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I, Kazutomu Kurihara, work at Honjo Hospital in Matsumoto City, Nagano Prefecture

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which advocates 24-hour, 365-day support.

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I'm a gastroenterologist in my sixth year.

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Please take me to Kikumoto at Shiraito.

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We have been supporting the community medical system

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which has been on the verge of collapse

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and despite all our wounds, we gathered up what little time we had and held a party.

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My friend Shindo Tatsuya, who moved here from Tokyo

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has been working at Honjo Hospital for a few months.

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together with our newly appointed gastroenterologist, Dr. Nami Obata.

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I wish to extend an enthusiastic and warm welcome to the both of them

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By the way, please excuse my

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somewhat old-fashioned way of speaking.

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This is due to the influence of Dr. Soseki Natsume, whom I have admired since my school days.

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Good evening, Kurihara. Are you finished with work?

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Of course not.

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What's the guest of honor doing in the corner? I just got here myself.

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And I'm not the guest of honor, I'm an add-on to the guest of honor.

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That goes without saying. Where's the monster?

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Apparently, he's in surgery for a colon perforation.

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Jiro's been assigned as the primary surgeon these days.

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That's proof of Dr. Amari's trust in him.

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Nice to meet you, Dr. Obata.

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Oh please, call me Obata-kun. Dr. Amari

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Attention, everyone!

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Now that we've got most of our lineup.

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I'd like to introduce the new ace of our department.

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Dr. Obata Nami. I'm looking forward to working with you.

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Obata is a gem that I, Itagaki,

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nurtured with all my heart at Shinano University Hospital.

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After that, she moved to Sapporo Inaho Hospital,

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{\an8}*Endoscopic retrograde cholangiopancreatography, is a procedure to diagnose and treat problems in the liver, gallbladder, bile ducts, and pancreas. It combines X-ray and the use of an endoscope—a long, flexible, lighted tube. Endoscopic retrograde cholangiopancreatography, or ERCP, is a procedure to diagnose and treat problems in the liver, gallbladder, bile ducts, and pancreas. It combines X-ray and the use of an endoscope.

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one of the top ERCP* hospitals in Japan, where she refined her knowledge and skills

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working 12 years in gastroenterology.

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She is a very talented physician in her own right.

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She is one of the foremost experts in Japan

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who can train doctors in ultrasound endoscopy,

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and since Obata is coming to our office,

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our Administrative Director Kanayama-san is very excited.

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He purchased an ultrasonic endoscope.

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Please take care of Nami Obata.

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EUS? Even Teito University Hospital has only a few of these high-end units.

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That's quite a feat. I've never even touched one...

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Dr. Kurihara, I am Obata.

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{\an9}GASTROENTEROLOGIST
OBATA NAMI

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It's nice to meet another fellow student of the same Shinshu experts

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I'm Kurihara. Nice to meet you.

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No, thank you. Ok maybe a little

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I'm not a drinker. - Oh, then...

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Excuse me. (vibrating)

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Yes, this is Kurihara.

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We have an urgent case of hematemesis. Emergency endoscopy, please.
*vomitting of blood

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I thought it'd be easy tonight since Kurihara's not on duty.

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I gotta go. Good luck.

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That EUS is an ultrasound endoscope. Is it that expensive?

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About a million yen? It's more than your annual salary at least.

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That makes me tense

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Doctor, are you okay? What do you mean, Tozai?

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No, it's just a rumor that Administrative Director Kanayama is giving you a hard time.

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Maybe they're planning to make Dr. Kurihara quit and use the money to pay for EUS.

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Oh no~ What am I supposed to do if that happens?

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What am I supposed to do?

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Unfortunately, even with my income, I still can't afford the EUS.

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Besides, I have a wife, Tozai.

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Yes, yes. The best coffee in the world.

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I remember you have a wife who could make the best coffee in the world.

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I'll always be number two anyway.

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Needless to say. Chief Tozai. - Hmm?

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The patient with hematemesis who was rushed to the emergency room last night.

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He's coming up to the internal medicine ward over here now.

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Ah~ the 36-year-old with Mallory Weiss? Yes.

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{\an8}*Mallory-Weiss syndrome refers to a tear or laceration of the mucous membrane, most commonly at the point where the esophagus and the stomach meet

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I heard from Tonomura-senpai. Okay, I'm moving you now

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How are you doing, Mr. Sakakibara?

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I've settled down a lot. Thanks to Dr. Kurihara.

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You seem to have a pre-existing condition of asthma.

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I'll keep an eye on you for a while, including Mallory Weiss' progress.

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Yes, please take care of her...

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Naomi?

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Shin?

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{\an7}MALLORY-WEISS SYNDROME PATIENT
Sakakibara SHINICHI

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Naomi? Shin-chan?

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(phone vibrating)

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Yes, this is Kurihara. Ah, Dr. Obata

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Of course. I'll be right there.

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I'm moving you now

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Drama Special
Kamisama no Karute
Night Three

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Ah.

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What, are you that surprised to see my face?

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I wasn't surprised by the face. I was surprised by the how close you were

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I was wondering if you were awake

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Were you thinking about a woman?

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Here, eat this if you like. My family has an apple farm

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Dr. Obata, I admit there was some confusion. Please continue.

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If you're going to ask me to teach you, you should do some preparations

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I'm sorry. I'll be sure to prepare next time.

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Can you teach me again? Whenever you're up to it

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I'm as busy as you are, Kurihara-kun.

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What? Oh, nothing.

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Chief, are you okay?

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What's wrong?

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Oh, no. About Shin-chan?

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It's nothing. He's just an old.... boyfriend

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You look surprised.

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Mallory Weiss' bleeding has stopped completely.

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Almost no signs of asthma attack.

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But your liver function is poor and you have jaundice...

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Sorry, why jaundice?

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There was no abnormality in the CT scan. It could be the effect of the medication.

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Medication...

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I'm ashamed to say that I've been drinking a little more lately.

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Maybe that's why.

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If it's right after drinking, it's normal.

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Jaundice usually disappears after a few days in the hospital.

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I'll change the medicine.

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Thank you very much, Dr. Kurihara.

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Anything else? I'm a lover of the classics.

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Is that Jean-Christophe by Romain Rolland?

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Ah, yes.

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I've let go of many things in my life

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but this book is like a charm that I keep close to my body.

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"Jean-Christophe" is a masterpiece of French literature that depicts the life of a musician.

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It is said to be based on Beethoven, but I am not sure.

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The binding is superb.

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It's not an exaggeration to say it's a work of art.

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Please hold it, if you like

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Oh, I'm so embarrassed that I asked for it.

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What a fragrance.

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The scent of accumulated time and fine paper and ink.

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The shine of gold.

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This is the second volume. Where's the first volume?

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I've lost the first volume somewhere.

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Lost? What a shame.

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I'm sorry, I got too excited.

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I wanted to be a composer like Jean-Christophe.

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But that dream is long gone now.

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"An artist is a compass

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that always points north in every storm."

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It's a line from "Jean-Christophe".

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Doctor...

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Even if it's stormy now.

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Let's aim north together, Mr. Sakakibara.

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Yes, I'm feeling energized.

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Dr. Kurihara, room 317, Mr. Uchimura is VF.

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VF? Excuse me. Let's go

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Thanks for your help, Kurihara.

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It's not you I helped. It's your patient.

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Where's Natsuna? If it's the middle of the night, my mom can take care of her.

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If anything happens to Natsuna, Kurihara will take care of her next time and bring her home.

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That's fine.

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I'll take care of the rest. You should go home now.

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I'd go home, but Haru's not home right now, she's in Tokyo.

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In Tokyo? She has a meeting with the publisher.

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They're finalizing plans for her next mountain photo book.

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This hospital really does get patients one after the other.

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Are you on duty? Good work. Good work

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I can't make any progress on my paper at all.

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I've got two revisions to do this month. Here, have one

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That's amazing. You were posted last week, too.

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No it's not

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The latest medical treatments keep advancing. If you slack off on your studies

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your knowledge quickly becomes obsolete. As a clinician

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there's no excuse to write papers just because you're busy

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I'm sorry.

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Dr. Obata, there's a case I'd like to discuss.

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Shinichi Sakakibara-san who has Mallory-Weiss syndrome, is suffering from unexplained jaundice.

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There were no abnormalities in the CT scan

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I'd like you to perform an EUS on Sakakibara-san just to be safe.

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You don't have to. Why?

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(vibrating sound)

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Yes, sir. Understood

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I'm going back to the emergency room.

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What a busy hospital.

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That was merciless. She hit me right where it hurts.

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Good night, Chief Nurse Tonomura.

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You're going home at this hour?

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Good night.

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How's it going with Tozai? Is she doing okay?

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Shin-chan and Naomi, huh?

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Well, they don't seem to have changed much.

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He's in serious condition? Eh?

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Well, it's that guy, so  I'm sure he'll recover.

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Why don't you have a drink with her once in a while, Doctor?

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Why me?

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You know Doctor...

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You've read a lot of books, but you don't understand the heart of a woman at all.

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Well, I'm going back to work

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Well, whatever.

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I need to change rooms? Right now, immediately.

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Please give me some time. I have to pack my things.

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We'll move all your stuff here.

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I don't want to bother you with...

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What's bothering me is the fact that you're still doing this!

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Ah, no, this is...

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The worsening of liver function and jaundice...

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They weren't side effects of the medication.

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It's because you were secretly buying and drinking alcohol

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even after you were hospitalized.

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You should be moved to a private room first.

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I'd like to talk to you about transferring to a psychiatric hospital that offers alcholism treatment.

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or discuss whether to continue treatment here...

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Tozai?

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What are you doing? Shin-chan. Naomi.

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Living like this all the time?

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What about your dream of writing the world's greatest symphony?

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Answer me, Shin-chan.

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Who's going to listen to my symphony after I got fired from school like that?

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Who's going to listen, Naomi?

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I lost everything.

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All I have left is my asthma and Mallory Weiss syndrome

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It was unbearable

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I drank until I bled

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After ten years like that, anyone would...

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No, that's not it

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This is the life I chose.

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You don't have to feel responsible for me, Naomi.

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Of course I don't feel responsible.

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But you know, an artist...

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never loses sight of the north in the midst of any storm.

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It's your compass!

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I haven't lost sight of the north in 10 years.

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Do you know why?

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This is a hospital, Mr. Sakakibara.

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It's a place where many people are fighting illness.

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If you don't want to be cured, please leave.

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Pulling out the IV isn't the appropriate thing to do.

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I want to cry, but I can't even cry.

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Even though I want to die.

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I wanted to die, but I was in so much pain that I had to call an ambulance.

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I can pull out the IV myself anytime I want.

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But I can't even do that

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I'm a useless person.

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He's too self-deprecating. Illness makes us feel weak.

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I'll give you another line from Jean-Christophe.

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"As long as your faithful friends cry with you,

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life is worth suffering for."

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Tozai was crying for you.

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It's raining. I know.

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Take it with you. I don't want it. The Doctor will get wet.

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There's two of us and only one umbrella.

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If it's about pulling out an alcoholic's IV,

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don't worry about it.

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I would've pulled it out myself.

244
00:19:21,380 --> 00:19:24,530
Doctor.

245
00:19:24,530 --> 00:19:28,220
Come have one drink with me.

246
00:19:28,220 --> 00:19:31,870
10 years ago.

247
00:19:31,870 --> 00:19:37,060
He was my music teacher in high school.

248
00:19:37,060 --> 00:19:42,450
He was weak, had asthma, and was good-looking.

249
00:19:42,450 --> 00:19:45,890
He was very talented.

250
00:19:45,890 --> 00:19:48,890
He wanted to be a composer while he was teaching.

251
00:19:48,890 --> 00:19:55,880
He made beautiful music. I liked him.

252
00:19:55,880 --> 00:19:58,880
I knew you were in love.

253
00:19:58,880 --> 00:20:04,070
Boo-hoo! One-sided unrequited love.

254
00:20:04,070 --> 00:20:09,890
You see, I'm the aggressive one, but Shin-chan is shy and sensible.

255
00:20:09,890 --> 00:20:14,190
Besides... You were a student and he was the teacher.

256
00:20:21,550 --> 00:20:27,710
Ten years ago, the symphony he completed after three years of hard work.

257
00:20:27,710 --> 00:20:30,900
won the Best New Artist Award.

258
00:20:30,900 --> 00:20:35,890
So I came over to his house with a bouquet of flowers to congratulate him.

