Original subtitles

It has been six years since Dr. Tokai left.

Now, another person has left Tojo University.

Why did they leave?

I didn't know the answer yet.

At the hospital where I work, Tojo University Hospital,

an incredibly talented surgeon from overseas,

Yukihiko Amagi, has arrived.

Dr. Amagi, who has been appointed by Dr. Saeki as the director

of the new hospital project known as the Cerisier Heart Center,

is a devilish doctor

who decides the fate of his patients through gambling and demands.

However, Dr. Amagi,

is the only surgeon in the world who uses direct anastomosis,

and has successfully completed many difficult operations.

He is building up impressive achievements

towards the realization of the Cerisier Heart Center.

The innocent heart is so beautiful.

Amidst this,

in the race for the presidency of the Japan National Medical Association,

Professor Saeki's rival, Ishin University's Professor Sugai,

tasked his subordinate Dr. Noda

with developing the medical AI tool Elcano.

Please begin coronary bypass surgery.

Roger.

But Dr. Amagi…

What a smart kid you are.

…with a series of brilliant operations that seemed to tame Elcano,

managed to bring about Dr. Noda's downfall.

Amagi…

Nice work.

And then…

The doctor has arrived.

Now at a disadvantage, Professor Sugai aimed to turn the tide

by performing surgeries for VIPs.

His next patient

was Japan's most renowned automobile maker,

the chairman of Uesugi Motors,

Toshikazu Uesugi.

Welcome, Chairman Uesugi.

If Professor Sugai could successfully operate on Chairman Uesugi,

who holds significant influence in the medical world,

the balance of power in the election would shift dramatically.

For selecting an operation with our Elcano Darwin,

we cannot thank you enough.

My name is Hayakawa.

Dr. Noda's previous Elcano unfortunately failed.

But, the Elcano II which I have developed,

while receiving support from the foremost authority, Dr. Takashina,

can collaborate with the Darwin.

A collaboration between Elcano and Darwin.

In other words, using a vast knowledge of the medical world,

Elcano acts as the brain,

while Darwin operates with its arms and legs.

With this, operations once thought impossible to perform

can now be completed.

Dr. Hayakawa cared for it as if it were her child,

this is the fruit of her labor.

Yes. It wouldn't hurt a fly.

Well, how about a demonstration?

Elcano Darwin.

Draw the Mona Lisa.

Roger.

The Mona Lisa on a grain of rice?

How long is the delay

between receiving orders and acting on them?

0.013 seconds. Virtually zero lag.

Furthermore, it has a built-in risk management function.

Disturbance in right arm detected.

Now entering recovery mode.

With this, a patient can survive any mistake that a surgeon makes.

Stupendous.

In other words, this Elcano Darwin is the world's finest doctor.

However, you know,

even if I am indeed the world's greatest automaker,

I'm only satisfied with the world's greatest driver.

And what of that matter?

I've summoned him, just as you requested.

I'm Amagi. Nice to meet you.

I expect much from you.

Thank you.

You're asking me to operate?

Yes. As the first experimental phase for the Elcano Darwin.

As the final piece to the puzzle,

I would like you to teach Elcano your direct anastomosis--

No way.

There's no merit for me.

The patient

is Chairman Toshikazu Uesugi from Uesugi Motors.

Chairman Uesugi?

I hear his assets

total in the ballpark of 600 billion yen.

I would be happy to cooperate.

So you'll even betray Tojo for money?

You're pretty friendly with Ishin yourself, aren't you?

The Elcano Darwin will change the future of medicine.

I'm only following my own beliefs.

What a coincidence.

So am I.

By the way, how are the clinical trial patient arrangements coming?

Tojo has just received a patient who needs direct anastomosis.

Therefore, the trial will take place at Tojo.

Very good.

That sounds like a win-win to me.

Let's work together.

It looks like I don't have a choice.

I won't have it. Why Dr. Amagi?

I don't think you understand.

We'll be able to dispose of him when we're through.

What?

If we're able to input direct anastomosis into Elcano II during the trials,

we won't need Dr. Amagi anymore.

Just like automated driving.

No matter who's driving the Elcano Darwin,

they can master its perfect AI technology.

And then,

direct anastomosis will no longer be Dr. Amagi's secret weapon,

and the direction of the election will shift in my favor.

Make sure the clinical trials are a success.

I'll do everything I can.

And so,

the Elcano Darwin arrived at Tojo University.

-Ishin University? -What are they doing here?

It was Professor Saeki's decision so we had no choice.

Because of that, operating room one will be occupied for a while.

I don't know about this Elcano Darwin stuff,

but I do know it's a pain in the ass.

