank you. ... I'll have it now. - You're welcome.

You had a puzzled expression on just now.

What's up?

The last patient I saw this morning.

- I couldn't determine what the trouble was. - Really?

Even you couldn't tell what was wrong from her symptoms, Minagawa sensei?

It was a 35 year old woman complaining of nausea and abdominal pain.

Her belly was slightly swollen ... so I thought she was pregnant at first.

But ...

No, that's impossible.

She checks regularly with a testing kit.

- We're trying to have children. - I see ...

Then I suspected an ovarian tumor.

But I didn't detect any lumps on the ovaries.

But when I examined with ultrasound ... there was fluid accumulating in her abdomen.

Fluid?

But protein levels in her blood test were normal ...

So it's not abdominal fluid caused by hypoproteinemia.

That's the first time I've had a patient like that.

This is delicious.

What about her liver functions?

- Normal. - And tumor indicators?

Her CEA was elevated.

What are you thinking?

Peritoneal pseudomyxoma?

This is what Kaoru has?

Put simply ...

A tumor that's formed on her appendix is producing large amounts of mucus.

Mucus?

However ... it's still not known exactly why the tumor produces mucus.

Peritoneal pseudomyxoma is an incredibly rare disease.

It's said to affect ...

Only one in one million people.

- What!? - One in a million!?

Can she be healed?

Could it ...

Possibly kill her?

She has developed a tumor ...

So if it's malignant and has spread ...

In the worst case scenario, yes.

But ...

We've discovered it early.

If we operate ...

There is an excellent possibility that she can be healed.

Perform the operation.

Please!

Of course ... Sagara sensei intends to do so.

That's right.

Peritoneal pseudomyxoma.

This is the first time I've ever seen this.

- Do you intend to operate on this patient here? - Impossible!

- Nobody's ever done it before. - This is exactly the kind of patient that needs to be sent to Shotoku University.

None of the doctors at Shotoku University ... have ever done this operation either.

But ...

I've seen this kind of case before.

He must be kidding ...

- Then why don't you take care of it, Sagara sensei. - This has nothing to do with any of us.

See, I told you.

You knew these doctors would act like this.

- As usual, you may as well do the operation yourself. - As usual?

He's not the only surgeon at this hospital, you know.

- Until now we've done all the operations. - That's right.

The patient said that since she's Sagara sensei's patient, then he should be the one to do the surgery.

I wish that turncoat would just butt out!

Did you ... just call me a turncoat?

Hold on here.

I said that ...

I knew about peritoneal pseudomyxoma, but ...

I didn't perform the operation.

This is a one-in-a-million disease.

This patient ...

Should receive our comprehensive care.

- Comprehensive care? - That's right.

I'd like to handle this operation ... with a team of all the surgeons and assistance from internal medicine.

- A team? - You want us to all be your assistants?

Figures!

I would like the surgeon ...

To be Moriyama sensei.

What?

Moriyama sensei?

I can't lead the team myself.

Moriyama sensei ...

Please.

That guy's got something up his sleeve for sure!

It's too weird, suddenly asking Moriyama sensei to do the surgery like that.

Do you think he's forcing him to do a difficult surgery so he can watch him blow it?

I'm gonna blow it?

Oh, no. Peritoneal pseudomyxoma is just very unusual. We wouldn't expect you to fail.

- You'd succeed for sure! - But I'm not gonna do it.

Why should I deal with his patient?

Moriyama sensei!

One of my former classmates works at Tokyo Medical University Hospital.

Know what he told me?

He told me why ...

Sagara sensei quit.

Beer here!

Why did Sagara sensei quit?

His wife died.

She died?

She fell ill last spring and was hospitalized.

Sagara sensei himself handled her care.

But ...

He couldn't save her ...

She only lived another six months.

And you know what she had?

Peritoneal pseudomyxoma.

What?

Surprising, huh?

[Welcome home, dear. I'll make dinner, so wake me up.]

That's OK, you can sleep.

Maki?

Maki!

What's wrong!?

Maki!

Maki!

Your wife was putting up with the pain for quite a long time.

Since you're so busy, she didn't want to bother you.

I've never seen this disease before.

And ...

It's really progressed quite far ...

I'm sorry.

I'm so sorry.