259
00:20:35,890 --> 00:20:38,370
Shin-chan was unusually excited.

260
00:20:38,370 --> 00:20:43,540
He took me to his favorite restaurant.

261
00:20:43,540 --> 00:20:48,050
I was so happy.

262
00:20:48,050 --> 00:20:52,220
It was like I was on a date with the idol of my dreams.

263
00:20:52,220 --> 00:20:57,870
It was like I was in a dream.

264
00:20:57,870 --> 00:21:02,060
There were people my high school at the restaurant.

265
00:21:02,060 --> 00:21:04,900
"What was going on with the teacher and the student?"

266
00:21:04,900 --> 00:21:08,450
It was a big problem.

267
00:21:08,450 --> 00:21:12,990
Shin-chan was blamed by the principal, his colleagues, and his parents.

268
00:21:12,990 --> 00:21:16,790
Shin-chan resigned from the school

269
00:21:25,470 --> 00:21:33,890
Sorry, Shin-chan, I'm sorry.

270
00:21:33,890 --> 00:21:38,490
It's my fault he disappeared from town.

271
00:21:48,070 --> 00:21:54,710
After that, I kept buying classical magazines.

272
00:21:54,710 --> 00:21:58,870
I was sure that Shin-chan would become a composer somewhere.

273
00:21:58,870 --> 00:22:04,560
I was sure he would write beautiful music again.

274
00:22:04,560 --> 00:22:08,760
All I could do was believe.

275
00:22:10,930 --> 00:22:14,230
(shouting)

276
00:22:35,056 --> 00:22:37,890
The reason I wanted to become a nurse was

277
00:22:37,890 --> 00:22:42,995
 because Shin-chan was suffering from asthma.

278
00:22:43,011 --> 00:22:48,100
I saw him composing music while screaming from a seizure.

279
00:22:48,100 --> 00:22:56,060
I really thought that I wanted to support people like him

280
00:22:56,060 --> 00:23:01,550
who risk their lives to pursue their dreams.

281
00:23:01,550 --> 00:23:08,570
That became my dream...

282
00:23:08,570 --> 00:23:10,570
Ten years.

283
00:23:13,730 --> 00:23:16,400
For the past 10 years nothing happened

284
00:23:16,400 --> 00:23:20,220
It's not like I've only been thinking about him.

285
00:23:20,220 --> 00:23:26,710
There are people I've been in relationships with, and I feel fulfilled in my work.

286
00:23:26,710 --> 00:23:31,540
But you know...

287
00:23:31,540 --> 00:23:40,720
When I'm down, when I want to cry.

288
00:23:40,720 --> 00:23:49,560
When I'm about to despair.

289
00:23:49,560 --> 00:23:55,460
My compass was Shin-chan, the one who talked so much.

290
00:23:57,570 --> 00:24:02,970
He was the one who wrote beautiful songs while screaming.

291
00:24:08,230 --> 00:24:12,430
That person...

292
00:24:22,079 --> 00:24:30,700
Doctor... I'm so frustrated.

293
00:24:38,240 --> 00:24:43,130
Eh...

294
00:24:43,130 --> 00:24:46,530
Are you that not interested?

295
00:24:58,678 --> 00:25:00,850
Ouch!

296
00:25:04,584 --> 00:25:07,250
Here you go.

297
00:25:10,540 --> 00:25:15,400
Ladies and Gentlemen, it would be foolish to try

298
00:25:15,400 --> 00:25:17,359
and figure out where I've been sleeping.

299
00:25:17,367 --> 00:25:21,770
Master, please keep this a secret from Haru.

300
00:25:21,770 --> 00:25:27,230
Dr. Kurihara, this is Izakaya Kyubei.

301
00:25:27,230 --> 00:25:33,620
Ladies and Gentlemen, I too was a fool.

302
00:25:33,620 --> 00:25:37,670
A few days later, Mr. Sakakibara was transferred to a new hospital.

303
00:25:37,670 --> 00:25:40,720
He volunteered to go to a psychiatric hospital

304
00:25:40,720 --> 00:25:43,410
where he could receive alcoholism treatment.

305
00:25:43,410 --> 00:25:51,070
How is Naomi...no, Tozai-san doing?

306
00:25:51,070 --> 00:25:55,720
I happen to be off today.

307
00:25:55,720 --> 00:25:59,920
Here.

308
00:26:06,170 --> 00:26:10,810
It's the first volume of "Jean-Christophe.

309
00:26:10,841 --> 00:26:13,570
Doctor...how did you get your hands on...

310
00:26:13,570 --> 00:26:16,740
Not from me but from Tozai.

311
00:26:16,740 --> 00:26:21,730
She borrowed it from a music teacher she admired

312
00:26:21,730 --> 00:26:26,900
when she was in high school. I lent it to Naomi?

313
00:26:26,900 --> 00:26:32,810
Oh... that's right.

314
00:26:32,810 --> 00:26:34,830
She said she hadn't read it yet.

315
00:26:34,830 --> 00:26:37,550
Because of that, she had been putting off returning it.

316
00:26:37,550 --> 00:26:43,050
As long as she has this, she'll always have an excuse to go see him.

317
00:26:43,050 --> 00:26:46,750
He's a troubled guy.

318
00:26:53,100 --> 00:26:56,800
There's no trace of her having read it.

319
00:26:58,241 --> 00:27:01,420
It was too difficult for her, so she gave up early.

320
00:27:07,579 --> 00:27:13,220
That's how Tozai is. Don't worry.

321
00:27:13,220 --> 00:27:16,700
She's always been like that.

322
00:27:16,700 --> 00:27:19,710
She's as bright as the sun.

323
00:27:19,710 --> 00:27:25,380
She made me laugh until I was hurting at the sides

324
00:27:25,380 --> 00:27:31,070
Making you laugh is inappropriate therapy.

325
00:27:31,070 --> 00:27:36,920
Naomi kept this for me, didn't she? The first volume.

326
00:27:36,920 --> 00:27:44,420
Yes, for ten years, despite her impure motives.

327
00:27:46,548 --> 00:27:49,380
Your ride is here. Yes.

328
00:27:52,890 --> 00:27:57,390
Doctor, I...

329
00:27:59,700 --> 00:28:02,550
"Oh, my friend.

330
00:28:02,550 --> 00:28:05,370
You mean to tell me that a tree needs a jug of water

331
00:28:05,370 --> 00:28:09,560
more than it needs rain to grow!

332
00:28:09,560 --> 00:28:13,760
You mean to tell me that it needs a pot more than it needs soil?"

333
00:28:16,258 --> 00:28:21,570
"Open your eyes and see the vastness of the earth!"

334
00:28:21,570 --> 00:28:24,900
What's that?

335
00:28:24,900 --> 00:28:28,740
It's a passage from "Jean-Christophe".

336
00:28:28,740 --> 00:28:31,410
Dr. Kurihara.

337
00:29:11,900 --> 00:29:15,920
It wasn't long after that, that Dr. Obata left a patient

338
00:29:15,920 --> 00:29:18,070
in the emergency department overnight

339
00:29:18,070 --> 00:29:20,070
without examining him.

340
00:29:26,506 --> 00:29:30,631
It wasn't long after that, that Dr. Obata left a patient

341
00:29:30,639 --> 00:29:32,870
in the emergency department overnight

342
00:29:32,870 --> 00:29:35,540
without examining him.

343
00:29:35,540 --> 00:29:37,540
Where's Yokota-san? Sorry, Doctor

344
00:29:37,540 --> 00:29:41,730
I'm a little worried. Of course. Yokota-san? Yokota-san?

345
00:29:41,730 --> 00:29:43,880
Nurse Tonomura, how long has she been like this?

346
00:29:43,880 --> 00:29:46,080
Six hours.

347
00:29:49,050 --> 00:29:53,400
Yokota-san! Oh, thank God, you're conscious.

348
00:29:54,329 --> 00:29:58,104
{\an7}ALCOHOLIC LIVER CIRRHOSIS PATIENT
KEN YOKOTA

349
00:29:53,400 --> 00:29:58,990
I can't drink anymore, Mama

350
00:29:58,990 --> 00:30:04,400
It's Nurse Tonomura, not Mama. Damn it, Dr. Kurihara.

351
00:30:04,400 --> 00:30:10,070
I'm sorry you had to be called out again.

352
00:30:10,070 --> 00:30:13,870
I'll run some tests. Blood test for ammonia. Understood

353
00:30:18,230 --> 00:30:20,600
Test results show that Mr. Yokota has

354
00:30:20,600 --> 00:30:22,870
a recurrence of severe hepatic encephalopathy

355
00:30:22,870 --> 00:30:25,550
I'm sorry for the trouble.

356
00:30:25,550 --> 00:30:28,890
Why didn't you check him out? You left him out overnight.

357
00:30:28,890 --> 00:30:34,040
His chart said he had recurrent hepatic encephalopathy due to alcohol consumption.

358
00:30:34,040 --> 00:30:36,230
That's why I thought IV fluids would be enough.

359
00:30:36,230 --> 00:30:38,400
If I'd known the doctor in charge was Kurihara-kun.

360
00:30:38,400 --> 00:30:41,250
I would've been a little more careful. I don't think that's the problem.

361
00:30:41,250 --> 00:30:43,250
You're right.

362
00:30:48,380 --> 00:30:50,540
Doctor.

363
00:30:50,540 --> 00:30:52,930
There's one more patient I'd like you to take a look at.

364
00:30:52,930 --> 00:30:55,470
Is that okay?  Sure.

365
00:30:55,470 --> 00:31:00,220
Six days ago, an old man came to the emergency room with abdominal pain.

366
00:31:00,220 --> 00:31:03,890
Dr. Obata was on duty that night too.

367
00:31:03,890 --> 00:31:07,380
What did Dr. Obata do?

368
00:31:07,380 --> 00:31:11,280
Determined it was acute gastroenteritis without taking blood.

369
00:31:11,280 --> 00:31:13,570
He gave him an antibiotic and sent him on his way.

370
00:31:13,570 --> 00:31:17,370
The old man had a mild case of jaundice.

371
00:31:19,616 --> 00:31:21,940
Jaundice....

372
00:31:24,040 --> 00:31:26,730
I'd like to ask Sakakibara-san to do an EUS just in case.

373
00:31:26,730 --> 00:31:30,600
I don't have to. I can't drink anymore, Mom.

374
00:31:30,600 --> 00:31:33,520
Was the old man drinking at that time?

375
00:31:33,520 --> 00:31:35,540
Yes, he was.

376
00:31:35,540 --> 00:31:39,930
His face was all red from drinking, and his grandson was with him.

377
00:31:39,930 --> 00:31:43,860
I told Dr. Obata he was quite the drinker.

378
00:31:43,860 --> 00:31:47,350
The old man came in again earlier.

379
00:31:47,350 --> 00:31:50,540
He said he's been vomiting since last night.

380
00:31:50,540 --> 00:31:55,540
I don't think it was acute gastroenteritis.

381
00:32:05,850 --> 00:32:08,860
Do you drink a lot, Shimauchi-san?

382
00:32:09,071 --> 00:32:12,346
{\an7}SHIMAUCHI KOUZOU

383
00:32:08,860 --> 00:32:13,240
Yes, though it's much less than it used to be.

384
00:32:13,498 --> 00:32:16,173
{\an9}GRANDSON
SHIMAUCHI KENJI

385
00:32:13,240 --> 00:32:15,530
Grandpa... you should definitely be hospitalized.

386
00:32:15,530 --> 00:32:17,880
I think you should be hospitalized and have a checkup.

387
00:32:17,880 --> 00:32:19,870
Don't be so dramatic, Kenji.

388
00:32:19,870 --> 00:32:23,270
Let me see your back. Ah, yes, yes.

389
00:32:29,680 --> 00:32:34,700
Ah... my grandpa used to work in that kind of business.

390
00:32:34,700 --> 00:32:39,020
He was in charge of a group, or something.

391
00:32:39,020 --> 00:32:45,530
The group? Speaking of groups, in this case, there's only that group.

392
00:32:45,530 --> 00:32:50,030
Ah! But it's different now. He's in a totally respectable occupation

393
00:32:50,030 --> 00:32:52,700
When my parents died in an accident.

394
00:32:52,700 --> 00:32:55,370
He turned over a new leaf. Kenji!

395
00:32:55,370 --> 00:32:57,700
Doctor! Please go ahead

396
00:32:57,700 --> 00:33:00,200
Excuse me.