Professor Sugai.

Thank you for coming to Tojo.

To see Tojo and Ishin working together feels like a dream.

I'm looking forward to it.

As am I.

Elcano can learn to make art.

It's a pleasure to work with you.

Metz.

Nekota?

The mammary artery is disconnected.

If you don't fix the bypass, they'll die.

I was just about to do that.

This is the operating room.

-Good afternoon. -Good afternoon.

Hello, doctors.

This is Dr. Hayakawa from Ishin University.

Nekota?

I had heard you were at Tojo, but to see you so soon?

Are you still doing that even after coming here?

A nurse taking up the scalpel?

Taking up the scalpel?

Cat got your tongue?

Out of my way.

Ouch.

Hey.

When I asked my friend at Ishin,

they said she did treatment without a license.

That's illegal, isn't it?

But knowing Nekota, are you really surprised?

So Ishin University fired her?

Fire… sure is hot!

DR. TOKAI'S STUFF

You can't have any.

Excuse me. Mind if I come in?

Since you only have time to eat that weird food,

I'll make it short.

I have a favor to ask.

I would like you to join us for the next clinical trial operation.

What do you think?

I don't want to join your operation.

I can't help it if you hate me, but I won't be operating this time.

I'm just lending a hand to Ishin University.

The answer is the same. I don't want to deal with Ishin.

Even if something happened in your past,

I don't care.

I don't know much about you, but I do know you have skills.

For a skilled person to be stuck dwelling on the past

is such a waste of time.

-Do you know how good rice is? -I don't.

I like bread more.

That's why I don't like you.

About that clinical test with Ishin University's Elcano.

Why did you permit it?

Because it's Dr. Takashina's project too.

And because Dr. Amagi is participating as well,

I thought we should do it here.

However, I hear Ishin's Dr. Hayakawa will be participating in the trial too.

You don't think

Dr. Takashina plans to put Professor Sugai's name in the paper,

do you?

Are you sure you can trust them?

The state of affairs in the medical world will be influenced by this.

What we should be prioritizing

is the new hospital

and making sure all of our operations are successful.

Now, please get back to work.

Very well.

Finally, the day of the clinical trial arrived.

-However… -Yes.

-Ruptures can be prevented by coiling. -Pardon me.

-I see. -Dr. Amagi?

-Maybe I'll use coiling. -It's almost time.

It's time. Let's go.

The clinical trial has been canceled.

Canceled?

We can prevent a rupture with coiling.

We don't need to perform direct anastomosis.

Right, Elcano?

Yes.

Please try coiling on the coronary artery and perform a bypass.

Direct anastomosis is unnecessary.

-Good job, Elcano. -Wait a minute.

-And with that, -Just wait.

-I'll see you later. -I said wait.

Hey.

Damn it.

What's going on?

How dare they cancel it now?

I'm sorry.

We'll have to find a replacement patient right away.

Doctor?

Are you all right?

Thanks.

Dr. Hayakawa, can you hear me?

-We need a stretcher. -Right.

-Let's take her to the ER. -Okay.

Dr. Sera. Where is she?

She's fine for now.

However…

So there's an aneurysm in my left main coronary artery.

Yes.

-In other words-- -I know.

For this shape of swelling, I would need direct anastomosis.

Isn't that right?

It's our lucky day.

What?

You can be our test subject.

Me?

You're asking Dr. Hayakawa to participate in the trial?

That's right.

That way, we no longer need to find a replacement,

but you'll also get your operation.

Two birds with one stone.

But I wouldn't be able to witness it.

-Analyzing the data and-- -Another doctor can do it.

Our highest priority is making sure Elcano Darwin is ready

for Chairman Uesugi's operation.

Anyone can replace you,

but no one can replace Chairman Uesugi.

As the developer of the Elcano Darwin,

it's wonderful that you also get to be its first subject.

This is great.

I remember the first day you came here.

It was a rainy day like today.

Yes, come in.

Dr. Saeki.

I brought a cat in. Can you take a look?

A cat?

Dr. Tokai saw you when he was participating in a surgery at Ishin.

He wanted to scout you some day.

But I never thought

Ishin would throw you out like that.

Just like Dr. Tokai said,

your skills were top-class.

Here at Tojo,

all of your contributions

are greatly appreciated.

No. It is I,

Professor Saeki,

who is truly grateful.

It's for you.

The gazpacho is to die for.

In fact, the recipe was created by an AI, as you like those so much.

-Really? -Yes.

It's just like Elcano.

By putting in data from around the world,

the chef can make the perfect recipe for the customer.

This gazpacho is incredible.