I'm sorry.

Let's do it.

Let's do Kaoru Matsumura's operation.

We'll save her through team treatment.

It's about time Dogami Hospital switched to that kind of system.

Thank you.

Peritoneal pseudomyxoma is an extremely rare condition.

However, at present, research has not determined the cause or an effective method of treatment.

So ... the only way to learn about this condition is to look at past examples.

From these we see ...

Tumors that form on either the appendix or ovaries produce the mucus ...

Sagara sensei ...

We don't want to see material that you've gotten from other sources.

Show us something more clinical.

What do you mean?

From one of your own patients, Sagara sensei.

Tell us about when your wife had it.

Huh?

His wife?

Since I'm the one whose going to perform the surgery, I want some more practical examples.

Of course ...

I express my sympathy for the loss of your wife ...

She died?

- This is a comprehensive effort, right? - That's why the nurses are participating.

Isn't that right, head nurse? We've all gathered here.

I agree.

Tell us what it was like ... Sagara sensei ...

So everyone here ... can get a better idea.

You're right.

My wife ...

Had a tumor on one of her ovaries.

The mucus it produced continued to accumulate, applying pressure on the ovaries ...

And burst the ovary walls.

I see.

In addition ...

She suffered intestinal obstructions.

In the surgery ...

Her lower abdomen was opened wide and the mucus was suctioned out.

There were copious amounts, and it was extremely thick.

The suctioning became plugged up ...

So then ...

It was taken out by hand.

The tumor was then removed ...

But it was found to be malignant ...

And it had already spread to the peritoneum and mesentery.

We treated her with chemotherapy ...

But ultimately ...

Six months after entering the hospital ...

My wife ...

Passed away.

I see.

But ...

The operating surgeon was not yourself, right, Sagara sensei?

Right.

That hospital holds us to a tacit agreement that we not treat our own relatives.

Then the operation ...

Did you observe it?

No.

What I just told you now ...

Was what the operating surgeon told me.

Then, Sagara sensei, in the actual operation ...

I'm not sure you'll be of much help.

Oh ... but of course you will participate.

That's because this is a team effort, right?

But it will be difficult ...

How old is this patient?

- 35. - Oh, she's still young.

- I sure hope we can save her. - Moriyama sensei.

We'll just have to do our best, and leave the rest to fate.

OK ... guess it's time to plan out the operation.

Thank you ...

Sagara sensei.

- Thank you. - Thank you.

- Thank you. - OK, let's go.

So, Sagara sensei ...

You quit your last hospital because ...

You couldn't ...

Save your wife.

Your reason for wanting to change this hospital ...

And why you have so much concern for the patients ...

Is because of what happened to your wife.

I ...

Couldn't save the person most precious to me.

When that happened, Doctor Kousuke Sagara ...

Died.

Matsumura-san.

I don't want to die.

I want to ... be with you forever, Shin-chan.

It'll be all right.

There's nothing to worry about.

Sagara sensei.

- Good morning. - Morning.

- Is something wrong? - Huh?

It looked like something was troubling you.

Really?

No ... I'm just fine.

I brought the data on the medication that I told you about over the phone.

- ... with these results. - Oh, impressive.

I'm going to recommend this as recuperative medication for our next operation.

Moriyama sensei is the team leader.

- I heard. It sounds like a difficult operation. - It is.

I'd like to see it too.

Sure, why not?

What?

You're welcome to watch.

- Are you sure? - Yes, of course.

That's a good idea.

This would be a perfect operation ... for young doctors to see.

Shibuya-san.

Yes?

Oh! Miyabe-san.

- Yes? - Kaoru Matsumura's temperature hadn't been recorded.

- She's your patient, right? - I'm sorry. I forgot.

- You forgot!? - I was so busy, I just ...

- What's wrong with you? This patient's about to have surgery! - I'm sorry ...

That's so unlike you.

- Make sure you take her temperature this afternoon. - Yes. I'm sorry for the trouble.

No way! Even you make mistakes.

Unbelievable!

What's wrong, Sachi?

I ...

Could't bring myself to ...

Go in the room.

You couldn't go in?

Matsumura-san ... was crying.

She was despondent over her disease.

But taking her temperature is also important.