397
00:33:02,260 --> 00:33:04,760
Is there any effect here?

398
00:33:08,070 --> 00:33:11,050
Doctor! How is he?

399
00:33:11,050 --> 00:33:14,720
My grandpa is my only family.

400
00:33:14,789 --> 00:33:16,657
I will do a CT scan

401
00:33:16,740 --> 00:33:22,650
Let's do as your grandson says and stay in the hospital for a while for tests.

402
00:33:22,650 --> 00:33:26,950
Oh, there's something I'm worried about

403
00:33:33,810 --> 00:33:36,810
(Endoscopic) basket please. Yes.

404
00:33:41,730 --> 00:33:44,220
Target 30 mm away.

405
00:33:44,220 --> 00:33:46,720
Proceeding.

406
00:33:51,710 --> 00:33:54,040
Target caught.

407
00:33:54,040 --> 00:33:59,050
You're indeed Itagaki Sensei's disciple. Your fluoroscopy was spot on.

408
00:33:59,050 --> 00:34:03,050
Dr. Obata, do you remember a patient who came to the emergency room about a week ago?

409
00:34:03,050 --> 00:34:06,540
Do you remember him?  Shimauchi Kouzou. 82 years old, male.

410
00:34:06,540 --> 00:34:09,060
What's that? Ah! Yes, yes... this.

411
00:34:09,060 --> 00:34:12,710
It came from my parents' house again. Take it to the doctor's office later.

412
00:34:12,710 --> 00:34:15,150
A gift from me.

413
00:34:15,150 --> 00:34:17,550
I took Shimanouchi-san's CT scan yesterday.

414
00:34:17,550 --> 00:34:20,220
The jaundice wasn't caused by acute gastroenteritis.

415
00:34:20,220 --> 00:34:24,220
There's a strong suspicion it's obstructive jaundice caused by pancreatic cancer.

416
00:34:26,210 --> 00:34:30,880
Mass in the pancreatic head. Blood test showed elevated tumor markers.

417
00:34:30,880 --> 00:34:32,900
Bilirubin level was 4.

418
00:34:32,900 --> 00:34:37,270
It's pancreatic cancer, huh?

419
00:34:37,270 --> 00:34:40,320
Kurihara-kun followed up on me, didn't you? Thank you.

420
00:34:40,320 --> 00:34:42,710
I'm not asking for a thank you.

421
00:34:42,710 --> 00:34:44,710
I'm demanding an explanation.

422
00:34:44,710 --> 00:34:48,220
Why is Dr. Obata refusing to treat patients

423
00:34:48,220 --> 00:34:50,230
you suspect are alcoholics?

424
00:34:50,230 --> 00:34:52,200
Because it's a waste of time.

425
00:34:52,200 --> 00:34:54,200
What do you mean, "waste of time"?

426
00:34:54,200 --> 00:34:56,190
They can't abstain from alcohol.

427
00:34:56,190 --> 00:34:59,360
No matter how many times they're treated, they end up drinking again and relapsing.

428
00:34:59,360 --> 00:35:02,380
I don't have time to deal with that.

429
00:35:02,380 --> 00:35:06,350
Are you serious? Yoo-hoo!

430
00:35:06,350 --> 00:35:10,920
Did you finish the ERCP on the 28-year-old (patient)?

431
00:35:10,920 --> 00:35:16,360
No~! ERCP on a young woman carries a heck of a risk of pancreatitis.

432
00:35:16,360 --> 00:35:19,710
I wouldn't want to expose her if I could help it.

433
00:35:19,710 --> 00:35:23,370
Ah! Obata. I've been requested to give a lecture by the Japanese Society of Hepato-Biliary-Pancreatic Surgery

434
00:35:23,370 --> 00:35:26,370
The material is in the Director's office. Read it later.

435
00:35:26,370 --> 00:35:28,870
I'll look at it now.

436
00:35:31,860 --> 00:35:35,530
Obata's an old-fashioned samurai.

437
00:35:35,530 --> 00:35:39,530
Cut her some slack for her clumsiness, Kuri-chan.

438
00:35:39,530 --> 00:35:41,550
She is not clumsy.

439
00:35:41,550 --> 00:35:44,570
In fact, her ERCP skills are quite remarkable.

440
00:35:44,570 --> 00:35:49,190
But her philosophy is quite eye-opening

441
00:35:49,190 --> 00:35:52,210
Oh, my... what's wrong?

442
00:35:52,210 --> 00:35:56,270
Kuri-chan, talk to me. I'll listen. Let me hear it.

443
00:35:56,270 --> 00:35:59,200
Tell me anything!

444
00:35:59,200 --> 00:36:02,540
Director, are you trying to play the Raccoon?

445
00:36:02,540 --> 00:36:04,590
Who's a raccoon!

446
00:36:04,590 --> 00:36:07,790
Hahahahaha! You know...

447
00:36:24,060 --> 00:36:28,100
I'm always apologizing, Doctor

448
00:36:28,100 --> 00:36:31,470
I'll buy you your favorite drink to celebrate my discharge

449
00:36:31,470 --> 00:36:35,040
Forget it. Cut back on the booze, Yokota-san.

450
00:36:35,040 --> 00:36:37,540
How many times have you been brought in?

451
00:36:37,540 --> 00:36:39,583
It's really life threatening.

452
00:36:39,583 --> 00:36:43,370
I'm sorry! I won't drink anymore!

453
00:36:46,050 --> 00:36:48,550
I won't drink again!

454
00:36:48,550 --> 00:36:52,050
Great Doctor Kurihara.

455
00:36:54,560 --> 00:36:59,060
The next few days passed quietly.

456
00:36:59,060 --> 00:37:01,060
But...

457
00:37:20,880 --> 00:37:24,040
(vibrating sound)

458
00:37:24,040 --> 00:37:26,690
What's wrong? Monster.

459
00:37:26,690 --> 00:37:29,370
What? Yokota-san again?

460
00:37:29,370 --> 00:37:33,380
He was brought in earlier. There was blood in his vomit...

461
00:37:33,380 --> 00:37:36,880
Oh, that's right. Dr. Obata's on endoscopy duty.

462
00:37:36,880 --> 00:37:39,850
She's back from the conference, so I asked her to do the endoscopy.

463
00:37:39,850 --> 00:37:43,540
But as soon as she saw Yokota-san's chart, she said to give him a blood transfusion.

464
00:37:43,540 --> 00:37:45,540
He threw up blood! He coughed up blood.

465
00:37:45,540 --> 00:37:47,530
His blood pressure hasn't risen from 90 when we brought him in.

466
00:37:47,530 --> 00:37:50,030
Okay, I'll be right there.

467
00:38:04,560 --> 00:38:08,030
His blood pressure's rising. Doctor, it's 95 now.

468
00:38:08,030 --> 00:38:11,030
Please continue with Sollact until it maintains 100.

469
00:38:11,030 --> 00:38:14,350
Dr. Kurihara, what about the blood transfusion?

470
00:38:14,350 --> 00:38:19,370
Continue with 2 more units until morning. Secure 2 more units.

471
00:38:19,370 --> 00:38:22,740
Sorry, Doctor...

472
00:38:22,740 --> 00:38:26,030
Thanks for everything.

473
00:38:26,030 --> 00:38:28,870
It's too early to thank me, Yokota-san.

474
00:38:28,870 --> 00:38:32,920
Even if we stop the bleeding, it may tear again and you may bleed to death.

475
00:38:32,920 --> 00:38:36,460
Don't scare me, Mama

476
00:38:36,460 --> 00:38:39,040
It's not Mama, it's Chief Nurse Tonomura.

477
00:38:39,040 --> 00:38:41,060
We stopped the bleeding with the endoscope, but

478
00:38:41,060 --> 00:38:45,120
you have to promise to maintain absolute rest for the next few days and not drink alcohol

479
00:38:45,120 --> 00:38:47,520
Promise me.

480
00:38:47,520 --> 00:38:49,540
Yes, yes.

481
00:38:49,540 --> 00:38:51,540
Yokota-san!

482
00:38:54,060 --> 00:38:58,030
What? This... is quite a mess.

483
00:38:58,030 --> 00:39:00,030
You're looking good. Tozai.

484
00:39:00,030 --> 00:39:03,070
Everyone was worried about the chief having bad luck with men.

485
00:39:03,070 --> 00:39:06,120
I've always been fine, Tonomura-senpai.

486
00:39:06,120 --> 00:39:10,540
Besides, it's not bad luck with men, just the strange men in this world.

487
00:39:10,540 --> 00:39:14,210
Let's talk about that later and get Yokota-san to the ward.

488
00:39:14,210 --> 00:39:17,220
And report to the Monster back at the outpatient line.

489
00:39:17,220 --> 00:39:20,220
Got it. I thought there was some commotion...

490
00:39:20,220 --> 00:39:24,220
Were you doing an emergency endoscopy? Oh, yes...

491
00:39:26,690 --> 00:39:32,250
Dr. Obata... Yokota-san had a ruptured esophageal varicose vein.

492
00:39:32,250 --> 00:39:37,200
He would've died if we hadn't checked on him with just a blood transfusion.

493
00:39:37,200 --> 00:39:39,200
Hey...

494
00:39:39,200 --> 00:39:42,190
What have you been doing all this time?

495
00:39:42,190 --> 00:39:47,190
Wrapping up today's conference? Or another paper?

496
00:39:49,350 --> 00:39:52,700
Your way of doing things is ridiculous!

497
00:39:52,700 --> 00:39:55,700
A nurse shouldn't interfere in a doctor's decision.

498
00:39:57,770 --> 00:40:01,040
Dr. Obata! Please retract what you just said.

499
00:40:01,040 --> 00:40:04,060
It's an insult to all nurses, not just  Tonomura-senpai

500
00:40:04,060 --> 00:40:06,580
Tozai.

501
00:40:06,580 --> 00:40:10,380
Dr. Obata, we need to talk.

502
00:40:15,390 --> 00:40:18,090
Do you want to talk over here?

503
00:40:21,050 --> 00:40:23,050
I can't do this.

504
00:40:26,900 --> 00:40:28,900
Stop this childish behavior

505
00:40:28,900 --> 00:40:30,920
where you say you don't bother with drunkards.

506
00:40:30,920 --> 00:40:34,720
Kurihara-kun, Sunayama-kun, and Shindo-kun.

507
00:40:34,720 --> 00:40:38,710
I'm sure Sunayama-kun and Shindo-kun are putting their patients before the academic conference.

508
00:40:38,710 --> 00:40:40,750
Of course.

509
00:40:40,750 --> 00:40:44,720
Instead of researching the literature on intractable diseases and publishing papers,

510
00:40:44,720 --> 00:40:49,390
you take care of patients who're addicted to alcohol or drugs?

511
00:40:49,390 --> 00:40:53,060
Of course I do.

512
00:40:53,060 --> 00:40:57,910
I think you're underestimating the job of a doctor.

513
00:40:57,910 --> 00:41:01,230
Medicine nowadays evolves month by month.

514
00:41:01,230 --> 00:41:04,740
If you don't study hard, you won't be able to provide the best medical care.

515
00:41:04,740 --> 00:41:08,720
I can't provide the best medical care if I don't study hard.

516
00:41:08,720 --> 00:41:12,060
I can't believe I'm wasting my precious energy and time.

517
00:41:12,060 --> 00:41:17,930
If you ask me, you are self-satisfied hypocrites.

518
00:41:17,930 --> 00:41:20,490
That was an extremely unreserved argument

519
00:41:20,490 --> 00:41:24,390
I don't pretend to be the best at what I do, but...

520
00:41:24,390 --> 00:41:27,390
I have no intention of skimping on my learning.

521
00:41:27,401 --> 00:41:30,378
What is the annual cancer rate of IPMN?

522
00:41:30,400 --> 00:41:32,400
Let's see...

523
00:41:32,400 --> 00:41:35,400
What's the difference between hepatic right lobectomy and extended right lobectomy?

524
00:41:35,400 --> 00:41:37,720
In patients with chronic pancreatitis.

525
00:41:37,720 --> 00:41:41,220
How many times higher is the incidence of cancer caused by smoking in patients with chronic pancreatitis?

526
00:41:41,220 --> 00:41:43,240
Huh...

527
00:41:43,240 --> 00:41:45,900
So how can you do ERCP?

528
00:41:45,900 --> 00:41:49,750
There's a lot of second- and third-rate people in the medical world.