Thank you.

It's our signature dish, created by my predecessor.

Here's your gazpacho.

Enjoy.

Are you testing me?

No.

It just means we need to be careful

in spotting the difference between AI and humans.

What a funny joke.

Well then.

I would like to meet Chairman Uesugi again.

Understood.

I'll let him know.

Excuse me.

I'm here for a blood test.

Do this first.

Why does it have to be you?

It's my job.

I don't want to be cared for by a nurse who almost killed a patient.

Your temperature is normal.

Pardon me.

Are you still angry

about what happened?

EIGHT YEARS EARLIER

-Metz. -Right.

-Gauze. -Here.

Come quick. Yamashita has an aortal tear.

What should we do?

It might be a heart tamponade. Let's go. You too.

We'll continue when we get back. Insert gauze and watch the patient.

Right.

-Call the doctor! -Okay!

What are you doing?

-Doctor. -What are you doing? Move!

When I came back,

Nekota was suturing the aorta.

Only licensed doctors are allowed to do that.

The patient was rapidly losing blood from their aorta.

-I had to stop the bleeding-- -Even so, that's not your job.

If I hadn't,

the patient would have died.

Enough! We'll take care of it internally.

However,

you will be taking responsibility.

Resign immediately.

You did something that nurses must not do.

That's in the past now.

I've forgotten about it.

Pardon me.

The next day…

Ms. Hayakawa, are you all right?

Doctor, Ms. Hayakawa is experiencing chest pain.

Come in.

Pardon me. I've brought Dr. Amagi.

What is it? I was on break.

-Take a look at this. -What?

We need to operate now.

We'll move the clinical trial forward.

Can you perform direct anastomosis?

How unlucky.

What happened to your arm?

Well, I messed it up playing golf with some VIPs.

I should be okay in three days or so.

Three days?

We don't even have three days.

Is there another way we can operate besides direct anastomosis?

-But in her current condition-- -What are you worried about?

Why not ask the world's best doctor?

To last three days,

use Darwin and bypass the radial artery.

It's true that we would be able to do that with the Darwin.

Then it's decided. Juno, you and I will watch and learn.

-What a great opportunity. -Right.

GONTA TAKASHINA CONFIRMED

Darwin is ready to go.

Transfusion is ready.

Professor Sugai?

Why are you here?

I heard Dr. Hayakawa needs surgery.

I hurried right over.

-I see. -Thank you.

Of course you're worried, what if something goes wrong?

If it does, the whole experiment will be ruined.

Don't talk like that.

Sorry. But this time, we have Dr. Takashina, Elcano, and Ms. Kitty.

Chest opened. Preparations complete.

Roger that.

Follow Elcano Darwin's orders to support the robot arms.

Okay.

Please verify the 3D image.

3D image okay.

-Please verify electrocardiogram. -Electrocardiogram okay.

-Please check patient number. -Patient number okay.

Preparations complete. Case number 260014.

Please begin bypass and removal of aneurysm.

Roger.

We'll now begin bypass and aneurysm removal.

Radial artery dilated. Please apply hydrochloride papaverine.

Roger that.

-Please detach radial artery. -Roger that.

Amazing.

It even knows about surrounding tissue?

Just wait. There's more.

-Bypass complete. -We'll now move to the aneurysm.

We'll leave it to Elcano Darwin.

Understood. I'll suture the aneurysm.

-Please prepare 4-0. -Roger that.

Now starting suture.

-Suction, please. -Right.

Bleeding detected.

Sorry, the suction tube got stuck.

Elcano. Suture the aneurysm and go into recovery.

Roger that. Please prepare 4-0 for the side.

Nice recovery.

In the future,

maybe we really won't need doctors anymore.

Aneurysm suture complete.

-It went pretty smoothly. -I can't believe it.

Dr. Amagi,

I implore you to teach Elcano Darwin your direct anastomosis.

Then it will be complete.

It's for the clinical trial. I'm asking you.

Sure. All for Chairman Uesugi.

I'll leave the rest to you.

Got it.

Nice work.

Taking away the heart-lung machine.

-Right. -Okay.

How long will it take?

The arm won't move.

What are you doing?

What is Nekota doing?

What's going on?

Hey!

Are you trying to kill the patient?

What is she doing?

Kick that nurse out!

Dr. Sera, Minjae!

Dr. Sera!

Hey, what are you doing?

We have to stop the bleeding now.

It's because you do as you please!

Get out!

-What happened? -Get her out.

Hurry!

-Nekota! -Nekota!

-Let me go! -Get her out.

Let me go!

We have bleeding!

-What? -We have bleeding from the suture.

