Original subtitles

Black forceps.

The symbol of a fateful connection between Professor Saeki

and another genius surgeon.

Seishiro Tokai had incredible surgery skills

but was known as the "Devil of the Operating Room"

for extorting money from colleagues.

I'll cover it up for ten million yen.

Pursuing past medical errors related to the black forceps,

he unleashed a storm upon Tojo University.

Although the storm eventually settled,

Dr. Tokai, as if to cut ties with Professor Saeki,

left Tojo University.

And then, yet another devil appeared.

Yukihiko Amagi, while demanding half of their assets to be gambled,

has saved many patients.

And so,

the next chapter of the black forceps was coming to an end,

with each key player

harboring their own hidden agendas.

After a successful operation on Chairman Uesugi of Uesugi Motors,

Professor Saeki, who was running for president

of the Japan National Medical Association,

finally assumed the position.

However, upon returning to Tojo University, he announced his intention

to run for reelection as hospital director.

It's time we welcome a new generation.

I will be laying off all current professors and teachers.

-Lay off? -To create opportunities for young staff.

As you all know, Professor Saeki

is attempting to stage a revolution here at Tojo University.

NORIE EJIRI, VICE DIRECTOR INAUGURAL ADDRESS

Let us unite our collective strength

and overthrow this dictator!

She seemed so closely attached to Dr. Saeki.

He pulled the ladder out from under her.

Professor Saeki, are you positive this reform plan is a good idea?

There comes a time when every organization requires new blood.

To aim for new horizons,

we must overcome our pain and continue forward.

I understand, but--

It'll be the same for the nurses.

I have been at your side for so long.

-And I continue to-- -I am grateful for you.

However, making way for the next generation

is your duty now.

SURGICAL RECORDS

When Chairman Uesugi collapsed,

why didn't you perform the Saeki Method?

Metz.

Sir?

Keeping secrets isn't good.

Is that a threat?

A threat?

I know you've been snooping around.

You would be smart to mind your own business.

I appreciate the warning.

But being the contrarian that I am,

that only makes me want to snoop around even more.

Come in.

I'm from the Ministry of Health, Labor and Welfare.

My name is Tomizawa.

Pardon me,

but what brings you here?

We hear that Dr. Amagi has been requesting exorbitant amounts of money from patients.

It's not exorbitant.

I'm only asking them to bet half of their assets to receive surgery.

That's what the public would refer to as exorbitant.

There has been some discussion within the Ministry

about whether it is really appropriate to grant a license to a hospital

with such a director.

You know…

he is receiving the patients' consent.

And discussions regarding the new hospital have been going on for months.

-Why now? -Very well.

We'll start from scratch.

In that case,

please make the necessary revisions to your license application.

I'll return them to Professor Saeki shortly.

No way.

You can't do that.

Are you serious?

Mr. Saeki is the president of the Medical Association now.

My job here is done.

I guess I should be leaving soon.

No.

We'll do an operation.

We'll perform an operation

and show the Ministry what you're capable of,

to prove you're fit to be the director.

-Impossible. -It'll work.

Do you have any patients?

Of course, I do.

There's one.

However, I won't be giving up on testing their luck.

It appears my condition is worsening.

How about taking a break for a while?

-We have the director election too. -That is indeed true.

But I have more work to do.

I'll have to take a break from operating, however.

Make sure to create a schedule for me so nobody takes notice of it.

Understood.

Come in.

Pardon me.

Here are the documents.

Thank you.

MASAYUKI TOMIZAWA MINISTRY OF HEALTH

The Ministry of Health?

HOSPITAL DEVELOPMENT LICENSE APPLICATION

It's all thanks to your support, Dr. Shingyouji.

Thank you for dealing with the Ministry of Health.

Please excuse me.

Dr. Takashina.

Professor Saeki wants to see you.

You seem to be quite close to Dr. Shingyouji these days.

Indeed.

Is there a problem?

Was it you who filed the tip-off?

Tip-off?

CERISIER HEART CENTER YUKIHIKO AMAGI

I have not shared secret information.

I only report.

HOSPITAL DEVELOPMENT LICENSE APPLICATION

Report, you say?

I'll be leaving now.

CHAIRMAN SHINGYOUJI

Go ahead, answer it.

Yes? What is it?

I just received a call from Mr. Tomizawa at the Ministry of Health.

Regarding the Cerisier Heart Center,

it seems the higher-ups have decided to issue the license.

Just as originally planned.