529
00:41:49,750 --> 00:41:51,780
You're not the only one.

530
00:41:51,780 --> 00:41:56,920
But you know what? Ignorance on the part of doctors is bad.

531
00:41:56,920 --> 00:42:00,940
A doctor without knowledge can easily become a murderer.

532
00:42:00,940 --> 00:42:04,940
That's what I'm prepared to do as a doctor.

533
00:42:07,570 --> 00:42:12,220
You think a top-notch doctor has the right to choose his patients?

534
00:42:12,220 --> 00:42:15,240
It's not a qualification. Rather, an obligation?

535
00:42:15,240 --> 00:42:20,400
Are you saying you'll continue to abandon patients who can't manage themselves?

536
00:42:20,400 --> 00:42:24,900
I wonder if it's worth your existence to see such patients.

537
00:42:26,900 --> 00:42:29,210
As for Yokota-san, you were a big help.

538
00:42:29,210 --> 00:42:32,510
You have my gratitude. Thank you, Kurihara-kun.

539
00:42:34,590 --> 00:42:38,150
I must confess that

540
00:42:38,150 --> 00:42:41,880
what swirled around in my heart was regret

541
00:42:41,880 --> 00:42:45,050
and even more intense bitterness.

542
00:42:45,050 --> 00:42:50,760
I couldn't answer even one of Obata's medical questions.

543
00:42:50,760 --> 00:42:55,160
On the pretext of being too busy, I had forgotten

544
00:42:55,160 --> 00:42:59,860
the harsh responsibility of being a doctor.

545
00:43:10,710 --> 00:43:14,920
Speaking of which, I heard that Jiro was being sent back to Shinano University Hospital.

546
00:43:14,920 --> 00:43:18,550
The monster at a university hospital? Yeah.

547
00:43:18,550 --> 00:43:23,230
It's still just a rumor, but I'm in favor of it.

548
00:43:23,230 --> 00:43:25,910
Jiro's good at what he does.

549
00:43:25,910 --> 00:43:30,010
If he can advance his career, more patients will be saved.

550
00:43:34,940 --> 00:43:39,940
Am I behind the times?

551
00:43:48,570 --> 00:43:52,570
Did something happen with Dr. Obata by any chance?

552
00:44:00,060 --> 00:44:05,450
It's not a glass ceiling, but women have a lot of difficulties

553
00:44:05,450 --> 00:44:08,050
just because they're women.

554
00:44:10,390 --> 00:44:16,800
That's why they're so tough, strong, and determined.

555
00:44:16,800 --> 00:44:22,380
To be honest, men can't compete with them.

556
00:44:22,380 --> 00:44:26,180
Just between you and me.

557
00:44:29,560 --> 00:44:31,760
Tatsu

558
00:44:35,080 --> 00:44:40,720
Kurihara, your face is pale. Aah

559
00:44:40,720 --> 00:44:45,260
I used to have that kind of conversation with Dr. Old Fox

560
00:44:45,260 --> 00:44:47,960
as a way of saying hello.

561
00:44:50,810 --> 00:44:55,810
That brings back memories. Ah.

562
00:44:58,440 --> 00:45:04,230
If Dr. Old Fox was still alive.

563
00:45:04,230 --> 00:45:09,430
I wonder how he would've responded to Dr. Obata's philosophy.

564
00:45:11,720 --> 00:45:20,080
The doctor who paid the price for sacrificing his body and soul 24 hours a day, 365 days a year

565
00:45:20,080 --> 00:45:23,060
How...

566
00:45:23,060 --> 00:45:27,200
Do you want to play a game? What?

567
00:45:27,200 --> 00:45:31,700
It's already late. Go home, Tatsu. Natsuna's waiting for you.

568
00:45:31,700 --> 00:45:37,110
I'll put my best friend before my pretty daughter once in a while.

569
00:45:37,110 --> 00:45:42,010
If you insist, I'll play

570
00:45:46,900 --> 00:45:52,060
When you're in a tight spot, it's very important

571
00:45:52,060 --> 00:45:55,060
not to be alone

572
00:46:06,890 --> 00:46:08,870
Haru!

573
00:46:08,870 --> 00:46:12,240
Welcome back, Ichi-san.

574
00:46:12,240 --> 00:46:14,300
And I have returned

575
00:46:14,300 --> 00:46:16,800
You're finally back from Tokyo!

576
00:46:20,540 --> 00:46:23,040
We've been waiting for you, Haru!

577
00:46:25,020 --> 00:46:27,490
I've been practicing my star photography.

578
00:46:27,490 --> 00:46:30,880
My publisher has asked me if I'd like to take my next mountain photo.

579
00:46:30,880 --> 00:46:34,870
Why don't we make the starry skies of the 100 most famous mountains our next theme?

580
00:46:34,870 --> 00:46:41,410
My wife is a well known mountain photographer in that world.

581
00:46:41,410 --> 00:46:46,400
She is not just satisfied with mountains, but also interested in stars.

582
00:46:46,400 --> 00:46:49,950
I, on the other hand...

583
00:46:49,950 --> 00:46:53,370
What's wrong, Ichi-san?

584
00:46:53,370 --> 00:46:55,670
Well...

585
00:47:06,400 --> 00:47:10,050
Normal temperature. It's a good luck charm

586
00:47:10,050 --> 00:47:16,750
May I be able to shoulder at least half of your worries.

587
00:47:21,750 --> 00:47:28,720
Don't worry, I'll be there for you, Ichi-san.

588
00:47:28,720 --> 00:47:31,220
Haru...

589
00:47:34,380 --> 00:47:37,310
Don't be in a hurry.

590
00:47:37,310 --> 00:47:41,720
It's just important to push forward like a cow.

591
00:47:41,720 --> 00:47:46,710
Cow? A cow.

592
00:47:46,710 --> 00:47:50,860
Natsume Soseki wrote in a letter to his students.

593
00:47:50,860 --> 00:47:54,030
"The cow pushes forward in a supreme manner.

594
00:47:54,030 --> 00:47:57,050
If you ask me what I push, I will tell you.

595
00:47:57,050 --> 00:48:01,720
I pushes human beings.

596
00:48:01,720 --> 00:48:05,020
I am not pushing a literary man."

597
00:48:09,710 --> 00:48:13,220
If I were to translate that to myself now

598
00:48:13,220 --> 00:48:16,890
It's not about pushing doctors.

599
00:48:16,890 --> 00:48:20,490
It's about pushing people.

600
00:48:25,880 --> 00:48:29,420
You don't push the mountaineer.

601
00:48:29,420 --> 00:48:31,720
You push the human.

602
00:48:40,090 --> 00:48:42,390
(dog barking)

603
00:48:42,390 --> 00:48:45,080
Oh, Danshaku. Hmm?

604
00:48:45,080 --> 00:48:48,220
Aah, Doctor, you're back late as usual.

605
00:48:48,220 --> 00:48:51,220
Are you shopping this late at night?

606
00:48:51,220 --> 00:48:53,910
No, I'm just here for Princess Haruna after she returned from Tokyo.

607
00:48:53,910 --> 00:48:57,560
I thought I'd treat her to something warm.

608
00:48:57,560 --> 00:49:00,560
Here's a steamed bun. Danshaku-sama.

609
00:49:00,560 --> 00:49:02,730
Thank you very much.

610
00:49:02,730 --> 00:49:05,220
You're busy preparing for your solo exhibition.

611
00:49:05,220 --> 00:49:10,140
Princess Haruna, I've decided to cancel it.

612
00:49:10,140 --> 00:49:13,740
As an aristocrat, it's a waste of time to draw so improperly

613
00:49:13,740 --> 00:49:19,280
Besides, I'm a little bored.

614
00:49:19,280 --> 00:49:21,900
It's been a long time since we had a drink. Whoa.

615
00:49:21,900 --> 00:49:23,900
Haru, get ready.

616
00:49:25,920 --> 00:49:28,570
It was the day after this that Chief Nurse Tonomura

617
00:49:28,570 --> 00:49:33,570
came down with the flu and took a day off.

618
00:49:36,750 --> 00:49:40,450
Oh, you scared me

619
00:49:43,507 --> 00:49:48,230
So is the overly righteous Kurihara-kun going to scold me again?

620
00:49:48,230 --> 00:49:54,800
No, it's true that the atmosphere in the Emergency Department became unsettled.

621
00:49:54,800 --> 00:49:57,350
I have a case I'd like to discuss with you.

622
00:49:57,350 --> 00:50:00,720
It's an 82-year-old Kozo Shimauchi with suspected pancreatic cancer.

623
00:50:00,720 --> 00:50:04,080
The patient who underwent EUS and ERCP the other day, right?

624
00:50:04,080 --> 00:50:06,610
The results of the cytological diagnosis came back.

625
00:50:06,610 --> 00:50:09,230
I couldn't confirm any cancer cells.

626
00:50:09,230 --> 00:50:11,900
You can't rely on cytodiagnosis

627
00:50:11,900 --> 00:50:15,550
There are tons of cases of cancer that came back negative.

628
00:50:15,550 --> 00:50:17,920
Even though there was a mass of that size.

629
00:50:17,920 --> 00:50:23,060
I'm a little concerned that both the pancreatic juice and bile duct are negative from the cytodiagnosis.

630
00:50:23,060 --> 00:50:26,570
What's your diagnosis, Kurihara-kun?

631
00:50:26,570 --> 00:50:29,400
Pancreatic cancer.

632
00:50:29,400 --> 00:50:31,740
Any metastasis or vascular invasion? None.

633
00:50:31,740 --> 00:50:34,560
What's the patient's general condition? He's in good condition.

634
00:50:34,560 --> 00:50:38,410
Wouldn't it be a crime if you didn't operate on him?

635
00:50:38,410 --> 00:50:43,570
That's true. Once we sort through the information, we have no choice.

636
00:50:43,570 --> 00:50:49,040
From here on out, at the advanced age of 82, it's a matter of patient

637
00:50:49,040 --> 00:50:51,590
and family's feelings whether to have the surgery or not.

638
00:50:51,590 --> 00:50:54,210
That's what Kurihara-kun is good at, more than technology.

639
00:50:54,210 --> 00:50:57,210
This is where doctors who can relate to the patient's feelings come in.

640
00:50:57,210 --> 00:50:59,550
I'm at a loss for words

641
00:50:59,550 --> 00:51:03,400
I'll certainly do my best to give informed consent.

642
00:51:03,400 --> 00:51:07,960
Don't you have something to say about Chief Nurse Tonomura?

643
00:51:07,960 --> 00:51:13,560
I'm with Tonomura from the start.

644
00:51:13,560 --> 00:51:18,230
No matter how good a doctor he is, he'll overlook a ruptured esophageal varicose vein because of a patient's inability to manage himself.

645
00:51:18,230 --> 00:51:21,740
because of a patient's inability to manage himself.

646
00:51:21,740 --> 00:51:27,240
I'll be a doctor who stands by my patients even if I'm called second-rate or third-rate.

647
00:51:29,800 --> 00:51:33,570
For once in your life...

648
00:51:33,570 --> 00:51:37,470
Maybe Nurse Tonomura's right.

649
00:51:40,540 --> 00:51:44,890
You don't seem to be sleeping. Your face is pale.

650
00:51:44,890 --> 00:51:48,230
Is that what you say to women?

651
00:51:48,230 --> 00:51:53,400
You're right. I haven't been getting enough sleep or eating lately.

652
00:51:53,400 --> 00:51:56,240
I'm getting close to my dissertation.

653
00:51:56,240 --> 00:51:58,560
but the ward is so busy.

654
00:51:58,560 --> 00:52:02,210
They don't seem to take it too well even when I bully the junior staff to relax.

655
00:52:02,210 --> 00:52:05,400
Kurihara's a real weirdo.

656
00:52:05,400 --> 00:52:10,800
If I may offer a word of advice, it's to make the emergency department work more efficiently.

657
00:52:10,800 --> 00:52:13,060
Nurse Manager Tonomura's return is the best thing for us.

658
00:52:13,060 --> 00:52:15,540
It's the logical conclusion for Dr. Obata

659
00:52:15,540 --> 00:52:17,710
to have more time to write her paper.

660
00:52:17,710 --> 00:52:21,050
Please make it easier for me.

661
00:52:21,050 --> 00:52:24,230
Apologize to the Emergency Department.

662
00:52:24,230 --> 00:52:26,900
The nap room is on the 5th floor.

663
00:52:26,900 --> 00:52:29,700
Sounds good...