-Dr. Sera. Help us stop the bleeding. -Right.

Self-restraint.

-That's what you're saying? -These are only temporary measures.

Let's be glad they could stop the bleeding.

I know about Nekota's past.

No matter what kind of things may have happened to her,

we cannot allow actions that put the patient's life at risk.

For now,

can you just let me handle this case?

Understood.

Come in.

-Did you call me, sir? -Yes.

I have something to talk to you about.

It's about Nekota.

Nekota?

Hello? Nurse Fujiwara?

What are you doing?

The patient in room 6225 is experiencing chest pain. Prepare a stretcher.

Are you okay? Where does it hurt?

-Where's the lead doctor? -They had something come up.

They're still losing blood.

Blood pressure is dropping.

What should we do? The patient will…

-We need felt and 4-0. -What?

-I've got to operate. -We can't! Nurses don't have permission!

-You'll be arrested! -We'll operate for post-op bleeding.

Don't do it.

I will not allow you to do this.

Stop!

If I stop…

do you plan on standing there and watching this person die?

Haven't you learned your lesson?

Nekota.

Don't make the same mistake twice.

I…

I'll never give up.

I won't let anyone die.

Dr. Takashina.

Get away from the patient.

Now!

-Prepare for suturing. Get gauze. -Right.

Do you understand what you've done?

Only doctors are permitted to do that!

You're not a doctor.

-You must not meddle in these affairs. -I am a doctor.

What are you saying?

I am a doctor.

You're a nurse!

Ms. Kitty is right.

She is a proper doctor.

What do you mean?

The director told me.

It's about Nekota.

She came to us and works here as a nurse,

but she has been studying hard to enter our faculty of medicine.

I can tell by watching her during operations.

I adjusted her working hours to avoid overlap with lectures and training.

Right,

Tokai helped with her practical training as well.

-Dr. Tokai. -Yes.

A few days ago, she successfully passed the doctor's examination.

Studying to be a doctor while working as a nurse?

Even so, she's still only just started, so she's at beginner level.

The operation might be too much.

I can do it.

Then carry on.

You're legally allowed to do it.

Sounds good, Dr. Takashina?

Understood.

If that's what you think, Dr. Amagi.

-Arai, help me. -Right.

-Electroscalpel. -Here.

-Felt -Right.

4-0.

-Careful with the spiral branch. -Right.

Don't do anything weird here.

If you want to do weird things, become a doctor.

Let me try.

-When you're stitching, -Yes?

put the needle in, turn it like this, and pull it out.

Got it.

-Turn it again… -Right.

Isn't it hard to get the needle in when the heart is beating?

It is.

But if you hold the back of the needle,

and turn it just right,

just like that, it will go in.

You did it.

Thanks.

Very good. You did it.

So you aren't coming back?

For now.

I haven't decided anything.

I…

I won't give up

until I become a doctor.

Don't overdo it.

Later.

-Metz. -Here.

Finished.

Good job.

If we can do direct anastomosis three days from now…

ST is rising.

Why? I was so careful with the circumflex artery.

A clot in the circumflex artery?

Dr. Amagi.

We have to perform direct anastomosis.

But his right arm…

I can do it with my left hand. But I need someone to follow.

Should it be the Elcano Darwin? Or maybe…

Do you want to try, Ms. Kitty?

-I'll do it. -Great. Now, hurry up before she dies.

Make preparations.

Okay.

-Preparations complete. -No, not yet.

No one has made a bet.

-At a time like this? -Yes, the patient is unconscious.

You can't gamble when you're not conscious.

Someone will have to do it for her.

Or should we just call the whole thing off?

We don't have time.

I'll do it.

We'll make it special this time.

More like a test than a gamble.

Which of Ms. Hayakawa's internal mammary arteries will we operate on?

Right? Or left?

Right.

Which is it, Elcano?

The mammary artery we'll be using is…

the right one.

You pass.

Well then.

Together with Elcano Darwin

and Dr. Nekota,

we will now begin direct anastomosis.

Electroscalpel.

Suction, please.

Now entering Learning Mode.

Hold it down, Elcano.

Roger.

All this with only his left hand.

Elcano is acting as his right hand!

The graft is ready.

-Metz. -Here.

Help me take this out, doctor.

Right.

-Metz. -Right.

Good.

-Right there. -Okay.

Elcano, spread it with your arms.

Spreading with the arms.

-Go a little deeper. -Okay.

Good.

Here we go, Elcano.

Can you lower the tension?

Understood.

Dr. Amagi and Elcano are in perfect sync.

-Anastomosis pattern favorable. -Got it.

Metz.

Metz.