You should just smile when you go in and say, "How are you doing?"

That's easy for you, Ami-chan.

But me ...

I can only do things business-like.

Like a robot.

Like a robot?

Did I always used to be like this?

Suguru-chan.

You heard Sagara sensei, didn't you?

You're the only one fit to be team leader.

He recognizes your abilities, Suguru-chan.

Of course he does.

You're prepared for this operation, right?

You'd better do your best on this.

Since I'm doing the operation, naturally I want it to succeed.

But this is a one-in-a-million disease ...

And if I fail ...

I lose absolutely nothing ... Not me.

- What? - But ...

If Sagara sensei ...

Lost another patient to the same disease his wife had ...

He'll probably have to quit being a doctor.

Suguru-chan!

How dare you say such a thing!

Yes, come in.

Excuse me.

What is it?

Just now we received a call from Director Mizuta of Kugayama Central Hospital.

For this upcoming peri... peri... peri...

- Peritoneal pseudomyxoma. - That! He wants to know if they can observe the operation.

- Observe? - Yes.

Since it's such a rare operation, he'd like his young interns to observe.

How come he knows we're performing this operation?

Dogami General Hospital.

Yes.

Yes, we will be performing that operation.

We got another one!

I see. Certainly. You're welcome to come.

How come everyone knows about this?

It's not just one or two places either.

- Shotoku Medical University is also coming to observe! - They are?

- Well, it is a one-in-a-million disease. - What's wrong with that?

Dogami General Hospital is gaining attention because of this.

It's a great chance to show others the superior skills of our surgeons.

- That's right, Moriyama sensei. - It's peritoneal pseudomyxoma, after all.

If the operation goes well, Moriyama sensei ...

You'll become famous!

Famous ... ?

Well, well ... that was a rare intelligent insight from you, Sagara sensei.

You finally understand us.

Let's work hard to make this operation a success.

We've gotta pull this off, Moriyama sensei.

Right.

Let's do it, sensei?

C'mon, sensei.

As soon as the tumor is removed ...

Immediate pathological diagnosis shall be performed.

If malignancy or intermediate malignancy is determined ...

The peritoneum shall be thoroughly searched for dispersed and metastasized lesions ...

- And removed to the best of our abilities. - Moriyama sensei.

In this case, searching by section would be more effective.

I understand that.

Pardon me.

First ...

Subphrenic dispersed lesions.

Next, residual tumors in the pelvic peritoneum.

If there is excessive invasion into the rectum ...

Who is it?

It's nurse Miyabe.

I'm going to turn off your light.

Nurse?

Yes?

What's ...

Going to happen to me?

You'll be just fine.

Be honest with me.

Sagara sensei is an excellent doctor.

He'll be participating in your surgery too, Matsumura-san.

There's nothing to worry about.

Everything will be absolutely all right.

- Good morning. - Good morning.

- We're from Shotoku Medical University. - We've been expecting you.

Right this way.

Do your best, Suguru-chan.

You show 'em just how good a surgeon you are.

- He brought them here. - He who?

Sagara got someone to contact all of 'em.

I mean, this is crazy!

Why ... why are there so damn many observers!?

- What're you losing your nerve now for!? - He's trying to embarrass me in front of a huge crowd!

Look into my eyes!

Look at my eyes!

Listen!

Sagara sensei ...

He's wants you to handle this because he can't do it.

Remember who you are. You're my nephew, right?

You'll be fine.

You won't fail, Suguru-chan.

You'll succeed for sure!

Make yourselves comfortable.

Kido sensei. Over here.

Excuse me.

OK, is everyone ready?

We're ready.

All right then ...

Let's begin this surgery for peritoneal pseudomyxoma.

I want you to do it just like we planned.

No mistakes.

Yessir!

Hooked forceps.

Hooked forceps.

Electric scalpel.

What the ... ?

What's all this?

Is all that mucus?

Her abdomen is full of it.

First ...

We remove this mucus from the abdomen ...

And simultaneously remove the mucus producing tumor.

Then ... we excise the primary lesion.

After that, according to plan ... we remove the peritoneum.

Let's go!

It's begun.

There's still more.

There must be five liters of that mucus.

I can't believe this ...

- This must be the tumor that's producing the mucus. - It's stuck fast to the surface of the liver.