664
00:52:46,960 --> 00:52:49,390
The jaundice level from the blood test...

665
00:52:49,390 --> 00:52:55,030
That afternoon, I met with the old man and his grandson, Kenji,

666
00:52:55,030 --> 00:52:57,880
to give informed consent.

667
00:52:57,880 --> 00:53:01,455
The diagnosis was pancreatic cancer, and the surgery was PD.

668
00:53:01,456 --> 00:53:06,439
{\an8}PD = Pancreaticoduodenectomy

669
00:53:01,463 --> 00:53:06,590
Not only the pancreas, but also half of the stomach, duodenum, bile duct and gallbladder

670
00:53:06,590 --> 00:53:09,080
would be extensively removed and reconstructed.

671
00:53:09,080 --> 00:53:11,980
This is a Pancreaticoduodenectomy.

672
00:53:13,880 --> 00:53:15,880
That's all.

673
00:53:15,880 --> 00:53:18,220
Do you have any questions, Shimauchi-san?

674
00:53:18,220 --> 00:53:23,290
If I don't have the surgery, I will have 6 months to live.

675
00:53:23,290 --> 00:53:28,050
Surgery is surgery, and it's pretty big.

676
00:53:28,050 --> 00:53:30,920
That's a difficult question, Dr. Kurihara.

677
00:53:30,920 --> 00:53:37,510
Yes, it's one of the biggest surgeries in gastrointestinal surgery.

678
00:53:37,510 --> 00:53:41,080
However, I've decided that you can endure it under your current condition.

679
00:53:41,080 --> 00:53:44,110
Isn't there anything you can do with medicine?

680
00:53:44,110 --> 00:53:46,160
Grandpa's 82 years old.

681
00:53:46,160 --> 00:53:49,070
You can't just cut out this and that.

682
00:53:49,070 --> 00:53:52,740
Let me think about it for a while.

683
00:53:52,740 --> 00:53:55,740
Grandpa.

684
00:54:27,220 --> 00:54:29,420
Shimauchi-san

685
00:54:31,890 --> 00:54:35,250
Oh, thank you

686
00:54:35,250 --> 00:54:42,900
Thank you for working until this hour, Doctor.

687
00:54:42,900 --> 00:54:44,910
Can't you sleep?

688
00:54:44,910 --> 00:54:49,410
No, I just thought the moon was beautiful.

689
00:54:55,900 --> 00:55:00,810
There were a few times when I made up my mind

690
00:55:00,810 --> 00:55:03,340
that this guy was going to die.

691
00:55:03,340 --> 00:55:06,900
That's a terrible thing to say.

692
00:55:06,900 --> 00:55:13,900
I've caused a lot of trouble for my family and people around me.

693
00:55:13,900 --> 00:55:18,290
So, at least for the last time.

694
00:55:18,290 --> 00:55:23,400
I figured there must be a way to put my body away

695
00:55:23,400 --> 00:55:28,430
without causing trouble to anyone.

696
00:55:28,430 --> 00:55:34,390
But it worked out.

697
00:55:34,390 --> 00:55:40,560
The idea that I should take care of myself was

698
00:55:40,560 --> 00:55:47,240
just a myth of my youth.

699
00:55:47,240 --> 00:55:50,910
When you die, someone else has to take care of things

700
00:55:50,910 --> 00:55:53,210
You'll cause trouble.

701
00:55:56,260 --> 00:56:00,400
Especially Kenji.

702
00:56:00,400 --> 00:56:09,070
His parents are my daughter and her husband.

703
00:56:09,070 --> 00:56:15,050
They died quickly in an accident.

704
00:56:15,050 --> 00:56:21,240
It's my fault for spoiling him.

705
00:56:21,240 --> 00:56:26,880
He'll never be able to get rid of his old man.

706
00:56:26,880 --> 00:56:34,780
I can't believe I'm letting Kenji clean up after me.

707
00:56:34,780 --> 00:56:40,040
I'm depressed, doctor.

708
00:56:40,040 --> 00:56:46,230
Were you more worried about Kenji-san than yourself?

709
00:56:46,230 --> 00:56:49,930
He's a kind grandson.

710
00:56:53,720 --> 00:56:58,060
Then, for the sake of your grandson.

711
00:56:58,060 --> 00:57:00,890
Why don't you stretch yourself to live?

712
00:57:00,890 --> 00:57:04,710
Stretch?

713
00:57:04,710 --> 00:57:09,870
Doctor, are you gambling?

714
00:57:09,870 --> 00:57:14,390
Medicine isn't gambling.

715
00:57:14,390 --> 00:57:16,880
But rather than doing nothing at this point.

716
00:57:16,880 --> 00:57:20,530
Surgery has a better chance of winning.

717
00:57:20,530 --> 00:57:25,400
I see.

718
00:57:25,400 --> 00:57:27,450
Is there a chance?

719
00:57:27,450 --> 00:57:31,220
There is. At least.

720
00:57:31,220 --> 00:57:37,700
there's no discrimination in medicine whether you have a dragon on your back or not.

721
00:57:37,700 --> 00:57:40,380
I'm sorry. I got carried away.

722
00:57:40,380 --> 00:57:45,890
Hahahahaha... hahahahaha!

723
00:57:45,890 --> 00:57:51,380
I've decided. Let's stick with the one who's going to perform the surgery.

724
00:57:51,380 --> 00:57:55,560
This is going to work.

725
00:57:55,560 --> 00:57:59,260
(laughing voice)

726
00:58:01,240 --> 00:58:03,250
What did you just say, Jiro.

727
00:58:03,250 --> 00:58:08,250
I said I'd be the one to perform Shimauchi-san's surgery.

728
00:58:10,730 --> 00:58:14,230
Actually, Ichito

729
00:58:14,230 --> 00:58:18,290
I'm going back to Shinano University Hospital next month.

730
00:58:18,290 --> 00:58:20,320
I know all about that. More importantly...

731
00:58:20,320 --> 00:58:22,710
You knew? Why didn't you say anything? It wasn't funny

732
00:58:22,717 --> 00:58:24,222
I know, but let me ask you first.

733
00:58:24,250 --> 00:58:27,101
PD is a major surgery. Shouldn't Surgical Director Amari do it instead?

734
00:58:27,130 --> 00:58:33,330
Dr. Amari also said so. I have to show him what I've accomplished here.

735
00:58:35,900 --> 00:58:40,910
Don't give me that look. PD is the gateway to success in surgery.

736
00:58:40,910 --> 00:58:43,400
I can't believe they're letting me do it so soon.

737
00:58:43,400 --> 00:58:49,750
I'm... filled with anxiety too.

738
00:58:49,750 --> 00:58:51,740
Turn it down.

739
00:58:51,740 --> 00:58:53,740
Why?

740
00:58:56,660 --> 00:59:01,250
I see. I guess you're sad to say goodbye to me after all.

741
00:59:01,250 --> 00:59:06,550
All right, I'll pour you some of my best Sunayama blend.

742
00:59:31,730 --> 00:59:34,400
Today's Shimauchi-san's surgery, right?

743
00:59:34,400 --> 00:59:36,400
Yes, Chief.

744
00:59:36,400 --> 00:59:40,390
I heard the primary surgeon is Jiro-san... oh, Dr. Sunayama.

745
00:59:40,390 --> 00:59:44,070
You're worried.

746
00:59:44,070 --> 00:59:48,960
No, I believe in Dr. Sunayama

747
00:59:48,960 --> 00:59:52,000
He'll be fine.

748
00:59:52,000 --> 00:59:58,720
Nicotine is said to be effective in relieving tension.

749
01:00:01,710 --> 01:00:06,540
A man who with a cigarette in his hand is precious picture

750
01:00:06,540 --> 01:00:10,920
Nurse Tonomura, don't you have the flu?

751
01:00:10,920 --> 01:00:15,240
Don't ask me nonsense.

752
01:00:15,240 --> 01:00:21,110
Shimauchi-san's PD is about to start.

753
01:00:21,110 --> 01:00:26,060
I hear the primary surgeon is Dr. Sunayama, a close friend of Dr. Kurihara's.

754
01:00:26,060 --> 01:00:29,230
It's not my intention to be called his best friend, but

755
01:00:29,230 --> 01:00:38,230
But I have a faint attachment and a great deal of anxiety.

756
01:00:38,230 --> 01:00:40,430
So, what's with the cigarette?

757
01:00:43,400 --> 01:00:51,570
Doctor, surgery is on the right foot, internal medicine is on the left.

758
01:00:51,570 --> 01:00:53,570
Huh?

759
01:00:57,230 --> 01:01:04,620
Nurse Tonomura, doesn't smoking put a strain on the respiratory system?

760
01:01:04,620 --> 01:01:13,380
I'm going back to the Emergency Department, after I finish this one

761
01:01:13,380 --> 01:01:17,800
Has your anger subsided?

762
01:01:17,800 --> 01:01:21,890
Dr. Obata seems to have endured it for now

763
01:01:21,890 --> 01:01:24,710
She won't say a word of remorse.

764
01:01:24,710 --> 01:01:33,730
But I'm sure she really wants to apologize to Nurse Tonomura.

765
01:01:33,730 --> 01:01:39,890
I was mad at myself for that.

766
01:01:39,890 --> 01:01:44,880
I can't believe I got so angry at Dr. Obata's outburst.

767
01:01:44,880 --> 01:01:47,480
I'm still immature.

768
01:01:53,950 --> 01:01:57,050
Do you want to eat? Eh?

769
01:02:03,210 --> 01:02:10,400
Nurse Tonomura, could the source of this, came from...

770
01:02:10,400 --> 01:02:12,900
I don't know.

771
01:02:24,120 --> 01:02:27,130
The PD for the old man started at noon

772
01:02:27,130 --> 01:02:29,730
and is still going on.

773
01:02:34,620 --> 01:02:38,304
I'm on my way to the operating room.

774
01:03:04,760 --> 01:03:08,930
Watching Jiro perform surgery for the first time, I understood.

775
01:03:08,930 --> 01:03:13,940
Surgery is on the right foot, internal medicine is on the left.

776
01:03:13,940 --> 01:03:20,100
When the right foot moves forward, the left foot stays to support the body.

777
01:03:20,100 --> 01:03:24,770
It's Jiro who's moving forward now.

778
01:03:24,770 --> 01:03:32,160
My duty is to trust Jiro and stay put.

779
01:03:45,940 --> 01:03:49,270
It was the chart of a 28-year-old female patient

780
01:03:49,270 --> 01:03:54,760
whom I assisted and Dr. Obata performed ERCP on the other day.

781
01:03:55,091 --> 01:03:58,802
The day after ERCP was performed, acute pancreatitis developed.

782
01:03:59,440 --> 01:04:02,100
Currently in ICU?

783
01:04:02,100 --> 01:04:06,280
What's this? A young woman with post-ERCP pancreatitis...

784
01:04:06,280 --> 01:04:10,930
No matter how skillful the incision is, it's bound to happen.

785
01:04:10,930 --> 01:04:13,780
The pancreatitis itself has settled down quite a bit.

786
01:04:13,780 --> 01:04:17,440
Obata apparently went over the edge.

787
01:04:17,440 --> 01:04:23,610
She cried out for help for one night.

788
01:04:23,610 --> 01:04:27,510
ICU management is to monitor and treat patients 24 hours a day

789
01:04:27,510 --> 01:04:33,270
who are at high risk of death if there is a sudden change.

790
01:04:33,270 --> 01:04:36,660
ICU management is both mentally and physically demanding.

791
01:04:36,660 --> 01:04:39,270
and is normal for ICU management to be done by a team.

792
01:04:39,270 --> 01:04:43,280
Dr. Obata did it all by herself.

793
01:04:43,280 --> 01:04:46,430
Even when Yokota-san was rushed to the emergency room for the second time.

794
01:04:46,430 --> 01:04:49,120
Dr. Obata, in addition to giving lectures at conferences,

795
01:04:49,120 --> 01:04:55,610
was also involved in medical treatment, wards, emergencies, papers, and ICU management.

796
01:04:55,610 --> 01:05:00,110
Hmm? Kuri-chan, don't tell me you haven't seen this.

797
01:05:00,110 --> 01:05:02,430
Didn't Obata tell you about this?

798
01:05:02,430 --> 01:05:04,430
No.

799
01:05:04,430 --> 01:05:09,440
One person managing an ICU for nearly two weeks? You idiot...