-What? -They got us.

I never imagined the chairman's authority would influence even the Ministry.

There is no one left standing in my way.

But why?

Why are you so focused on the new hospital?

Of course,

it's for the patients.

Over here.

These are Dr. Tokai's things. We've gotten rid of a lot of it.

Has everything else been thrown away?

We're too scared to do that.

We shipped them to his mother's house.

Happy birthday!

TOJO UNIVERSITY HOSPITAL

Hello?

Dr. Saeki?

It's unlike you to call unannounced.

He's been snooping through my things.

He's getting in my way.

Didn't you say you would do something about that?

Tokai.

You don't have to tell me.

It's time to make a move.

We need to hurry.

If we don't act soon…

Right?

Goodbye.

Was that Dr. Tokai?

On the phone?

You must have misheard.

Where is Dr. Tokai now?

I don't know.

What were you doing here?

Did you need Dr. Amagi?

You're a strange one too.

Earning the trust

of two devils.

Professor Saeki.

Are you okay?

Maybe the future of Tojo University

would really be better in the hands of a doctor like yourself.

The next day,

something unusual happened at Tojo University.

-Where is Professor Saeki? -I can't get a hold of him.

What's going on?

Professor Saeki will not be attending today.

The conference is canceled.

Back to work.

It's unlike the professor to suddenly not show up.

What is it?

It's an express delivery for Dr. Amagi.

-I'll take it for him. -Thank you.

Excuse me.

YUKIHIKO AMAGI

OPEN IMMEDIATELY

Dr. Amagi isn't here?

Yes. But you know…

He always does that.

It's nothing new.

It says "open immediately," doesn't it?

Shouldn't you take a look?

Yes, but we can't just open someone's mail.

What if it's a matter of life and death?

Hey, hold it.

-Oh… -What is it?

It looks like bypass surgery was performed in the past.

This heart needs surgery right away.

Hey, you!

Are you her son?

Yes, probably.

How wonderful!

Please go in.

I've been taking care of the house since she passed away,

but there are just so many belongings.

Which patient are these from?

There's no name here.

The information is usually included on these documents.

OCCLUSION IN BYPASS GRAFTS SURGERY NECESSARY

"Please operate immediately…"

Something is strange about Professor Saeki.

You're right. Dr. Kurosaki took over his last operation, right?

-Do you think he's sick? -What?

Sick?

Dr. Sera.

Professor Saeki received bypass surgery before, didn't he?

Do you think I could see

Professor Saeki's check-up medical records?

Please. It's important.

No. That's personal information.

Please.

I'm sorry. I cannot help you.

Maybe Professor Saeki was hoping to have Dr. Amagi cure his illness.

But where did Dr. Amagi go?

I'll look into it.

Go back to work.

-Okay, I will. -Thanks.

Dr. Sera?

SEISHIRO TOKAI MEDICAL LICENSE

ONE YEAR OLD

TWO YEARS OLD

THREE YEARS OLD

4 YEARS OLD

NEWBORN YUKIHIKO 2,358 GRAMS

ONE YEAR OLD

THIRD BIRTHDAY

Happy birthday!

I hope we can play together soon.

MOTHER AND CHILD HEALTH HANDBOOK

You want to see Dr. Saeki's medical records, right?

Yes.

Just this once.

Are you sure?

Well, do you want to see these or not?

I knew I would find you here.

Good guess.

I heard you were looking for something in the break room.

What are you doing here?

I found a pretty interesting photo.

I came here because I wanted to confirm something.

About my other father,

at Ichiro Tokai's house.

So you knew.

So,

you know about your twin?

Of course.

My brother Seishiro.

Dr. Sera.

It wasn't Professor Saeki.

What?

Thank you.

DIAGNOSIS CARDIAC FUNCTION

Nothing strange showed up in the tests after his surgery.

That means…

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

Dr. Amagi. What happened?

Hold on.

Do you have any patients?

Of course, I do.

There's one.

It's Dr. Amagi.

Dr. Amagi?

Where are you going?

Money is so ironic.

I could have stayed here if they had money.

We could have avoided splitting the family up.

There was nothing they could do.

Nothing they could do?

Really?

You're right.

To keep me alive,

I needed multiple operations throughout the years.

But that was incredibly expensive.

My father, unable to afford the costs,

put me up for adoption by a respected authority in cardiac surgery

at the French National University Hospital.

That's how I became Dr. Tsukasa Amagi's adopted son.

Metz.