- We have to be extremely careful removing it. - I know that!

Shall we use a ball-tipped scalpel?

Ball-tipped scalpel.

- Just like we've heard, that's an amazing scalpel. - You're right.

It's removing just the tumor without harming the organs.

- Something's wrong! - What is it?

- Her urine is level is falling. - What!?

- Urine's falling? - Urine?

- Are you certain? - Yes.

Moriyama sensei ...

Since all that mucus was removed from her body, the fluid in her bloodstream has fallen.

Moriyama sensei ...

We've prepared the albumin.

Moriyama sensei!

Shall we begin administering it?

- Administer albumin immediately! - Yessir!

Suguru-chan ...

Please save Kaoru ...

I beg you.

That's it!

That's the primary lesion.

The appendix.

- Where is it? - Is it the appendix?

Moriyama sensei ...

- It appears the tumor has invaded the right ovary. - The ovary?

It does appear to be adhering strongly to it ...

But there's a strong possibility it is only inflammatory adhesion.

- We'll exfoliate the adhesion and remove the ileocecum. - Moriyama sensei ...

That will not result in complete removal.

For peritoneal pseudomyxoma it's pointless unless complete removal is achieved.

If there is the slightest possibility of invasion ...

Everything must be removed, including the ovary.

Ovarian resection?

It'll be OK.

It's just the right one.

- But that's outside our speciality. - Moriyama sensei can handle it!

We have to take it all out ...

Moriyama sensei.

OK!

We'll start with removal of the ovarian ligament. Kelly!

They're gonna do it.

Clamp the ovary.

Metsenbaum.

- Sever the ligament. - 3-0.

I'll ligate the ligament.

I'm going to remove the tumor now.

How long have we been operating?

Three hours.

OK!

In two hours ...

- We'll remove the peritoneum and finish this up. - Yessir.

- Towel. - Yessir.

Kaoru ...

Cooper.

Moriyama sensei ...

That was fantastic.

Kaoru Matsumura's operation ...

Is over.

It was a complete success!

- Really! - Awesome!

- Guess Moriyama sensei had it in him. - Unexpectedly.

- Don't talk like that! - Sorry.

I'm so glad.

I'm so glad.

That was a really amazing operation.

- What a great example of team treatment. - Thank you.

Please allow us to come again for some training.

Certainly! Anytime!

That operation went perfectly.

All that's left ...

Is to pray that mucus doesn't accumulate again, and that no more tumors are formed.

You really didn't operate on your own wife?

You knew exactly how to proceed.

I didn't operate.

But ...

- I've watched the video of her operation hundreds of times. - Then why did you have me do it!?

If you'd done it, we would have finished faster!

The only person who can bring this team together is you.

To improve the level of this hospital ...

Effective treatment teams are essential.

- Moriyama sensei ... Moriyama sensei. - Yeah?

- The doctors that observed said they would like to meet you. - OK, I'll be there in a second.

We're a team?

Don't make me laugh.

A team!?

Sensei, at what point did you realize that the there had been invasion into the ovary?

When I checked the tumor on the appendix, it was very easy to tell.

That was an excellent decision to remove the ovary as well.

In the case of peritoneal pseudomyxoma, one must always keep in mind the chances of relapse.

Any other questions? ... Yes, you.

Sagara.

- Well done. - Kitajima sensei.

- Long time, no see. - It's been a while.

I was really surprised.

I couldn't believe you'd participate in a peritoneal pseudomyxoma operation.

Actually, I would like to have done it sooner.

- I thought you still hadn't gotten over your wife. - I haven't.

I remembered her several times during the operation.

But ...

I will never ...

Allow another patient to die from that again.

Later, Moriyama sensei ...

Will come to explain about postoperative care.

Thank you ... so very much.

We'll do our very best to take care of her ...

- And bring her back to health. - Thank you. I appreciate it.

OK, good-bye.

Nurse.

Yes?

Kaoru said ...

Thanks to you ...

- She felt completely reassured. - Huh?

Thank you very much.

You're welcome.

Take care.

What did you say to her?

Nothing really.

OK, I have to go prepare for a transfusion.

Thank you, Maki.

Thanks to you ...

We were able to save a patient.

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