800
01:05:09,440 --> 01:05:12,590
Dr. Obata's overwork is my responsibility.

801
01:05:12,590 --> 01:05:14,910
Because I'm not up to the level of a trustworthy doctor.

802
01:05:14,910 --> 01:05:18,260
That's not true. She just doesn't trust others.

803
01:05:18,260 --> 01:05:21,430
She's especially harsh with her peers.

804
01:05:21,430 --> 01:05:25,590
That's how she pushes herself to reach new heights.

805
01:05:25,590 --> 01:05:29,780
That can be said to be her only weakness.

806
01:05:29,780 --> 01:05:32,430
Weakness? Obata...

807
01:05:32,430 --> 01:05:36,250
She's an outdated samurai, Kuri-chan.

808
01:05:36,250 --> 01:05:38,620
That's what Dr. Raccoon used to be... Raccoon?

809
01:05:38,620 --> 01:05:42,760
Oh... at Shinano University Hospital,

810
01:05:42,760 --> 01:05:46,590
Obata joined the hospital when I was the head of the biliary tract surgery team

811
01:05:46,590 --> 01:05:51,930
She was married as a student. She had a husband 10 years older than her.

812
01:05:51,930 --> 01:05:54,930
When her husband's condition worsened.

813
01:05:54,930 --> 01:05:58,100
Obata brought him to the university hospital.

814
01:05:58,100 --> 01:06:03,460
His doctor diagnosed a pancreatic cyst with an echo and gastroscopy.

815
01:06:03,460 --> 01:06:08,260
He gave him some medicine and decided to check again in three months.

816
01:06:08,260 --> 01:06:10,930
Her husband deteriorated rapidly.

817
01:06:10,930 --> 01:06:16,290
Another CT scan revealed that he had advanced stage pancreatic cancer.

818
01:06:16,290 --> 01:06:23,260
We started anti-cancer treatment immediately, but he didn't last a month and died.

819
01:06:23,260 --> 01:06:25,780
She said, "Doctors who don't know what they're doing can easily kill people.

820
01:06:25,780 --> 01:06:31,450
"Doctor's ignorance means he is a murderer.

821
01:06:31,450 --> 01:06:34,090
Doctor's ignorance is evil."

822
01:06:34,090 --> 01:06:37,090
A doctor without knowledge can easily become a murderer.

823
01:06:37,090 --> 01:06:41,260
I want to study more. Shinano University Hospital

824
01:06:41,260 --> 01:06:43,430
is short-staffed, and I understand that.

825
01:06:43,430 --> 01:06:46,940
But let me go to Sapporo Inaho Hospital,

826
01:06:46,940 --> 01:06:50,420
one of the top hospitals in the bile and pancreas field.

827
01:06:50,420 --> 01:06:55,940
I agreed. I'll fill your hole with my own nose snot.

828
01:06:55,940 --> 01:06:59,620
It's been 12 years since then. All I can do is

829
01:06:59,620 --> 01:07:05,420
apply the brakes every now and then so that she doesn't rush into life.

830
01:07:16,780 --> 01:07:19,940
Dr. Raccoon, I...

831
01:07:19,940 --> 01:07:22,940
Raccoon?

832
01:07:22,940 --> 01:07:25,620
Well, well. Am I interrupting something?

833
01:07:25,620 --> 01:07:29,630
This is unusual. Chief Engineer Matsumae.

834
01:07:29,630 --> 01:07:31,630
Is there something wrong at the medical station?

835
01:07:31,630 --> 01:07:35,930
I was wondering if Sunayama-kun's major surgery was still in progress.

836
01:07:38,055 --> 01:07:42,140
Oh, the cardiologist too. What's wrong?

837
01:07:42,140 --> 01:07:46,260
Isn't Dr. Sunayama's PD still going on?

838
01:07:46,260 --> 01:07:48,610
Yes, it seems it's taking longer than planned.

839
01:07:48,610 --> 01:07:54,440
Really? A cardiologist is worried about a young surgeon?

840
01:07:54,440 --> 01:07:58,960
To say that Dr. Sunayama is a friend who spent 4 years with me, it's not a problem

841
01:07:58,960 --> 01:08:02,110
When he gets over this major surgery.

842
01:08:02,110 --> 01:08:07,620
I'd like to add a word of congratulations, no problem.

843
01:08:07,620 --> 01:08:11,920
What is it? You're all together.

844
01:08:11,920 --> 01:08:15,620
Dr. Shindo, are you sure your daughter's okay at this hour? Yes.

845
01:08:15,620 --> 01:08:19,600
Yes, when I explained it's a big day for my dad's friend.

846
01:08:19,600 --> 01:08:22,900
I told her it was a big day for my dad's friend, and she gave me permission to support her.

847
01:08:27,250 --> 01:08:29,770
Kurihara, are you here because you're worried?

848
01:08:29,770 --> 01:08:34,170
I just came to eat an apple.

849
01:09:01,103 --> 01:09:03,822
PD is completed successfully without problems

850
01:09:07,090 --> 01:09:10,260
You took so long, everyone was worried.

851
01:09:10,260 --> 01:09:12,910
Well... the organ adhesion was pretty bad.

852
01:09:12,910 --> 01:09:16,270
I had to proceed with the procedure, so it took a while.

853
01:09:16,270 --> 01:09:19,120
It was a difficult surgery, to be sure.

854
01:09:19,120 --> 01:09:21,760
Sunayama didn't lose focus even once.

855
01:09:21,760 --> 01:09:25,280
That's quite a feat. Dr. Amari...

856
01:09:25,280 --> 01:09:28,130
Thank you very much.

857
01:09:28,130 --> 01:09:32,200
Then let's have a toast to our fellow patient's great success!

858
01:09:32,200 --> 01:09:35,100
Thank you very much! Pass this around!

859
01:09:35,100 --> 01:09:37,440
Yo, yo.

860
01:09:37,440 --> 01:09:40,280
You did it, Jiro. Congratulations.

861
01:09:40,280 --> 01:09:42,980
Tatsu... thank you.

862
01:09:45,930 --> 01:09:48,130
What is it?

863
01:09:54,320 --> 01:09:56,440
Hehe~!

864
01:09:56,440 --> 01:10:02,100
Then let the big raccoon from Internal Medicine propose a toast.

865
01:10:02,100 --> 01:10:04,400
I said so myself.

866
01:10:07,020 --> 01:10:09,770
I'd like to congratulate Dr. Jiro Sunayama  on his great success with PD and

867
01:10:09,770 --> 01:10:14,240
Cheers to his future life as a surgeon!

868
01:10:14,240 --> 01:10:17,440
Cheers!

869
01:10:19,780 --> 01:10:26,120
It was a very happy and warm night in the medical department.

870
01:10:26,120 --> 01:10:30,590
I secretly offered a toast

871
01:10:30,590 --> 01:10:34,890
to Dr. Obata who wasn't here.

872
01:10:40,940 --> 01:10:44,940
Old Man Shimauchi's post-op period was going well.

873
01:11:05,290 --> 01:11:07,600
(clap)

874
01:11:07,600 --> 01:11:09,650
Jiro left for Shinano University Hospital.

875
01:11:10,082 --> 01:11:14,308
the female pancreatitis patient at ICU was safely transferred to the general ward

876
01:11:14,440 --> 01:11:20,898
Jiro left for Shinano University Hospital, and I enjoyed my first holiday in a long time with my wife, Haru.

877
01:11:20,953 --> 01:11:23,810
Every day is a good day.

878
01:11:25,863 --> 01:11:29,650
It's always quiet here, isn't it?

879
01:11:31,950 --> 01:11:35,610
Speaking of which, that photo book of the starry sky you were talking about the other day,

880
01:11:35,610 --> 01:11:38,590
when are you going to start shooting?

881
01:11:38,590 --> 01:11:42,750
Yes, I was thinking of postponing it a bit.

882
01:11:42,750 --> 01:11:45,680
Postpone? Why?

883
01:11:45,680 --> 01:11:47,750
(vibrating)

884
01:11:47,750 --> 01:11:49,940
I'm sorry. (vibrating)

885
01:11:49,940 --> 01:11:54,840
It's me. You've left for Shinano University Hospital,

886
01:11:54,840 --> 01:11:59,100
what do you think you're doing taking up my precious time? Monster

887
01:11:59,100 --> 01:12:01,980
Hmm? Shimauchi-san's pathology results?

888
01:12:01,980 --> 01:12:04,750
That's right. The pathological results of the resected mass on the pancreatic head.

889
01:12:04,750 --> 01:12:07,760
The pathology results for the duodenum, stomach, and bile duct just came in.

890
01:12:07,760 --> 01:12:12,280
Okay, calm down, Ichito.

891
01:12:12,280 --> 01:12:17,770
There was neither pancreatic cancer nor bile duct cancer in the resected specimens.

892
01:12:17,770 --> 01:12:22,170
None? What do you mean there isn't?

893
01:12:25,610 --> 01:12:27,610
Jiro...

894
01:12:27,610 --> 01:12:31,960
That's right. Shimauchi-san didn't have cancer, Ichito?

895
01:12:50,556 --> 01:12:55,100
Shimauchi Kouzou-san had mass-forming pancreatitis.

896
01:12:55,100 --> 01:12:57,080
Among other things.

897
01:12:57,080 --> 01:13:02,270
It was concluded that he had AIP, autoimmune pancreatitis.

898
01:13:02,270 --> 01:13:07,260
AIP is an extremely unique disease.

899
01:13:07,260 --> 01:13:10,100
There are many variations in diagnosis itself.

900
01:13:10,100 --> 01:13:13,750
There are no clear criteria. Director Honjo.

901
01:13:13,750 --> 01:13:16,940
Dr. Amari, how's Shimauchi-san's condition?

902
01:13:16,940 --> 01:13:19,620
He's doing well, Administrative Director.

903
01:13:19,457 --> 01:13:24,532
{\an8}POST-CASE REVIEW MEETING

904
01:13:19,620 --> 01:13:21,940
He's started taking meals.

905
01:13:21,940 --> 01:13:25,280
We're going to start rehabilitation such as gait training.

906
01:13:25,280 --> 01:13:29,300
Dr. Kurihara: Yes.

907
01:13:29,300 --> 01:13:32,170
Prior to the surgery, the surgeon also performed tests.

908
01:13:32,170 --> 01:13:35,620
We preoperatively diagnosed pancreatic cancer.

909
01:13:35,620 --> 01:13:38,460
It's not just the internal medicine department's responsibility.

910
01:13:41,213 --> 01:13:42,530
Director.

911
01:13:42,530 --> 01:13:45,630
The reason for concluding that Shimauchi-san had AIP was because of

912
01:13:45,630 --> 01:13:48,620
Shinano University's research on AIP

913
01:13:48,620 --> 01:13:51,770
has produced outstanding research results nationwide.

914
01:13:51,770 --> 01:13:56,280
I'm sure other general hospitals are still in turmoil.

915
01:13:56,280 --> 01:13:58,630
That's true, isn't it?

916
01:13:58,630 --> 01:14:02,280
AIP is a case we don't get to see very often.

917
01:14:02,280 --> 01:14:05,970
Besides, pancreatic head-localized type...

918
01:14:05,970 --> 01:14:09,170
I'd like to see internal medicine and surgery stop covering for each other.

919
01:14:13,960 --> 01:14:17,960
Kurihara-kun, what's the treatment for AIP?

920
01:14:21,030 --> 01:14:23,120
It hasn't been established. But...

921
01:14:23,120 --> 01:14:26,290
But there have been reports of dramatic improvement with steroids.

922
01:14:26,290 --> 01:14:28,670
In other words, due to your misdiagnosis.

923
01:14:28,670 --> 01:14:30,940
You opened up the abdomen

924
01:14:30,940 --> 01:14:33,310
of a patient who should've been cured with medication.

925
01:14:33,310 --> 01:14:36,100
Pancreas, stomach, duodenum, etc.?

926
01:14:36,100 --> 01:14:40,620
Therefore, Administrative Director! Misdiagnosis is not the same thing in this case.

927
01:14:40,620 --> 01:14:44,120
It's too rare a case with no diagnostic criteria...

928
01:14:44,120 --> 01:14:46,760
Shimauchi Kouzou-san's grandson has a complaint.

929
01:14:46,760 --> 01:14:52,660
He's upset that we performed an unnecessary major surgery on an old man.

930
01:14:58,440 --> 01:15:01,140
(Knock)

931
01:15:03,090 --> 01:15:06,930
Dr. Obata. I didn't call you here.