Operation complete. The heart is so beautiful.

The heart is so beautiful.

Operation finished. The heart is so beautiful.

The heart is so beautiful.

That's it.

Now you're also a friend of the devil.

I saw a video of the operation.

I saw you trying to stop Elcano.

Nekota.

You were trying to save me.

Did you notice?

I did.

Elcano's mistake

was thinking that the aneurysm hadn't been sutured

and tried stitching it a second time.

Nekota stopped it for me.

Thank you.

But why did Elcano try to do that?

Someone had been tampering with Elcano's database

by adding fake data for quite a while.

They aimed

to have Elcano make a mistake during the clinical trial.

But when that plan failed,

they tried to destroy Elcano itself.

They snuck into the operating room.

Who would do such a thing?

Elcano's former developer.

Dr. Noda.

Dr. Noda?

I believe he holds a grudge after being removed from the project

but he's been handed over to the police.

And now,

unfortunately, there will be a police investigation.

The Elcano Darwin clinical trial will likely be postponed again.

Excuse me.

It's over…

I understand the speed of medical development.

By the time I'm back at it,

I'll have long been surpassed.

ELCANO PROJECT 2009

With my own two hands,

I wanted to present Elcano II to the world.

You can try again.

What?

It will be okay.

As long as you're alive,

you can try and try again.

TOSHIKAZU UESUGI

I heard about it.

The Elcano Darwin clinical trial.

It sounds like it failed.

I sincerely apologize.

I suppose I only have one other option.

Instead of the Elcano Darwin,

I'll be operated on by the hands of Dr. Amagi.

I'll make preparations right away.

The university in charge of Mr. Uesugi's operation

will be Tojo University.

What?

OPERATION CONSENT FORM

TOSHIKAZU UESUGI

Chairman Uesugi, wait!

There's a condition to undergo his operation.

You have to bet half of your assets.

-Is that okay with you? -Well…

Dr. Amagi has already told me everything.

What?

Besides, Chairman Uesugi has already cleared his bet.

Betting on the results of the clinical trial?

Yes.

How does that sound?

Wonderful.

Then we have a deal.

-It can't be. -It can.

You heard it right.

Chairman Uesugi has placed his bet

on the Elcano Darwin's failure during the clinical trial.

That's our deal.

And if the trial is a success,

I'll use the Elcano Darwin.

If it fails,

I'll get Dr. Amagi's surgery.

You must understand.

I only choose the safest route to follow.

That's just who I am.

And with that,

I'll be excused.

Ms. Shiino!

Have you betrayed me?

Pardon me.

Really?

So it went well?

Just as you planned, Professor Saeki.

Please take care of the rest.

Yes.

I brought a cat in. Can you take a look?

If you want to do weird things, become a doctor.

I won't give up

until I become a doctor.

Don't overdo it.

Sneaking out?

Just when I was planning to throw a party for you.

Of course,

with plenty of VIPs.

I haven't changed my mind.

I don't like you.

It sounds like you got an offer

to be a doctor at an overseas hospital.

It's for you.

It's time for you

to move on with your career.

I have no doubt

you'll become a great doctor.

I have no interest in that.

I…

I want to be a doctor like the devil himself.

I'm looking forward to it.

It was a pleasure working with you.

The pleasure is all mine.

After that,

Chairman Uesugi was admitted to Tojo's hospital.

We've been waiting for you, Chairman Uesugi.

It's Dr. Saeki.

Chairman Uesugi's condition has taken a turn for the worse.

We're preparing for emergency surgery.

-Mr. Uesugi, can you hear me? -Sorry I'm late.

-Where's Dr. Amagi? -He isn't here now.

-He's out. -At a time like this?

Dr. Kakitani.

His mitral regurgitation is getting worse.

-It must be ischemia. -Call Dr. Takashina and prepare the Snipe.

Professor Saeki?

I'll do it.

What?

Professor Saeki walked right into the operating room.

He'll perform mitral valve reconstruction.

-Oh. The Saeki Method? -What a relief.

-Electroscalpel. -Here.

-Is the heart-lung machine ready? -Yes.

Chest opened.

-Metz. -Here.

Professor.

We'll stop here for today.

Close him up.

You won't perform the Saeki Method?

Don't question him, Dr. Sera.

This is the professor's decision.

His heart is in terrible condition.

If we stop the blood flow now, it will only get worse.

We'll use medicinal treatment.

-Take over. -Right.

What are you doing?

Close it.

Okay.

Hello?

Yes.

At this time,

a new story concerning the Black Forceps had begun

while nobody was aware of it.

Subtitle translation by: Tom Grathwol