My life was saved, thanks to my new father.

However…

my heart wasn't entirely cured.

Thanks to my adoptive father, I was able to face my condition.

Also,

thanks to my birth parents,

I learned the pain of a broken family.

No.

You're wrong.

Come here.

Your mother Harue loved cherry blossoms.

Until the day she died,

she cared for those two sakura trees as if they were her own children.

It was the same for Dr. Ichiro.

Even though you were far apart,

he always cared for you.

He never forgot about you

for a single instant.

3RD BIRTHDAY

Amagi.

You know,

when I found that photo, I thought there must be a mistake.

For me,

the only memory I have of my birth parents

is that toy.

But that, too,

was my memory playing tricks on me.

What are you saying?

You look happy in the photograph.

Right. We did look happy, at a time like that.

I've lived my life

telling myself that the reason I was put up for adoption

was because of my illness and its costs.

However…

The sick child in that photograph is holding a blue car.

Mine was the yellow one.

Why is the sick child holding the blue one?

The answer is…

that child is not me…

but my brother Seishiro.

I hope we can play together soon.

Seishiro.

That's right.

I wasn't the one with the bad heart.

It was Seishiro.

-You're mistaken. -Really?

What's this?

SEISHIRO TOKAI

CORONARY ARTERY DISORDER

Explain this to me.

I was planning

to never tell you about it.

Dr. Ichiro and Dr. Tsukasa

kept you and your brother separated on purpose.

To keep the secret of your surgeries at three years old.

At three years old, Tokai had multiple coronary aneurysms

and fell into a life-threatening situation.

He had to undergo emergency surgery.

Let's begin.

Having the cooperation of Dr. Tsukasa, who was in Japan for a medical conference,

Dr. Ichiro began surgery on his own son.

The surgery faced significant difficulties,

and Seishiro's life was on the brink.

That's when the two of them took a gamble.

They decided to take your left internal thoracic artery

and connect it to your brother's internal thoracic artery.

Tokai's life was saved.

However, there was a problem with the operation.

The vascular transplant was an illegal operation.

If the brothers were to grow up as twins,

they would one day realize the truth,

and the illegal act would come to light.

That's why you were…

Ichiro and Harue

were heartbroken.

However,

the real tragedy came after that.

As you started living in France, with an unlucky twist of fate,

you also developed multiple coronary aneurysms.

After losing your thoracic artery during the transplant,

they had no choice but to use veins for your bypass despite risk of clogging.

The reason Dr. Tsukasa devoted his life to treating your heart

was because of these circumstances.

Dr. Tsukasa

was deeply hurt.

That's why he was determined, no matter the odds,

to save your life.

This must be a joke.

How could you?

Give it back.

I promise.

I will not let you die.

I'll do everything I can.

Even if I lose the trust of other doctors.

I promise you

I will cure your heart.

Listen to me.

You can't.

Don't you know?

The only one who can fix my heart

is me.

Amagi.

What is it?

Hello? Dr. Amagi?

Where are you?

You need treatment now.

What are you talking about?

Before we operated on Dr. Hayakawa, you said you hurt your arm playing golf.

But the truth is your immune system was compromised and you had shingles.

During Chairman Uesugi's operation,

you pretended to make a mistake and we sutured in two parts,

but that was because your heart condition had worsened.

You should have been able to handle that on your own.

Tell me it's a lie.

Just laugh like you always do and tell me it's a lie!

When the Cerisier Heart Center is finished

I bet the cherry blossoms will be beautiful.

Stop it.

Why are you talking like that?

I'm counting on you…

Juno.

Dr. Amagi, are you listening?

Dr. Amagi?

Amagi!

Why didn't he tell anyone?

It's not that he didn't.

He couldn't.

After moving to France as a child, he developed multiple aneurysms.

Although he received a bypass, all the veins are now blocked.

The only way to operate on him

is by direct anastomosis.

So you mean he's the only one who can cure his own heart?

No.

The direct anastomosis…

I'll do it.

All right. Revisions complete.

-Restart it and reprogram it. -Right.

The restart will take about 30 minutes.

Excuse me.

This is Takashina. What is it?

Amagi collapsed.

Dr. Amagi collapsed?

It's due to a childhood illness.

We must perform direct anastomosis.

But in that case, wouldn't the operation be impossible?

No, I'll use Elcano to manually recreate the surgery.

You're going to use Elcano, Dr. Saeki?

We don't have a moment to spare.

Get me access to Elcano.

Understood.