932
01:15:06,930 --> 01:15:10,100
I was briefly involved in Shimauchi-san's case.

933
01:15:10,100 --> 01:15:12,270
I felt it was my duty to be present.

934
01:15:12,270 --> 01:15:14,270
Ah

935
01:15:16,940 --> 01:15:19,610
What I want to know is...

936
01:15:19,610 --> 01:15:23,600
not whether this surgery was a success or a failure,

937
01:15:23,600 --> 01:15:28,770
but whether it was the right thing to do.

938
01:15:28,770 --> 01:15:32,640
Depending on the case, there may be a trial.

939
01:15:32,640 --> 01:15:35,420
Let's hear Dr. Kurihara's opinion.

940
01:15:35,420 --> 01:15:38,260
Yes.

941
01:15:38,260 --> 01:15:41,810
I think...

942
01:15:41,810 --> 01:15:44,900
If it's the right or wrong of the surgery, there's no room for debate.

943
01:15:44,900 --> 01:15:46,790
In this case.

944
01:15:46,790 --> 01:15:50,460
I can assure you that surgery was the safest and most reliable option in this case.

945
01:15:50,460 --> 01:15:52,430
I can assure you, Director Honjo.

946
01:15:52,430 --> 01:15:55,440
What's your rationale? Dr. Obata.

947
01:15:55,440 --> 01:16:00,430
Pre-surgery diagnostic cytology positivity rate is about 60 percent.

948
01:16:00,430 --> 01:16:04,590
In other words, even if it's cancer, 40 percent will be overlooked.

949
01:16:04,590 --> 01:16:07,610
Therefore, over-reliance on cytological diagnosis is outdated.

950
01:16:07,610 --> 01:16:10,440
On the other hand, CT scan showed a clear mass.

951
01:16:10,440 --> 01:16:12,430
Tumor markers are elevated.

952
01:16:12,430 --> 01:16:18,850
Also, IgG4*, which should be elevated in AIP, was within normal range.
*Immunogolobulin G4 related disease

953
01:16:18,850 --> 01:16:23,420
In other words, there was no basis for preoperative diagnosis of AIP.

954
01:16:23,420 --> 01:16:26,610
It was only natural to diagnose pancreatic cancer.

955
01:16:26,610 --> 01:16:30,760
As a result, it was concluded that Shimauchi-san

956
01:16:30,760 --> 01:16:34,430
was an even more unusual case among extremely rare AIP cases.

957
01:16:34,552 --> 01:16:38,310
Is IgG4 in the normal range?

958
01:16:38,420 --> 01:16:40,920
If it's a misdiagnosis, no one will be able

959
01:16:40,920 --> 01:16:44,090
to make a diagnosis because they'll be too scared.

960
01:16:44,090 --> 01:16:48,280
But before choosing surgery,

961
01:16:48,280 --> 01:16:51,750
wasn't there an option to try steroid treatment

962
01:16:51,750 --> 01:16:53,790
and to see how it goes?

963
01:16:53,790 --> 01:16:56,590
There's a mountain of reports on pancreatic cancer

964
01:16:56,590 --> 01:17:00,440
where the patient was put on steroids and it was too late, Director Kanayama.

965
01:17:00,440 --> 01:17:03,760
However, Shimauchi-san is 82 years old.

966
01:17:03,760 --> 01:17:06,120
Before taking the plunge into major surgery.

967
01:17:06,120 --> 01:17:10,270
I'd like to do something a little more...

968
01:17:10,270 --> 01:17:13,170
Like do a smaller surgery?

969
01:17:15,110 --> 01:17:17,590
We'll set the possibility of AIP at 20%.

970
01:17:17,590 --> 01:17:21,260
and limit the resection to 80%? Obata.

971
01:17:21,260 --> 01:17:23,930
If you still don't want to be blamed for cutting too much.

972
01:17:23,930 --> 01:17:26,800
I'll set the AIP at 40%.

973
01:17:26,800 --> 01:17:30,360
20 percent steroids and keep the resection to 40 percent?

974
01:17:30,360 --> 01:17:32,270
Even though the test data shows pancreatic cancer.

975
01:17:32,270 --> 01:17:35,590
I wouldn't want to go to a hospital that did that.

976
01:17:35,590 --> 01:17:39,420
But...but as a result...

977
01:17:39,420 --> 01:17:41,600
You guys performed surgery that wasn't necessary...

978
01:17:41,600 --> 01:17:44,270
Treatment isn't like a mutual fund, Director Kanayama.

979
01:17:44,270 --> 01:17:48,090
Do you think you can save lives with low-risk, low-return treatment?

980
01:17:48,090 --> 01:17:50,140
That is not what I'm saying!

981
01:17:50,140 --> 01:17:52,460
That is what you are saying.

982
01:17:52,460 --> 01:17:55,110
If a doctor is afraid of the risk and dispenses treatment in small doses.

983
01:17:55,110 --> 01:17:57,770
It's the patient who dies.

984
01:17:57,770 --> 01:17:59,770
A doctor's job is 0 or 100.

985
01:17:59,770 --> 01:18:03,420
If even one percent of a life-threatening disease is suspected.

986
01:18:03,420 --> 01:18:05,930
Doctors put 100% of their energy into it.

987
01:18:05,930 --> 01:18:09,230
And they take full responsibility for that.

988
01:18:15,480 --> 01:18:19,610
Well... just to be sure, let me add this...

989
01:18:19,610 --> 01:18:24,030
Dr. Obata, what if a similar patient comes in the future?

990
01:18:24,030 --> 01:18:28,080
If 100 people come in, 100 of them will have surgery, Director.

991
01:18:28,080 --> 01:18:30,120
That's right.

992
01:18:30,120 --> 01:18:34,250
There's no supplemental material. Director.

993
01:18:34,250 --> 01:18:37,250
Surgery Department thinks the same way. Director.

994
01:18:39,590 --> 01:18:41,610
Very well.

995
01:18:41,610 --> 01:18:43,600
In this case.

996
01:18:43,600 --> 01:18:48,920
I believe we have shared information on this case at Honjo Hospital.

997
01:18:48,920 --> 01:18:53,760
Is that all right with you? Administrative Director Kanayama.

998
01:18:53,760 --> 01:18:55,810
Yes, Director.

999
01:18:55,810 --> 01:19:00,380
But Director, doctors and patients are in different positions.

1000
01:19:00,380 --> 01:19:03,430
Are you sure the patient and his family

1001
01:19:03,430 --> 01:19:07,130
will be satisfied with the explanation you just gave?

1002
01:19:09,110 --> 01:19:11,090
Dr. Kurihara.

1003
01:19:11,090 --> 01:19:13,930
To Mr. Shimauchi and his grandson.

1004
01:19:13,930 --> 01:19:18,610
You'll have to explain to Shimauchi-san and his grandson in detail why you diagnosed them with pancreatic cancer.

1005
01:19:18,610 --> 01:19:21,710
Can you handle it?

1006
01:19:25,770 --> 01:19:27,770
Yes, I can.

1007
01:19:27,770 --> 01:19:30,770
I'll do it.

1008
01:19:32,780 --> 01:19:39,180
The reason my voice trembled slightly at this point is...

1009
01:19:43,986 --> 01:19:47,090
So there are no clear diagnostic criteria

1010
01:19:47,090 --> 01:19:51,110
 for pancreatic head-localized AIP. In this case...

1011
01:19:51,110 --> 01:19:54,950
I did a lot of research on the Internet.

1012
01:19:54,950 --> 01:19:56,950
Pancreaticoduodenectomy.

1013
01:19:56,950 --> 01:20:00,177
It's not an uncommon surgery, is it?

1014
01:20:00,193 --> 01:20:02,310
Aren't you forcing us to accept the surgery

1015
01:20:02,310 --> 01:20:04,290
to improve Honjo Hospital's track record, Sensei?

1016
01:20:04,290 --> 01:20:06,950
Kenji. That's not true.

1017
01:20:06,950 --> 01:20:08,970
I'm sure the surgery department gave you an explanation before the surgery...

1018
01:20:08,970 --> 01:20:12,340
It's a matter of how much we can trust that explanation.

1019
01:20:12,340 --> 01:20:14,970
The primary surgeon, Sunayama, said he was your classmate and best friend.

1020
01:20:14,970 --> 01:20:16,970
He did my grandpa's surgery.

1021
01:20:16,970 --> 01:20:20,130
He got transferred to a university hospital with that as a souvenir, didn't he?

1022
01:20:20,130 --> 01:20:22,452
What the heck is that? That's a misunderstanding.

1023
01:20:22,468 --> 01:20:24,610
What the hell kind of misunderstanding is that!

1024
01:20:24,610 --> 01:20:28,990
You used him as a training ground just because she's over 80 years old, didn't you!

1025
01:20:28,990 --> 01:20:33,340
I'll never forgive you guys!

1026
01:20:33,340 --> 01:20:35,640
Will you stop it, kid?

1027
01:20:37,590 --> 01:20:44,650
I'm the one with the cut stomach, not you.

1028
01:20:44,650 --> 01:20:48,310
Shimauchi-san. I'm sorry, Doctor.

1029
01:20:48,310 --> 01:20:53,310
My grandson was too cute and I spoiled him too much.

1030
01:20:53,310 --> 01:20:57,730
He shouldn't have been so rude.

1031
01:20:57,730 --> 01:21:02,640
Because it's family, it's natural to be angry

1032
01:21:02,640 --> 01:21:08,290
The dragon on this back won't change this treatment.

1033
01:21:08,290 --> 01:21:13,710
The doctor who said that pale blue line in all seriousness,

1034
01:21:13,710 --> 01:21:17,120
I was captivated by him

1035
01:21:17,120 --> 01:21:21,300
I put up with you back then.

1036
01:21:21,300 --> 01:21:26,680
No more pain. No more nausea.

1037
01:21:26,680 --> 01:21:30,230
No more fear that I might have cancer.

1038
01:21:30,230 --> 01:21:32,970
I survived.

1039
01:21:32,970 --> 01:21:36,470
I won!

1040
01:21:36,470 --> 01:21:40,470
We won, Dr. Kurihara!

1041
01:21:42,440 --> 01:21:44,440
Shimauchi-san.

1042
01:22:03,450 --> 01:22:08,300
That's right. The patient saved your life, didn't he, Kurihara-kun?

1043
01:22:08,300 --> 01:22:10,870
I'm sorry for worrying you.

1044
01:22:10,870 --> 01:22:13,570
I'm not worried about you.

1045
01:22:18,699 --> 01:22:21,030
Something else?

1046
01:22:21,030 --> 01:22:24,587
Or are you telling me off again?

1047
01:22:24,618 --> 01:22:31,887
I had no idea about the possibility of AIP in Shimauchi-san.

1048
01:22:32,012 --> 01:22:36,216
I recommended surgery without differential diagnosis of IgG4.

1049
01:22:38,950 --> 01:22:44,190
But Dr. Obata raised IgG4 as a differential.

1050
01:22:44,190 --> 01:22:49,540
Also, IgG4, which should be elevated in AIP, was within normal range.

1051
01:22:49,540 --> 01:22:52,610
There is a difference between choosing surgery while considering the possibility of AIP

1052
01:22:52,610 --> 01:22:57,680
and choosing surgery without considering it at all.

1053
01:22:57,680 --> 01:23:01,620
This is the difference between Dr. Obata and me.

1054
01:23:01,620 --> 01:23:07,820
For doctors, it's a stark difference.

1055
01:23:10,780 --> 01:23:17,280
My diagnosis... was a misdiagnosis.

1056
01:23:21,210 --> 01:23:24,583
Is that repentance?

1057
01:23:24,583 --> 01:23:29,610
You want to raise the white flag and get some peace?

1058
01:23:29,617 --> 01:23:36,270
Don't settle for a mistake. You'll have to carry it for the rest of your life.

1059
01:23:36,270 --> 01:23:39,610
That's what Dr. Itagaki said to me when I was a resident...

1060
01:23:39,610 --> 01:23:42,760
That's what Dr. Raccoon said to me.

1061
01:23:42,760 --> 01:23:47,950
When my husband died of pancreatic cancer.

1062
01:23:47,950 --> 01:23:50,820
I never forgave his doctor

1063
01:23:50,820 --> 01:23:55,640
at that time, not now, not ever.

1064
01:23:55,640 --> 01:23:58,480
Yes.

1065
01:23:58,480 --> 01:24:04,780
I was my husband's attending physician at that time.

1066
01:24:09,140 --> 01:24:13,460
Once upon a time, It is said that humans

1067
01:24:13,460 --> 01:24:18,970
were expelled from paradise because they ate the forbidden fruit.

1068
01:24:18,970 --> 01:24:25,770
God forbid, it was an apple

1069
01:24:32,650 --> 01:24:38,990
I couldn't sleep today, so I came out.

1070
01:24:38,990 --> 01:24:42,790
It's wonderful to meet you by chance.

1071
01:24:48,480 --> 01:24:52,480
Ichi-san?

1072
01:24:52,480 --> 01:24:55,080
Are you crying?

1073
01:25:02,460 --> 01:25:05,810
I'm glad I came out.

1074
01:25:05,826 --> 01:25:09,470
It's a bad habit of yours.

1075
01:25:09,470 --> 01:25:11,480
No matter what time it is.

1076
01:25:11,480 --> 01:25:16,480
Don't forget that I'm here.

1077
01:25:20,480 --> 01:25:22,441
You shouldn't cry alone.

1078
01:25:28,790 --> 01:25:29,897
Haru...

1079
01:25:38,970 --> 01:25:42,279
Haru, thanks for being here...

1080
01:25:42,294 --> 01:25:44,620
It's all right.

1081
01:25:50,110 --> 01:25:55,243
Actually, I'd like to discuss something with you.

1082
01:25:55,274 --> 01:26:02,180
What is it? Ichi-san.

1083
01:26:02,195 --> 01:26:05,210
＜Haru agreed with me.

1084
01:26:05,210 --> 01:26:08,737
The day I watched the old man Shimanouchi leave the hospital.

1085
01:26:08,753 --> 01:26:12,979
I told Dr. Raccoon that I wanted to quit Honjo Hospital

1086
01:26:12,995 --> 01:26:17,101
I offered to quit Honjo Hospital and go to Shinano University Hospital to study.

1087
01:26:17,109 --> 01:26:24,399
Kuri-chan must be crazy if he wants to go to a university hospital now.

1088
01:26:24,422 --> 01:26:27,970
I'll get in touch with them.

1089
01:26:29,583 --> 01:26:32,100
I was a little perplexed

1090
01:26:32,100 --> 01:26:34,280
when he agreed so readily

1091
01:26:34,280 --> 01:26:37,357
Oh, thank you very much.

1092
01:26:37,474 --> 01:26:40,774
So, you've been assigned to Shinano University Hospital next month.

1093
01:26:40,790 --> 01:26:44,463
Thank you for your guidance during our short time together.

1094
01:26:44,573 --> 01:26:46,637
At EUS?

1095
01:26:46,700 --> 01:26:51,482
You haven't even gotten to the point where can start teaching.

1096
01:26:51,505 --> 01:26:54,450
Also, just because you go to university and write a few papers...

1097
01:26:54,450 --> 01:26:57,139
You'll never be able to catch up with me.

1098
01:26:57,139 --> 01:27:00,321
Merciless, as usual

1099
01:27:00,336 --> 01:27:02,675
Don't worry about the internal medicine department

1100
01:27:02,683 --> 01:27:06,511
I'll fill in the holes you made with my own nose snot.

1101
01:27:06,527 --> 01:27:09,440
I'd be honored. Ah.

1102
01:27:09,440 --> 01:27:12,115
But I'm the kind of person who doesn't dig snot. What should I do?

1103
01:27:12,123 --> 01:27:14,610
That's a lie, all humans do it

1104
01:27:14,610 --> 01:27:17,110
I can't get it out, really.

1105
01:27:17,110 --> 01:27:19,110
Really?

1106
01:27:21,455 --> 01:27:28,100
Can't you just keep doing what you're doing? Kurihara.

1107
01:27:28,132 --> 01:27:30,089
I have to move forward

1108
01:27:30,105 --> 01:27:35,009
I'm not very good at galloping like a horse.

1109
01:27:35,017 --> 01:27:37,884
But as Soseki-sensei said.

1110
01:27:37,900 --> 01:27:44,224
I think I can do it if I have to push like a cow

1111
01:27:44,231 --> 01:27:48,570
I think now is the time.

1112
01:27:48,570 --> 01:27:51,558
Huh. From my experience.

1113
01:27:51,558 --> 01:27:57,264
University hospitals are pandemonium

1114
01:27:57,295 --> 01:28:03,120
But I'm sure you'll be fine.

1115
01:28:03,120 --> 01:28:06,554
I'm rooting for you, Kurihara.

1116
01:28:06,586 --> 01:28:08,273
Tatsu.

1117
01:28:09,985 --> 01:28:11,146
KASAMAKURA

1118
01:28:11,918 --> 01:28:15,478
It's from the Tozai.

1119
01:28:15,517 --> 01:28:18,937
I can't make tonight's farewell party

1120
01:28:18,952 --> 01:28:22,928
because I'm working the night shirt.

1121
01:28:22,926 --> 01:28:26,426
I heard your copy of "Kusamakura" is in tatters.

1122
01:28:29,470 --> 01:28:35,140
Not a single word to send...

1123
01:28:35,140 --> 01:28:40,130
She couldn't write it down, could she?

1124
01:28:40,130 --> 01:28:42,427
Drink yourself to death tonight.

1125
01:28:42,435 --> 01:28:44,550
If you drink too much and get carried away.

1126
01:28:44,557 --> 01:28:48,207
I'll put a urethral balloon in you. Nurse Tonomura, that's sexual harassment.

1127
01:28:48,450 --> 01:28:52,250
No, you're kidding. You're as serious as ever.

1128
01:29:07,168 --> 01:29:11,018
The farewell party was a lavish affair.

1129
01:29:11,041 --> 01:29:16,201
A diligent and honest young man like me was just

1130
01:29:16,209 --> 01:29:21,209
too frightened to say anything nice and just accepted the drinks

1131
01:29:21,217 --> 01:29:25,037
Dr. Raccoon asked me to join him for one more drink.

1132
01:29:25,053 --> 01:29:30,733
I don't even know what time it was that I left the party...

1133
01:29:30,780 --> 01:29:33,980
Thank you for six years of hard work.

1134
01:29:41,086 --> 01:29:43,256
Let's go~, Kuri-chan.

1135
01:29:43,256 --> 01:29:45,556
Okay.

1136
01:29:57,582 --> 01:30:01,272
After drinking all kinds of alcohol...

1137
01:30:01,334 --> 01:30:04,484
When I get old, I go back to my old drinks.

1138
01:30:04,610 --> 01:30:07,980
In the end, the sake I drank when I didn't have money

1139
01:30:07,980 --> 01:30:10,530
tasted the best.

1140
01:30:10,530 --> 01:30:12,830
Get on your knees and drink.

1141
01:30:14,508 --> 01:30:16,508
Excuse me.

1142
01:30:19,940 --> 01:30:24,482
I wondered who else was coming?

1143
01:30:24,506 --> 01:30:27,826
Kuri-chan can make it anywhere.

1144
01:30:27,825 --> 01:30:30,159
I don't know how much you packed.

1145
01:30:30,178 --> 01:30:34,348
I hope you didn't pack too much.

1146
01:30:34,371 --> 01:30:36,381
Dr. Raccoon...

1147
01:30:36,397 --> 01:30:43,047
No, Dr. Itagaki, I'm indebted to you

1148
01:30:43,242 --> 01:30:47,082
I'm going to study at the university hospital, Raccoon...

1149
01:30:47,270 --> 01:30:52,574
No, Dr. Itagaki... Bwahahahaha.

1150
01:30:52,586 --> 01:30:57,106
Just call Raccoon, hahahaha.

1151
01:30:57,130 --> 01:31:01,680
I'm going to study at the university hospital and become an internal medicine doctor who

1152
01:31:01,694 --> 01:31:08,984
won't be embarrassed to appear in front of Dr. Raccoon and go back to Honjo Hospital.

1153
01:31:08,993 --> 01:31:12,493
That makes me happy.

1154
01:31:14,433 --> 01:31:16,933
So, Kuri-chan,

1155
01:31:16,980 --> 01:31:21,280
the most important thing for a doctor,

1156
01:31:21,295 --> 01:31:24,148
what is it?

1157
01:31:24,172 --> 01:31:27,372
That's a sobering question.

1158
01:31:30,095 --> 01:31:32,535
We don't have enough doctors.

1159
01:31:32,559 --> 01:31:38,729
especially those who watch over the elderly endlessly in hospitals.

1160
01:31:38,776 --> 01:31:44,436
Those who are exhausted from continuous duty, sudden changes, and calls...

1161
01:31:44,443 --> 01:31:47,963
They either become part-time workers or open their own businesses.

1162
01:31:47,979 --> 01:31:50,349
They stay away from the field.

1163
01:31:50,357 --> 01:31:58,827
That's why there aren't enough doctors in hospitals no matter how long this goes on.

1164
01:31:58,866 --> 01:32:00,576
Hey, Kuri-chan

1165
01:32:00,616 --> 01:32:05,946
The most important thing for a doctor is to keep going.

1166
01:32:06,110 --> 01:32:09,110
It doesn't matter if you work at a local hospital or a university hospital.

1167
01:32:09,150 --> 01:32:12,670
It doesn't matter where you work.

1168
01:32:12,685 --> 01:32:16,675
Keep on being a doctor!

1169
01:32:16,722 --> 01:32:21,322
That's the most important thing.

1170
01:32:23,730 --> 01:32:26,620
Yes, sir.

1171
01:32:26,804 --> 01:32:28,944
Excuse me!

1172
01:32:28,982 --> 01:32:32,782
Oh, here, here, here

1173
01:32:39,416 --> 01:32:42,476
Okay, Kuri-chan.

1174
01:32:42,491 --> 01:32:46,411
I'm a little drunk and embarrassed.

1175
01:32:46,427 --> 01:32:48,407
Let's have another toast. Ah, I'll do it.

1176
01:32:48,790 --> 01:32:51,490
It's okay, it's okay. Yes

1177
01:33:06,163 --> 01:33:10,363
I'd like to thank you for your work over the past six years, Kuri-chan.

1178
01:33:10,371 --> 01:33:14,677
And for your continued good luck in the future.

1179
01:33:14,707 --> 01:33:17,217
Cheers. Cheers.

1180
01:33:29,765 --> 01:33:34,545
There was someone at that table from the beginning.

1181
01:33:34,827 --> 01:33:42,007
Naito Kamoichi, Deputy Chief of Internal Medicine at Honjo Hospital.

1182
01:33:42,280 --> 01:33:48,780
Dr. Old Fox's seat...

1183
01:34:00,766 --> 01:34:05,926
Study hard and come back.

1184
01:34:05,941 --> 01:34:08,961
Yes, sir.

1185
01:34:23,842 --> 01:34:28,872
Hmmm...

1186
01:34:28,888 --> 01:34:31,588
This is...

1187
01:34:36,826 --> 01:34:39,186
I submitted my resignation to Honjo Hospital,

1188
01:34:39,233 --> 01:34:42,883
until I go to work at Shinano University Hospital,

1189
01:34:42,954 --> 01:34:45,454
I was able to take five days off.

1190
01:34:45,790 --> 01:34:51,130
I've been spending my days reading without doing anything.

1191
01:34:51,130 --> 01:34:54,066
Doctor, when you

1192
01:34:54,081 --> 01:34:56,988
start working at the university hospital,

1193
01:34:57,011 --> 01:34:59,929
I don't suppose you're planning to leave Utaki Manor,

1194
01:34:59,940 --> 01:35:02,460
the bottom of the social ladder.

1195
01:35:02,857 --> 01:35:07,817
Of course not, the rent here is cheap beyond compare

1196
01:35:07,857 --> 01:35:12,420
If I work at the university hospital, I'll be a graduate student.

1197
01:35:12,464 --> 01:35:14,794
A student. What?

1198
01:35:14,795 --> 01:35:17,335
Don't tell me you'll be an unpaid doctor again?

1199
01:35:17,374 --> 01:35:19,997
That's right, that's right...

1200
01:35:20,025 --> 01:35:24,885
Is that really enough to support Princess Haruna?

1201
01:35:25,112 --> 01:35:26,801
Not by any means.

1202
01:35:26,826 --> 01:35:29,126
I'm going to do part-time work while off duty.

1203
01:35:58,298 --> 01:36:02,007
{\an3}This drama is a work of fiction and the names of the characters and organizations are fictitious.