I'll do it right away.

I was listening.

-I'm going to prepare Elcano. -Dr. Takashina.

Think this through.

With Dr. Amagi out of the picture,

the new hospital that only serves the rich will be finished.

You were planning on restarting Elcano.

Just tell him it wasn't ready in time.

Isn't it time for a decision?

I've made a request to use Elcano.

Our preparations are complete. We're just waiting for connection.

Right.

Dr. Takashina.

Are we ready to restart?

No.

I'll do it.

I see.

Now connected to external terminal.

CONNECTION COMPLETE

Why?

My goal is equal healthcare for all.

That will never come true

by letting a patient go.

It's Dr. Amagi?!

Dr. Saeki will perform direct anastomosis following Elcano's orders.

But last time, the Darwin was there to assist.

True.

Can it be done without the Darwin?

Chest is open. Adhesions have been removed and the heart-lung machine is on.

Please check the 3D image.

3D image, okay.

-Please check electrocardiogram. -Electrocardiogram, okay.

Please confirm patient number.

Patient number confirmed.

Preparations complete. Case number 291013.

Please begin direct anastomosis.

We will now begin direct anastomosis.

Here we go.

Now initiating direct anastomosis.

Please use the electroscalpel to dissect adhesions in the thoracic artery.

Roger. Electroscalpel.

-Micro tweezers. -Here.

It has begun.

Please use electroscalpel to dissect the thoracic artery by 32 millimeters.

Roger that.

What's the output level?

Fifteen. Shall I turn it down?

-No, this is fine. -Okay.

Now dissecting.

This is a careful procedure.

Indeed.

Graft collection complete.

His condition is good.

-We'll dissect the coronary artery. -Right.

Dissect the left main coronary artery by 25 millimeters with Metz scissors.

-Roger. Metz. -Right.

-Micro tweezers. -Here.

Water.

-Water, please. -Sure.

-Blower. -Right.

-More power. -Right.

-Raise to two liters, please. -Right.

-Set the clip. -Right.

-Clip, please. -Here.

-Hold on. -What is it?

Take a look at the echocardiogram.

Mitral valve regurgitation detected.

Please repair the mitral valve.

He'll have to use the Saeki Method to fix that first.

Professor Saeki.

Performing the Saeki Method in these conditions…

If we hold back,

Amagi will die.

I will save him

with my own hands.

Now starting Saeki Method.

-Scalpel. -Here.

-Metz. -Right.

Direct anastomosis halted.

Now switching to mitral valve repair mode.

-Cooley hook. -Here.

-Suture ring. -Here.

Mitral valve reached.

Please stitch the mitral valve annulus with 2-0 sutures.

Understood.

-2-0. -Okay.

Here.

Okay.

His suturing is as fast as always.

He really is the best.

-Suction -Right.

Warning. Needle removed from valve ring.

Warning. Needle removed from valve ring.

What happened?

I can't see.

You can't see?

My eyes.

My glaucoma is getting worse.

My vision is impaired.

Depending on the angle during surgery,

sometimes I'm not able to see at all.

However,

I have to keep trying.

-But-- -Lead the needle.

Lead it to the valve annulus.

After that,

I'll do it by feeling with the needle tip.

-Is that possible? -It's the only way.

Now.

Let's begin.

Understood.

Incredible.

Just by feeling?

Something is wrong.

The movement of the left ventricle is getting worse.

What's the heart's condition?

Dropping.

-Oh, no. -ST elevation is getting worse.

Professor, what should we do?

What?

The LAD is blocked?

At this rate,

we'll have to simultaneously perform direct anastomosis.

Myocardial ischemia detected. Perform direct anastomosis immediately.

Blood pressure below 30.

Professor Saeki.

Shall we stop?

Prepare for myocardial protection!

-Right! -Are we administering Bosmin?

-Yes! -Is the pump on and working?

-Yes! -Okay.

Professor Saeki.

Professor.

The heart will stop at this rate.

Let's proceed with the occlusion.

They can't do it.

No one can perform direct anastomosis.

So this is the end?

It's VF.

Patient in danger. Please perform direct anastomosis immediately.

It can't be.

This man is…

Dr. Tokai?

Tokai.

You made it.

You still haven't paid me that hundred million.

Thank you for coming.

For ten million yen,

I'll clean up this mess.

Please help us.

Tokai.

Can you perform direct anastomosis?

No.

I won't do it.

I don't like gambling.

Subtitle translation by: Tom Grathwol